Pharmacy student perceptions of academically dishonest behavior in skills activities.

INTRODUCTION: Academic dishonesty is prevalent across pharmacy education. Understanding student perceptions and engagement in academically dishonest behaviors across skills activities is important, as skills curricula are essential components in assessing APPE readiness. The objectives of this study were to assess pharmacy student perceptions of academically dishonest behavior within a skills curriculum and to determine if correlations exist between students' perceived wrongness of a described behavior and their willingness to engage in the behavior or past engagement in that described behavior. METHODS: Students within a Doctor of Pharmacy program were asked to respond to an anonymous, electronic survey. The survey described 18 specific academically dishonest student behaviors across 12 skills scenarios. For each behavior, students were asked to indicate their perception of the wrongness of the behavior, their willingness to engage in the behavior, and if they had engaged in the behavior in the past. Descriptive statistics were completed to assess responses. Fisher analysis was used to compare "yes" responses to "no/not sure" responses for each question. RESULTS: Students indicated general agreement that most described behaviors were wrong. There was <50% agreement in the wrongness of behaviors that described failing to report another student's academically dishonest behavior. Generally, students who agreed that a particular behavior was wrong were less likely to report willingness to engage in the behavior or past engagement in the behavior. DISCUSSION: Generally, students in our cohort agreed that the presented actions across multiple skills activities were wrong, with less agreement regarding turning classmates in for academic dishonesty. Relatively small percentages of students responded that they had engaged in these activities in the past. CONCLUSIONS: Understanding these perceptions, as well as students' willingness to engage in academic dishonesty, can guide instructors in communicating expectations regarding academic integrity within the skills curriculum.

Personality and Academic Performance During Years Two and Three of a Doctor of Pharmacy Curriculum.

OBJECTIVE: To evaluate academic success among students with different dominant personality styles as determined by DiSC (dominance, influence, steadiness, and conscientiousness) assessment via a comparison of grade point average (GPA) during the 3-year didactic portion of a PharmD curriculum. METHODS: This was a prospective evaluation of students admitted to the PharmD program as part of the graduating classes of 2019-2022 who provided written informed consent, completed an online DiSC assessment, and forwarded their personality style results to study investigators. Participant demographics were collected upon enrollment and individual course grades, semester, and cumulative GPA, and any academic standards penalties imposed were collected at the end of each semester. RESULTS: The overall participation rate for the student cohort studied was 96%. No significant differences were seen when evaluating the primary objective by comparing GPA of each of the 4 individual dominant personality styles. However, significant differences were found when evaluating the secondary objective comparing conscientiousness vs all other dominant personality styles regarding both individual semester and cumulative GPA. Students with conscientiousness as a dominant personality style also had significantly higher pharmacotherapeutics-focused systems-based therapy cumulative GPA during the second and third years of the PharmD didactic curriculum. CONCLUSION: Students with a dominant personality style of conscientiousness on DiSC assessment performed significantly better within the more clinically focused systems-based therapy courses in a PharmD curriculum. This ultimately culminated in higher cumulative GPA at the end of both the second and third professional years in those with a dominant personality style of conscientiousness.

Student Personality Style and First-Year Academic Performance in a Doctor of Pharmacy Program.

Objective. To evaluate whether the personality styles of Doctor of Pharmacy (PharmD) students as determined by the DiSC assessment are associated with students' cumulative grade point average (GPA) or with academic penalties imposed in the first year of a PharmD program. Methods. All incoming PharmD students that provided informed consent and completed the DiSC personality assessment were included in the study. Participants provided demographic data and forwarded their electronic DiSC assessment results to study investigators upon completion. Relevant academic data were collected at the end of each semester. Results. The overall response rate for the classes of 2019-2022 was 95.6%. No significant associations were found when comparing personality styles as defined by the DiSC assessment and cumulative GPA at the end of the first year. Additionally, no associations were noted when comparing students' personality style and semester GPA or academic penalties received. Conclusion. Understanding factors that contribute to students' academic success can aid in early identification of students who are likely to succeed and of students who may benefit from early academic intervention. While no significant associations were found in the first-year of the curriculum, continued evaluation will be conducted to determine the impact of personality style on students' overall academic performance beyond the first year of the PharmD curriculum.

Student and faculty perceptions of lecture recording in a doctor of pharmacy curriculum.

OBJECTIVE: To describe students' and faculty members' perceptions of the impact of lecture recording in a doctor of pharmacy (PharmD) curriculum. METHODS: Second- and third-year pharmacy students and faculty members completed an anonymous survey instrument regarding their perceptions of lecture recording with 2 classroom lecture capture software programs, Camtasia Studio and Wimba Classroom. RESULTS: Most students (82%) responded that Camtasia was very helpful and almost half (49%) responded that Wimba Classroom was helpful (p<0.001). Forty-six percent of the students reported being more likely to miss a class that was recorded; however, few students (10%) reported using recordings as a substitute for attending class. The most common concern of faculty members was decreased student attendance (27%). CONCLUSION: Pharmacy students consider lecture recordings beneficial, and they use the recordings primarily to review the lecture. While faculty members reported concerns with decreased attendance, few students reported using recordings as an alternative to class attendance.

Clinical relevance of linezolid-associated serotonin toxicity.

OBJECTIVE: To evaluate and review the literature surrounding serotonin toxicity in patients receiving linezolid and determine the clinical relevance of this reaction. DATA SOURCES: Literature was accessed via MEDLINE/PubMed and Google Scholar (both through February 2013) using the search terms linezolid, serotonin syndrome, serotonin toxicity, and adverse reaction. STUDY SELECTION AND DATA EXTRACTION: Relevant case reports, retrospective studies, surveys, and review articles were included. Bibliographies of all relevant articles were reviewed for additional sources. DATA SYNTHESIS: Linezolid exhibits mild, nonselective inhibition of monoamine oxidase and has been associated with serotonin toxicity when used in combination with other serotonergic agents. Based on published reports, the incidence of linezolid-associated serotonin toxicity is between 0.54% and 18.2%. Our review identified 32 documented cases, including 3 fatalities. Most cases occurred in patients concurrently receiving selective serotonin reuptake inhibitors. Receipt of multiple agents with serotonergic activity seems to increase the risk of serotonin toxicity. Both onset and resolution of symptoms varied from hours to days. CONCLUSIONS: Current Food and Drug Administration recommendations to avoid the use of linezolid in patients receiving select serotonergic agents highlight the need to carefully balance the risk/benefit ratio in this situation. Although linezolid has been available for 12 years, reports of serotonin toxicity with this agent are uncommon. While clinicians should be aware of this potentially severe interaction and closely monitor patients who are receiving linezolid in combination with serotonergic agents, our findings show that linezolid is not contraindicated in this situation.

An in vivo-in vitro study of cefepime and cefazolin dialytic clearance during high-flux hemodialysis.

STUDY OBJECTIVES: To assess the influence of in vitro and in vivo hemodialysis with a new high-flux dialyzer on the clearance of cefazolin and cefepime; to assess the correlation of in vivo dialytic clearance of these antibiotics with blood flow rate; and to assess the correlation between in vitro and in vivo dialytic clearances of these antibiotics. DESIGN: Prospective, open-label, dialysis clearance study. SETTING: A tertiary-care, university health science center. PATIENTS: Five adults who received high-flux hemodialysis 3 times/week. Intervention. For the in vivo experiment, patients received a single intravenous infusion of cefazolin 1 g and cefepime 1 g before dialysis and then underwent a modified hemodialysis session. For the in vitro experiment, a buffered simulated plasma water (SPW) solution containing cefazolin and cefepime was used. Hemodialysis for both experiments was performed with use of a new high-flux polysulfone dialyzer. MEASUREMENTS AND MAIN RESULTS: Cefazolin and cefepime dialytic clearances were determined at blood and/or SPW flow rates of 100, 200, 300, and 400 ml/minute after a 15-minute equilibration period. The degree of correlation of in vitro and in vivo clearances with blood flow rate was determined. Cefepime dialytic clearance increased proportionally with blood flow rate (p<0.01), reaching a maximum mean +/- SD value of 178.9 +/- 24.3 ml/minute at a blood flow rate of 400 ml/minute. Cefazolin dialytic clearance ranged from a mean +/- SD of 42.3 +/- 7.7 to 52.7 +/- 16 ml/minute; no significant correlation was noted between blood flow rate and dialytic clearance. In vitro cefazolin and cefepime dialytic clearances increased proportionally with SPW flow rate (p<0.05). After adjusting the in vitro cefazolin and cefepime dialytic clearances based on their degrees of protein binding, the correlation between the in vitro and in vivo cefepime dialytic clearances was significant (r(2)=0.91, p=0.04), but no significant correlation was noted between the in vitro and in vivo cefazolin clearances (r(2)=0.61, p=0.22). CONCLUSION: The in vivo hemodialysis clearances of cefepime and cefazolin with the new high-flux polysulfone dialyzer used in this study are markedly higher than values reported with conventional dialyzers but similar to values observed with other high-flux hemodialyzers. The in vivo dialytic clearance of cefazolin was significantly lower than the in vitro values, most likely due to cefazolin's high degree of protein binding. These results highlight the limitation of directly applying in vitro data to clinical situations.