An Integrative Review of Micro-Credentials and Digital Badges for Pharmacy Educators.

Micro-credentials (MCs) and digital badges (DBs) have gained popularity in recent years as a means to supplement traditional degrees and certifications. MCs and DBs can play a significant role in supporting student-centered learning by offering personalized and flexible learning pathways, emphasizing real-world relevance and practical skills, and fostering a culture of continuous learning and growth. However, barriers currently exist within health professions education, including pharmacy education, that could limit the full adoption and implementation of MCs and DBs. Research on the use of MCs and DBs in Doctor of Pharmacy degree programs is sparse. In this integrative review, literature on the use of MCs and DBs in health professions education is reviewed, and perspectives on the benefits, issues, and potential future uses within Doctor of Pharmacy degree programs are presented.

Engaging early experiential learners to improve quality at a VA medical center - a cross-sectional analysis.

PURPOSE: An innovative population health-based introductory pharmacy practice experience (IPPE) leveraging a Veterans Affairs (VA) and college of pharmacy collaboration was implemented in fall 2019. All second-year pharmacy students from the college actively engage in the evaluation of the medical records of veterans identified using population health management tools as needing additional care or experiencing a gap in care. This study examines the clinical impact of the experience on the care of patients at the partnering VA medical center. METHODS: Course and patient records were reviewed to enumerate the number and types of interventions performed as part of the IPPE from fall 2019 to spring 2021. Descriptive statistics were used to report clinical impact. Where relevant, t test analysis was used to compare pre- and postintervention clinical values. RESULTS: A total of 1,794 medical records were reviewed. An average of 2.67 interventions were completed for each of the 615 veterans receiving an intervention. A total of 155 patients were identified as needing routine laboratory tests (eg, glycated hemoglobin), with 48.4% of patients receiving recommended laboratory tests within 3 months. Thirty-three veterans were eligible for prescription renewals, resulting in 43 medication orders. Thirty-six veterans were recommended to take a statin medication, and statin therapy was initiated in 11, resulting in a significant decrease in the mean (SD) low-density lipoprotein cholesterol concentration (-42.4 [30.3] mg/dL, P < 0.05). Eight hundred immunizations were recommended for 632 veterans, and 286 recommendations were verbally accepted. CONCLUSION: This study demonstrates that a population health-based IPPE can provide significant clinical support to the care of patients within the VA health system.

Impact of a health and wellness IPPE focused on immunizations and health assessments.

BACKGROUND AND PURPOSE: Health and wellness principles are included in pharmacy education outcomes and standards, supporting the importance of integrating these concepts within pharmacy curricula. The objective of this study was to describe the development, implementation, and assessment of an intensive community pharmacy-based health and wellness introductory pharmacy practice experience (IPPE) focused on immunizations and health assessments. EDUCATIONAL ACTIVITY AND SETTING: The health and wellness IPPE was a required, one-week rotation developed to provide second-year student pharmacists with direct patient care opportunities to reinforce knowledge, skills, and abilities related to health and wellness principles. Students administered immunizations, performed hypertension and diabetes assessments, and provided education to patients at community pharmacy training sites. Students completed pre- and post-rotation self-assessments. Preceptors completed individual summative student performance evaluations and were surveyed to obtain IPPE feedback. FINDINGS: One hundred forty-seven students completed the IPPE across 89 sites. The pre-post analysis of student self-assessment results found statistically significant improvement in student confidence across all survey items. The largest improvements were found within the immunization items, specifically for preparing and administering immunizations. Ninety-nine percent of students agreed or strongly agreed participation in IPPE activities improved their ability to contribute to patient care. Qualitative analysis revealed students gained confidence and skills after practicing in a real-world setting. SUMMARY: The integration of the health and wellness IPPE within the curriculum resulted in increased student confidence in providing preventative care services. This study provides a solution to integrating health and wellness principles into pharmacy curricula to meet accreditation standards.

Clinical impact of a community pharmacy-based health and wellness introductory pharmacy practice experience.

OBJECTIVE: To assess the clinical impact of an intensive community pharmacy-based Health and Wellness Introductory Pharmacy Practice Experience (IPPE) completed by second-year (P2) student pharmacists. DESIGN: The Health and Wellness IPPE was a 1-week rotation developed to provide P2 student pharmacists with opportunities to provide clinical services to patients within the community pharmacy setting. Student pharmacists administered immunizations, performed blood pressure screenings and blood glucose measurements, and provided education to patients under the guidance of licensed pharmacist preceptors. SETTING AND PARTICIPANTS: Second-year student pharmacists completing a required Health and Wellness IPPE rotation in the community pharmacy setting. OUTCOMES MEASURED: Student pharmacist interventions were assessed to determine the course's clinical impact, and preceptors were surveyed regarding the feasibility of student pharmacists performing clinical services at their training sites. RESULTS: A total of 147 student pharmacists completed the IPPE at 89 community pharmacy training sites and administered 9392 injections, 90% of which were influenza vaccinations. Student pharmacists performed 3458 patient health assessments, including measuring patients' blood pressure and blood glucose and reviewing patient education materials. Most preceptors indicated that core activities were feasible during the experience. CONCLUSION: This study found that implementing a concentrated IPPE focused on immunizations and health screenings allowed student pharmacists to enhance their clinical skills and fulfill a large public health need, improving patient outcomes. Future studies should explore utilizing student pharmacists in community pharmacy settings to expand clinical services offered beyond these 2 services, such as diabetes risk tests, influenza point-of-care testing, and smoking cessation counseling.

Ambulatory care preceptors' perceptions on SOAP note writing in advanced pharmacy practice experiences (APPEs).

INTRODUCTION: Descriptions of SOAP note requirements and assessment methods used during advanced pharmacy practice experiences (APPEs) are limited in the literature. This study aimed to gather information from preceptors regarding SOAP note writing and assessment methods utilized during ambulatory care APPEs. METHODS: A survey was developed and distributed to ambulatory care preceptors with data collected via Qualtrics and analyzed using descriptive statistics, Fisher's exact test to assess the significance for associations between dependent and independent variables, and the Gamma test to assess dependent variables in grading habits and feedback types. RESULTS: The survey response rate was 62% with 75% of preceptors having students write SOAP notes during APPEs. A majority of preceptors (84%) do not formally grade SOAP notes with full-time faculty being more likely to grade and provide written feedback. Half of the preceptors perceived students as either prepared or very prepared to write SOAP notes but the majority felt that students struggle with the assessment portion of the note. There were significant differences between schools in the percentage of preceptors that formally grade SOAP notes, ranging from 2 to 45%. CONCLUSIONS: Preceptors' perception of student preparedness to write SOAP notes on ambulatory APPEs was similar, despite assessment methods varying widely.

Providing an Academic APPE Elective via Videoconference Between Off-campus Faculty and Students.

Objective. To describe students' experiences and learning outcomes of an academic advanced pharmacy practice experience (APPE) elective provided via videoconference. Faculty preceptor and experiential administration's perspectives also are described. Methods. This 5-week APPE was developed using backward design and delivered starting in 2015 via videoconferencing, with the faculty preceptor and students physically located in different locations throughout the state. After the APPE, students completed a retrospective survey comparing their perspectives and learning outcomes before and after the rotation. They also provided feedback on the experience. Students completed the standard APPE evaluation. Faculty preceptor's self-reflections and experiential administration's perspectives were documented. Results. Six students completed this unique APPE over three academic years. After the rotation, five students (83%) stated that their interest in a full-time academic career increased, while one student's (17%) interest stayed the same. All students stated there was "no hindrance" with this rotation being conducted via videoconference or with the geographical distance between the faculty preceptor and them. Student ratings of nine learning outcomes increased after completing the APPE, demonstrating their perception of their knowledge improved in all topic areas. Conclusion. Students, the faculty preceptor, and experiential administration deemed this videoconference academic APPE effective and successful. This experience affords students, without regard for physical location, the opportunity to pursue interests in academia, adds to the variety of APPEs offered by the school, and allows students to learn about careers in academic pharmacy, an area of growing need in the pharmacy profession.

Factors associated with herpes zoster vaccination status and acceptance of vaccine recommendation in community pharmacies.

OBJECTIVES: 1. Identify patient characteristics, awareness and knowledge associated with herpes zoster (HZ) vaccination status. 2. Identify self-reported reasons for not receiving Zostavax(®). 3. Assess the impact of a patient education program by measuring post-intervention interest in obtaining the Zostavax(®) vaccine across reasons for being unvaccinated. METHODS: A cross-sectional design with patients aged 60 years or older in 51 community pharmacies in Alabama and Florida was utilized. During the Introductory Pharmacy Practice Experience in summer 2013, 137 immunization-certified student pharmacists provided patient education on HZ and Zostavax(®) to unvaccinated patients using the Shingles Vaccine Information Statement. An interviewer-administered questionnaire assessed patient awareness of HZ, receipt of recommendations to receive Zostavax(®), and patient characteristics as well as vaccination status, reasons for being unvaccinated and interest in obtaining Zostavax(®) after the educational session. RESULTS: A total of 681 patients participated in a conversation with a student pharmacist regarding their HZ vaccination status. The majority were female (57.6%), white (84.6%), and unvaccinated (73.6%). Results from logistic regression suggest that participants were more likely to be vaccinated if they received a recommendation from a healthcare provider (OR=5.15), received the influenza vaccine during the previous year (OR=3.56), or knew that Zostavax(®) was recommended for individuals over 60 years of age (OR=3.55). The most frequently provided reasons for being unvaccinated were "haven't gotten around to it/forgot" (27.2%) and "didn't know it was needed" (27.1%). After the educational session, the majority (72.5%) of unvaccinated patients were interested in speaking with their pharmacist or physician about receiving Zostavax(®). Analysis suggests that interest differed across initial reason for being unvaccinated (χ(2)=64.44; p<0.01). IMPLICATIONS/CONCLUSIONS: Recommendations from healthcare providers are valued by patients and can improve vaccination rates. The patient education program increased interest in receiving Zostavax(®) and this interest differed depending on the reason provided for being unvaccinated.

Association of blood pressure with sodium-related knowledge and behaviors in adults with hypertension.

OBJECTIVES To describe sodium-related knowledge and self-reported behaviors in adults with hypertension and assess the association between knowledge and behaviors and blood pressure levels in this population. METHODS Using convenience sampling of patients with hypertension, an oral cross-sectional survey was administered by student pharmacists in 45 community pharmacies in Alabama and Florida in May to July 2012. After survey questions were administered, patients' blood pressures were measured. Data were tested for significance at alpha < 0.05 using bivariate analyses of independent and dependent variables (systolic/diastolic blood pressure [SBP/DBP]) and parallel linear regression of significant independent variables. RESULTS The majority of the 664 patients surveyed were women (59.3%) and white (75.2%). Most resided in urban areas (81.5%). The mean SBP/DBP was 133.3 (SD = 15.7)/81.7 (SD = 9.1) mg Hg. Most participants recognized the relationship between salt intake and high blood pressure (91.1%) and stroke (78.0%). A small percentage of patients reported that they always look for sodium content on food products (15.0%) and always buy low-sodium products (10.6%). Patients with lower knowledge scores (B = -0.01, P < 0.001) and those who were advised to cut down on salt (B = 0.02, P = 0.037) had higher SBP levels when controlled for gender, race, and awareness of their blood pressure goals. In regression analysis, lower knowledge scores were associated with increased DBP levels (B = -0.52, P = 0.014) when controlled for gender and race. CONCLUSION Many patients were not aware of salt in processed food and did not always look for sodium content on nutritional labels. Pharmacists should address dietary salt when interacting with patients with hypertension.

Incorporating hypertensive patient education on salt intake into an introductory pharmacy practice experience.

OBJECTIVE: To evaluate the impact of the Salt Education Program for hypertensive adults on student pharmacists' knowledge, behaviors, and attitudes regarding sodium consumption. DESIGN: As part of the introductory pharmacy practice experience program in community pharmacies, student pharmacists assessed patients' sodium intake knowledge and behaviors, taught them how to read nutrition labels, and obtained information about their hypertensive conditions. Students completed pre-and post-intervention questionnaires in April and August 2012, respectively. ASSESSMENT: One hundred thirty student pharmacists (70% female, 78% white) completed pre- and post-intervention questionnaires. Students demonstrated significant improvements in knowledge scores (p<0.001) and perceived benefit of a low-salt diet (p=0.004). Further, there were significant improvements in the self-reported frequency of looking at sodium content of foods when shopping (p<0.001) and purchasing low-salt foods (p=0.004). CONCLUSION: Changes in students' knowledge, behaviors, and attitudes after participating in the Salt Education program suggested that the program was effective in improving student knowledge, behaviors, and attitudes.

Consortium-based approach to an online preceptor development program.

OBJECTIVE: To describe the implementation process of a consortium-based preceptor development program and to review completion and assessment data over the first 27 months. DESIGN: Five 1-hour, Web-based preceptor development modules were developed using streaming media technologies. Modules were released using a password-protected Internet site and were free to consortium-affiliated preceptors. Preceptor's institutional affiliation, module completion dates, module assessments, and continuing education credits were recorded and made available to each institution. ASSESSMENT: Three hundred eighty-two preceptors completed 1489 modules. Fifty-six percent of preceptors were affiliated with more than 1 consortium institution. The number of participating preceptors per institution varied from 72 to 204. Sixty-five percent of preceptors completed all 5 modules. Preceptor satisfaction was high, with 93% agreeing with each course evaluation statement. Program cost per institution ranged from $12 to $35 per preceptor. CONCLUSIONS: A consortium-based approach to preceptor development is a convenient and effective means of providing required training.

A quality improvement course review of advanced pharmacy practice experiences.

OBJECTIVES: To determine strengths of and quality improvements needed in advanced pharmacy practice experiences (APPE) through a systematic course review process. DESIGN: Following the "developing a curriculum" (DACUM) format, course materials and assessments were reviewed by the curricular subcommittee responsible for experiential education and by key stakeholders. Course sequence overview and data were presented and discussed. A course review worksheet was completed, outlining strengths and areas for improvement. ASSESSMENT: Student feedback was positive. Strengths and areas for improvement were identified. The committee found reviewing the sequence of 8 APPE courses to be challenging. CONCLUSIONS: Course reviews are a necessary process in curricular quality improvement but can be difficult to accomplish. We found overall feedback about APPEs was positive and student performance was high. Areas identified as needing improvement will be the focus of continuous quality improvement of the APPE sequence.

Implementation of a school-wide clinical intervention documentation system.

OBJECTIVE: To evaluate the effectiveness and impact of a customized Web-based software program implemented in 2006 for school-wide documentation of clinical interventions by pharmacy practice faculty members, pharmacy residents, and student pharmacists. METHODS: The implementation process, directed by a committee of faculty members and school administrators, included preparation and refinement of the software, user training, development of forms and reports, and integration of the documentation process within the curriculum. RESULTS: Use of the documentation tool consistently increased from May 2007 to December 2010. Over 187,000 interventions were documented with over $6.2 million in associated cost avoidance. CONCLUSIONS: Successful implementation of a school-wide documentation tool required considerable time from the oversight committee and a comprehensive training program for all users, with ongoing monitoring of data collection practices. Data collected proved to be useful to show the impact of faculty members, residents, and student pharmacists at affiliated training sites.

Barriers to expanding advanced pharmacy practice experience site availability in an experiential education consortium.

OBJECTIVES: To compare 2006-2007 and projected 2010-2011 advanced pharmacy practice experience (APPE) availability and needs for 4 colleges and schools of pharmacy in Georgia and Alabama and to examine barriers and offer potential solutions to increase APPE site and preceptor availability. METHODS: Data on APPE needs and availability were gathered prospectively and evaluated relative to current and projected enrollment and planned programmatic changes. RESULTS: Combined 2006-2007 non-community APPE needs and availabilities were 3,590 and 4,427, respectively, with a surplus availability of 837. Combined projected 2010-2011 non-community APPEs were estimated at 4,309. Assuming 2006-2007 non-community availability remained unchanged, the surplus availability declined to 118. CONCLUSIONS: The need for quality experiential education represents a significant barrier and rate-limiting step to the matriculation of the increased numbers of pharmacists. Barriers to expanding APPE availability include: introductory pharmacy practice experience (IPPE) and APPE expansion, growth of new and existing pharmacy programs, financial instability of acute care facilities, and lack of preceptor development resources. Regional experiential education consortiums can provide a constructive approach to improve access to quality sites and preceptors through standardizing processes and leveraging resources.