Pharmacist perceptions of and views on postgraduate year 3 training.

PURPOSE: To determine the attitudes and perceptions of pharmacy residency program participants regarding proposed expansion of postgraduate year 3 (PGY3) residency training opportunities. METHODS: An online questionnaire was emailed to all directors of ASHP-accredited residency programs with a request to distribute the survey among program participants, including residents, preceptors, coordinators, and other pharmacists working with residents. Survey questions assessed participants' views and attitudes about PGY3 programs vs other avenues of career advancement, including potential benefits and limitations, program structure, and ramifications for the profession. RESULTS: Eight hundred forty-five individuals participated in the survey, for a 22.47% response rate. Only 288 pharmacists (34.4%) were familiar with the PGY3 residency training concept. Perceived benefits of PGY3 training, by percentage of respondents citing them, included job specialization (34.41%), an additional year of training (19.93%), and obtaining research skills (5.44%). The main perceived limiting factors included personal finances (21.62%), lack of justification for PGY3 training (13.83%), and time commitments (12.94%). As alternatives to PGY3 training for career advancement, board certifications (49.5%), scholarly activity (19.8%), and leadership in pharmacy organizations (19.2%) were the 3 highest-rated areas. A majority of respondents were opposed to ASHP standardization of PGY3 residency programs (74.3%) and/or had negative preconceptions of the potential impact of expanded PGY3 training initiatives on the job market (80.94%). CONCLUSION: Overall, surveyed pharmacy residency program participants were opposed to the concept of expanded PGY3 training initiatives and indicated their view that PGY3 training offers limited benefits in terms of professional development. Participants favored on-the-job training and other avenues of career advancement over PGY3 residency training.

Factors That Influence Students' Selection of Advanced Pharmacy Practice Experience.

Objective. To determine factors influencing Doctor of Pharmacy (PharmD) students' selection of advanced pharmacy practice experiences (APPEs) in one school of pharmacy. Methods. In their final year, PharmD students are required to complete a minimum of 1440 hours of experiential education, including ambulatory, community, inpatient general medicine, and hospital/health system APPEs, and elective APPEs. Third-year (P3) and fourth-year (P4) PharmD students were invited to complete an anonymous online survey to determine what factors impacted their decision process when selecting their required experiences. Students selected up to five factors that most influenced their selection of APPEs. Factors included areas of interest, size of institution, location, future employment, preceptor reputation, rotation hours, faculty rotation, non-faculty rotation, peer recommendation, cost/housing, level of difficulty, size of institution, and whether the site offered a residency program. Results. Of the 143 students enrolled, 100% responded to the survey. Students in both classes (71 P3 and 72 P4 students) selected location as the number one factor that influenced their decision when selecting required APPEs. Cost/housing was the second most important factor overall for P3 students, while peer recommendation was the second most important factor overall for P4 students. Conclusion. Location was the driving factor behind P3 and P4 pharmacy students' selection of APPE sites. Schools should consider establishing more APPE sites that offer housing to reduce cost. Further research into the factors that influence ranking on APPE electives is warranted.

Development and perception of a multiple-site nontraditional postgraduate year 1 residency program.

PURPOSE: To describe the development and perception of a multiple-site nontraditional postgraduate year 1 (PGY1) residency program from the resident and preceptor perspectives. SUMMARY: A multiple-site nontraditional residency program was developed within a Florida health system to increase the education level and clinical responsibilities of hospital staff pharmacists. The program provided pharmacists interested in residency training an opportunity to pursue postgraduate credentials while maintaining their current position. The nontraditional residency program was implemented at 1 site and subsequently expanded across multiple affiliated hospital sites due to its success. Pharmacists currently working in the health system's network of hospitals for at least 2 years were eligible to enter into the 24-month program after successfully completing the application, interview, and matching process. The number of nontraditional resident positions available has varied by residency year and site. Offering this opportunity has increased the clinical knowledge of pharmacists, exposed them to a variety of practice areas, and increased their departmental contributions. In response to a request for feedback regarding the multiple-site nontraditional program, both residents and preceptors have reported benefits and challenges. CONCLUSION: Adequate resources are needed and a number of factors must be considered in developing a multiple-site nontraditional PGY1 residency program. Although there are potential challenges, it is perceived that the benefits justify continuation of the program.

Student Perspectives Regarding Specialty Pharmacy Within Doctor of Pharmacy Curricula.

BACKGROUND: The rapid growth of the specialty pharmacy industry will require many pharmacists with experience and/or training in specialty pharmacy practice (SPP). Unfortunately, there is no standard requirement set forth by the Accreditation Council for Pharmacy Education (ACPE) for specialty pharmacy education among pharmacy schools, which has resulted in graduates with doctor of pharmacy degrees (PharmD) having little to no didactic or experiential training in SPP. OBJECTIVES: To (a) assess PharmD student perspectives on coverage of specialty pharmacy in their respective curricula and (b) identify whether attitudes and perspectives towards SPP vary based on student work experience. METHODS: Study investigators created a 16-item web-based survey that assessed student work experience in pharmacy practice, presence of learning experiences that cover SPP in PharmD curricula, and familiarity with, exposure to, and interest in SPP, SPP learning experiences, and SPP careers. The survey was made available to students at ACPE-accredited colleges of pharmacy from January to April 2018. RESULTS: 643 students from 20 different colleges of pharmacy completed the survey. Over half of the surveys (63.3%) originated from schools in the Midwest region of the United States. Just over one third (37.7%) of students reported that their curricula offered a learning experience specifically dedicated to SPP, whereas 17.6% reported that SPP was integrated into other pharmacy coursework. 28% reported that SPP was covered using a mixture of dedicated courses and class integration. Students with current or previous work experience in SPP or managed care were more likely to report willingness to take an experiential rotation in SPP and pursue a career in SPP than students with no or other pharmacy-related work experience. These students were also more likely to report that their curriculum performed poorly in preparing students to pursue a career in SPP. CONCLUSIONS: In a convenience sample survey of pharmacy students at ACPE-accredited colleges of pharmacy, perspectives on SPP, curricular coverage of SPP, and SPP careers varied significantly based on student work experience. DISCLOSURES: This study received funding support from the Wayne State University Department of Pharmacy Practice Research & Development Fund. The authors do not have any conflicts of interest or financial disclosures to declare.

Development of a required longitudinal residency experience focused on deprescribing.

PURPOSE: In this article we describe a novel required longitudinal experience focused on deprescribing designed for postgraduate year 2 (PGY2) geriatric pharmacy residents. This experience was embedded within a clinical pharmacist-driven deprescribing service. Insights on challenges faced and benefits gained during the first offering are also highlighted. SUMMARY: Through collaboration with the University of Pittsburgh School of Pharmacy (UPMC) Palliative and Supportive Institute and the UPMC St. Margaret PGY2 geriatric pharmacy residency program, a year-long required deprescribing-focused experience was developed and executed. The experience was aligned with the American Society of Health-System Pharmacists' standard goals and objectives and was designed to focus and evaluate 3 skills necessary for all pharmacy practitioners: empathy, critical thinking, and communication. There is a need for proactive deprescribing initiatives to reduce the unnecessary burden and cost associated with potentially inappropriate medications for older patients. Focused deprescribing experiences can better equip pharmacist learners with the ability to lead these initiatives. CONCLUSION: A required longitudinal deprescribing-focused experience can provide PGY2 geriatric pharmacy residents with opportunities to practice empathy, critical thinking, and communication beyond those typically offered in a residency program.

Development of a community-academic collaborative pharmacy residency program.

PURPOSE: To describe the development of a collaborative community-academic postgraduate year 1 pharmacy residency program in San Diego that provides a hybrid experience of opportunities in community practice, ambulatory care, and teaching. SUMMARY: Residency training programs are being developed to better match the evolving role of the community pharmacist. In 2016, the University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences partnered with Ralphs Pharmacy, a division of the Kroger Co., to launch a 1-year community residency to develop community-based pharmacists with diverse patient care, leadership, and education skills. Learning experiences include pharmacy operations, clinical services focusing on chronic disease management and education, teaching, and practice-based research. Training settings include community pharmacy, corporate pharmacy, ambulatory care, and academia. Graduates are prepared to work in these settings as well as capitalize on advanced training opportunities, including postgraduate year 2 residencies and professional certifications. The program has been successfully accredited, and graduates have completed the program: one completed a postgraduate year 2 residency, and both have obtained a management or clinical pharmacist position. CONCLUSION: An innovative community-academic residency program preparing postgraduate year 1 learners for careers in community-based pharmacy, corporate, ambulatory care, and academic settings was developed, with positive preliminary outcomes.

Using a multisite and multi-health system pharmacy resident program model for care documentation quality improvement.

OBJECTIVES: To implement and evaluate a pharmacy resident documentation peer review process. SETTING: The University of Minnesota Postgraduate Year One Pharmacy Residency Program is a multisite program with 25 residents across 16 different health care organizations. PRACTICE DESCRIPTION: Sites within the program provide comprehensive medication management (CMM) services to patients in ambulatory care settings, including participation in the full patient care process of assessment, care plan development, follow-up, and appropriate documentation. PRACTICE INNOVATION: In this innovative peer review process model, residents undergo a deidentified CMM documentation review process with residents from other practice sites, exposing them to different documentation templates and perspectives. EVALUATION: A workgroup of residency preceptors led by a research team developed a peer review process, which evolved through 3 phases over 2 years in response to resident, preceptor, and administration team feedback. Resident feedback was compiled and analyzed. RESULTS: Forty-two residents responded to the survey (67% response rate); 71% found the review process to be helpful. Residents reported that the process improved their understanding of how to improve patient care documentation (74%), how to provide peer feedback (90%), and the importance of effective interprofessional communication in clinical decision making (81%). DISCUSSION: The core perceived benefit of the peer review process was exposure to how other health systems and practitioners document CMM. Some residents participate in a peer review process at their home institutions, which may explain some of the lack of perceived benefit. Generalizability of this study is limited by being within a single residency program with a relatively small number of participants. CONCLUSION: Pharmacy residents found a peer review process of documentation to be helpful during their residency education. The process exposed residents to different documentation practices at various health care systems, which led to ideas of how to improve documentation and provided a foundation for how to provide peer feedback in practice.

Health Informatics Competencies for Pharmacists in Training.

Objective. To gather feedback from focus groups regarding health informatics competencies that should be taught in a Doctor of Pharmacy (PharmD) curricula and to revise the competencies based on this feedback. Methods. The pharmacy informatics task force of the American Association of Colleges of Pharmacy (AACP) used 11 sources to create a list of pharmacy informatics competencies. Subsequently, faculty feedback about the competency list was obtained via two synchronous online focus groups in August 2015. The list was then revised based on the feedback. Results. Eight people (a department chair, six faculty members and a graduate student) participated in the focus groups (six were from private and two were from public institutions). Participants felt the list had too many competencies to be covered in a timely manner and some indicated that basic computer and Internet competencies should be considered pre-requisites. Participants also recommended that competencies be split by proposed curricular placement (eg, prerequisite, required, elective, didactic, experiential) for each objective. The competency list was revised in response to focus group feedback. Conclusion. The proposed curriculum aligns with the new Accreditation Council for Pharmacy Education (ACPE) standards requiring that professional pharmacy curricula cover multiple aspects of health informatics. The proposed competencies list can serve as a reference to assist in the development of the curriculum and ensure compliance with the new standards.