Assessing Student Performance Using a Novel Rubric Based on the Dreyfus Model of Skill Acquisition.

OBJECTIVE: Pharmacy student performance on practicum was previously assessed using a Likert scale from 0 to 9, resulting in challenges with clarity and assessor subjectivity. To address these issues, an assessment rubric based on the Dreyfus model of skill acquisition was developed and implemented. This study sought to evaluate student, practice educator (PE), and faculty perceptions related to the rubric's effectiveness in assessing student performance within the direct patient care practicum setting. METHODS: An exploratory sequential mixed methods approach was used. A qualitative component using focus groups and semistructured interviews was followed by a quantitative component using a survey questionnaire. Data gathered from the qualitative component were collectively analyzed and used to inform questionnaire development intended to confirm identified themes and collect further data on stakeholder perceptions. RESULTS: A total of 7 students, 7 PEs, and 4 faculty participated in the focus groups/interviews and 70 of 645 (10.9%) students and 103 of 756 (13.6%) PEs participated in the survey questionnaire. The majority of the participants felt that the rubric clearly communicated the expectations for student performance, is relevant and consistent with pharmacy practice, and is useful in accurately assessing performance. For PEs with experience, the novel rubric was an improvement over the previous assessment processes and perceived as more thorough and clearer in describing performance expectations. The identified challenges included the rubric's visual organization, length, and redundancy of some of the assessment elements. CONCLUSION: Our findings suggest that a novel rubric based on the Dreyfus model is effective in assessing student performance on practicum and may address some of the challenges commonly observed with performance assessment.

PHArmacy Students as Educators (PHASE): Implementation and evaluation of an educator's curriculum for pharmacy students.

BACKGROUND AND PURPOSE: Designed to address the Association of Faculties of Pharmacy of Canada's competency "teach pharmacy team members, the public, and other health care professionals," the PHArmacy Students as Educators (PHASE) program was developed by the institute's entry-to-practice doctor of pharmacy program. The program's objective was to support students in developing the necessary skills to fulfill their role as pharmacist-educators. EDUCATIONAL ACTIVITY AND SETTING: We performed a two-year pilot (2017-2019) of the PHASE program which consists of a large-group didactic session followed by an academic half-day (AHD) session. Evaluation was conducted using Likert-scale and qualitative student survey data collected pre- and post-sessions to determine: (1) how the PHASE program supported students as future educators, and (2) students' perceptions and experiences related to teaching and learning. FINDINGS: All students in the 2020 and 2021 graduating cohorts were included in the study following consent. We determined that while respondents agreed to the statement, "A role of a pharmacist includes being an educator" (93.7% and 98.2% for 2020 and 2021 cohorts) at baseline, the proportion of strongly agree responses increased following the didactic session (P < .005). Of note, average Likert-score for respondents' confidence in educating increased following the AHD session (P < .001). Qualitative analysis identified an increase in students' self-rated ability for determining learners' needs, developing and conducting educational sessions, and confidence related to educating others. SUMMARY: Overall, the PHASE program showed positive impact during the first two years of implementation and lessons learned from the pilot are discussed.

Hypercalcemia due to all trans retinoic acid in the treatment of acute promyelocytic leukemia potentiated by voriconazole.

All-trans-retinoic acid (ATRA) is a new and effective treatment of acute promyelocytic leukemia. It has many side-effects, including the retinoic acid syndrome and Sweet's syndrome. There have been only nine cases of hypercalcemia associated with ATRA described in the literature. We discuss a case of hypercalcemia, which we believe was due to inhibition of cytochrome P450 function by voriconizole when used concomitantly with ATRA.

A review of etomidate for rapid sequence intubation in the emergency department.

Etomidate is a sedative-hypnotic chemically unrelated to other induction agents. The pharmacological and safety profile of etomidate offers many advantages for induction during rapid sequence intubation (RSI) in the emergency department (ED). Its onset of action is within 5 to 15 seconds, and its duration of action is 5 to 15 minutes. Unlike thiopental, propofol, midazolam and, to a lesser extent, ketamine, etomidate has minimal respiratory or cardiovascular effects and can be safely used in patients with hemodynamic instability or cardiac ischemia. Etomidate is cerebroprotective, with the ability to decrease intracranial pressure and maintain cerebral perfusion, making it an ideal agent for patients with head injuries. Of the currently available induction agents, etomidate offers the most favourable safety profile and is the least likely to produce adverse effects in patients with unknown or untreated medical conditions. Etomidate may cause pain on injection, myoclonic movements on induction, hiccups, nausea and vomiting. Transient adrenal suppression has been reported, but not to a clinically significant degree, after single induction doses for ED RSI. Etomidate has been well studied in the ED and should be adopted for RSI in specific ED patient groups.