The road less traveled: Developing pharmacist clinician-scientists through divergent training pathways.

DISCLAIMER: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE: Professional organizations have emphasized the growing need for pharmacists to possess advanced research skills; however, there is a scarcity of training programs aimed at nurturing clinician-scientists. This report outlines 3 critical care-focused research programs, each offering a unique approach to training clinician-scientists. SUMMARY: Limited resources and formalized programs are available to bridge the gap between the demand for and availability of skilled clinician-scientists. Several programs have stepped forward to share their experiences in establishing and executing training initiatives aimed at cultivating skilled clinician-scientists in the critical care practice space. CONCLUSION: Enhancing the development of clinician-scientists for clinical and translational research is necessary in the critical care clinical pharmacy community.

Reconsidering Pharmacy: We Need to Turn Career Regret into Career Options.

Declining interest in pharmacy as a career is a growing concern. This commentary investigates the factors contributing to career regret among pharmacy graduates, based on data from the American Association of Colleges of Pharmacy National Graduating Student Survey. We identify 3 key contributing factors: workplace environment, professional identity formation, and marketing of the Doctor of Pharmacy degree. We argue that students observe, in many work environments, a lack of autonomy, repetitive tasks, and unfulfilling work. This leads to diminished job satisfaction and disillusionment. Additionally, marketing tactics and curricular structures can inadvertently contribute to career regret. We propose potential interventions, emphasizing the need for improved working conditions, more versatile roles in pharmacy, and enhanced career development services within colleges/schools of pharmacy. Additional research is needed to fully understand career regret and the steps that academic institutions can proactively take to mitigate career dissatisfaction among their graduates.

Assessing Cognitive Apprenticeship Impact on Clinical Reasoning in Third-Year Student Pharmacists.

OBJECTIVE: The objective of this study was to evaluate the impact of implementing a cognitive apprenticeship theory (CAT) model into a Doctor of Pharmacy course in improving clinical reasoning skills of third-year student pharmacists over time and preparing them for Advanced Pharmacy Practice Experiences (APPEs). METHODS: This was a single center, nonrandomized, observational before-and-after study from January 2022 through May 2022. Third-year student pharmacists enrolled in the Critical Care Integrated Drugs and Disease pharmacotherapy course at the University of Kentucky College of Pharmacy were administered a well-established and nationally recognized clinical patient case assessment on weeks 1 and 15 of the course. Students were asked to prioritize patient problems and provide recommendations for therapy, goals, and monitoring. Responses were then scored using a predefined case key. In addition, student pharmacists were asked to self-evaluate their confidence in APPE readiness on a 5-point Likert scale. RESULTS: Of the 136 student pharmacists enrolled in the course, 92 (68%) student pharmacists completed both week 1 and week 15 clinical cases and self-assessment surveys, provided informed consent, and were included. Cumulative clinical case scores were significantly increased from week 1 to week 15 (34.8 vs 39.7). In addition, significant improvement was seen in overall problem prioritization, overall recommendations, and self-perceived preparedness for APPE rotations. CONCLUSION: The use of a CAT model into a 15-week pharmacotherapy course improved comprehensive scores of clinical reasoning assessment in third-year student pharmacists and was associated with increased self-perceived confidence and readiness for APPEs.

The Role of Artificial Intelligence in the Future of Pharmacy Education.

Recent developments making an artificial intelligence (AI) large language model available for public use have generated significant interest and angst among educators. Viewed as both a time saver and a threat to academic integrity, several questions have arisen about AI's role in education. Numerous opportunities exist to use AI for teaching and learning, but new questions have also arisen regarding AI's impact on the future of healthcare. The pharmacy Academy should be at the center of these discussions to address the technical, philosophical, and ethical issues that AI presents for the future of pharmacy and pharmacy education.

Fixed mindset and imposter phenomenon: Determining the correlation and prevalence among pharmacy students.

INTRODUCTION: To determine the prevalence of fixed vs. growth mindsets and imposter phenomenon (IP) scores among pharmacy students at one institution, identify variables that explained variance in fixed mindsets and IP, and determine if a correlation exists. METHODS: A survey was developed and administered to first- to fourth-year students at the University of Kentucky College of Pharmacy. The survey included demographic questions, the Clance Imposter Phenomenon Scale (CIPS), and the Implicit Theories of Intelligence Scale (ITIS). Descriptive and inferential statistical analyses were conducted to determine the prevalence of IP and fixed vs. growth mindsets, identify variables that explained variance in CIPS and ITIS scores, and investigate if a correlation exists. RESULTS: Pharmacy students reported a high rate of IP experiences; mean (SD) CIPS score of 67.2 (14). Thirty percent of students reported at least moderate IP experiences and 68.2% reported frequent or intense IP experiences. The majority of students (59.6%) reported a growth mindset. Gender was the only tested variable that explained variance in CIPS or ITIS scores, as male gender respondents had lower CIPS score as compared to those reporting female gender (63.27 vs 68.87, p=.006). A correlation was found between lower ITIS and higher CIPS scores (r = -0.221, P < .001). CONCLUSIONS: Pharmacy students surveyed exhibited a high rate of IP and growth mindsets. Understanding that fixed mindsets and high rates of IP are correlated can help educators make informed decisions regarding targeted interventions, with the goal to improve overall student wellbeing.

Improving and Expanding Research on Burnout and Stress in the Academy.

Objective. To conduct an integrative review of existing literature evaluating burnout and stress to identify reliable, valid, psychometrically sound survey instruments that are frequently used in published studies and to provide best practices in conducting burnout and stress research within academic pharmacy.Findings. We reviewed 491 articles and found 11 validated reliable surveys to be most frequently cited in the literature that can be used in future burnout and stress research. We also noted frequent misunderstandings and misuse of burnout and stress terminology along with inappropriate measurement. Additionally, we identified a variety of useful websites during the review. Lastly, we identified a relative dearth of published research evaluating organizational solutions to burnout and stress beyond personal factors, ie, resilience.Summary. Burnout and stress among student pharmacists, faculty, and staff is an important research area that necessitates more robust, rigorous evaluation using validated reliable surveys with appropriate contextualization within psychological frameworks and theory. Future research evaluating organizational-level attempts to remedy sources of burnout and stress is also needed.

Counteracting the sedentary aspects of academia by incorporating physical activity into the educational process.

INTRODUCTION: In many ways, traditional education environments contribute to a sedentary lifestyle, and this can lead to several negative health outcomes. This study determined the extent of anti-sedentary physical activity outcomes resulting from conducting pharmacy academia rotation topic discussions while walking. METHODS: Topic discussions during six, one-month pharmacy resident academia rotations were converted from a traditional sitting environment to walking discussions conducted at a conversational pace. The preceptor's time, distance, steps, ascent, and caloric expenditure for the discussions were tracked via the hiking feature on Garmin Fenix 3 Global Positioning System watch (Garmin Ltd.). Results were synced to the Garmin Connect mobile application, from which they were manually transcribed to spreadsheet software. Descriptive statistics for the variables were calculated. RESULTS: A total of 46 topic discussions were conducted while walking. The average walking topic discussion lasted 44.62 min, covered 2.13 miles with 3896 steps, and expended 159  calories. CONCLUSIONS: Results of this study demonstrate the various physical activity benefits of conducting topic discussions while walking as opposed to more traditional stationary discussions. Walking topic discussions are a simple way to counteract the sedentary aspects of academia by incorporating physical activity into the educational process without additional time or resources. Opportunity exists for other aspects of academia to adopt similar strategies to benefit faculty, staff, student, and resident wellness.

Exploring cognitive apprenticeship and teaching practices in pharmacy education.

Health professions schools in the United States and internationally have engaged in curricular changes to better prepare students for the future of health care. However, designing or selecting evidence-based teaching activities can be a challenge. Research suggests the Cognitive Apprenticeship theory is an effective framework for the health professions to inform instruction design, yet these studies have mainly focused on the clinical setting and not the didactic learning environment. This study used qualitative methods to explore the Cognitive Apprenticeship framework in the didactic learning environment and the teaching practices that pharmacy faculty used to explicate their expert thinking to students. Faculty were observed using all four Cognitive Apprenticeship dimensions (ie, Content, Sequencing, Methods, Sociology) in their teaching practice. Patterns were observed in the data revealing complex, short and sometimes spontaneous teaching practices that faculty used to promote learning.

Prevalence of phubbing by student pharmacists at two colleges of pharmacy.

INTRODUCTION: Problematic smartphone use has been associated with numerous factors of mental health including depression, stress, and anxiety. Most of the research in this area has focused on the effects to the smartphone user. One relatively new phenomenon in this area of research is phone snubbing ("phubbing") and its effect on others. The purpose of this pilot study was to determine the prevalence of phubbing behavior among a group of student pharmacists. METHODS: The validated Generic Scale of Phubbing (GSP) was administered to a convenience sample of student pharmacists at two different doctor of pharmacy programs. The scale is scored from 15 to 105, with higher scores indicating a greater degree of phubbing behavior. RESULTS: Of 555 eligible students, 262 (47.2%) responded to the survey. Scores were similar to, but lower than, scores from other studies. Institution was a significant factor in predicting GSP score. Gender and age group, when taking into account institution, were not significant predictors of GSP scores. Overall, the data in our study showed good internal consistency with a Cronbach's alpha for the combined group of 0.86. CONCLUSIONS: As a relatively new phenomenon, limited data are available about the long-term effects of phubbing on mental health. Our research showed comparable, but lower levels of phubbing behavior to previous studies and establishes a baseline measurement for which further research can be added.

An inter-institutional PharmD elective course and qualitative analysis exploring student engagement and collaboration.

BACKGROUND AND PURPOSE: There are limited reports in the literature of integrated inter-institutional doctor of pharmacy (PharmD) coursework where learners and faculty are connected using synchronous web conferencing. Furthermore, the impact of this learning environment on student engagement and collaboration has not been reported previously. EDUCATIONAL ACTIVITY AND SETTING: Faculty members from two separate schools of pharmacy collaborated to create the Current Concepts and Controversies in Cardiology (C4) elective, a two-credit hour elective course that was delivered via synchronous web conferencing. The course was designed to build upon students' pre-existing cardiovascular knowledgebase using case-based discussions, critical appraisal of clinical trials, and pro/con debates. Qualitative analysis using semi-structured interviews was performed to explore aspects of the course that promoted, or hindered, students' engagement and collaboration. FINDINGS: Seven students completed the semi-structured interviews following completion of the course. Themes identified that promoted student engagement and collaboration included, but were not limited to, observing professional relationships and interactions among faculty as well as faculty specifically calling on students by name or location. Three themes were found to be barriers to engagement and collaboration across institutions and included glitches in technology, the adversarial setup of the pro/con debates, and the inability to partake in impromptu discussion before and after class. SUMMARY: The C4 elective course was an integrated inter-institutional PharmD elective delivered using web conferencing. We highlight aspects of the course that promoted engagement and collaboration. The impact of inter-institutional PharmD education remains largely unexplored but may be an area of future interest and research.

An Intervention Utilizing the Salience Principle to Reduce Pharmacy Students' Psychological Attraction to Smartphones.

Objective. To determine pharmacy student reactions to and experiences with an intervention based on the principle of salience to reduce psychological attraction and attention to smartphones.Method. For a period of three weeks, participants were directed to change their smartphone's color setting to grayscale mode, turn off social media notifications, remove social media icons from smartphone home screen, and place the device away from their bed when sleeping. A thematic analysis was performed on responses to an anonymous, open-ended survey question that asked participants to record any positive/negative changes to their life and well-being as a result of participating in the study.Results. Thematic analysis revealed 20 unique themes and a variety of notable observations, including a reduction in both smartphone and social media use, reduced allure because of grayscale mode, frustrations caused by grayscale mode, increased productivity, and general improvements in sleep, face-to-face interactions, and overall well-beingConclusion. Results of this study provide initial evidence that changes to smartphone settings and physical placement at night may lead to positive outcomes. Participants reported primarily positive effects regarding well-being and reduced smartphone usage as a result of participating in the study. In many cases, less time on smartphones meant improved sleep, more productivity, more time for social/leisure activities, improved face-to-face interactions, and/or improvement in well-being.

Deficiencies of Traditional Grading Systems and Recommendations for the Future.

Objective. To review issues surrounding the use of grades in the educational process and provide evidence-based recommendations for how to redesign grading practices for optimal value.Findings. Traditional tiered grading systems (ie, A, B, C, etc) have historically been a major component of the formal educational process. The way grades are used and interpreted are typically based on some commonly held assumptions, including that they are accurate measures of learning, that they motivate students to learn, and that they provide feedback to learners. However, much of the research regarding grades indicates that flaws exist in these assumptions. Grades may not always accurately measure learning, they can have adverse effects on student motivation, and they are not a good form of feedback.Summary. The Academy should consider the evidence regarding the purpose, effects, and interpretation of grades in the educational process. Despite barriers and potential pushback, pharmacy educators should revise grading practices to be more accurate, interpretable, and beneficial to learner development.

Design and evaluation of a mobile serious game application to supplement instruction.

BACKGROUND AND PURPOSE: Pharmacy students often exhibit minimal interest in pharmacy management courses. This pilot study reports on the design and testing of a mobile game application (app) prototype to improve student engagement and learning of financial management concepts. EDUCATIONAL ACTIVITY AND SETTING: A mobile app (Planet Finance) was designed to supplement instruction for two key financial management topics. The app was introduced to students in two schools of pharmacy after content on financial management was taught. Students were requested to use the game app for a minimum of two weeks and complete a questionnaire assessing their knowledge of management content and perceptions of the app. FINDINGS: The overall survey response rate was 41%. The majority of respondents played the game app two to four times (48.3%). Only 13.8% of respondents completed all 10 levels. Participants generally agreed that game instructions were clear, and that the game was easy to navigate, entertaining and made learning fun; allowed more engagement with content; and enhanced financial statements and ratios comfort. Those who played the game app more often had more favorable perceptions. User data from the game app showed that the majority of respondents accessed the game app on not more than two days (89.1%) and played up to four levels (69.6%). SUMMARY: Overall, students enjoyed playing Planet Finance; however, uptake of the app was low. Future revisions may involve adding additional competitive features, content, levels, incentives, and focusing on strategies to incorporate the game into traditional classroom instruction.

Implementing cognitive apprenticeship theory into the design of a doctor of pharmacy course.

BACKGROUND AND PURPOSE: Cognitive apprenticeship theory is a model instructors can use to develop expert thinking in a classroom setting. Cognitive apprenticeship theory has been discussed in the literature; however, descriptions of its application in the classroom setting are lacking. We describe how cognitive apprenticeship guided the development and implementation of a new critical care course with a goal of making expert thinking "visible" to students. EDUCATIONAL ACTIVITY AND SETTING: A four-credit-hour course implemented in the 2018-2019 academic year was developed around the dimensions of cognitive apprenticeship. Clinical pharmacists with the affiliated healthcare system contributed to the design and implementation. Elements of the course in which cognitive apprenticeship theory guided the design included pre-class work, in-class group work, and an attending-facilitated discussion session. FINDINGS: All four dimensions of cognitive apprenticeship were incorporated throughout the course. The course coordinator perceived that student questions and the quality of the discussion were higher level than in previous years. SUMMARY: Cognitive apprenticeship theory can be used to design and implement a professional doctor of pharmacy course that prepares students for the types of thinking required in practice. We believe this model could be successfully implemented at other schools of pharmacy.

Grant deadline: An escape room to simulate grant submissions.

BACKGROUND AND PURPOSE: Previous lectures for graduate trainees did not convey the urgency, complexity, and challenges of a successful grant submission. To increase engagement, instructors applied gamification principles to create an educational escape room. Serious games used in other settings engage participants to solve problems, build teamwork, and improve communication skills. This study was designed to fill a gap in the types of educational training effectively conducted via escape rooms. EDUCATIONAL ACTIVITY AND SETTING: A college of pharmacy team implemented a game to simulate the grant submission process and familiarize trainees to internal processes and resources. Participants searched for grant opportunities, identified proposal errors, solved research-related clues to open locks, contacted a difficult collaborator, physically located resources, and requested permission for late submission. The activity was implemented during an introductory class for first-year graduate students (n = 19). Learning objectives targeted the technical and relational aspects of proposals within a realistic, timed setting. Student perceptions of the escape room experience were gathered via individual interviews (n = 8) and evaluated by thematic analysis. FINDINGS: Analysis of participant emotions, thoughts, and attitudes identified common themes of excitement (63%), fun (50%), stress (38%), and frustration (25%). Compared to didactic instruction, many interviewed students preferred the escape room (63%) and found it conducive to learning (63%). A subset thought it might not work for everyone (13%) or would be improved by adding a didactic component (13%). SUMMARY: This escape room served as an engaging method to introduce graduate students to the grant submission process.

Pharmacy students' personal and professional use of social media.

INTRODUCTION: Current literature does not describe behaviors or the overarching opinion of pharmacy students on the use of different types of social media for personal and professional purposes. The objectives of this study were to identify predominant beliefs among pharmacy students regarding use of social media for professional and personal purposes, characterize pharmacy students' opinions on the effects of social media on their professional career, and determine pharmacy students' perceptions of using social media as tools for learning and discovery. METHODS: A self-administered questionnaire was administered to pharmacy students at Auburn University (N = 450) and Lipscomb University (N = 212). Linear regression was performed to predict students' perceptions of the importance of social media to their future professional life. RESULTS: The leading platforms commonly used by students for personal reasons were Facebook (92.5%), Instagram (70.5%), and Snapchat (70.5%). The most popular platforms used for professional reasons included LinkedIn (40.4%), Facebook (35.4%), and YouTube (29.2%). About 50% of respondents perceived social media to be important to their future professional life as pharmacists. Most students used YouTube and Wikipedia while studying or learning. The regression model predicting students' perceptions of the importance of social media to their future professional life was significant. CONCLUSIONS: Pharmacy students most commonly use Facebook, Instagram, and Snapchat for personal reasons, and LinkedIn, Facebook, and YouTube for professional reasons. Educators may leverage YouTube and wikis to support the education of pharmacy students. Pharmacy students appear to be more aware and active with security settings than previously reported.

The clinical educator's guide to fostering learner motivation: AMEE Guide No. 137.

Motivation theory and research remain underused by health professions educators. Some educators say it can seem too abstract. To address this, we applied health care language to learner motivation theories. Using a familiar metaphor, we examined the indications, mechanism of action, administration, and monitoring of learner motivation interventions. Similar to the treatment monographs in medicine compendia, we summarized each motivation intervention in the form of a monograph. The purpose of this guide is for health professions educators to develop an understanding of when (i.e. indication) and how (i.e. mechanism of action) learner motivation interventions work. With this information, they can then access ready-to-implement strategies (i.e. administration) to increase their learner interest and assess the effects of these interventions (i.e. monitoring).