An active-learning laboratory focused on critical care topics.

BACKGROUND AND PURPOSE: To describe an active-learning laboratory on critical care topics including advanced cardiac life support (ACLS), rapid sequence intubation (RSI), and toxicology and its effect on students' knowledge, skills, and confidence. EDUCATIONAL ACTIVITY AND SETTING: Third year pharmacy students (n = 88) participated in a critical care focused laboratory with four stations focused on ACLS review, ABBOJECTⓇ syringe assembly, ACLS simulations, RSI cases, and toxicology. Prior to the critical care focused skills laboratory, students completed an optional assessment composed of six confidence and eight knowledge questions. After the laboratory, students completed the same confidence and knowledge assessment. Descriptive statistics assessed pre/post-assessment responses. Paired pre/post-assessment Likert data were analyzed using the Wilcoxon signed-rank test and paired pre/post-test multiple choice responses were analyzed using the McNemar test. FINDINGS: Of the 88 students in the cohort, 76 students completed both the pre/post-assessments (response rate: 86.4%). Students demonstrated a significant increase in their overall knowledge and confidence scores on the post-assessment. All students successfully assembled an ABBOJECTⓇ syringe. The majority of respondents rated the critical care laboratory as excellent or good with regards to how enjoyable and effective the activity was to help understand critical care topics. SUMMARY: A hands-on, active-learning laboratory devoted to teaching and reinforcing common critical care concepts allowed students to gain knowledge and confidence regarding ACLS, RSI, and toxicology.

Work-Family Conflict and Wellbeing in US Pharmacy Faculty with Children.

OBJECTIVE: Objectives of this study included characterization of the current landscape of work-family conflict (WFC), family-work conflict (FWC), wellbeing, and childcare-related factors in United States (US) pharmacy faculty members with children, as well as relationship determination between faculty characteristics and WFC, FWC, and wellbeing indices. METHODS: A survey was developed and administered to US pharmacy faculty members with children in February 2022. Questions included demographic and childcare-related factors and the validated Netemeyer WFC and FWC scales, and World Health Organization (WHO-5) Wellbeing Index. Data were summarized using descriptive statistics, one-way analysis of variance and t tests, and multiple linear regression analysis. RESULTS: The survey was completed by 368 faculty members with children. Respondents were primarily married females who identify as White or European American, with>90% having children less than 18 years of age. Respondents scored an average of 24.1 ± 7.2 points on the WFC scale, 19.5 ± 7.5 points on the FWC scale, and 56.8 ± 17.5 on the WHO-5 Wellbeing Index. Having dependent children resulted in statistically significantly higher WFC and FWC and lower wellbeing scores. Linear regression models for WFC, FWC, and wellbeing explained 20%, 8%, and 9% of the variability in scores, respectively. CONCLUSION: This study identified the presence of WFC, FWC, and decreased wellbeing in pharmacy faculty members with children. Future research is needed to further qualify contributors to the indices and place findings into a larger context.

Retention of students' knowledge of immunizations following a one-day or a five-week course.

INTRODUCTION: The American Pharmacists Association (APhA) Pharmacy-Based Immunization Delivery Certificate Program is commonly used by schools of pharmacy to train student pharmacists in immunizations. This study compared student pharmacists' knowledge retention of immunization content when the live seminar of the APhA Program was delivered as a one-day co-curricular activity or as a five-week required course. The impact of immunization experience on students' knowledge retention was a secondary objective. METHODS: A 45-question knowledge assessment about immunizations was administered to second and third-year student pharmacists eight months after completing either a five-week course (second-year students) or a one-day seminar (third-year students). Students were also asked about their experience providing patient education, screening, and administering immunizations. RESULTS: Knowledge assessment scores declined by an average of 26.3% from the initial to the eight-month assessment, and declines were similar for second and third-year students. However, students who reported immunizing over 50 patients had significantly higher knowledge retention than those who reported never immunizing. CONCLUSIONS: A live immunization training given over one day or five weeks did not impact the retention of immunization knowledge eight months later. However, students who immunized >50 patients had greater knowledge retention. These findings indicate the importance of including the application of immunization knowledge in pharmacy curricula to enhance long-term knowledge retention.

Introducing LGBTQIA+ Patient Care to Pharmacy Students Through Laboratory-Based Exercises.

Objective. To assess the impact of novel skills-based laboratory exercises on first-, second-, and third-year pharmacy students' confidence and knowledge regarding care for people identifying as lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other (LGBTQIA+).Methods. An LGBTQIA+ lecture discussing pronouns, common terminology, health disparities, health screenings, and gender-affirming hormone therapy was presented to students. During laboratory sessions, students applied lecture topics via a learning level-specific activity. Students completed a pre- and post-activity survey assessing their knowledge, confidence, and activity experience.Results. Seventy-nine students (N=348) completed both the pre- and post-activity survey. Students' overall increase in knowledge scores was significant, with improvement in four out of six questions among each cohort. A significant increase was seen in students understanding of the role of the pharmacist, their confidence in caring for LGBTQIA+ patients, and their comfort with using appropriate terminology. Most students (92%) agreed or strongly agreed that learning about LGBTQIA+ patient care was a positive experience, while 74% agreed that additional education on LGBTQIA+ patients is needed within their pharmacy curriculum.Conclusion. After a brief skills-based laboratory course, students' knowledge and confidence in caring for LGBTQIA+ patients improved; however, students agreed that more exposure was necessary. Future studies will follow students as they progress through the curriculum to determine the impact of exposure to LGBTQIA+ content across all three didactic years.

A Case Report of Cangrelor Bridge Therapy for a Diagnostic Bronchoscopy With Biopsy.

Although premature discontinuation of dual antiplatelet therapy (DAPT) is associated with an increased risk of ischemic complications, patients may present with an urgent need for surgery that would require interruption of DAPT. Antiplatelet bridge therapy using cangrelor, an intravenous P2Y12 inhibitor, has been studied as a potential option to ensure continuation of DAPT perioperatively. However, limited evidence exists supporting the off-label use of cangrelor bridge therapy to noncardiac procedures. We describe the case of a 67-year-old class 3 obese female on DAPT (aspirin and ticagrelor) for recent drug-eluting stent placement who required a bronchoscopy with biopsy for suspected lung cancer. Cangrelor bridge therapy was utilized both preoperatively and postoperatively without ischemic or bleeding complications, and the patient was subsequently able to begin radiation therapy after a confirmed diagnosis of lung cancer.

Contemporary Anticoagulation Reversal Focus on Direct Thrombin Inhibitors and Factor Xa Inhibitors.

Several oral direct thrombin inhibitors (DTIs) and factor Xa (FXa) inhibitors have recent Food and Drug Administration approval or are under investigation in late-stage clinical trials for the prevention and treatment of thromboembolic events. Rapid reversal of anticoagulation is typically recommended in patients with severe or life-threatening bleeding and in patients requiring surgery or invasive procedures. However, no antidote exists for DTIs or FXa inhibitors though replacement of coagulation factors using clotting factor concentrates is routinely considered in some clinical scenarios. Clotting factor concentrates available in the United States include prothrombin complex concentrate, activated prothrombin complex concentrate, and recombinant factor VII, activated. Coagulation tests to confirm adequate reversal of anticoagulation should be considered and commonly include activated partial thromboplastin time and thrombin time (TT) for DTIs, and chromogenic FXa assay and TT for FXa inhibitors. Monitoring of coagulation tests should continue for 1 to 2 days after achievement of hemostasis, since the duration of the clotting factor concentrate may be shorter than the oral anticoagulant, especially in patients with organ dysfunction. Utilization of decision-support tools and use of standardized reversal protocols are recommended to prevent errors in prescribing and dispensing for clotting factor concentrates.