The Struggle is Real: Facilitating Pharmacy Student Success on Rotations When Challenges Arise.

Pharmacy preceptors are pivotal to facilitating and maximizing student learning on experiential rotations. However, preceptors may encounter a variety of behaviors or barriers that can hinder student success. Although some guidance exists for preceptors, emerging learner challenges along with new educational outcomes call for an updated practical approach to promoting student success on rotations. This paper provides preceptors with a structured approach to facilitate success for students who exhibit challenges on rotations. Four categories that preceptors can use to identify behaviors and barriers to learning are outlined - knowledge, skills, professional attitudes and behaviors, and external factors including the Social Determinants of Learning™. We describe strategies to help preceptors identify and categorize these challenges and provide a stepwise approach to facilitate student success.

Helping fourth year student pharmacists develop their professional brand.

BACKGROUND AND PURPOSE: Building a professional brand is an important skill for student pharmacists, as this could provide them with a competitive edge given the current market environment and employment opportunities. One way to do this is through developing a personal digital brand. A pilot program was created to introduce fourth year pharmacy students to the basics of personal branding and positive uses of social media for professional development and networking. EDUCATIONAL ACTIVITY AND SETTING: A two-part workshop series was developed to introduce student pharmacists to the concept of personal digital branding and to help them optimize their professional documents (i.e. curricula vitae, resumes, and letters of intent). The workshops were offered in a virtual format and involved subject matter experts as well as alumni stakeholders. Students were asked to participate in pre- and post-surveys relating to their perceptions of professional branding and the usefulness of the workshop series. FINDINGS: Prior to the workshops, students expressed a moderate interest in using social media for professional purposes, yet few felt confident in how to do so. Following the workshops, students indicated the information provided had been beneficial, and they all had action plans for developing their social media profiles and revising their professional documents. SUMMARY: Initial findings suggested students are interested in and would benefit from training on professional branding. While this first attempt at such programming had limitations, such as being delivered to a small sample, the results provide insights for expanding and improving these offerings in the future.

"Put me in Coach!" Engaging Faculty to Form a Winning Assessment Team.

This commentary uses the metaphor of an athletic team model to provide guidance when managing a successful assessment committee and assessment processes. To become a winning team, a joint effort must be exerted by players, coaches, and the athletic director. The topics of developing a team of productive members, creating, and implementing an assessment plan, forming a positive culture, and establishing leadership are discussed. Examples and advice are provided to assist with promoting an engaged faculty to form a well-rounded and productive assessment committee with clearly defined roles and responsibilities.

Making progress: A national study on the development and use of progression assessments in United States pharmacy curricula.

BACKGROUND: The objective was to determine the utilization, frequency, characteristics, and standard-setting methods of progression assessments in pharmacy education. METHODS: A survey was sent to 139 United States schools/colleges of pharmacy having an identifiable assessment lead and students enrolled in the doctor of pharmacy program. The survey examined programs' use, frequency, and characteristics of progression assessments within their curriculum. Respondents also reported any changes made due to the COVID-19 pandemic and which, if any, would be maintained in future years. Analysis consisted of descriptive statistics and thematic coding. This research was deemed exempt by the university's institutional review board. RESULTS: Seventy-eight programs responded to the survey (response rate = 56%). Sixty-seven percent of programs administered at least one progression assessment in 2019-2020. There was some variability in assessment practice, including professional year(s) administered, course(s) involved, and content. Approximately 75% of programs used assessments to ensure student competency in the programs' learning outcomes and to identify individual student learning deficiencies. Diversity was seen in validity and reliability practices, and most programs used pre-determined cut scores without formal standard setting. Because of the pandemic, 75% of programs changed the assessment delivery mode and 20 programs planned to maintain at least one pandemic-related change in future iterations. CONCLUSIONS: Most pharmacy programs utilize some type of progression assessment within their curriculum. While many schools administer progression assessments, there is little agreement on their purpose, development, and use. The pandemic changed the mode of delivery, which numerous programs will continue with in the future.

Comparison of student pharmacists' performance on in-person vs. virtual OSCEs in a pre-APPE capstone course.

INTRODUCTION: Objective structured clinical examinations (OSCEs,) provided in-person or virtually, assess student pharmacist readiness for advanced pharmacy practice experiences (APPEs). During the COVID-19 pandemic in 2020, it was necessary for many educators to design and implement virtual OSCEs (vOSCEs). Impact on student performance utilizing in-person vs. vOSCE has not been well evaluated. The objective of this study was to determine if a difference existed in student performance when comparing in-person vs. vOSCE in a third year (P3) pharmacy pre-APPE capstone course. METHODS: In winter 2019, four in-person OSCE stations were designed and implemented in a pre-APPE P3 capstone course. In winter 2021, the same four stations were transitioned into vOSCE stations. Assessment (summative) data from similar student cohorts from OSCE 2019 were compared vOSCE 2021 stations using Mann-Whitney U test. RESULTS: There was no meaningful difference found when comparing student performance on in-person OSCE vs. vOSCE. There was no significant difference for the number of students offered remediation. For most stations, performance improved from formative to summative assessments. CONCLUSIONS: Providing vOSCEs to assess students' skills in a pre-APPE P3 capstone course is a reasonable alternative to in-person OSCEs.

Rethinking the Pharmacy Workforce Crisis by Exploring Unconventional and Emerging Career Pathways and Training.

Given the limited availability of conventional pharmacy positions, pharmacy programs face a challenge in ensuring that all graduates obtain jobs that fulfill their goals and ambitions. Thus, it is imperative to explore and discuss unconventional but promising positions, specifically regarding their availability and needs. In exploring these positions, it is important to recognize technical and nontechnical skill sets that pharmacy graduates possess at graduation, identify unique pathways to help students explore job alternatives, and educate faculty and students about employment opportunities beyond the traditional setting if desired or necessary. Students must become aware of the opportunities that exist in both conventional (pharmacist clinician) and unconventional (pharmacist innovator) pharmacy careers and be able to articulate the translational skills from their training. Pharmacy programs and faculty can better support students by fostering the development and marketing of their skills.

Engaging faculty advisors to promote students' personal and professional development.

BACKGROUND AND PURPOSE: With the increasing emphasis on personal and professional development in pharmacy curricula, programs often need to enhance or modify existing resources to meet standards. A major initiative of developing a consistent and standardized student advising process involving both clinical and non-clinical faculty as advisors to promote development of pharmacy students was an avenue taken at our institution. EDUCATIONAL ACTIVITY AND SETTING: Faculty were identified as ideal individuals to assist in mentoring and assessing students' personal and professional development given the long-term relationships they develop with students throughout both the didactic and experiential curriculum. Development and implementation of a longitudinal faculty advising program incorporating elements of student self-assessment, reflection, and faculty-based objective assessment is described. FINDINGS: We found both students and faculty benefited from this advising program in different ways, with students feeling more supported and faculty feeling more engaged and informed about the pharmacy curricula and student career-pathways. SUMMARY: A faculty advising program, as described in this article, can be utilized for both student success and faculty development in the pharmacy education setting.

Evaluation of an Instrument to Assess Students' Personal and Professional Development During the Faculty Advising Process.

Objective. To evaluate a tool designed to assess Doctor of Pharmacy (PharmD) students' personal and professional development prior to beginning advanced pharmacy practice experiences (APPEs).Methods. A five-item instrument, entitled the Faculty Advisor's Assessment of the Advisee (FAAA) tool, was developed to assess and monitor pharmacy students' progress over the three-year didactic curriculum. Question anchors were created to describe characteristics exhibited by the student that matched categories of not engaged, beginning, emerging, or engaged. Possible FAAA composite scores ranged from 7 to 20. Using the FAAA tool, faculty advisors assessed their advisees' values, engagement, self-awareness, professionalism, and leadership in 2017, 2018, and 2019. Individual and aggregate cohort reports were run and data for each of the three years were matched with students. To determine if the FAAA showed progression in assessed dimensions in the students during the first, second, and third professional (P1, P2, and P3) years, a Friedman test was performed. Cronbach alpha was used to assess the reliability of the instrument.Results. The data of 93 students were matched for the P1 through the P3 years. Median (IQR) for the FAAA composite score levels for the P1, P2, and P3 were 13 (12-16), 17 (15-19) and 18 (16-20), respectively. Significant differences existed at all timepoints compared, including from the P1 to P2, P2 to P3, and P1 to P3 years. The reliability of the FAAA scale was strong across all three years (winter 2017, α=0.87; winter 2018, α=0.89; and winter 2019, α=0.87). All items appeared worthy of retention as removal did not significantly increase their reliability.Conclusion. A five-item tool which assesses pharmacy students' personal and professional development during the first three years of a PharmD program could be used by faculty advisors to assess student's progress across the didactic curriculum.

Evaluating interprofessional socialization: Matched student self-assessments surrounding underserved clinic participation.

INTRODUCTION: To determine if an existing tool, the Interprofessional Socialization and Valuing Scale (ISVS), can be used to measure student perceptions of interprofessional (IP) socialization and teamwork in a cohort of pharmacy, medicine, physical therapy, and social work students volunteering in a student-run free clinic (SRFC). METHODS: The ISVS was distributed to these health professions students before and after participation at the SRFC. After a one-month pilot, the plan was to collect data for 12 months. A power analysis determined a minimum sample size was 15 students (power = 0.8). Student surveys were matched utilizing unique alphanumeric identifiers. Results of IP socialization were analyzed by total group and health profession. RESULTS: A mean value for each ISVS domain was compared before and after the IP SRFC experience over 11 months; the pilot was not included in the final data set. Significant improvement in interprofessional socialization was observed across all ISVS factors including Self-Perceived Ability to Work with Others (p < 0.001), Value in Working with Others (p = 0.002), and Comfort in Working with Others (p < 0.001). Pharmacy and social work disciplines met the threshold for statistical significance for at least one factor. CONCLUSIONS: Utilizing the ISVS in an IP SRFC setting can detect changes in professional development that is influenced by beliefs, behaviors, and attitudes as self-assessed in our student population. Engaging students in such a clinic demonstrates educational value and potentially leads to significant improvement in their interprofessional socialization and teamwork skills.

Student perceptions of the utility of the Pharmacy Curriculum Outcomes Assessment.

INTRODUCTION: This study assessed student perceptions, preparation, and result use strategies of the Pharmacy Curriculum Outcomes Assessment (PCOA). Secondarily, it studied the effect of schools/colleges of pharmacy (S/COP) PCOA management on student perceptions. METHODS: A 52-item electronic questionnaire assessed PCOA preparation of final year students, review/use of results, remediation participation, self-reported motivation, and perceptions of the exam's ability to measure PCOA blueprint areas and North American Pharmacy Licensure Examination (NAPLEX)/advanced pharmacy practice experience (APPE) readiness. Programs were given a questionnaire to determine their PCOA practices. RESULTS: The student survey was completed by 341 students (40% response rate). Students prepared very little for the PCOA and few reported participation in PCOA-based remediation (6%). Students perceived the PCOA to measure the four domains moderately well, although administrative sciences were significantly lower. Students reported less confidence in the exam's ability to measure APPE/NAPLEX-readiness. Although few used the PCOA to guide their NAPLEX preparation (18%), they were more likely to do so than for APPEs (4%). Students reported a higher perceived increase in motivation if PCOA results were connected to APPE placement, remediation, and progression as opposed to prizes, rewards, or other recognitions. CONCLUSION: This is the first multi-institutional study to review student perceptions about the PCOA. These data can be used along with other PCOA data to help schools develop incentive, remediation, and examination administration procedures depending on the programs desired use for the PCOA exam.

Characterization of Use of the Pharmacy Curriculum Outcomes Assessment Across Accredited Colleges of Pharmacy.

Objective. To characterize use of the Pharmacy Curriculum Outcomes Assessment (PCOA) in terms of timing, manner of delivery, and application of the results by accredited colleges of pharmacy. Methods. Accredited pharmacy programs were surveyed regarding PCOA administration, perceived benefits, and practical application of score reports. Survey items were comprised of new items developed from a literature review and items from prior studies. The survey addressed five domains: program demographics, administration, student preparation, use of results, and recommendations to improve the utility of the PCOA. Results. Responses were received from 126 of 139 (91%) surveyed programs. The majority of respondent programs administered PCOA in one session on a single campus. Most indicated PCOA results had limited use for individual student assessment. Almost half reported that results were or could be useful in curriculum review and benchmarking. Considerable variability existed in the preparation and incentives for PCOA performance. Differences in some results were found based on prior PCOA experience and between new vs older programs. Open-ended responses provided suggestions to enhance the application and utility of PCOA. Conclusion. The intended uses of PCOA results, such as for student assessment, curricular review, and programmatic benchmarking, are not being implemented across the academy. Streamlining examination logistics, providing additional examination-related data, and clarifying the purpose of the examination to faculty members and students may increase the utility of PCOA results.

National Trends in the Adoption of Pharmacy Curriculum Outcomes Assessment for Student Assessment and Remediation.

Objective. To determine and describe the current uses of the Pharmacy Curriculum Outcomes Assessment (PCOA) by US schools and colleges of pharmacy. Methods. Assessment professionals from 135 US schools and colleges of pharmacy were invited to complete a 38-item electronic survey. Survey items were designed to investigate common uses of the PCOA, cut points, and "stakes" assigned to the PCOA, identification of at-risk students, and remediation approaches. Results. The school response rate was 68%. The most common uses of the PCOA included curricular assessment (76%), individual student performance assessment (74%), and cohort performance assessment (71%). The PCOA was most frequently administered to third-year pharmacy (P3) students. The approach for assigning "stakes" to PCOA performance varied among programs depending on the student's professional year in the curriculum. Programs used a variety of approaches to establish the benchmark (or cut point) for PCOA performance. Remediation for at risk students was required by less than 25% of programs. Remediation was most commonly required for P3 students (22%). Conclusion. Survey results indicate wide variability between programs regarding PCOA cut points (benchmarks), stakes, and remediation approaches. In the future, it will be important for pharmacy educators to identify and study best practices for use of PCOA within student assessment and remediation plans.

A Study of the Relationship Between the PCOA and NAPLEX Using a Multi-institutional Sample.

Objective. To examine the relationship between the Pharmacy Curriculum Outcomes Assessment (PCOA) and the North American Pharmacist Licensure Examination (NAPLEX) using a large, multi-institutional sample of student scores. Methods. A matched dataset was obtained from the National Association of Boards of Pharmacy (NABP) consisting of examination scores for the 1,460 students who completed both the PCOA and the NAPLEX between 2012 and 2015 at six schools/colleges of pharmacy (S/COPs). Bivariate correlations were estimated for total and content area scores on both examinations. Students' total NAPLEX scores were predicted using linear regression models containing total and content area scores on PCOA and dummy variables for S/COP and year. Results. Students' PCOA total score and NAPLEX total score were significantly and moderately correlated (r=0.54). All correlations between PCOA and NAPLEX total and content area scores were significant. and ranged from r=0.22 to 0.56. Regression results showed pharmaceutical and clinical sciences PCOA content scores were significant predictors of NAPLEX total score while basic biomedical sciences and social/behavioral/administrative sciences were not. The PCOA total and content scores accounted for 30%-33% of the variance in total NAPLEX score. Conclusion. Student PCOA and NAPLEX total and content area scores were significantly correlated, which is consistent with the findings of previous research. The somewhat modest proportion of variance in NAPLEX scores accounted for by PCOA scores illustrates the need for use of additional performance measures when evaluating student preparedness for the NAPLEX. This study provides important baseline data that can be used by S/COPs for comparison with their own student data as well as by researchers seeking to conduct additional analyses following recent changes in the PCOA and NAPLEX blueprints.

Clinical Outcomes of Student Pharmacist-Driven Medication Histories at an Academic Medical Center.

BACKGROUND: Many studies have shown the positive impact that student pharmacists have on patients' health; however, no studies have been published evaluating student pharmacists' impact on direct patient outcomes (ie, readmission, emergency department [ED] visits, length of stay) related to the medication history process. OBJECTIVE: To evaluate the impact of student pharmacist-obtained medication histories on identification of medication discrepancies and clinical outcomes. METHODS: Student pharmacists obtained medication histories and then compared the history to that obtained by other health-care providers. Students documented discrepancies and interventions were completed. Control patients were identified and discharge medication list and 30-day readmissions were compared. RESULTS: Seventeen students conducted 215 patient interviews, and 1848 modifications were made to documented home medications in the electronic medical record. Compared to controls (n = 148 student pharmacist, 149 controls), a nonsignificant improvement was found in discharge medication list completeness scores in patients seen by student pharmacists (3.94 vs 3.63; P = .06); but no difference was found in accuracy scores (0.92 vs 0.93; P = .41). Fewer ED visits at 30 days were found in the student pharmacist group (8 vs 18; P = .045), with no difference in readmissions. CONCLUSIONS: Student pharmacist-obtained medication histories improved the information available for identifying drug-related problems for inpatients, completeness of the discharge medication list, and ED visits within 30 days.

Implementing and sustaining a mentorship program at a college of pharmacy: The Keys to Successful Mentorship.

OBJECTIVE: To evaluate mentor and mentee opinions of The Keys to Successful Mentorship, a longitudinal student-led mentorship program established at a college of pharmacy. EDUCATIONAL ACTIVITY AND SETTING: In 2008, a mentorship program was created whereby first year pharmacy students (mentees) were paired with third year pharmacy students (mentors). An anonymous survey was administered to second (P2) and fourth (P4) year pharmacy students identifying strengths and weaknesses of the program. FINDINGS: Results of the survey administered to the P2 and P4 pharmacy students revealed that there was a strong desire to take part in the mentorship program. Of the respondents, 77% of P2 and 70% of P4 students stated the mentorship program aided in their professional growth. Mentors disagreed significantly more than mentees that participation in the program should be optional. Qualitative findings suggested that the program assisted students in building professional relationships and networks, better prepared them for experiential training, and helped with post-graduate decisions. CONCLUSION: The implementation of a longitudinal student-led mentorship program was supported by student pharmacists and may aid in their professional development.

Alcohol withdrawal syndrome in medical patients.

The authors provide a critical review focusing on pharmacotherapy of alcohol withdrawal syndrome in hospitalized patients who are not critically ill. They outline recommendations for patient assessment and monitoring.

Implementation and Use of the Pharmacy Curriculum Outcomes Assessment at US Schools of Pharmacy.

OBJECTIVE: To describe how schools and colleges of pharmacy use the Pharmacy Curriculum Outcomes Assessment (PCOA) in relation to student assessment and curricular feedback. METHODS: A survey was distributed to all programs that have implemented the PCOA. The survey was designed to assess 3 domains regarding the use of the PCOA: rationale for use, logistics of administration, and performance data review and distribution. RESULTS: A 79% response rate (41/52) was obtained. The mix of responses was 93% current PCOA users and 7% past users. The most common reasons for PCOA use were for programmatic assessment and benchmarking. The examination was most frequently administered during the P3 year, with minimal stakes attached to performance. Significant differences in responses based on public vs private institution were seen with respect to length of accreditation of current PCOA users, messaging to students regarding performance, inclusion of results in student advising, and distribution of results to stakeholders. CONCLUSION: Programs were using the PCOA primarily as an assessment in the P3 year for reasons related to programmatic and curricular assessment. Some differences existed between public and private institutional PCOA use and examination-related processes and results distribution.

The prevalence and characteristics of dual PharmD/MPH programs offered at US colleges and schools of pharmacy.

OBJECTIVE: To assess the prevalence and characteristics of curriculum in dual doctor of pharmacy (PharmD)/master of public health (MPH) degree programs offered by US pharmacy programs. METHODS: An 18-item survey instrument was developed and distributed online to faculty members at US colleges and schools of pharmacy. RESULTS: Of the 110 colleges and schools that responded, 23 (21%) offered a PharmD/MPH degree. Common characteristics of these 23 programs included current PharmD program structure (3 + 1 year), early curricular recruitment, small enrollment, and interdisciplinary coursework occurring online and in the classroom. The impact of the dual degree on the curriculum and longevity of the dual-degree programs varied. About 55% of responding programs without a formal dual-degree program reported that additional public health training was available. CONCLUSION: Twenty-one percent of colleges and schools of pharmacy offer a combined PharmD/MPH dual degree. Most programs required an additional 1 or 2 semesters to complete both degrees.

Is there a role for fondaparinux in perioperative bridging?

PURPOSE: A possible role for fondaparinux as a bridging agent in the perioperative setting is explored. SUMMARY: Anticoagulation guidelines provide minimal direction on the perioperative use of fondaparinux. Fondaparinux's extended half-life of 17-21 hours complicates its use as a perioperative bridging therapy. The ideal time for discontinuation before surgery is an issue, particularly in surgeries with a high bleeding risk or in which neuraxial anesthesia is used. Guidance for perioperative bridging with fondaparinux must be derived from pharmacokinetic data, surgical prophylaxis trials, case reports, and anesthesia guidelines. Published trials used fondaparinux sodium 2.5 mg daily for venous thromboembolism prophylaxis in surgical patients, and the majority avoided its use before surgery in patients receiving neuraxial anesthesia. Three case reports cited the use of fondaparinux sodium as perioperative bridge therapy; one used a 2.5-mg dose, and the other two used a full treatment dose of 7.5 mg. Furthermore, professional anesthesia guidelines conflict in their recommendations regarding the timing of drug administration with neuraxial catheter use. For these reasons, it may be optimal to avoid fondaparinux use before surgery. In some instances, the use of low-molecular-weight heparin or inpatient use of i.v. unfractionated heparin is not possible, is contraindicated, or has limited efficacy, such as a patient with history of heparin-induced thrombocytopenia or antithrombin III deficiency. Fondaparinux may have a role in bridge therapy for these patients. CONCLUSION: The role of fondaparinux in perioperative bridge therapy has not been established, and there are some important limitations to its use as a routine bridging agent.