If like produces like, do we like where we are going?

PURPOSE: This wisdom of experience commentary, written by three pharmacy educators of various backgrounds - PharmD, PhD, and EdD - will discuss potential contributors to the lack of professional advocacy exhibited by pharmacists. Authors will describe the issue using a "What? So What? Now What?" reflective model. DESCRIPTION: Students enrolled in 14 cohorts at two US colleges of pharmacy possess similar CliftonStrengths® top 5 themes with four themes most commonly reappearing in the top 5: Achiever, Learner, Harmony, and Restorative. These themes are housed in three of the four CliftonStrengths® domains: Executing, Relationship Building, and Strategic Thinking. Themes in the fourth domain, Influencing, were not represented in the top 5. Students from these same cohorts reported a self-identified weakness in their ability to Challenge the Process and Inspire a Shared Vision, two of five leadership practices described by Kouzes and Posner. ANALYSIS/INTERPRETATION: The authors explore the possibility that the lack of evolution within the pharmacy profession is a result of the inherent tendencies of the typical student pharmacist and faculty member, coupled with the lack of curricular accreditation expectations focused on teaching and assessing professional advocacy. CONCLUSIONS: As educators at institutions poised to adopt new educational outcomes in our respective colleges and schools of pharmacy, institutions must take a holistic view of the profession and ensure the curricula prepare graduates to handle the many challenges awaiting them post-graduation. This may require pharmacy educators to make changes in their pedagogical approaches, addressing content that they are not inherently inclined to teach or practice. IMPLICATIONS: For pharmacy to continue to exist as a profession committed to patient advocacy, educational institutions must find meaningful ways to incorporate professional advocacy into the curriculum. Addressing professional advocacy is no longer an "and/or" option. Our profession is in crisis; we must ensure we are pointing graduates toward a sustainable professional future.

Teaching conflict management: An approach to increasing students' value, confidence, and ability.

INTRODUCTION: The primary aim was to explore how to effectively teach conflict management. We focused on three aspects of conflict management: (1) the value students place on conflict management, (2) their confidence in their ability to manage conflict, and (3) their skill in navigating conflict scenarios. METHODS: This approach to teaching conflict management included a consistent educational approach applied by three different instructors at two universities. The class session, provided to second-year student pharmacists, was designed to address ACPE Standards focused on students' conflict management skills. A Likert-style survey, administered pre- and post-classroom intervention, assessed three aspects of conflict management: value, confidence, and ability. The survey also included open-ended questions to explore students' perceptions of conflict management. RESULTS: Analysis of pre- and post-intervention surveys found that 76 out of 83 students completed both surveys (91.5% response rate). Cronbach's alphas of the value, confidence, and ability scales were 0.82, 0.86, and 0.78, respectively, at pretest and 0.93, 0.86, and 0.90, respectively, at posttest. CONCLUSIONS: Changes in student beliefs regarding the value of conflict management, as well as their confidence in and ability to engage in a crucial conversation, were statistically significant after one classroom session.

Determining Indicators of High-Quality Application Activities for Team-Based Learning.

Objective. To determine the indicators of quality for application activities in pharmacy team-based learning (TBL). Methods. A modified Delphi process was conducted with pharmacy TBL experts. Twenty-three experts met the inclusion criteria, including having at least four years of TBL experience, designing at least eight TBL sessions, training others to use TBL, and authoring a peer-reviewed TBL pharmacy paper. In round 1, panelists responded to five open-ended questions about their successful TBL applications activities, including satisfaction with the activity and methods for creating positive student outcomes. In round 2, panelists indicated their level of agreement with the round 1 quality indicators using a four-point Likert rating. Consensus was set at 80% strongly agree/agree. In an open comment period, panelists provided suggestions to help expand the indicator descriptions. Indicators were verified based on TBL and the education literature. Results. Twenty panelists (87% of those eligible) responded in round 1 and 17 (85% participation) in round 2. Sixteen quality indicators were identified in round 1, with 14 achieving consensus in round 2. "Uses authentic pharmacy challenges or situations" (88% strongly agree/agree) and "incorporates or provides effective feedback to groups" (88% strongly agree/agree) met consensus. However, "has multiple right answers" (76% strongly agree/agree) and "incorporates elements from school specific emphases (eg, faith, underserved)" (53% strongly agree/agree) did not reach consensus. Conclusions. These indicators can assist faculty members in designing application activities to provide high-quality TBL exercises that promote deep thinking and engaged classroom discussion. The indicators could also guide faculty development and quality improvement efforts, such as peer review of application activities.

Improving advanced pharmacy practice experiences with an intention/reflection practice.

BACKGROUND AND PURPOSE: Experiential learning in pharmacy has the potential to offer transformative experiences for students. Advanced pharmacy practice experiences (APPEs) can be improved if students are encouraged and able to (1) identify and track individual learning gains and interests, and (2) develop self-awareness and intrinsic motivation. EDUCATIONAL ACTIVITY AND SETTING: The intention/reflection (I/R) practice was developed to address these educational concepts and help facilitate meaningful experiences during APPEs. The I/R tool is a simple, nontechnical, resource-light activity consisting of a set of three to five questions at the beginning, midpoint, and end of an APPE. The questions were designed to help students identify how they can attain meaningful gains from each APPE. Preceptors across three universities designed, implemented, and evaluated the impact of an I/R practice within the context of a variety of APPEs. The APPEs varied between 4, 5, 6, and 10 weeks and were focused on patient care and academia. FINDINGS: Three of the I/R questions were selected for thematic analysis, one at each point of the rotation. These questions were strategically selected because they demonstrate the value resulting from the progressive nature of the I/R tool. The answers to the three questions were descriptively coded to capture the main thought(s) of each student's response. A quarter of students indicated I/R helped them achieve their goals. SUMMARY: A retrospective pre-post survey demonstrated statistically significant improvements in all survey items, including (1) ability to identify learning outcomes, (2) focus and motivation, and (3) self-awareness and metacognition.

Supporting formative peer review of clinical teaching through a focus on process.

BACKGROUND: The professional need for development of clinical faculty is clear. Previous scholarship provides insight into the formative potential of peer review in both didactic and experiential settings. Less information exists on a comprehensive peer review process (PRP) designed to support faculty change. EDUCATIONAL ACTIVITY AND SETTING: A clinical faculty PRP was developed and implemented based on input from the literature, stakeholders, and field experts. The process included: 1) self-reflective pre-work, 2) a peer-observation component, 3) self-reflective post-work, and 4) creation of a specific action plan via meeting with an educational expert. The process was assessed by collecting evaluative data from peer reviewer and clinical faculty participants. FINDINGS: Eight of 26 faculty members participated in a pilot of the PRP and formed four clinical faculty-peer dyads. When surveyed, all participants unanimously reported that they would participate in the PRP again. Aspects perceived among most helpful to clinical teaching included peer observation, self-reflection, and meeting with an educational expert. Challenges related to the process included anxiety of peer observation, burden of pre-work, and logistics of scheduling meetings. DISCUSSION: While instruments are important in guiding and documenting the evaluation of clinical teaching during an observation period, this initiative focused on the process supporting the observation and evaluation, in order to optimize the formative feedback received by participating faculty and encourage professional development actions. SUMMARY: A PRP that incorporates preparation, reflective practice, and a meeting with an educational expert may support meaningful faculty development in the area of clinical teaching.