Developing Disability Advocates Through Deliberate Interprofessional Conversations Regarding Quality of Life After Stroke.

OBJECTIVE: Stroke can result in significant mental and physical impairment. Training health care professionals on effective strategies for mitigating stroke-related quality-of-life issues is crucial in facilitating comprehensive stroke management. This study aimed to evaluate the impact of an interprofessional education (IPE) experience on students' attitudes regarding poststroke disability. METHODS: In this pre-post interventional study, pharmacy and medical students received an electronic patient chart and a store-and-forward video depicting physical and cognitive impairment in a patient with stroke. Students were instructed to discuss the acute management and postdischarge needs of the patient from an advocacy perspective. After the IPE experience, students completed the Student Perceptions of Interprofessional Clinical Education-Revised, version 2 and an unvalidated disability attitudes survey. The surveys were analyzed using a paired t test. In addition, students reflected on the prompt, "What are some things you had NOT considered prior to this IPE?" RESULTS: A total of 708 students completed the surveys. After IPE, there was a significant improvement in all domains of the Student Perceptions of Interprofessional Clinical Education-Revised, version 2. On the disability survey, there was significant improvement on all statements, including "rate your comfort with…": "discussing the expected disabilities associated with new-onset stroke" and "discussing strategies for improving the quality of life of a patient who has long-term disabilities." On the self-reflections, 31.7% (n = 211) had not considered the need for poststroke care services before this IPE. CONCLUSION: This IPE experience was instrumental in improving student perspectives regarding poststroke disability.

Impact of Just-in-Time TeamSTEPPS Training on Team Performance in a Pediatric Escape Room Interprofessional Experience.

OBJECTIVE: To compare differences in observed and self-reported team dynamics between those who received versus those who did not receive TeamSTEPPS training prior to an interprofessional escape room scenario. METHODS: Final-year pharmacy (N = 27) and physician assistant (N = 88) students participated in an escape room featuring pediatric dosing, asthma, otitis media, type 1 diabetes, and vaccine fundamentals. In total, 29 teams were randomized to control (14) or intervention arm (15). The control group went to the escape room and then returned to the classroom for a team-building module including TeamSTEPPS training. The intervention group started with the team-building module then went to the escape room. One faculty observer was assigned to each team and utilized the Performance Assessment Communication and Teamwork (PACT) expert-observer form to assess team performance. Post-event, students completed an abbreviated PACT post-assessment and a self-reflection on the prompt "What were the most important takeaways from today's interprofessional education experience?" RESULTS: On the PACT expert-observer form, significantly higher global scores were noted for the intervention arm on all items except situation monitoring. On the aggregate observer data from all stations, leadership emerged as statistically different between the 2 groups. On the PACT post-assessment, the intervention arm reported significantly more leadership during the simulation. On the self-reflections, 70.9% versus 64% in the control arm recognized the importance of teamwork in managing patients. CONCLUSIONS: Just-in-time TeamSTEPPS training improved observed and to a lesser extent, self-reported teamwork and communication skills. Incorporating TeamSTEPPS training immediately prior to an interprofessional education experience may enhance team performance.

Exploring the COVID-19 Landscape and Our Path Forward Using a Formalized SWOT Analysis.

OBJECTIVE: This study aimed to share the results of a formalized SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis focusing on perceptions and the long-term impact of the COVID-19 pandemic. METHODS: The study used a parallel mixed-methods approach. This included a quantitative component, which used presurvey descriptive data, and a qualitative component, which involved SWOT analysis via focus groups. Participants were recruited via email. Volunteers responded to survey questions regarding the COVID-19 pandemic. Ten focus groups were created and conducted in February 2022. Responses were transcribed and coded by 2 independent investigators and a third to resolve disagreement. Group consensus determined the themes. RESULTS: On the survey (n = 55), over half of respondents noted lack of motivation and attention deficit emerging during the pandemic. However, less than half felt that they had access to appropriate support/services. Regarding mental health, some reported increased anxiety, loneliness, depression, and sleep disorders, yet a small percentage of respondents felt that they were provided with support to mitigate these issues. Focus group sessions resulted in 404 statements, which determined the following 8 themes: communication, pivoting the learning and assessment process, COVID-19 safety, interpersonal relationships, health and wellness, finances, student services, and competition in the job market. The top strength was in pivoting the learning process, top weakness was in university communications, and the top opportunities and threats were in pivoting to virtual learning. CONCLUSION: As the country continues to experience COVID-19 waves, it is important to reflect on and understand the effects of the previous reactions, and explore ways to increase and sustain motivation, limit lasting negative effects, and remain proactive and prepared for the future.

Finalizing the Work Related to the Curriculum Outcomes and Example Objectives and Entrustable Professional Activities (COEPA) Document: The Report of the 2022-2023 Academic Affairs Standing Committee.

The 2022-2023 Academic Affairs Committee (AAC) was charged to (1) complete the Center for the Advancement of Pharmacy Education Outcomes and Entrustable Professional Activities (EPAs) revisions (now renamed as COEPA - Curriculum Outcomes and Entrustable Professional Activities) after receiving feedback at the 2022 American Association of Colleges of Pharmacy (AACP) Annual Meeting; (2) offer guidance on how the revised COEPA education outcomes and EPA statements should be used by member institutions, faculty, preceptor, and students; (3) guide input into the ongoing revision of the Accreditation Council for Pharmacy Education (ACPE) standards for the Doctor of Pharmacy program. The published report of the 2021-2022 AAC outlines the work of the Committee through the spring of 2022.1 This 2022-2023 AAC report focuses on the work related to finalizing the COEPA educational outcomes, EPAs, preamble, and glossary and formally receiving approval from the AACP Board of Directors.2 This report also describes the creation of a COEPA guidance document, including educational outcomes example learning objectives, and EPA example tasks for the Academy, however, the actual guidance document will be published separately. Finally, this current report outlines the feedback the AAC sought, received, synthesized, summarized, and prioritized from key interested and affected parties about the ACPE 2016 standards revisions for the ACPE 2025 draft standards.3 The Committee offers revisions for 1 AACP policy statement pertaining to diversity, equity, inclusion, accessibility, justice, and anti-racism. One new policy statement is also offered that urges ACPE to create accreditation standards for pharmacy education that support diversity, equity, inclusion, accessibility, justice, and anti-racism, despite presence of laws, executive orders, and policies that oppose these concepts.

Using Emotional Intelligence as a Framework for Students' Professional Identity Formation.

Emotional intelligence and professional identity formation (PIF) intersect at various levels. Professional identity formation requires acute observation of others in the profession and the ability to decipher intentionality in behaviors. The developing pharmacist must make a deliberate effort to emulate positive norms and values that coincide with those associated with the profession while deliberately ignoring those that are incongruent. To learn from others in the profession, social skills are required, so one can ask questions, determine the best course of action, set goals, grow, and maintain relationships, and ask for help. The ability to manage one's emotions regardless of external circumstances can be valuable for any profession. Self-regulation and self-assessment of one's emotions and motivations can be useful for reevaluating our perspectives and priorities as pharmacists. Emotional intelligence is a critical component of building, demonstrating, and improving PIF. This commentary will provide strategies to facilitate and solidify the connection between the two.

The AACP Academic Affairs Committee's Final 2022 Curricular Outcomes and Entrustable Professional Activities (COEPA) for Pharmacy Graduates to Replace 2013 CAPE and 2016 EPAs.

The American Association of Colleges of Pharmacy (AACP) Academic Affairs Committee was charged with revising both the 2013 Center for the Advancement of Pharmacy Education (CAPE) Educational Outcomes (EOs) and the 2016 Entrustable Professional Activities (EPAs). The Committee changed the document name from the CAPE outcomes to COEPA, (Curricular Outcomes and Entrustable Professional Activities) since the EOs and EPAs would now be housed together. A draft of the COEPA EOs and EPAs was released at the AACP July 2022 Annual meeting. After receiving additional stakeholder feedback during and after the meeting, the Committee made additional revisions. The final COEPA document was submitted to and approved by the AACP Board of Directors in November 2022. This COEPA document contains the final version of the 2022 EOs and EPAs. The revised EOs have been reduced to 3 domains and 12 subdomains (from 4 domains and 15 subdomains previously in CAPE 2013) and the revised EPAs have been reduced from 15 to 13 activities.

The AACP Academic Affairs Committee's Guidance for Use of the Curricular Outcomes and Entrustable Professional Activities (COEPA) for Pharmacy Graduates.

The 2021-2023 American Association of Colleges of Pharmacy Academic Affairs Committee (AAC) was charged with and completed the revision of the 2013 Center for the Advancement of Pharmacy Education Outcomes and the 2016 Entrustable Professional Activity (EPA) statements for new pharmacy graduates. This work resulted in a new combined document, the Curricular Outcomes and Entrustable Professional Activities (COEPA) that was unanimously approved by the American Association of Colleges of Pharmacy Board of Directors and was published in the Journal. The AAC was also charged with providing stakeholders with guidance about how to use the new COEPA document. To achieve this charge, the AAC created example objectives for all 12 Educational Outcomes (EOs) and example tasks for all 13 EPAs. Although programs are asked to retain the EO domains, subdomains, one-word descriptors, and descriptions, unless they are adding more EOs or increasing the taxonomy level of a description, colleges and schools of pharmacy can expand or edit the example objectives and example tasks to meet local needs, as these are not designed to be prescriptive. This guidance document is published separately from the COEPA EOs and EPAs to reinforce the message that the example objectives and tasks are modifiable.

Training pharmacy students to deliver bad news using the SPIKES model.

BACKGROUND AND PURPOSE: Delivery of bad news or negative health information is a complex skill critical to the provision of patient care. While counseling models with this focus exist within other health care professions, their use in pharmacy education is lacking. The purpose of this study is to assess pharmacy students' ability to deliver bad news with the implementation of a counseling model titled SPIKES (Setting, Perception, Invitation, Knowledge, Emotions with Empathy, and Strategy/Summary). EDUCATIONAL ACTIVITY AND SETTING: First-year pharmacy students attended a one-hour training on the SPIKES model and completed three simulations with its application. Pre- and post-training surveys were administered to assess confidence, attitudes, and perceptions. Student performance during the simulations was evaluated by teaching assistants (TAs) as well as a self-assessment using the same grading rubric. A paired t-test was used to test for significant mean improvement in competency scores, confidence, attitudes, and perceptions from Week 1 to Week 3. FINDINGS: One hundred and sixty-seven students were included in the analysis. There was a significant improvement in the student's self-assessment of their performance for each of the SPIKES components and summative scores. For the TA assessment, there was a significant mean improvement in the summative SPIKES score; however, within each component of SPIKES, only the knowledge component showed significant mean improvement. There was also a significant improvement in student confidence in the post-training surveys. SUMMARY: Implementation of the SPIKES protocol in the pharmacy curriculum showed an overall improvement in students' self-assessed performance in delivering bad news.

Impact of an Interprofessional Education Activity on Student Knowledge and Attitudes Regarding Patient Safety.

This study aimed to measure the impact of an interprofessional education (IPE) activity on student knowledge and attitudes regarding patient safety. Two 4 h IPE activities were designed to provide students with foundational information regarding patient safety. Interprofessional teams discussed the individual curricula and roles/responsibilities of each represented health profession. Teams then served on a mock committee tasked with completing a root cause analysis of a fictitious sentinel event. Students completed a pre/post-quiz and pre/post-attitudes survey to measure knowledge and attitudes. Five months later, students reconvened to serve on a second mock sentinel event committee. Students completed a post-activity survey after the second activity. Four hundred and seven students participated in the first activity, while two hundred and eighty participated in the second activity. Quiz score comparisons revealed improved knowledge, with post-quiz scores being significantly higher. Pre- and post-attitude survey comparisons indicated a significant improvement in participant attitudes towards interprofessional teamwork. Seventy-eight percent of students reported the IPE activity enhanced their ability to "engage other health professions students in shared patient-centered care". This IPE activity resulted in knowledge and attitude improvement related to patient safety.

Assessing Learner Engagement and the Impact on Academic Performance within a Virtual Learning Environment.

BACKGROUND: The objective of this pilot study was to examine student engagement with weekly self-paced learning materials in a virtual therapeutics course, and how sub-factors in the Motivated Strategies for Learning Questionnaire (MSLQ) may have influenced academic performance. METHODS: Students within a diabetes module of a therapeutics course were provided with weekly asynchronous optional self-directed learning activities. Student submissions, on-time rates, self-reported weekly study time, and exam performance were collected. Students completed the MSLQ at the completion of the study. Data was evaluated using various correlation analyses to determine the predictive ability of the MSLQ and its 5 subscales. RESULTS: In total, 173 students completed the study. Students' self-efficacy score on the MSLQ subscale and case submission on-time rate have the strongest positive correlation with the exam score, while the test anxiety as reported on the MSLQ test anxiety subscale had the strongest negative correlation with the exam score. CONCLUSIONS: Study results proved the MSLQ to be an effective predictive tool in students' self-regulation skills. Results can be used to develop intentional interventions aimed at improving self-regulation skills while providing opportunities to enhance student learning.

Revising the Center for the Advancement of Pharmacy Education (CAPE) Educational Outcomes and Entrustable Professional Activities (EPAs): The Report of the 2021-2022 Academic Affairs Standing Committee.

EXECUTIVE SUMMARY. The 2021-22 Academic Affairs Committee was charged to 1) Update the Center for the Advancement of Pharmacy Education (CAPE) Outcomes and Entrustable Professional Activity (EPA) statements for new pharmacy graduates; 2) Nominate at least one person for an elected AACP or Council Office; and 3) Consider ways that AACP can improve its financial health. This report primarily focuses on the process undertaken by the committee to revise the CAPE Educational Outcomes and EPAs. Proposed changes to the current outcomes are discussed and the reasoning behind these revisions are described. AACP members will have the opportunity to provide feedback prior to the final document being approved and published later this year.

Evidence and Strategies for Including Emotional Intelligence in Pharmacy Education.

Objective. This integrative review summarizes the literature addressing emotional intelligence among health care professionals and students to better define and incorporate it into the pharmacy curricula.Findings. Emotional intelligence is an essential attribute for relationship building, stress management, and self-regulation. Pharmacy students must develop and improve their emotional intelligence to support their development of successful relationships with patients, pharmacy colleagues, and other health care providers. In addition, awareness of one's own biases and emotions can help with behavioral regulation, which can facilitate enhanced communications with others. Increasing evidence suggests that emotional intelligence can influence academic success, the ability to provide compassionate and competent patient care, the ability to lead and influence others, and the ability to manage stress, all of which are important in pharmacy education. Educators can help learners develop emotional intelligence by designing activities that directly identify and target areas of weakness while leveraging areas of strength.Summary. This article discusses key background studies on emotional intelligence in the health professions literature and identifies specific methods and strategies to develop learners' emotional intelligence within the curriculum.

Social and Emotional Development in a Telehealth-Based Ambulatory Care Skills Course.

Objective. To determine the impact of telehealth-based simulations on students' social and emotional development.Methods. First-year pharmacy students enrolled in a professional skills course were eligible to participate in the study. Before and after the course, students completed the Personal-Interpersonal Competence Assessment, which codes onto eight subcategories: situation monitoring, inspire others, intimacy, awareness of one's aptitude, initiative to pursue leadership, empathy, sociability, and awareness of one's emotions. Students participated in seven telehealth-based simulations. Prior to each simulation, students watched a role modeling video highlighting social and emotional competence techniques used by a pharmacist during a consultation. Students then participated in simulated consultations that occurred in Zoom breakout rooms. Each student completed one consult while a teaching assistant completed a rubric derived from the Personal-Interpersonal Competence Assessment. Teaching assistants then provided formative feedback related to the student's social and emotional competence. At the semester midpoint, students completed a video log reflecting on their social and emotional development. Statistical analyses compared different time points of students' scores on the Personal-Interpersonal Competence Assessment and scores given by teaching assistants, while qualitative analysis was used for the video logs.Results. At the end of the course, improvement was noted on all factors of the Personal-Interpersonal Competence Assessment. Scores given by teaching assistants showed significant improvement over the semester, with the highest improvement noted on the subcategories inspiration and situation monitoring. On the video log, 80% of students noted improvements in their consideration of others.Conclusion. These findings suggest value in using role modeling, telehealth-based simulations, and teaching assistant feedback on pharmacy students' social and emotional development.

Peer Teaching in an Interprofessional Education Activity Focused on Professional Skills Development.

The purpose of this study was to assess the impact of a peer-taught interprofessional education (IPE) activity on pharmacy and physician assistant (PA) student self-assessed confidence and attitudes related to professional skills. First-year pharmacy (n = 210) and PA (n = 45) students participated in a two-hour IPE activity. Forty-five teams consisting of one PA and at least four pharmacy students completed three peer-teaching stations focused on diabetes device education, pulmonary device teaching/case workup, and physical assessment skills. Students completed a pre- and post-activity confidence survey and a post-activity attitudes survey. For pharmacy students, highest confidence gains were noted on the items related to performing a physical exam. For PA students, largest gains were noted on the items related to insulin delivery systems. Eighty-three percent of students either agreed or strongly agreed with the statement "I learned things during this IPE activity that I will implement in clinical practice." Seventy six percent of students felt that the physical assessment station was "beneficial or very beneficial" to their learning. A vast majority of students noted the IPE activity "somewhat or definitely" enhanced their communication with other health professionals and promoted a climate of mutual respect. In conclusion, peer teaching improved student attitudes and confidence.

A telehealth-based interprofessional education module focused on social determinants of health.

BACKGROUND: This report describes a telehealth-based interprofessional education (IPE) module that connected medical and pharmacy students across different geographical locations. The IPE module focused on developing strategies aimed at reducing health inequities related to social determinants of health. INTERPROFESSIONAL EDUCATION ACTIVITY: Teams of one doctor of osteopathic medicine and one or two doctor of pharmacy students were created by the course faculty member. Teams were instructed to meet at least four times via videoconferencing technology to discuss their assigned health inequity. Teams were instructed to design possible interventions to reduce the health inequity in their communities. Students completed the Interprofessional Collaborative Competency Attainment Scale (ICCAS) and a peer evaluation to provide feedback to their team member(s). DISCUSSION: Four hundred and seventy teams comprising 1099 students have participated in this IPE module. On the ICCAS, significant improvement was noted on all items with highest gains on items related to communication and collaboration. On the 2018-2019 peer evaluations, 84.5% of students rated their teammates as exceptional on the item "rate your team member's respect for you and others on the team." On the 2019-2020 peer evaluations, highest agreement was noted on the statement "this student is able to act with honesty and integrity in relationships with other team members." A total of 81% of students felt that the IPE module was useful to their learning. IMPLICATIONS: Improvement in the ICCAS and positive peer evaluations support a telehealth-based model for provision of IPE.

Comparison of an In-Person versus a Virtual Interprofessional Education Activity Focused on Professional Communication.

Early provision of interprofessional education (IPE) is imperative to ensure effective communication between healthcare professionals. However, there are several barriers to offering adequate IPE, including space restrictions and lack of human resources, prompting exploration of alternative modalities. In 2019, an IPE activity was offered in person with 213 pharmacy and 45 physician assistant (PA) students participating in one-on-one team huddles focusing on managing an acutely ill patient. In 2020, the same IPE activity, including 194 pharmacy and 45 PA students, was offered virtually. Peer evaluations, an attitudes survey, and confidence surveys were administered to evaluate the impact of the IPE activity. A student t-test and descriptive statistics were utilized to analyze the data. On average, PA students in the virtual group rated their peers higher than PA students in the in-person group, with little difference in the pharmacy peer evaluation of their PA partner. Ninety percent of pharmacy students and 91% of PA students in the virtual group felt that "they learned something new regarding therapeutic management" from their partner versus 84% of pharmacy and 81% of PA students in the in-person group. In conclusion, using a virtual modality for a communications-focused IPE was not detrimental to student attitudes and did not adversely affect peer perceptions.

The use of a metacognition and contemplation intervention in improving student abilities to recognize order entry errors.

BACKGROUND AND PURPOSE: To describe a pilot study testing a metacognition and contemplative pedagogy intervention designed to improve student abilities to identify errors on orders entered into a computerized provider order entry (CPOE) system. Educational activity and setting: Student teams worked up five patient cases and entered new orders into a CPOE system. All orders entered by teams were analyzed for errors and faculty members identified fifteen orders representing the top errors and selected these for the pre-exercise, in-class contemplation activity, and post-exercise. Course instructors instructed students to identify all errors on these orders. Students completed a pre/post-survey rating their ability to enter new orders. Two weeks later, students worked up a new patient case and entered orders into the CPOE. These orders were graded and scores were compared to the 2017 cohort to determine any differences in error rates. FINDINGS: Study participants included 205 students The average score of correctly identified errors increased from 22% on the pre-exercise to 62.8% on the post-exercise. On the survey of their skills, students rated their ability to "accurately enter medication orders into the [electronic health record] EHR" more highly after the intervention. The 2017 cohort made 73 errors on 170 orders compared to 45 errors on 165 orders by the 2018 cohort. SUMMARY: Based on improvements in student ability to identify order entry errors and overall positive student feedback, this strategy may be adopted by other educators looking to improve student identification of errors on orders entered into a CPOE system.

Effectiveness of Music Interventions to Reduce Test Anxiety in Pharmacy Students.

BACKGROUND: The main objective of this pilot study was to evaluate the impact of a classroom activity involving music on anxiety associated with preparing for and taking an assessment. METHODS: Two hundred and two (202) pharmacy students were randomly assigned to one of two conditions of the experimental study: active music playing (n = 103) versus passive music listening (n = 99). All students completed a pre-test, a mid-test, and a post-test including: an "Attitudes and Perceptions" survey, State-Trait Anxiety Inventory for Adults (STAI Survey), and a knowledge assessment. Data were analyzed to determine the impact each of the music interventions had on students' test anxiety. RESULTS: Both types of musical interventions produced similar results in terms of anxiety reduction. Faced with an upcoming test prior to the musical intervention, average state-trait anxiety scores increased; after the musical intervention, state-trait anxiety scores decreased. CONCLUSIONS: The use of music helped to reduce test anxiety, even after one brief musical intervention, regardless of whether students passively listened to music or actively played music.

Training Students to Address Vaccine Hesitancy and/or Refusal.

Objective. To determine the impact of a vaccine hesitancy learning unit on student knowledge, attitudes, and ability to address vaccine hesitancy and/or refusal. Methods. The learning unit consisted of two standardized patient simulation encounters performed one week apart. A 13-item attitudes survey was administered prior to the simulations to determine student confidence and knowledge regarding vaccine hesitancy. Students then participated in an encounter with a simulated patient who assessed the students' abilities using a 16-item grading rubric related to the art of the rhetoric, communication skills, and social, emotional competence. Post-simulation, students received feedback, completed a self-reflection exercise, and received formal coursework on addressing vaccine hesitancy. The following week, students participated in a second simulated patient encounter and thereafter completed the same attitudes and satisfaction surveys. Results. There were 203 students who went through the learning unit, with 180 (88.6% response rate) completing all the survey tools. The results showed significant improvements in all 16 items of the assessment rubric. On the pre/post attitudes questions, 9 out of 13 items showed significant improvement. Gains were largest for knowledge on the use of thimerosal as a preservative, speaking about how vaccines will not overwhelm a child's immune system, and knowledge about vaccinations not overwhelming a child's immune system. Overall, 94% of students were satisfied with the learning unit. Conclusion. This learning unit was effective in improving student confidence and ability to address vaccine hesitancy.

Use of Standardized Patient Simulations to Assess Impact of Motivational Interviewing Training on Social⁻Emotional Development.

The objective of this study was to assess the impact of motivational interviewing (MI) training on students' social⁻emotional development. Two simulations using standardized patients (SP) were conducted within a smoking cessation module. Students first completed a 4 h self-study module focused on smoking cessation tools and general counseling techniques. Faculty then administered a 15-item rubric focused on students' self-assessment of their verbal/non-verbal communication, social⁻emotional competence and MI skills. Students then participated in a smoking cessation counseling session with an SP. SPs used the same rubric to assess student performance. Teaching assistants (TAs) observed and assessed the students using the same rubric and an additional 22 items related to clinical skills. TAs and SPs then provided feedback on areas of improvement. The following week, students first completed a 3 h self-study module on MI then participated in a different smoking cessation scenario. After completion, the 15-item self-assessment rubric was administered. There was a significant improvement in TA assessed student performance with an average score improvement of 8% (pre-intervention score = 67%; post-intervention mean = 75%). Students had dramatic gains in their self-assessment with their scores rising by an average of 22%. Using MI techniques can improve students' self-assessed and perceived social⁻emotional competency.