Transforming pharmaceutical education: A needs-based global analysis for policy development.

Background: A needs-based approach is desirable for the transformation of pharmaceutical education, and to link pharmaceutical education with the health needs of populations and national priorities. There are varying levels of data in the literature on the status of pharmaceutical education in all six World Health Organization (WHO) regions, especially in the context of needs identification and evidence-based policy interventions. The framework for this study was the FIP Development Goals. Objectives: The aim of the study was to develop evidence-based policies through a needs-based approach for pharmaceutical education transformation nationally, regionally and globally by addressing the following objectives: 1. Identify global and regional needs in pharmaceutical education, through a regional SWOT analysis and prioritization of FIP development goals; 2. Develop valid and credible regional roadmaps for pharmaceutical education advancement according to the identified prioritized goals and 3. Develop a global call to action as a policy intervention for advancing pharmaceutical education. Methods: This study was conducted between 2020 and 2021 using a mixed methods approach. Surveys of higher education institutions and a series of qualitative interviews were conducted with national professional leadership organizations, with further regional workshops having 284 participants recruited from the International Pharmaceutical Federation (FIP) membership base, spanning all six WHO regions. Results: Eleven out of 21 FIP DGs were identified as priorities for regional roadmaps and FIP DG 1 (Academic capacity) was identified as a priority in four regions. All regions had distinctive results with an area of commonality between them. There were common weaknesses in the adoption of competency-based education and inter-professional education. Conclusions: It is critical for every country and region to develop needs- and evidence-based policies for the transformation of pharmaceutical education, for which FIP DGs provide a systematic framework.

A Pre-matriculation Success Program to Improve Pharmacy Students' Academic Performance at a Historically Black University.

Objective. The Pharmacy Biomedical Preview program is a five-week summer academic reinforcement program held for students entering the Howard University College of Pharmacy. The objective of this study was to evaluate the impact of the program and preadmission factors on pharmacy students' first semester academic performance.Methods. A retrospective cohort study was conducted of students entering the preview program from 2012 to 2015. The primary outcome assessed was first semester grade point average (GPA). Descriptive statistics of all study variables were conducted. Bivariable analyses were used to compare students by program status. Pearson correlations and point biserial R were conducted to evaluate which factors were associated with the first semester GPA. Multiple linear regression analysis was used to evaluate whether participation in the preview program predicted GPA during the first semester in pharmacy school after adjusting for other factors. All analyses were conducted using SPSS, version 23, at an alpha of .05.Results. Incoming overall undergraduate GPA was the strongest predictor of students' first semester GPA in pharmacy school, followed by participation in the Pharmacy Biomedical Preview Program. After adjusting for other factors, mandatory participation in the program was associated with a higher first semester GPA, and voluntary participation in the program was also associated with a first semester GPA that was higher.Conclusion. Findings from this study indicated that implementation of a pre-matriculation success program at a college of pharmacy in a historically Black institution is a viable strategy to improve students' academic success in the first year.

Antiretroviral therapy in community pharmacies - Implementation and outcomes of a differentiated drug delivery model in Nigeria.

INTRODUCTION: The World Health Organization recommended differentiated models of care portends opportunities to decongest hospitals providing antiretroviral therapy (ART) and improve retention, especially in developing countries. A community pharmacy-based ART refill model was implemented where stable clients were devolved to community pharmacies for routine refills at a service fee, to promote private sector participation and sustainability of ART services. The aim of this study was to assess the feasibility, acceptability and outcomes of this model in Nigeria. METHODS: A population-based retrospective analysis of the community pharmacy ART refill program of the United States Agency for International Development-funded 'Strengthening Integrated Delivery of HIV/AIDS Services' project in Lagos, Rivers, Cross River and Akwa Ibom States from October 2016 to February 2018 was conducted. Standard descriptive statistical methods were used for baseline demographic and clinical characteristics of study participants. Outcomes were assessed using the Chi-square test and a multivariate logistic regressions model. Statistical significance was defined at α-level of 0.05. Analyses were performed using SPSS for Windows version 23 (IBM Corp, Armonk, USA). RESULTS: A total of 10015 participants representing 14.4% of ART clients in 50 hospitals opted for this model and were devolved to 244 community pharmacies. All clients consented and paid a service fee of N1000 (about $3) per refill visit. Median follow-up duration was 6 months. Prescription refill rate was 95% (95% CI 94.2-95.3). Retention rate was 98% while viral suppression was 99.12%. Refill rates were significantly affected by ART duration, regimen, age and location (P < 0.001, 0.004, 0.034 and < 0.001 respectively). CONCLUSIONS: This community pharmacy ART refill model of differentiated care is feasible and acceptable by clients and providers and demonstrated excellent clinical outcomes of retention and viral suppression. The ability and willingness of some clients to contribute financially to their HIV care was also demonstrated.

Implementing an Online Longitudinal Leadership Development Program Using a Leadership-Specific Continuing Professional Development (CPD) Tool.

As the roles of a pharmacist continue to evolve, leadership is an imperative skill for pharmacists to advance in their profession. To advance leadership behaviors, a number of tools, programs, and services have been developed worldwide to encourage the use of these behaviors in practice. A brief summary of different leadership opportunities around the globe are provided. A continuing professional development process and tool for developing and mentoring leaders that are ready to take the next step in their growth journey is introduced. This tool can be used in a live or online setting and is amenable to a longitudinal environment for leadership development and mentoring. A detailed process for implementing an online leadership development program and opportunities for future development are also described. While leadership skills can be developed in many ways, it is still unclear which methods and tools are the most effective in training pharmacists to maximize their leadership abilities. Additional research on effectiveness and impact of tools and processes for development are needed. Individuals and organizations are encouraged to consider implementing easily accessible leadership development and mentoring programs to advance the leadership skills of interested individuals.

Essential Elements for Core Required Advanced Pharmacy Practice Experiences.

Since 2004, concerns and calls for greater quality assurance in experiential education have been published. The Accreditation Council for Pharmacy Education (ACPE) "Standards 2016" provide limited differentiation across the four required practice experiences, and, as such, schools interpret them differently. Both schools and accreditation site visit teams would benefit from a common set of guidance for the required Advanced Pharmacy Practice Experiences (APPEs), so that they can ensure consistency and quality in student experiences across practice sites. To address this need for greater standardization, a taskforce of the American Association of Colleges of Pharmacy (AACP) Experiential Education (EE) Section conducted a peer-reviewed, consensus-building process, including experiential faculty and staff across multiple colleges and schools of pharmacy, to determine a common set of elements that could be used to bring consistency to the experiences and expectations for student learning in practice. Over a two year period, the taskforce reviewed the relevant literature and then drafted and revised the elements through an iterative process which allowed for established EE consortia and members of the EE section to review the draft and provide input for revision. The resulting essential elements presented here can be used to guide faculty and staff within experiential education programs in their quality assurance processes in ensuring students receive consistent experience as part of their education prior to graduation.

Cultural Sensitivity and Global Pharmacy Engagement in Africa.

Global engagement between schools and colleges of pharmacy in the United States and Africa is increasing. For a balanced and fruitful engagement, sensitivity towards the cultural and clinical needs of the people and professionals of the African region is critical. In this paper, we have divided the discussion into Southern, East, Central, and West Africa. General information about Africa, with unique aspects for individual subregions and countries, will be introduced. Stereotypes and misconceptions about the region and the people will also be discussed, along with recommendations for culturally sensitive engagement for pharmacy and other health care practitioners when hosting members from, or visiting this region. The paper is a resource for schools and colleges of pharmacy who are currently engaged or considering future outreach opportunities in Africa.

Using a global framework for health workforce development: National case studies on continuing professional development in pharmacy.

This article was migrated. The article was marked as recommended. Investing in the education, training and development of the global health workforce is integral to achieving global health goals, including universal health coverage and access to safe and quality services. Systemising and formalising CPD & CE for health workers as part of their professional development has become a central component of health workforce development. A global framework for pharmacy workforce development support countries to assess their CPD & CE development needs and facilitate progress towards global goals. This paper describes this global framework and how it's being used and implemented in countries worldwide.

Grading trends and evaluation of student performance across advanced pharmacy practice experiences (APPE) in the Big Ten Academic Alliance (The GRAPPES study).

INTRODUCTION: With over a third of the doctor of pharmacy curriculum relying on experiential education (EE), it is critical that students are assessed and graded in accordance with their actual performance. The objective of this paper is to review advanced pharmacy practice experience (APPE) grading across the Big Ten Academic Alliance to describe how APPE grading occurs at these institutions and highlight differences in approach and outcomes. METHODS: Experiential directors/deans were asked to import de-identified data (e.g., APPE curriculum, midpoint and final evaluation score and grade, number of preceptors, number of students, number of years of pharmacy school, total hours of APPEs offered, number and duration of APPEs per year, grading scale information). A chi-square test including pairwise comparisons with a Bonferroni p-value adjustment for multiple comparisons was performed. RESULTS: Seven college/schools submitted data from over 3600 students between 2012-2015. The distribution of letter grades differed significantly across all colleges/schools in 2012-2013, 2013-2014 and 2014-2015 (p < 0.0001). Similarly, the distribution of letter grades by rotation type varied significantly for all colleges/schools (p < 0.0001). Students in acute care, ambulatory care, and other patient care rotation types were less likely to obtain an "A" and more likely to obtain a "B" compared to students in other rotation types. CONCLUSIONS: When letter grades are used for APPEs, the trend suggests over 95% of students receive an "A" or "B" grade. Final grades varied by rotation type with more "B" grades observed in patient care rotations than "A" grades over the three-year period.

Transitioning from learning healthcare systems to learning health care communities.

The learning healthcare system (LHS) model framework has three core, foundational components. These include an infrastructure for health-related data capture, care improvement targets and a supportive policy environment. Despite progress in advancing and implementing LHS approaches, low levels of participation from patients and the public have hampered the transformational potential of the LHS model. An enhanced vision of a community-engaged LHS redesign would focus on the provision of health care from the patient and community perspective to complement the healthcare system as the entity that provides the environment for care. Addressing the LHS framework implementation challenges and utilizing community levers are requisite components of a learning health care community model, version two of the LHS archetype.

Structured Multi-Stakeholder Workshops to Advance a Global Transformative Roadmap for Pharmaceutical Workforce.

In November 2016, the International Pharmaceutical Federation (FIP) endeavored to create an environment to foster a shared vision to lead a transformative pharmaceutical workforce roadmap. Three milestone documents were developed and presented at the Global Conference on Pharmacy and Pharmaceutical Education. Workshops with the key themes and connecting Pharmaceutical Workforce Development Goals (PWDG) were conducted and analyzed. This Note serves to summarize the key aspects of these workshops, reporting on the innovative approaches used to generate guidance for stakeholders regarding implementation. INNOVATION: Seven workshops with a uniform structure were developed. These were designed to improve communication, harmonise outcome-generation, and allow for aggregate analysis. A team of seven conducted each workshop, each team consisted of: a Chair, a facilitator, one rapporteur, and four speakers purposively selected from FIP member organisations and other key stakeholders with expertise for sharing a variety of perspectives. Guidelines and templates were developed for all roles and each team was briefed in advance. KEY FINDINGS: Approximately 200 personnel participated in the seven workshops, with around 20 country representatives per workshop, covering all six World Health Organisation regions. Three key aspects of workforce transformation, using the PWDGs, were explored in each workshop: drivers for implementation; challenges to implementation; and ways of encouraging implementation. Drivers for implementation mentioned were enhancing collaboration and engagement. Challenges to implementation were identified as variance in terminology. Several ways of encouraging implementation were acknowledged, such as communication strategies, advocating for workforce development and sharing best practices to foster partnerships. NEXT STEPS: The unique format of the workshops, the innovative approach to include stakeholders across an array of settings and the parallel structure in all the seven workshops, aided in creating reliable findings. The achievability of the PWDGs depends on several factors. Engagement with stakeholders and engagement from and between professional associations are important factors to achieving workforce development goals.

Clinical Track Program Expansion Increases Rotation Capacity for Experiential Program.

Objective. To evaluate the rotation capacity at the University of Maryland School of Pharmacy and see if the implementation of clinical track programs across the state correlates to an increase in rotation capacity for the school. Methods. The following information was collected: number of preceptors over the years in the school's experiential learning program, number of clinical track programs from 2012 to 2015, rotation type, availability submissions per rotation type per year, and availability submissions per hospital participant in the clinical track program per year. The rotation capacity and rotation types from 2012 to 2015 academic years were assessed and compared to see if there was any impact on the clinical track programs implemented. Results. There was no statistically significant difference in the frequency distribution of rotation types among all sites from 2012 through 2015 academic years. However, there was a statistically significant difference in the total number/capacity of rotations from 2012 to 2015 academic years. There were also statistically significant differences in the rotation capacity in all sites except for three sites. Conclusion. Adding clinical track programs can help increase the capacity of a school's clinical rotations.

Current Practices in Hosting Non-US Pharmacy Students at US Pharmacy Schools in Experiential Clerkships.

Objective: To provide specific considerations for hosting non-U.S. pharmacy students at U.S.-based colleges/schools of pharmacy (C/SOP) for experiential clerkships and training. Findings: A literature review (2000-2016) in PubMed, Google Scholar and IPA databases was conducted using specific keywords. Recommendations and future directions for development of experiential rotations for non-U.S. students in U.S. experiential rotations are presented for both the home and host country. Summary articles and best practices across the disciplines, as well as expert opinion, were found across U.S. models for hosting non-U.S. students in advanced practice rotations in the medical disciplines. Consistent themes regarding legal agreements, acculturation, standardized calendars and social and safety considerations were considered for inclusion in the final document. Conclusion: Development of a successful experiential rotation/training for non-U.S. students requires consideration for well-developed objectives, qualified preceptors, multitude of legal and cultural considerations and recommendations for longevity and sustainability.

Current Practices in Global/International Advanced Pharmacy Practice Experiences: Preceptor and Student Considerations.

The objective of this article is to describe the key areas of consideration for global/international advanced pharmacy practice experience (G/I APPE) preceptors, students and learning objectives. At the 2013 Annual Meeting of the American Association of Colleges of Pharmacy (AACP), the GPE SIG prepared and presented an initial report on the G/IAPPE initiatives. Round table discussions were conducted at the 2014 AACP Annual Meeting to document GPE SIG member input on key areas in the report. Literature search of PubMed, Google Scholar and EMBASE with keywords was conducted to expand this report. In this paper, considerations related to preceptors and students and learning outcomes are described. Preceptors for G/I APPEs may vary based on the learning outcomes of the experience. Student learning outcomes for G/I APPEs may vary based on the type of experiential site. Recommendations and future directions for development of G/IAPPEs are presented. Development of a successful G/I APPE requires significant planning and consideration of appropriate qualifications for preceptors and students.

Current Practices in Global/International Advanced Pharmacy Practice Experiences: Home/Host Country or Site/Institution Considerations.

International outreach by schools and colleges of pharmacy is increasing. In this paper, we provide current practice guidelines to establish and maintain successful global/international advanced pharmacy practice experiences (G/I APPEs) with specific recommendations for home/host country and host site/institution. The paper is based on a literature review (2000-2014) in databases and Internet searches with specific keywords or terms. Educational documents such as syllabi and memoranda of understanding (MoUs) from pharmacy programs were also examined. In addition, a preliminary draft was developed and the findings and recommendations were reviewed in a 90-minute roundtable discussion at the 2014 American Association of Colleges of Pharmacy Annual Meeting. Recommendations for the host country include travel considerations (eg, passport, visa, air travel), safety, housing, transportation, travel alerts and warnings, health issues, and financial considerations. For the home country, considerations for establishment of G/I APPE site (eg, vetting process, MoU, site expectations) are described. The paper is a resource for development of new G/I APPEs and provides guidance for continuous quality improvement of partnerships focusing on G/I pharmacy education.

Strategies to grow an experiential learning program-The role of administrators.

With the newly released ACPE standards, challenges exist in growing experiential learning programs at many schools. The role of administrators in the experiential learning office, practice department, and the dean׳s office is critical for success. This article provides practical tips and strategies to help grow an experiential learning program by emphasizing the role of administrators. In 2012, the administrators of the University of Maryland School of Pharmacy brainstormed and came up with a list of challenges faced by its experiential learning program, provided suggested solutions to each challenge, and began a process of implementing solutions to help grow the program. As of fall 2014, we were able to document increases in the numbers of preceptors and different rotation types, growth in the clinical track program, changes in our learning management system to better accommodate our needs, and increases in satisfaction rates among our preceptors, sites, and students. This article summarizes the challenges faced by University of Maryland Experiential Learning Program, the practical solutions implemented, and the role of leadership in growing the program. Many of the suggestions and lessons learned here can benefit many programs with similar challenges.

Making a Curricular Commitment to Continuing Professional Development in Doctor of Pharmacy Programs.

As outlined in the Accreditation Council for Pharmacy Education (ACPE) Standards 2016, colleges and schools of pharmacy must provide an environment and culture that promotes self-directed lifelong learning. Continuing professional development (CPD) serves as a model that can foster and support self-directed, lifelong learning. The benefits of adopting a CPD model include assistance with attaining Center for the Advancement of Pharmaceutical Education (CAPE) 2013 Outcomes, such as self-awareness. This model can also support the individualization of experiential learning and student action on feedback from curricular-level assessments. The major skills involved in CPD, such as reflection and documentation, are frequently addressed in pharmacy curricula. However, these skills may be developed in isolation or exercised for purposes other than learning. The aim of this statement is to aid schools in creating "CPD ready" practitioners by defining the skill sets involved in CPD and making recommendations for advancing CPD in curricula.