Years of Rampant Expansion Have Imposed Darwinian Survival-of-the-Fittest Conditions on US Pharmacy Schools.

The number of applicants to US pharmacy schools has been declining since 2013, leading to a national enrollment crisis. Enrollment challenges threaten the viability of many pharmacy programs. Some schools are better equipped than others to confront the risk of having to downsize or close, creating survival-of-the-fittest conditions. Four potential risk factors have been identified based on how applicants might perceive the comparable value of respective programs. Schools with lower risk are public, established before 2000, located within an academic health center, and traditional (ie, four-year) programs. The Academy cannot sustain more than 140 schools much longer. Market forces are establishing a new equilibrium between the number of graduates and the availability of pharmacist jobs. As more jobs become available, more applicants will apply. Until then, the fittest Doctor of Pharmacy programs will thrive, while others might have to downsize to survive, and the weakest will be at risk of extinction.

Advancing Our Pharmacy Reformation - Accelerating Education and Practice Transformation: Report of the 2019-2020 Argus Commission.

The Argus Commission examined changes that should be considered by colleges and schools of pharmacy to meet the bold aim of better integrating pharmacists' and physicians' practices articulated by President Sorensen. The Commission assessed the readiness of pharmacy educators to contribute to the acceleration of practice transformation. The primary focus of the report is on how the doctor of pharmacy curriculum and post-graduate training might be modified and better aligned to ensure that graduates complete their education ready to engage in roles partnered with primary care clinicians. The aim is to achieve comprehensive medication management and other pharmacist patient care services as standards of care. The Argus Commission provides preliminary recommendations for new or more intensified priorities by the 2020-21 AACP Strategic Planning Committee as they update the AACP plan. This includes the recommendation that AACP should create the Center for Academic Innovation and Practice Transformation, a hub to coordinate many current and emerging activities relevant to accelerating change in pharmacy education and practice.

Trends in Research and Graduate Affairs in Schools and Colleges of Pharmacy, Part 3: Underrepresented Minorities.

Objective. To examine the landscape of research and graduate affairs nationally and within schools and colleges of pharmacy. This report, part 3 of a three-part series, focuses on underrepresented minority (URM) faculty members and students, with a focus on recruitment and retention. Findings. There has been a substantial increase in recruitment of Asian faculty members by schools of pharmacy over the last 10 years, but there has been only minimal changes in the numbers of Black and Hispanic faculty numbers, which reflects the challenges in recruitment and retention of URM faculty members. Consistently low enrollment of Black and Hispanic graduate students over a 10-year period demonstrates that pharmacy schools could improve their stated diversity initiatives and goals. Despite an overall increase in PhDs conferred over the last 10 years, international students continue to receive the majority of degrees conferred. Graduation rates of Black and Hispanic students have remained low, suggesting that continued and sustained efforts are needed to recruit, support, and graduate URM students. Summary. Pharmacy schools must make a focused investment and effort toward increasing the diversity of their graduate enrollees by modeling their recruitment, enrollment, and retention strategies after national programs and best practices. Because there is a direct link between the number of faculty role models and the recruitment of students, pharmacy schools must enhance the recruitment, retention, and success of URM faculty members. Further, pharmacy schools should provide inclusion training to encourage better communication with URM advisees.

Trends in Research and Graduate Affairs in Schools and Colleges of Pharmacy, Part 2: Students.

Objective. To examine the landscape of research and graduate affairs nationally and within schools and colleges of pharmacy. This report, part 2 of a three-part series, focuses on characteristics of full-time PhD enrollees and graduates in schools and colleges of pharmacy, and career planning and preparation in graduate programs. Findings. Despite a 41% increase in funding awarded by the National Institutes of Health (NIH) to schools and colleges of pharmacy over the last 10 years, NIH funding per principal investigator only increased 14% and graduate student enrollment increased just 6% during the period. However, there was a 15% increase in PhD degrees conferred in the 10-year period, which is evidence that degree completion time decreased. The number of female graduates from pharmacy schools consistently increased, and outpaced growth in the number of male graduates by more than 10%. Most graduate programs do not include training for industry-specific skills, abilities, and experiences to better prepare graduates for nonacademic careers, although national programs have been recognized as vital to graduate student career preparation. Summary. Graduate biomedical science programs and faculty members must recognize that academia is an "alternative" career choice for their trainees, and provide job skills training to support the majority of nonacademic career choices, without compromising the rigorous training in basic biomedical disciplines.

Trends in Research and Graduate Programs in Schools and Colleges of Pharmacy, Part 1: Programs.

Objective. To examine the landscape of research and graduate education nationally and within schools and colleges of pharmacy. This report is part 1 of a three-part series and focuses on graduate programs' research funding and science faculty composition and diversity. Findings. Between FY2008 and FY2017, the number of full-time faculty members in schools and colleges of pharmacy increased 36%. The number of pharmacy schools with National Institutes of Health (NIH) awards increased by 15%, while NIH grants per faculty principal investigator (PI) increased by 31%. However, unadjusted for inflation, the mean NIH dollar amount per-faculty member PI increased just 14% and the mean NIH dollar amount per-school declined 7%, indicating that number of funded faculty outpaced dollars available. Proportionately, the percentage of science faculty members at pharmacy schools decreased from 47% to 43%. Only 15 public, research-intensive schools and colleges of pharmacy received more than half of the combined FY2017 NIH funding and total funding, while all other public and private schools and colleges of pharmacy shared the remaining funds. Interdisciplinary programs are developing slowly, and may help to diversify and increase future funding. Proportions of tenured and tenure-track positions are declining, but biological sciences and social and administrative sciences disciplines are growing and women faculty are making significant gains in these fields and at the assistant professor rank. Summary. Research-intensive schools and colleges of pharmacy are best-positioned to lead the academy to reframe graduate education to build interdisciplinary team skills and attract more diverse funding and science faculty members.

Implementation of the Pharmacists' Patient Care Process in a Medicinal Chemistry Course.

Objective. To implement the Pharmacists' Patient Care Process (PPCP) in a medicinal chemistry course. Methods. Doctor of Pharmacy students in a medicinal chemistry course were challenged to apply the PPCP in a lesson on cholinesterase inhibitors and NMDA receptor antagonist in the treatment of Alzheimer's disease. A clinical faculty member with expertise in the topic reviewed the clinical information provided to ensure applicability to patient care. A pre- and post-course survey was administered to assess students' understanding of the PPCP and the effectiveness of the strategies used. Students' pre- and post-course responses were analyzed, and qualitative themes were identified. Results. Of the 141 students enrolled in the course, 96% and 97% completed the pre- and post-course surveys, respectively. Students' post-course responses were higher than pre-course answers to the question that they knew all the steps of the PPCP (96% vs 66%, respectively). Ninety one percent in the post-course survey compared to 62% in the pre-course survey listed the PPCP steps correctly. In addition, more than 90% of the students indicated that the strategies used in the class helped them understand and relate to the PPCP. Qualitative responses revealed themes with positive responses related to the course, course activities, PPCP goals and curriculum design based on the implementation of the PPCP. Conclusion. The introduction of the PPCP as a framework for all pharmacy practitioners is a worthy endeavor. Purposeful strategies to introduce the PPCP in a medicinal course were positively received by students. Formalized efforts to implement the PPCP in clinical, social and administrative, and science courses are critical to introduce the PPCP as a framework for all future pharmacy practitioners.

Assessment of a multi-institution integration of cultural competency activities.

INTRODUCTION: To meet educational standards and provide effective patient care, student pharmacists must be well-prepared to interact with a diverse patient population. Thus, the objective was to assess the effectiveness of four different active learning strategies in enhancing the cultural competency (CC) of student pharmacists at multiple institutions. METHODS: Across two years, eight colleges/schools of pharmacy integrated two sets of CC activities with different student cohorts (first-third professional year) that were designed to address different aspects of CC. Pre- and post-activity, a modified electronic version of the Clinical Cultural Competency Questionnaire (CCCQ) that included the addition of activity-specific questions was distributed to students. RESULTS: A total of 1009 students participated in these activities across eight colleges of pharmacy. The integration of activities resulted in significant increases in most items on three of the four subscales of the CCCQ (knowledge, skills, and encounters/situations). Items on the attitude subscale remained the same. Students also felt the activities were beneficial in addressing their intent. CONCLUSIONS: Faculty were able to incorporate these activities throughout their respective curricula with minimal time commitment and resources. The activities improved student perceptions of their CC knowledge, skills, and ability to handle encounters and situations. These activities may be useful for other institutions as they determine the best approach to improve student CC and prepare them for practice.

Characterization of pharmacy practice research centers across the United States.

BACKGROUND: Schools of Pharmacy are important contributors to pharmacy practice research and several have created research centers focusing on this area. OBJECTIVES: To identify and characterize pharmacy practice research centers in the United States. METHODS: A comprehensive list of research centers was gathered using three sources: 1) websites of Schools of Pharmacy obtained from the American Association of Colleges of Pharmacy website; 2) Google; and 3) department chairs. Two independent reviewers applied the following exclusion criteria to the list: 1) no affiliation with a School of Pharmacy; 2) no focus on research; 3) not an independent unit recognized at the school or university levels; and 4) research not focused on advancing pharmacy practice. Inter-rater reliability was calculated using a prevalence-adjusted bias-adjusted kappa (PABAK). A questionnaire was developed comprising 24 questions grouped into three sections - overall structure of the center, research and educational activities - and disseminated through center directors. Descriptive statistics of survey data were obtained. RESULTS: Twenty centers across 20 different states were identified. Survey response rate was 100%. Three-quarters of centers were at public institutions and half had an advisory board. Full-time equivalents ranged from 0.2 to 21. Areas of research primarily focused on medication and disease-state management and interprofessional collaboration in the ambulatory/outpatient setting. Few centers (35%) conducted experimental studies. Despite 85% centers conducting multi-site studies, the median number of sites engaged was low (range 1-3). Seven centers received over USD 1 million in total funding since inception. A majority of centers (90%) offered educational activities for both students and professionals. CONCLUSIONS: Pharmacy practice research centers are relatively small, received low funding and few conduct multi-site experimental studies. Collaboration among centers could be a means to overcome these issues.

Comparison of NAPLEX pass rates for non-modifiable determinants of pharmacy programs in the United States.

INTRODUCTION: Students consider numerous variables before applying to a doctor of pharmacy program. Some key non-modifiable variables may include program length, institution type, graduating class size, and pharmacy school grading system. The purpose of this study was to determine if there exists a difference in North American Pharmacists Licensure Examination (NAPLEX) performance based upon these variables. METHODS: This was a retrospective cohort study using observational data. NAPLEX pass rates from 2015 to 2017 were obtained from the National Association of Boards of Pharmacy (NABP) website. Data for pharmacy programs were extracted from the program, Pharmacy College Application Service, American Association of Colleges of Pharmacy, and NABP websites. RESULTS: Based on each pharmacy program's performance on NAPLEX, variables with significantly higher pass rates were public institutions and those with graduating class sizes of 100 or more students. CONCLUSIONS: The results of this study suggest that graduating class size of 100 or more students and public institutions were significant predictors of success on the NAPLEX. Lower pass rates in 2016 may be due to the examination changes implemented by NABP that year. It is possible that programs and students were not being adequately prepared for the changes made to the NAPLEX format. Although not statistically significant, there was a rise in pass rates between the years 2016 and 2017. Therefore, future studies such as this one should be performed to compare NAPLEX pass rates from 2017 forward.

Identifying the facilitators and barriers for scientific writing among pharmacy students in College of Pharmacy, Umm Al-Qura University - A qualitative study.

INTRODUCTION: English is the dominant international language for academic publication, thus mastering English writing is required for a successful career in research. Our objective was to identify facilitators and barriers to English language scientific writing among pharmacy students in Umm Al-Qura University in Saudi Arabia (where English is not the native language). METHODS: We used face-to-face semi-structured interviews in the Arabic language with fourth- and fifth-year students of the college to gain insight into their perspectives. An interview guide was prepared using the Arabic language. The interviews were conducted at the college of pharmacy. All interviews were recorded and transcribed verbatim. RESULTS: Twenty-three participants agreed to be interviewed and signed the consent form. The mean interview time was 10 min. Two researchers independently analyzed the qualitative data using thematic analysis and agreed on the coding and themes. A third researcher verified the themes on randomly selected transcripts. The analysis showed main facilitator themes of: having rich vocabulary, competency in English language, having new ideas, increased writing activities, and individual guidance. Barrier themes were: lack of vocabulary, incompetency in English language, time constraint, lack of ideas, lack of writing activities, and lack of guidance. CONCLUSIONS: Participants of this study showed limited understanding of scientific writing. This study also found that pharmacy students need to develop their writing skills through practice sessions and university courses.

Impact of an innovative partnership in patient care between an academic medical center department of pharmacy and a school of pharmacy.

PURPOSE: Pharmacy departments and schools of pharmacy have long held professional affiliations. However, the success of each entity is often not interdependent and aligned. In 2010, our institutions found ourselves in a position where the complementary motivations of each aligned to support a more meaningful and committed engagement, leading to the development of the Partnership in Patient Care. The impact of the partnership was evaluated 7 years postimplementation, and both the successes realized and the lessons learned are described. SUMMARY: The partnership provided many advantages to our pharmacy department and the school of pharmacy. This initial iteration of the partnership was a strong proof of concept that an intentional approach to the relationship between a school of pharmacy and a pharmacy department can lead to substantive improvements in a wide array of meaningful outcomes. We experienced an increase in the number of student rotation months completed, growth in the American Society of Health-System Pharmacists-accredited residency programs, and enhanced clinical services. However, the partnership was not without challenges. For instance, lack of a formalized tracking method made certain outcomes difficult to track. CONCLUSION: The purposeful establishment of the Partnership in Patient Care, built on the needs of a school of pharmacy and an academic medical center pharmacy department, allowed our institutions to develop an intertwined mission and vision. Over the initial years of the partnership, many successes were realized and lessons were learned. Both the successes and the challenges are serving as the foundation for future iterations of the partnership.

Consideration of Aggressive and Strategic Approaches to Address Declining Enrollment in US Pharmacy Schools.

Members from Cohort 13 of the Academic Leadership Fellows Program (ALFP) 2016-2017 were challenged to present a debate on the topic: "In Turbulent Times, Pharmacy Education Leaders Must Take Aggressive Action to Prevent Further Declines in Enrollment" at the American Association of Colleges of Pharmacy INfluence 2017 meeting in Rio Grande, Puerto Rico. This paper is the result of thoughtful insights emerging from this debate. We present a discussion of the question of whether pharmacy education leaders must take aggressive action or strategic approaches to prevent further declines in enrollment. There are many thoughts regarding current declines in enrollment. Some educators contend that a more aggressive approach is needed while others argue that, while aggressive actions might lead to short-term gains, a more viable approach involves strategic actions targeting the underlying causes for decreasing enrollment. This paper explores themes of enrollment challenges, current and future workforce needs, and financial issues for both pharmacy programs and students. In summation, both aggressive actions and a strategic, sustainable approach are urgently needed to address declining enrollment.

Institutional factors associated with global health education across US pharmacy schools.

INTRODUCTION: The objective of this study is to explore the relationship between institutional factors and offerings of global health education opportunities in pharmacy schools. METHODS: Data for this project came from a review of international advanced pharmacy practice experiences (APPEs) and global course offerings for US pharmacy schools conducted between February 1 and March 31, 2014. These data were merged with data on institutional factors which may influence a school's offering of APPEs or courses. Institutional factors included tuition, class size, academic medical center affiliation, year established, and others. Multivariable regression models were used to evaluate the relationship between individual institutional factors and APPEs and global courses. RESULTS: In multivariable adjusted models, older and more established schools had a larger percent of the graduating class with an international APPE (9.5% vs. 2.6%, p < 0.01) and a larger number of international APPEs (3.8 vs. 1.4, p < 0.01) than schools founded after 1980. Schools with higher tuition (>$25,000/year) had, on average, a larger percent of their graduating class with an international APPE (7.9% vs. 3.1%, p < 0.05), a larger number of international APPEs (3.7 vs. 1.5, p < 0.01), and more interprofessional international APPEs (3.1 vs. 0.7, p < 0.001). There were more course offerings at older schools (1.1 vs. 0.4, p < 0.05) and those with higher tuition (1.3 vs. 0.4, p < 0.01). CONCLUSIONS: More established schools and those with higher tuition appeared to have more robust global offerings. Schools can consider local opportunities to provide global experiential and didactic experiences, which may reduce the financial burden of global programs.

A model to predict NAPLEX outcomes and identify students needing additional preparation.

INTRODUCTION: Studies have been conducted to identify factors that may predict North American Pharmacist Licensure Examination (NAPLEX) outcomes, but there is no proposed single or combination of predictors that can be implemented reliably in academia. We aimed to develop a NAPLEX outcomes predictive model that could be practical, measurable, and reliable. METHODS: The study cohort consisted of students who graduated from 2012 to 2016 who had taken NAPLEX and whose first-attempt examination scores were available to the school of pharmacy. Students were considered to have poor performance on NAPLEX if they received an overall score of less than or equal to 82. Linear and logistic regression analysis were utilized to identify independent predictors. RESULTS: Seventy of 433 (16.2%) students were identified as poor performers. Independent factors that were associated with a poor outcome on NAPLEX were: age >28 years at graduation, Pharmacy College Admission Test scaled score <74, High Risk Drug Knowledge Assessment score <90, third-year Pharmacy Curriculum Outcome Assessment scaled score <349, and grades of <74 in more than three courses. These predictors were utilized to stratify students into four risk groups: Low, Intermediate-1, Intermediate-2, and High. Mean NAPLEX scores for these groups were 106.4, 97.4, 87.1, and 75.1, respectively. CONCLUSIONS: The model can be used as a practical tool to identify students who are at risk for poor performance on NAPLEX. Four of the five predictors in the model could be generalizable to other schools of pharmacy.

Perceived value of partnerships between schools of pharmacy and health systems.

INTRODUCTION: This study sought to quantify opinions of statewide health systems stakeholders regarding the value of partnerships with schools of pharmacy. Being better able to meet the needs of preceptors and their employers will allow schools to increase capacity of high-quality pharmacy practice experiences. METHODS: A brief survey was developed and administered to statewide contacts from systems currently partnering with member schools of the North Carolina Experiential Education Consortium. Respondents were asked to rate, using a Likert scale, 15 incentive statements relating to potential benefits provided by schools in exchange for experiential rotations. RESULTS: Forty-one responses were received from 53 invitees (77% response rate). The two most highly-valued incentives per survey respondents were continuing education (CE) accreditation by the school (74% essential), and access to school resources (74% essential). The lowest scoring incentives included system-wide committee involvement by faculty (26% essential), co-funded faculty positions (29% essential), and resident precepting by faculty (34% essential). CONCLUSIONS: Incentive ratings differed significantly from previous reports describing value, which primarily focus on clinical interventions and cost savings provided by student pharmacists. Experiential staff at schools of pharmacy should consider a similar study to ascertain how best to meet the needs of their local partners and maximize commitments for pharmacy practice experiences.

Development and assessment of an academic performance enrichment program for low-performing, first-year pharmacy students.

Pharmacy school applications have steadily declined over the past several years. Thus pharmacy schools are not only searching for effective means to increase enrollment of qualified candidates, but are also focusing on the development of programs to improve academic performance and retention of enrolled students. To address the needs of struggling first-year pharmacy students enrolled in an Integrated Biological Sciences (BSI) course, an academic performance enrichment program (APEP) was developed. The program was designed to improve academic success by engaging low-performing students with the aims of improving their time management skills, study skills, metacognition, and understanding of BSI course material. The APEP consisted of structured tutoring sessions twice per week, which were required for all students with a course grade ≤73.5% at any point during the semester. To assess program effectiveness, performance improvement on BSI exams by the APEP students were compared with that of non-APEP students in the same class and to those in the previous 3 yr. Student perceptions of the program were also evaluated via an online survey. The APEP was deemed effective in that a greater percentage of students were able to improve their exam scores and to a greater extent by attending the APEP sessions compared with non-APEP students in the same class and with low-performing students in previous years when the APEP did not exist. Furthermore, APEP students believed the program was effective in meeting its aims. In conclusion, the APEP was effective in improving academic performance of low-performing students in BSI.

Trends in the Pharmacist Workforce and Pharmacy Education.

This commentary is an observation of longitudinal trends in national data on the pharmacist workforce and pharmacy education. Data indicate seismic shifts in supply and demand, from critical shortage to imminent oversupply. The change in the profession to employing more patient-care focused jobs has been observed as slow and minimal, although academia has focused on the clinical training and rapidly increased enrollments. Pharmacy is on the brink of transforming the profession, but several important changes are still required to alter the current trajectories of supply and demand. Pharmacy schools, associations, and employers must devote all energies to immediate and significant actions that tip the balance in favor of pharmacists of the future.

Teaching of pharmaceutical care in Latin America: a structured review.

OBJECTIVE: To systematize the information available on the teaching of pharmaceutical care, at the undergraduate and postgraduate level, in Latin America describing the current situation, perspectives, challenges, and recommendations. METHOD: A structured review of works related to the teaching of  pharmaceutical care in Latin America was made in PubMed, Scopus, Scielo, and Google Scholar, without time limit. Additionally, an internet  search of study plans of the different pharmacy programs in this region and  the accreditation status was performed. RESULTS: Thirty-six publications on the teaching of pharmaceutical care were  identified. In addition, information from 146 pharmacy study plans with  predominance of the active teaching methodology; so 25 postgraduate studies in the healthcare area was obtained. The percentage of  accredited programs was 31.8% and 37.7% for graduate and postgraduate programs, respectively. Brazil was recognized by the use of simulation, information, and communication technologies, and addition by  frequency of the blended education; while Colombia by the incorporation of  early practices at the healthcare level. CONCLUSIONS: The information available in publications and study plans demonstrates a growing interest in the teaching of pharmaceutical care  in Latin America. However, it is necessary that universities perform  integrated work with health institutions, in pro to get the accreditation of  their services for teaching. Likewise, harmonize concepts and early practices  that help to optimize teaching and promote the results divulgation obtained.

Objetivo: Sistematizar la información disponible sobre la enseñanza de la atención farmacéutica, a nivel de pregrado y posgrado, en Latinoamérica, incluyendo situación actual, perspectivas/desafíos y  recomendaciones.Método: Revisión estructurada de trabajos relacionados con la enseñanza de  la atención farmacéutica en Latinoamérica, en PubMed,  Scopus, Scielo y Google Scholar; sin límites de tiempo. Adicionalmente, se  realizó una búsqueda en internet de los planes de estudio de los diferentes  programas de farmacia en esta región y el estado de acreditación de los  mismos.Resultados: Se identificaron 36 publicaciones sobre la enseñanza de la  atención farmacéutica. Además, se obtuvo información de 146 planes de  estudio de farmacia, con predominio de metodologías de enseñanza activas,  al igual que 25 posgrados en el área asistencial. El porcentaje de acreditación fue del 31,8% y del 37,7% para programas de pregrado y posgrado, respectivamente. Brasil se destacó por el uso de la simulación, las tecnologías de la información y las comunicaciones, al igual  que por la educación semipresencial; mientras que Colombia se resaltó por la  incorporación de prácticas tempranas a nivel asistencial.Conclusiones: La información disponible en publicaciones y planes de estudio muestra un interés creciente en la enseñanza de la atención  farmacéutica en Latinoamérica. Sin embargo, se requiere que las  universidades realicen un trabajo integrado con las instituciones de salud,  orientado a acreditar sus servicios para la docencia. Asimismo, es necesario  armonizar conceptos y prácticas tempranas que ayuden a optimizar la  enseñanza y propiciar la divulgación de los resultados obtenidos.

The Impact of the National Institute for Pharmaceutical Technology and Education on Academic Research.

Surveys of institutional representatives of member institutions and faculty members engaged in the National Institute for Pharmaceutical Technology and Education (NIPTE) revealed that NIPTE is having a positive impact on academic research in the area of pharmaceutical technology by aligning research directions with FDA needs, by providing funding that may not be available elsewhere, and by creating a collegial and collaborative relationship among researchers in this area from various institutions. NIPTE is contributing to the viability of pharmaceutics and pharmaceutical engineering research in academic settings. Some responders cite the fluctuations in funding and relative low levels of funding received as a problem in maintaining programs, but most perceived a positive impact.

Practical Tips for Integrating Clinical Relevance into Foundational Science Courses.

The integration of foundational science and clinical science education is a hallmark of educational reform within the health professions, and an increasing number of pharmacy schools are implementing integrated curricula in professional pharmacy programs. Although the foundational sciences serve as an essential framework for understanding clinical knowledge, instructors may face challenges when integrating clinical science into foundational science courses. Here we present practical learner-centered teaching tips to address these challenges.