Describing the evidence linking interprofessional education interventions to improving the delivery of safe and effective patient care: a scoping review.

Empirical evidence indicates that collaborative interprofessional practice leads to positive health outcomes. Further, there is an abundance of evidence examining student and/or faculty perceptions of learning or satisfaction about the interprofessional education (IPE) learning experience. However, there is a dearth of research linking IPE interventions to patient outcomes. The objective of this scoping review was to describe and summarize the evidence linking IPE interventions to the delivery of effective patient care. A three-step search strategy was utilized for this review with articles that met the following criteria: publications dated 2015-2020 using qualitative, quantitative or mixed methods; the inclusion of healthcare professionals, students, or practitioners who had experienced IPE or training that included at least two collaborators within coursework or other professional education; and at least one of ten Centers for Medicare & Medicaid Services quality measures (length of stay, medication errors, medical errors, patient satisfaction scores, medication adherence, patient and caregiver education, hospice usage, mortality, infection rates, and readmission rates). Overall, n=94 articles were identified, providing overwhelming evidence supporting a positive relationship between IPE interventions and several key quality health measures including length of stay, medical errors, patient satisfaction, patient or caregiver education, and mortality. Findings from this scoping review suggest a critical need for the development, implementation, and evaluation of IPE interventions to improve patient outcomes.

Development of a Novel Neurological Score Combining GCS and FOUR Scales for Assessment of Neurosurgical Patients with Traumatic Brain Injury: GCS-FOUR Scale.

BACKGROUND: Consciousness assessment is crucial for patients with traumatic brain injury. In this study, we developed a novel scoring system combining the Glasgow coma scale (GCS) and the full outline of unresponsiveness (FOUR) and evaluated its association with the intensive care unit (ICU) length of stay, mortality, and functional outcome. METHODS: We retrospectively analyzed the data from patients with traumatic brain injury admitted to the neurosurgical ICU of our institution during a 2-year period. The eye and motor components of the GCS and the brainstem reflex component of the FOUR were used to compute the GCS-FOUR. We performed statistical analysis to demonstrate the association between the GCS, FOUR, and GCS-FOUR and the ICU length of stay, mortality, the development of a persistent vegetative state, and desirable recovery. RESULTS: A total of 140 patients were included. The mean age was 30.6 years, and 89.3% were male. All 3 scores were associated with the ICU length of stay, mortality, a persistent vegetative state, and good recovery. In terms of predicting mortality, the GCS score exhibited a slight superiority compared with the other indexes, and the GCS-FOUR score showed a slight superiority over the other indexes in predicting for good recovery. CONCLUSIONS: The GCS-FOUR is a novel scoring system comparable to the GCS and FOUR regarding its association with functional status after injury, ICU length of stay, and mortality. The GCS-FOUR score provides greater neurological detail than the GCS due to the inclusion of brainstem reflexes, in addition to using the experience of healthcare providers with the GCS score compared with the FOUR in most settings.

Addressing the crisis: Leveraging the United Nations sustainable development goals to prepare student leaders to tackle the opioid epidemic.

The United States faces several ongoing public health issues including the opioid epidemic. This article describes a new model aimed at providing a framework that incorporates the United Nations (UN) Sustainable Development Goals (SDGs) to develop pharmacy student leaders through education, experiences, and development of critical skills. This holistic approach can serve as an example methodology to equip future leaders across public health domains to tackle many of the critical problems we face today.

Faculty assessment of scholarship of teaching and learning among United States pharmacy programs.

INTRODUCTION: Pharmacy faculty understanding of the scholarship of teaching and learning (SoTL) and its recognition remain unclear. This study aimed to determine faculty SoTL perceptions and whether it should be recognized in promotion and tenure decisions. METHODS: A survey instrument was developed and distributed to 6454 faculty in 139 United States pharmacy programs. The survey provided a list of scholarly activities and respondents were asked to select activities they perceived as SoTL and solicited faculty attitudes toward SoTL, its recognition and value in promotion and tenure, and SoTL engagement. Results were stratified based on SoTL participation, disciplines, and years of experience. RESULTS: Six hundred forty-three pharmacy faculty responded to the survey. Diverse scholarly works from teaching and learning practices to curriculum development, which lead to peer-reviewed public dissemination, were perceived as SoTL by most (78-98%) of the respondents. Participation in SoTL was reported by 74%. Pharmaceutical/biomedical science faculty were significantly less likely to accept the SoTL definition than pharmacy practice or social and administrative sciences faculty. Over 90% of participants indicated that college/school and departmental policies should encourage participation in SoTL activities. More than 70% of respondents strongly agreed that SoTL should be incorporated into criteria for promotion and tenure. Competing time commitments, lack of funding, interest, and institutional SoTL recognition were identified as challenges. CONCLUSION: Findings demonstrate that pharmacy faculty perceive SoTL as a broad spectrum of scholarly activities, including classroom practices and beyond, that culminate into peer-reviewed public dissemination. Pharmacy faculty support the incorporation of SoTL into promotion and tenure criteria.

Implementation and lessons learned from a mock trial as a teaching-learning and assessment activity.

BACKGROUND AND PURPOSE: To describe implementation and lessons learned from use of a mock trial as a teaching-learning and assessment activity in a required evidence-based practice course. This innovative self-directed learning strategy reinforced evidence-based skills and affective domain competencies in Center for the Advancement of Pharmaceutical Education (CAPE) 2013 Outcomes and Accreditation Council for Pharmacy Education (ACPE) Standards 2016. EDUCATIONAL ACTIVITY AND SETTING: During spring semesters 2015 and 2016, first professional year (P1) cohorts were divided into teams and assigned controversial topics to research and debate in mock trials. The activity provided opportunities for teaching-learning and assessment. Statistical analysis included inter-rater reliability (IRR), comparison of faculty-judge and student-juror evaluation of trial performance. FINDINGS: Two cohorts were divided into eight teams (four per cohort) to debate four issues. Students within each team were assigned individual scores. Mean individual scores are reported by trial/topic. Faculty-judges and student-jurors rated eight criteria including content/knowledge, critical thinking, application/discussion of federal/state law, citations/references, visual aids, delivery/style, and active listening. Analysis indicated students met competency expectations with overall judges' and jurors' mean scores above 54/60 points (90%) in 2015 and above 51/60 points (85%) in 2016. Judges' scores showed a wider distribution than jurors' scores. Peer evaluation mean scores were above 55/60 points in all four trials. Intra-class correlation was calculated. Judges' scores had excellent IRR in two trials, and good IRR in a third trial, whereas jurors had good IRR in one trial. SUMMARY: Evaluation scores demonstrated students successfully applied knowledge and skills from this and prior P1 courses, and met competency expectations for the mock trial.

A review of remediation programs in pharmacy and other health professions.

The Accreditation Council for Pharmacy Education (ACPE) Accreditation Standards and Guidelines 2007 states that colleges and schools of pharmacy must have a remediation policy. Few comparative studies on remediation have been published by colleges and schools of pharmacy, making it challenging to implement effective and validated approaches. Effective remediation policies should include early detection of problems in academic performance, strategies to help students develop better approaches for academic success, and facilitation of self-directed learning. While the cost of remediation can be significant, revenues generated either cover or exceed the cost of delivering the remediation service. Additional research on remediation in pharmacy education across the United States and abroad is needed to make sound decisions in developing effective policies. This paper provides a review of current practices and recommendations for remediation in pharmacy and health care education.

Achieving cholesterol target in a managed care organization (ACTION) trial.

STUDY OBJECTIVES: To objectively compare the results of a collaborative approach using pharmacists with the results of usual care for achieving a low-density lipoprotein cholesterol (LDL) goal of 100 mg/dl or less in outpatients with documented coronary heart disease (CHD) who are not at goal, and to document the effect on LDL after removal of such a collaborative model from the study population. DESIGN: Prospective, multiclinic, controlled study. SETTING: Four clinics of a 19-clinic staff model health maintenance organization in Minneapolis and St. Paul, Minnesota. Two clinics treated the intervention patients, two the controls; one clinic for each group was suburban, and one for each was urban. PATIENTS: Four hundred eighty-one patients aged 18 years or older with CHD and whose LDL levels were not at goal. INTERVENTION: Clinical pharmacists implemented the physician-approved care plan for each intervention patient; activities included managing lipid-lowering drug therapy and educating patients on cardiovascular risk reduction. MEASUREMENTS AND MAIN RESULTS: Primary outcomes were changes in LDL level and the proportion of patients achieving goal LDL in the intervention versus the usual care (control) group. Secondary outcomes were the sustainability of the impact observed up to 18 months after discontinuation of the intervention. Mean+/-SD baseline LDL levels were 131+/-28 and 131+/-26 mg/dl (p=NS) for the intervention and control groups, respectively. After a mean of 6.5 months follow-up, 107 (72%) patients in the intervention group and 61 (18%) patients in the control group had attained their LDL goal (p<0.001). Mean LDL levels were reduced by 35.6 mg/dl (27.5%) and 6.7 mg/dl (4.6%) in the intervention and control groups, respectively (p<0.001). When the active program was discontinued, results of the 18-month follow-up indicated that 85 (65%) intervention patients remained at goal compared with 96 (42%) controls (p<0.001). CONCLUSION: This trial provides quantitative evidence to support the effectiveness of the collaborative approach as an intervention to optimize management of patients with CHD whose LDL levels are not at goal; this approach is specifically called for in the executive summary of the National Cholesterol Education Program Adult Treatment Panel III. Furthermore, this study documents both the magnitude and sustainability of the impact collaborative care models can have in managed care environments.