A Call to Action to Remove ACPE Limits on Non-Patient Care Elective Advanced Pharmacy Practice Experiences.

The terms practice ready and direct patient care are evolving as the pharmacy profession transforms into a wide-ranging field of highly trained individuals. In a crowded job market, students are seeking opportunities to utilize their training beyond traditional patient care roles. As pharmacy colleges and schools update curricula to reflect current practice and drive this transformation, they are faced with the challenge to accommodate student interest in these growing nontraditional areas with the limit of two non-patient-care elective advanced pharmacy practice experiences (APPEs). This Commentary aims to bring attention to the curricular confinement by accreditation standards on elective APPEs. The time is right as ACPE is gathering input for standards revision. This is a call to action to remove the restriction of non-patient-care elective APPEs, support nontraditional career interests, and enhance opportunities for advocacy, leadership development, and innovation without sacrificing developing proficient direct patient-care skills for all future pharmacy professionals.

Relationship between advanced pharmacy practice experience grading schemes and pharmacy residency match rates.

PURPOSE: To determine the relationship of advanced pharmacy practice experience (APPE) grading schemes and other pharmacy program variables (ie, program age and funding) with pharmacy residency match rates. SUMMARY: A 12-question survey was disseminated to experiential administrators of pharmacy programs in October 2018. Respondents identified their program's APPE grading scheme (pass/fail, letter grades, or other) and associated pros and cons. Responding programs were categorized by age and funding status. Survey responses were correlated with the American Society of Health-System Pharmacists residency match rates for 2016 through 2018. Data were analyzed using descriptive statistics and logistic regression models as well as by attributes via thematic analysis. Most pharmacy programs (62%) reported using letter grades for APPEs compared to pass/fail (30%) or other (8%) schemes. Pharmacy programs using pass/fail grading were more likely to have students match to postgraduate year 1 (PGY1) (P < 0.001) and postgraduate year 2 (PGY2) (P = 0.0074) residencies. Older pharmacy programs for each grading scheme were more likely to have higher match rates; however, for PGY1 match rates, older programs utilizing letter grades correlated to lower match rates than those utilizing pass/fail grading (P < 0.0001). Likewise, both public and private pharmacy programs using pass/fail grading had higher PGY1 match rates than those using letter grades (P = 0.0006 and P = 0.0014). CONCLUSION: Pass/fail grading in APPEs does not hinder PGY1 or PGY2 residency placement compared to other grading schemes both overall and in combination with certain pharmacy program variables. Grading scheme strengths and weaknesses should be considered when deciding on optimal assessment strategies for APPEs and when evaluating candidates for residencies.

A Curriculum Crosswalk of the Core Entrustable Professional Activities for New Pharmacy Graduates.

Objective. To cross reference the core entrustable professional activities (EPAs) to a complete set of educational guidance documents for the Doctor of Pharmacy (PharmD) curriculum to create a map for pharmacy educators.Methods. The Mapping EPAs Task Force consisted of nine members who first worked independently and then together in small working groups to map five assigned educational guidance documents (eg, Center for the Advancement of Pharmacy Education [CAPE] Outcomes, Accreditation Council for Pharmacy Education [ACPE] Standards 1-4, and the Essential Elements for Core Advanced Pharmacy Practice Experiences [APPEs]) to the Core Entrustable Professional Activities for New Pharmacy Graduates. Four working groups completed the mapping process during phases 1 and 2, which was followed by an independent quality assurance review and consensus in phase 3.Results. All 15 core EPA statements were mapped to one or more of the educational documents. One item from the CAPE Outcomes could not be mapped to a core EPA statement. The first five EPA statements mapped directly to the five elements of the Pharmacists' Patient Care Process: collect, assess, plan, implement, and follow-up: monitor and evaluate.Conclusion. This comprehensive EPA map is the first curriculum crosswalk that encompasses a complete set of educational guidance documents including the Essential Elements for Core APPEs for the Doctor of Pharmacy curriculum. If adopted by the Academy, this curriculum crosswalk will provide pharmacy schools with a common interpretation of important educational guidance documents; serve as the foundation for curricular development, revision, and assessment; and ensure student pharmacists are prepared to enter the pharmacy profession.

Pharmacy Student Learning During Advanced Pharmacy Practice Experiences in Relation to the CAPE 2013 Outcomes.

Outcomes from The Center for Advancement of Pharmacy Education (CAPE) are intended to represent the terminal knowledge, skills, and attitudes pharmacy students should possess and have guided delivery of pharmacy education for more than two decades. Advanced pharmacy practice experiences (APPEs) are the endpoint of pharmacy curricula where demonstration and assessment of terminal learning occurs. This review examines published literature in relation to the most recent CAPE outcomes to determine the extent to which they have been addressed during APPEs since 1996. Details related to the APPE focus, intervention(s)/learning setting(s), and assessments are summarized according to the 15 CAPE outcomes. Further, the assessments are categorized according to the level of learning achieved using an available method. Common CAPE outcomes are highlighted, as well as those for which published reports are lacking for APPEs. The range and quality of assessments are discussed and emphasize the need for continuous improvement of scholarly design and assessment.

HIV-infected patients receiving lopinavir/ritonavir-based antiretroviral therapy achieve high rates of virologic suppression despite adherence rates less than 95%.

BACKGROUND: The observation that extremely high levels of medication adherence are required to achieve complete virologic suppression is based largely on studies of treatment-experienced patients receiving HIV protease inhibitor (PI)-based therapy without ritonavir boosting. This study aims to define the level of adherence needed to achieve virologic suppression in patients receiving boosted PI-based highly active antiretroviral therapy (HAART) with lopinavir/ritonavir. METHODS: HIV-infected adults receiving a regimen containing lopinavir/ritonavir were recruited into a prospective, observational study of the relation between adherence to lopinavir/ritonavir and virologic outcomes. Adherence was measured using the Medication Event Monitoring System (MEMS; Aardex, Union City, CA). HIV-1 viral load (VL) was measured at week 24. RESULTS: The final study population contained 64 subjects. Eighty percent had AIDS, 97% received lopinavir/ritonavir before enrollment, and most had more than 7 years of HAART experience. Mean adherence overall was 73%. Eighty percent and 59% achieved a VL <400 copies/mL and a VL <75 copies/mL, respectively. Mean adherence was 75% in those achieving a VL <75 copies/mL. High rates of virologic suppression were observed in all adherence quartiles, including the lowest quartile (range of adherence: 23.5%-53.3%). CONCLUSIONS: Moderate levels of adherence can lead to virologic suppression in most patients taking lopinavir/ritonavir-based HAART.