Rethinking residency recruitment, application, and interview processes to benefit applicants and programs long-term.

Pharmacy residency recruitment and interviews have been significantly impacted by the COVID-19 pandemic. Many traditional recruitment events and interviews were transitioned from in-person to virtual, and new approaches to recruitment, such as virtual open houses, were developed. There are limited data on how these changes impacted pharmacy residency applicants and programs, and the future of virtual events is currently unknown. We highlight recommendations for virtual recruitment and interviews and provide suggestions for residency programs and national organizations to improve virtual processes in the future.

Affective domain predictors of PharmD student pursuit of and successful matching for postgraduate pharmacy residency training.

PURPOSE: A study was conducted to identify significant associations between affective domain (AD) features identified using the Birkman Method assessment and students' likelihood to pursue and to successfully match for postgraduate residency training (PGRT), while controlling for demographic and academic variables known to impact PGRT match rates. METHODS: A retrospective analysis of 3 graduating classes of PharmD students from 2 colleges of pharmacy was performed. Data points such as PGRT match results, PGRT pursuit, student demographics, academic performance information, and AD data from the Birkman assessment were analyzed. Regression analysis was used to identify statistically significant associations between demographic, academic performance, and AD variables with both pursuit of PGRT and successful matching for PGRT. RESULTS: Data from 503 students were evaluated, with 211 (42%) pursuing PGRT. A variety of AD variables were significantly associated with pursuing PGRT and matching for PGRT. Two groups of actionable variables emerged: (1) variables associated with a lesser likelihood of pursuing PGRT but a greater likelihood of successful matching, and (2) variables associated with a greater likelihood of pursuing PGRT and a lesser likelihood of successful matching. CONCLUSION: Early identification of students' AD features along with specific interventions to promote PGRT pursuit in those less likely to pursue but more likely to match, as well as interventions to promote successful matching in students most likely to pursue but less likely to match for PGRT, is a strategy for possibly optimizing PharmD student career path planning and PGRT match success that merits further evaluation.

Trends in postgraduate year 2 pharmacy residencies.

PURPOSE: The purpose of this study was to quantify the growth and trends in postgraduate year 2 (PGY2) pharmacy residencies. METHODS: Summaries of the American Society of Health-System Pharmacists (ASHP) Resident Matching Program from 2008 to 2021 were obtained. Only standalone PGY2 residencies were included in the analysis. Descriptive analyses were completed for data related to the programs and positions. RESULTS: From 2008 to 2021, the total number of ASHP-accredited PGY2 programs increased from 282 to 1,131 (301%) and the overall number of unfilled positions decreased from 22% (77 of 351) to 2% (34 of 1,492). The percentage of positions filled early increased from 23% (81 of 351) to 40% (594 of 1,492) during this time. In 2021, programs with a clinical focus accounted for 91.6% of total positions. The Ambulatory Care category accounted for the largest percentage of all PGY2 residency positions, at 19.2% (287 of 1,492) in 2021 compared to 12.8% (45 of 351) in 2008. The total share of PGY2 residency positions in the Critical Care category decreased from 22.8% (80 of 351) in 2008 to 13.7% (205 of 1,492) in 2021; however, the share of PGY2 residency positions in the Emergency Medicine category increased from 1.4% (5 of 351) to 5.9% (88 of 1,492). CONCLUSION: From 2008 to 2021 the total number of PGY2 residencies increased; however, this growth was uneven, as the share of positions within individual residency categories changed. It is important for pharmacy stakeholders to review the current state of postgraduate training and ensure it reflects the goals for future practice.

Selection by design: Using job analysis to guide the selection of postgraduate pharmacy residents.

PURPOSE: To help ensure that we were accurately and consistently evaluating applicants to our postgraduate year 1 (PGY1) pharmacy residency program, we performed a job analysis to inform a redesign of our selection process. SUMMARY: A diverse panel of subject matter experts from our program was convened to develop a task inventory; a list of knowledge, skills, abilities, and other characteristics necessary for success in our program; and behavioral snapshots representing especially strong or weak resident performance (ie, critical incidents). After achieving a priori thresholds of consensus, these items were used to augment our application screening instrument (eg, development of anchored rating scales), build an online supplemental application consisting of a personality test and situational judgment test, develop a work sample consisting of a patient case presentation, and enhance the structure of our interviews (eg, by asking a consistent pattern of questions for all candidates). Preceptors reported that the redesigned process was more organized, easier to complete, and facilitated greater rating consistency. CONCLUSION: Job analysis represents an approach to designing selection processes that are more valid, reliable, transparent, and fair. Based on our experiences, recommendations for those who are considering changes to their selection process are provided.

Implementation of a pharmacy residency resiliency program for PGY1 and PGY2 residents: Program structure and resident perceptions.

PURPOSE: To describe the implementation of a pharmacy residency resiliency program (PRRP) for postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) pharmacy residents, including program structure, strengths and weaknesses/limitations, resident perceptions as captured by a postprogram survey, generalizability to other institutions, and opportunities for future directions. SUMMARY: Pharmacy residents face significant pressure, workload, and stressors that put them at risk for burnout and depression. While resiliency has been a major area of focus to help combat these risks for healthcare professionals, little has been published regarding formal, structured resiliency training in pharmacy, especially in pharmacy residency programs. American Society of Health-System Pharmacists (ASHP) residency standards recommend that programs consider education related to burnout prevention and that mitigation strategies be provided to residents and other pharmacy personnel, but no formal pharmacy-specific programs or strategies have been established. We implemented a 12-month PRRP for PGY1 and PGY2 pharmacy residents and conducted a postprogram survey to assess resident perceptions and to identify areas for growth. CONCLUSION: Implementation of a PRRP was feasible and could be replicated at other institutions. Residents in our program reported a high level of satisfaction, skills gained, and positive attributes of the addition of the PRRP. Some notable factors contributing to success included the program's longitudinal nature, use of a nonpharmacy facilitator, and impactful content from an established resiliency skills curriculum.

Evaluation of ß-lactam therapeutic drug monitoring among US health systems with postgraduate year 2 infectious diseases pharmacy residency programs.

PURPOSE: While some guidelines recognize the need for ß-lactam therapeutic drug monitoring (TDM), there is still a paucity of data regarding the prevalence of and barriers to performing ß-lactam TDM in the United States. We sought to estimate the prevalence of ß-lactam TDM, describe monitoring practices, and identify actual and perceived barriers to implementation among health systems in the US. METHODS: A multicenter, cross-sectional, 40-item electronic survey was distributed to all postgraduate year 2 (PGY2) infectious diseases (ID) pharmacy residency program directors (RPDs) listed in the American Society of Health-System Pharmacists pharmacy residency directory. The primary outcome was the percentage of institutions with established ß-lactam TDM. Secondary outcomes included assessing ß-lactam TDM methods and identifying potential barriers to implementation. RESULTS: The survey was distributed to 126 PGY2 ID RPDs, with a response rate of 31.7% (40 of 126). Only 8% of respondents (3 of 39) performed ß-lactam TDM. Patient populations, therapeutic targets, and frequency and timing of obtaining repeat ß-lactam concentration measurements varied among institutions. The greatest barrier to implementation was lack of access to testing with a rapid turnaround time. Institutions were unlikely to implement ß-lactam TDM within the next year but were significantly more inclined to do so within 5 years (P < 0.001). CONCLUSION: ß-lactam TDM was infrequently performed at the surveyed US health systems. Lack of access to serum concentration testing with rapid turnaround and lack of US-specific guidelines appear to be considerable barriers to implementing ß-lactam TDM. Among institutions that have implemented ß-lactam TDM, there is considerable variation in monitoring approaches.

Gender inequality in PGY1 residency leadership positions and conferral of health-system pharmacy professional awards.

PURPOSE: To address gender inequality, the American Society of Health-System Pharmacists (ASHP) created a steering committee that recommended the collection of baseline and ongoing metrics of pharmacy leadership. The purpose of this study was to quantify gender inequality in distributions of residency program director (RPD) and director of pharmacy (DOP) positions and to investigate gender distributions among recipients of ASHP professional leadership awards. METHODS: RPD and DOP information for postgraduate year 1 (PGY1) programs included in the online ASHP residency directory were collected in December of 2020. Publicly available records were used to collect information on recipients of the Harvey A.K. Whitney Award and John W. Webb Award during the periods 1950-2020 and 1985-2020, respectively. Gender information for RPDs, DOPs, and award recipients was collected from listed pronouns available in public records. A χ 2 test was used for analysis of the collected data. RESULTS: A total of 1,176 PGY1 residency programs were included. Of the RPD positions assessed, 66% (n = 775) were filled by women pharmacists (P < 0.0001), while the percentage of DOP leadership positions held by women was 42% (n = 496) (P < 0.0001). Evaluation of data on recipients of the Harvey A.K. Whitney Award and John W. Webb Award revealed the occurrence of female recipients is 19.7% (n = 14) and 16.7% (n = 6), respectively (P < 0.0001). CONCLUSION: RPD positions have a higher prevalence of being filled by women. DOP positions remain male-dominated and revealed gender inequality among senior-level leadership roles. Pharmacy leadership award analysis identified further gender inequality. The results from the study serve as a baseline of current gender metrics for pharmacy leaderships in hospital systems with PGY1 residency programs.

Assessment of gender differences in letters of recommendation for pharmacy residency applicants.

PURPOSE: Letters of recommendation (LORs) are highly regarded components of pharmacy residency applications, as they provide insight into an applicant's character and capabilities. In other medical fields, differences in language have been reported for letters written for female and male applicants; however, data on gender differences in LORs for pharmacy residency applications are currently lacking. METHODS: LORs for applicants to our institution's postgraduate year 1 pharmacy residency program for the 2019-2020 academic year were extracted and processed by a natural language processing service. Words within 18 categories were identified and counted for each LOR. Total word count was also compared. RESULTS: Of the 473 LORs included for analysis, 320 (67.7%) were written for female applicants and 153 (32.3%) were written for male applicants. Approximately two-thirds of all writers were women for both female and male applicants. In comparing letters for women and men, there was a statistically significant difference in the percentage of LORs that contained terms in categories described as gendered, solitary/reserved, and desire. There was no statistically significant difference in total word count or in the presence of words in other categories such as grindstone, standout, agentic, or communal. When controlling for grade point average, writer gender, duration that the writer knew the applicant, and the writer's professional position, there were no changes to the statistical findings. CONCLUSION: Letters written for female and male applicants were largely similar with regard to length and word categories utilized. While no clear gender bias was found when evaluating pharmacy residency LORs, writers must continue to assess their implicit biases and how those biases might affect a candidate's application.

Impact of COVID-19 pandemic on training of pharmacy residents and fellows: Results from a national survey of postgraduate pharmacy trainees.

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has impacted the activities of healthcare workers, including postgraduate pharmacy trainees. Quality training experiences must be maintained to produce competent pharmacy practitioners and maintain program standards. METHODS: A cross-sectional survey of postgraduate pharmacy trainees in the United States was conducted to evaluate training experience changes and assess perceived impacts on residents and fellows following the COVID-19 pandemic's onset. RESULTS: From June 4 through June 22, 2020, 511 pharmacy trainees in 46 states completed the survey. Participants' median age was 26 (interquartile range [IQR], 25-28) years, with included responses from postgraduate year 1 residents (54% of sample), postgraduate year 2 residents (40%), and postgraduate fellows (6%). Compared to experiences prior to the onset of the COVID-19 pandemic, fewer trainees conducted direct patient care (38.5% vs 91.4%, P < 0.001), more worked from home (31.7% vs 1.6%, P < 0.001), and less time was spent with preceptors per day (2 [IQR, 2-6] hours vs 4 [IQR, 1-4] hours, P < 0.001). Sixty-five percent of respondents reported experiencing changes in their training program, 39% reported being asked to work in areas outside of their routine training experience, and 89% stated their training shifted to focus on COVID-19 to some degree. Most respondents perceived either major (9.6%) or minor (52.0%) worsening in quality of experience, with major and minor improvement in quality of experience reported by 5.5% and 8.4% of respondents, respectively. CONCLUSION: Pharmacy resident/fellow experiences were perceived to have been extensively impacted by the COVID-19 pandemic in varying ways. Our findings describe shifts in postgraduate training and may aid in the development of best practices for optimizing trainee experiences in future crises.

A framework for graduate and postgraduate specialty pharmacy training.

PURPOSE: There is a growing need for specialty pharmacy leaders within integrated delivery networks (IDNs). Traditional training for students and residents has not met the demand for pharmacy leaders in this space. This article describes the partnership between UW Health (UWH) and the University of Wisconsin School of Pharmacy (UWSOP) in developing a specialty pharmacy elective course at UWSOP and in creating a postgraduate residency training program at UWH. Future directions for the partnership are discussed. SUMMARY: Members of the leaderships of UWH and UWSOP met to discuss expanding coursework related to specialty pharmacy business fundamentals at UWSOP. This meeting led to the development of a 2-credit elective course beginning in spring 2017. The course focused on marketplace economics, channel strategies, and specialty pharmacy practice development. Additionally, UWH identified the need to provide postgraduate training to meet the increasing demand across IDNs for specialty pharmacy leaders. The residency program was initiated in 2013 and received accreditation in 2016. The residency provides experience in specialty pharmacy leadership, managed care, finance, the revenue cycle, accreditation, and the supply chain. Future partnership opportunities include creation of a longitudinal student pharmacist track and joint project coordination between UWSOP students and UWH residents. CONCLUSION: This partnership has provided a pathway for students to gain expertise in specialty pharmacy business fundamentals as well as postgraduate training opportunities for future specialty pharmacy leaders. IDN and school of pharmacy partnerships can expand educational opportunities for future specialty pharmacy leaders and help fulfill the market gap in specialty pharmacy leaders.

Lessons learned from pharmacy learner and educator experiences during early stages of COVID-19 pandemic.

PURPOSE: To explore pharmacy learner (eg, resident, fellow) and educator (eg, residency program director, preceptor) experiences and lessons learned during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: In May 2020, attendees of the virtual Research in Education and Practice Symposium (REPS) were invited to participate in two 1-hour networking sessions. During these sessions, participants completed individual and group reflection exercises where they were asked questions about their experiences during the initial stages of the COVID-19 pandemic. Participants who volunteered submitted their responses through an electronic survey application. Anonymous responses were coded using thematic analysis to address the research questions. RESULTS: Sixty-eight and 38 participants, respectively, attended the 2 networking discussions. Participant-identified professional impacts of the COVID-19 crisis included unexpected learning experiences, greater adaptability, workflow and learning interruptions, and decreased productivity. Personal impacts included a greater focus on well-being, physical and social isolation, and changes in travel plans. Participants noted positive and negative emotions including acceptance, encouragement, anxiety, stress, and frustration. The main lessons learned focused on adaptability, gratitude, and empathy. Participants shared that they wished they would have known the anticipated duration of the pandemic, associated workflow changes, and reliance on technology prior to the start of the pandemic. In addition, they predicted that pharmacy practice will require changes to workflow flexibility, training expectations, the pharmacist's role, and organizational structure. CONCLUSION: The COVID-19 pandemic has positively and negatively impacted the professional and personal lives of pharmacy learners and educators, with the most notable impacts being in the areas of well-being and adaptability. Future research should explore the experiences of other workforce personnel and evaluate the long-term impact on pharmacy practice, patient outcomes, and workforce well-being and resiliency.

Health-system implementation of a collaborative core curriculum for advanced pharmacy experiential education during the COVID-19 pandemic.

PURPOSE: A collaborative advanced pharmacy practice experience (APPE) education model established within a healthcare institution during the coronavirus disease 2019 (COVID-19) pandemic is described. SUMMARY: The COVID-19 pandemic caused a nationwide disruption of APPE pharmacy education. Healthcare institutions faced the challenge of educating APPE students while attempting to simultaneously de-densify work areas and reduce transmission risk for employees and patients. A pharmacist coordinator and pharmacist academic partners at a large teaching hospital created a collaborative common core curriculum model for resourceful implementation of APPE education. Healthcare network pharmacists, clinical pharmacist academic partners, and pharmacy residents delivered the curriculum to 35 pharmacy students over a 9-week time period. Main components of the curriculum included patient case discussions, topic discussions, journal club presentations, live continuing education (CE) webinars, and development of pharmacy technician CE programs. A majority of students reported positive experiences working with a variety of preceptors from different specialties (81%) and collaborating with students from other universities (62%). CONCLUSION: A health system can leverage institutional, network-wide, and academic partner resources to implement a collaborative APPE curriculum during challenging times such as those experienced during the COVID-19 pandemic.

Rising to the challenge: Pharmacy residents on the front lines during COVID-19 pandemic.

PURPOSE: To provide pharmacy residents' perspective on how the department of pharmacy at a large academic medical center prepared and managed the surge in admissions of patients with coronavirus disease 2019 (COVID-19), to describe how residents were trained for intensive care unit (ICU) staffing, and to provide recommendations on how residency programs nationally could navigate a second wave of COVID-19 admissions or other disaster response situations. SUMMARY: The majority of postgraduate year 1 (PGY1) pharmacy residents at the institution were trained for ICU staffing and deployed throughout the hospital to ICU units converted to dedicated COVID-19 ICUs to assist in patient care. The training process included live videoconference lectures about relevant ICU topics and on-site experiences with critical care clinical pharmacists. Based on their experience in training for and participating in ICU care of patients with COVID-19, the pharmacy residents recommend considering additional cross-training of residents, integration of additional clinical education, creation of opportunities for resident involvement in telehealth, advancement of residents' roles in emergency responses, building robust mental health services, and continued advocacy for the advancement of pharmacists' and pharmacy residents' scope of practice. CONCLUSION: The onset of the COVID-19 pandemic caused the institution to reevaluate the allocation of resources, and the department of pharmacy elected to deploy PGY1 pharmacy residents with previous ICU experience to assist in caring for an ICU patient census that had doubled. This experience will be valuable in preparing for another potential wave of COVID-19 cases and a surge in admissions of other groups of patients who deferred care due to the pandemic.

Coping with the residency program during COVID-19: Hematology oncology pharmacy residents' perspective.

INTRODUCTION: The COVID-19 pandemic has led to significant changes in all governmental activities in Saudi Arabia including training and teaching, with the majority of such activities suspended in response to the COVID-19 pandemic. We aim to share the challenges that Hematology Oncology Pharmacy (HOP) residents faced during the quarantine period and provide recommendations on how to cope with the residency journey. METHOD: We followed a qualitative methodological approach in March 2020 using a structured virtual group discussion for data generation. RESULTS: All six PGY2 hematology oncology pharmacy (HOP) residents were included in the group discussion. The group agreed that the need for HOP services during this pandemic is beyond the scope of oncology pharmacists' normal daily practice. The group recognized two fundamental points. First, the goal of the current training should be customized to the most pressing need and recognized at the national level. Second, the current training system should be improved to ensure efficient use of current resources. On this basis, the group developed six main recommendations for action. CONCLUSION: The current situation is a challenge for all healthcare providers, and the majority of the nation's current generation never dealt with such a situation in days gone by. This paper presents the challenges that should be addressed at the national level and provide a fundamental consensus recommendation for practical approaches to maximize learning and minimize disruption to trainees' progression while maintaining patient-pharmacy quality of care.