The Impact of Motivational Interviewing and MOTIVE Tool Use by Pharmacists on Vaccine Acceptance.

Vaccines have played a significant role in reducing infectious disease burden. However, vaccine hesitancy remains a persistent challenge in public health, including for pharmacists who often interact with patients regarding vaccines. Thus, this study assesses the impact of motivational interviewing (MI) training and the MI-based vaccine hesitancy discussion tools (MOTIVE) on pharmacists' management of vaccine hesitancy. Pharmacists in eight Midwestern pharmacy practices who completed MI and MOTIVE training and engaged with vaccine-hesitant patients participated in this study. The pharmacist participants completed post-encounter surveys identifying the vaccine discussed, the tool utilized, and the outcome of the conversation. Descriptive results from 362 encounters indicated that the primary reasons for hesitancy were safety (39%), care coordination (31.5%), and efficacy (30.4%). Post encounter, 35.4% of patients received vaccines, 26% planned to, 25.1% considered it, and 13.5% were uninterested. The findings highlight the importance of patient-centered communication, such as MI, between patients and pharmacists to identify and address reasons for vaccine hesitancy. Pharmacists, equipped with conversation tools such as the MOTIVE tools, may effectively influence vaccine acceptance. Future research should evaluate the utility of MI and the MOTIVE tools in other settings and regions.

Exploring Tools to Manage Curricular Content and Overload within the Professional Pharm.D. Program.

OBJECTIVE: Given recent discussions in the literature and across the Academy about curricular overload and calls for tools that aid in reducing content, it is important to determine what tools and resources programs are using to evaluate curricular contents and how these resources are used to inform curricular change. Thus, the objective of this research project is to describe tools and resources pharmacy programs use for curricular content and change. METHODS: A 17-item instrument was created, pilot-tested, and then distributed electronically to assessment leads at accredited pharmacy programs with multiple reminders to improve response rates. The instrument covered various tools for pharmacotherapy, foundational sciences, social and administrative sciences, and top 200/300 medications. Respondents provided information related to the study objectives, and data were analyzed descriptively. RESULTS: With a 51% response rate, programs commonly used, and rated most helpful, the ACCP Pharmacotherapy Didactic Curriculum Toolkit to inform curricular prioritization. Programs indicated they did not have comparable resources commonly used for determining curricular content related to foundational sciences, social and administrative sciences, and top 200/300 medications. CONCLUSIONS: Established tools, such as the ACCP Pharmacotherapy Didactic Curriculum Toolkit, are helpful in selecting curricular topics, but additional guidance is needed to optimize its usefulness in managing curricular overload. Developing toolkits for foundational sciences, social and administrative sciences, and top 200/300 medications are necessary to provide similar guidance for the Academy.

Factors Influencing Older People's Intentions to Vaccinate.

Vaccination is crucial in reducing the spread of disease and improving overall patient mortality. Limited information exists regarding pharmacist accessibility outside traditional medical settings or impact on older patients' intention to vaccinate. This study aimed to examine patient perceptions regarding pharmacist accessibility and vaccination intention. Researchers used a quantitative research method of older people from Ohio, Kentucky, and Indiana. A survey was given to community-dwelling older people who attended different vaccine clinics. The survey included 10 questions describing reasons for not receiving vaccines in the past, how likely they are to receive vaccines if administered at community events, and the importance of having easy access to vaccines. For Likert-type items, a 5-point scale was used. The surveys were collected electronically and anonymously from several community events. Aggregate data were analyzed with descriptive and inferential statistics. One hundred seventy-eight responses were collected. The average age of participants was 75 years, and 70.8% were females. Of the respondents, 44.9% preferred to receive vaccines at a community center, 17.4% at the doctor's office, 4.5% at a clinic, and 9.6% at a sporting event like a boxing match. Men were more likely to receive a vaccine at a sporting event, while women were more likely to be interested in receiving a vaccine at a community center (P < 0.05). Respondents somewhat agreed (median = 4, interquartile range = 3-5) that they do not have transportation to places with vaccines. Age was significantly and negatively correlated with educational attainment (P < 0.001). However, as participants' ages increased, they were significantly more likely to have a belief that vaccines do not work (P = 0.011). The study addressed how pharmacists should consider more community outreach events in convenient locations, like community centers, for older people to improve vaccination rates.

A Deeper Reflection on the Integration of the Pharmacists' Patient Care Process.

OBJECTIVE: Given the importance of developing student understanding and application of the Pharmacists' Patient Care Process (PPCP), programs may be able to use successful approaches from other institutions to enhance their curricular and experiential learning and assessment of student outcomes. The study objective was to explore successful methods of integrating the PPCP and outline areas of challenge. METHODS: This study used a qualitative study design with semistructured interviews to gain insight from participants' lived experiences. Pharmacy faculty members participating in a national survey or who were authors of articles about PPCP initiatives were recruited to provide greater detail about building successful and innovative curricula. Thematic analysis identified commonalities and differences among the interviewed participants. RESULTS: A total of 10 interviews were conducted. The following 4 overarching themes arose from the data: discussions around intentional integration of the PPCP across multiple core courses may foster innovations in teaching strategies; intentional integration alone does not equate to PPCP integration across the curriculum; intentional integration may enhance program assessment; and PPCP data from experiential coursework may not be widely used in curricular continuous quality improvement. CONCLUSION: Pharmacy programs will ideally involve the entire faculty, including experiential and basic and social/administrative science members, in weaving the PPCP throughout the curriculum. Rigorous assessment can better inform interventions related to student competency in various steps of the PPCP. Pharmacy programs should also clarify how data obtained from preceptors observing student performance in each of the PPCP steps are used to assess student mastery of this critical skill.

Perceptions of Remediation Policies and Procedures in Pharmacy Education.

OBJECTIVE: This study aimed to (1) explore the perceptions of current remediation processes among pharmacy program administrators and faculty, and (2) identify factors surrounding successful or unsuccessful remediation in a pharmacy program. METHODS: This qualitative study used the following 3 stakeholder focus groups with distinct perspectives: didactic faculty, experiential faculty, and administrators. A screening survey was used to identify eligible participants, and quota sampling was used to represent various institution types and stakeholder experience. Focus groups were conducted using structured interview questions by an expert interviewer who was not part of the research team. Data were coded using the constant comparison method until consensus was achieved on the identified themes. RESULTS: Three themes associated with remediation were identified with 12 coded categories. The codes discussed by all 3 stakeholder groups included methods to identify students who need remediation, types of remediation, remediation challenges, consequences of remediation, remediation effectiveness, and necessary improvements to the remediation process. The didactic and experiential faculty groups discussed the management of remediation plans, methods of remediation prevention, and lessons learned from remediation. The timing of remediation was discussed by didactic faculty. The experiential faculty noted the need for preceptor development to provide timely feedback and ensure successful remediation. All 3 groups mentioned having clear policies and procedures for successful remediation. CONCLUSION: Overall, faculty and administrators had similar perceptions regarding remediation practices. The differences in concerns about remediation were most notable between the experiential and didactic faculty. While all 3 groups believed that remediation may be useful and necessary, challenges remain and monitoring is needed to determine the most effective practices, particularly in experiential education.

Evaluating the Need for Competency-Based Pharmacy Education (CBPE): The Report of the 2023-2024 Academic Affairs Standing Committee.

The 2023-2024 Academic Affairs Committee was charged to create a sense of urgency around the concept of Competency-Based Pharmacy Education and develop a "readiness for change" instrument that is based on the 5 essential elements that make up the definition of Competency-Based Pharmacy Education. This report describes the process undertaken by the committee to determine the societal needs of pharmacists and current state of pharmacy practice and pharmacy education. The practice gaps in pharmacy education and the key drivers needed to close these gaps are evaluated. To complete the charges, the committee conducted evidence-based literature reviews and completed a series of focus groups with stakeholders and thought leaders with experience in competency-based education.

Meaningful Connections: Exploring the Relationship Between Empathy and Professional Identity Formation.

OBJECTIVE: To describe the literature on the connections between empathy and professional identity formation (PIF) in pharmacy and other health professions education. A PRISMA-Scoping Review methodology was used for this study. Searches were conducted in PubMed and CINAHL from 2010 to January 12, 2023, with English added as a limiter. Articles had to address empathy and PIF, whether implicitly or explicitly. "Theory talk" was modified and utilized with 6 levels of connectedness to assess article quality. FINDINGS: A total of 419 articles were reviewed for inclusion into the study with a total of 45 articles being included. Seventeen (37.8 %) and 12 articles (26.7 %) included a definition for empathy and PIF, respectively. Thirty-eight articles (84.4 %) implicitly discussed a connection between PIF and empathy. Educational initiatives that fostered connections between empathy and PIF focused on classroom activities, clinical rotation activities, and assessments. Key elements to enhance empathy and PIF development across articles focused on mentorship, role models, and reflective practice, alongside intentional curricular integration. Similarly, barriers to empathy and PIF are multifaceted. SUMMARY: Despite educational initiatives in the literature that attempt to foster connections between empathy and PIF in classroom activities, clinical rotation activities, and assessments, most connections are implicit, as opposed to explicit. This may be due to the multiple barriers, such as the hidden curriculum, which make the connection between empathy and PIF difficult. This area needs further research and development given the importance of empathy in all health care provider interactions.

The Need for Competency-Based Education.

OBJECTIVES: While pharmacy education updates learning as new information arises, changes to learning experiences can trail behind current practices and technology. There have been multiple calls for radical changes in how health professions education is delivered to ensure patients are receiving high-quality care. Competency-based education has been one way discussed in the literature for how to handle this need to develop students who have a willingness to learn and can problem-solve. The goal of this review is to examine whether competency-based education is needed to drive the profession of pharmacy forward. FINDINGS: To address, we collaboratively identified stakeholder perspectives to evaluate the need. The following stakeholders achieved consensus among the committee members: patients/society, learners, workplace/profession, and academic institutions. SUMMARY: Based on those perspectives, needs, and gaps to address those needs were identified and are presented in this review.

Enabling Factors for the Implementation of Competency-Based Curricula in Colleges and Schools of Pharmacy.

OBJECTIVES: To review the implementation drivers of competency-based pharmacy education (CBPE) and provide recommendations for enablers. FINDINGS: Competency-based education is an emerging model in the health professions, focusing on time-variable competency development and achievement compared with a time-bound, course-based, traditional model. CBPE is an outcomes-based organized framework of competencies enabling pharmacists to meet health care and societal needs. However, challenges need to be recognized and overcome for the successful implementation of CBPE. Competency drivers include defining the competencies and roles of stakeholders, developing transparent learning trajectories and aligned assessments, and establishing lifetime development programs for stakeholders. Organization drivers include developing support systems for stakeholders; facilitating connections between all educational experiences; and having transparent assessment plans, policies, and procedures that align with core CBPE precepts, including the sustainability of time-variability. Leadership drivers include establishing growth mindset and facilitating a culture of connection between workplace and educational environments, program advocacy by institutional leaders, accepting failures as part of the process, shifting the organizational culture away from learner differentiation toward competence, and maintaining sufficient administrative capability to support CBPE. SUMMARY: The successful implementation of CBPE involves enabling the competency, organization, and leadership drivers that will lead to program success. More research is needed in the areas of creation, implementation, and assessment of CBPE to determine success in this model. We have reviewed and provided recommendations to enable the drivers of successful implementation of CBPE.

A Survey Evaluation of the American Association of Colleges of Pharmacy New Investigator Award Program.

OBJECTIVE: Sponsored by the American Association of Colleges of Pharmacy (AACP), the New Investigator Award (NIA) provides start-up funding for the independent research programs of early-career faculty. However, there is limited information on outcomes. Thus, the objective was to determine the impact of the NIA program on the stimulation of recipient research programs and AACP involvement. METHODS: A cross-sectional survey of 2012-2022 NIA Award recipients and current pharmacy Department Chairs was conducted. The instruments (NIA Recipient:28-items, Chair:15-items) were administered via Qualtrics with data reported descriptively. RESULTS: Responses were received from 96 NIA recipients and 157 Chairs (60%, 49% response rate). From the NIA recipients, most respondents received the award within their first 2 years of appointment (59%), received it on the first submission (61%), remained in academia (96%) at the same institution (90%), and were AACP members (80%) with a variety of involvement. Projects were typically completed (81%) and utilized for another grant (51%). Two-thirds of faculty had received external funding post-NIA (64%), and most felt the grant was valuable or very valuable. From the Department Chair survey, 40% had NIA recipients and 13% had served as a mentor. Departments did not have an NIA development/review process (77%) but had a mentoring program (59%). Most perceived the NIA program to be valuable/very valuable. CONCLUSION: Overall, chairs and NIA recipients have positive perceptions of the value of the NIA and recipients reported evidence of scholarly success.

Perceptions and Utility of Course Evaluations in US Pharmacy Schools.

OBJECTIVE: This study aimed to describe the purpose, implementation, and perceived utility of course evaluations in pharmacy programs. METHODS: After a literature review, a 34-item survey was developed, pretested, and sent to assessment administrators at accredited pharmacy programs (N = 139) with at least 3 follow-ups. Descriptive and inferential statistics were performed in IBM SPSS Statistics software. RESULTS: A total of 90 programs responded (64.7% response rate). Most students (94%) were offered the opportunity to complete course evaluations. Some students completed evaluations during the course (47%), while others did so within 1 week of completion of the course (49%). Whether or not class time was given for students to complete the survey was often dependent on faculty choice (52.2%). Results were typically released after final grades were posted (92%), in time to use for the next semester of teaching (77%). Faculty were chosen to be evaluated by the number of teaching hours (50%) followed by all instructors (45.6%). Programs used the results for performance reviews by chairs (91%), course coordinator reviews (84%), and committee continuous quality improvement efforts (72%). Most programs did not provide faculty guidance on using evaluations (78%) nor development/mentoring (57%); only 22% of programs offered student development in completing evaluations. CONCLUSION: While most programs invite feedback from all students via evaluations, most did not provide guidance to faculty on how to use this feedback for faculty or course development purposes. A more robust process to optimize the use of course evaluations should be developed.

A Description of Required NAPLEX Preparation Courses Among US Pharmacy Programs.

OBJECTIVE: One of the final tasks for pharmacy graduates to enter practice is passing the North American Pharmacist Licensure Examination (NAPLEX). Given the recent national declines in pass rates, programs are making significant investments of time and money in NAPLEX preparation. The objective is to characterize the structure and content of required NAPLEX preparation courses. METHODS: A survey on NAPLEX preparation practices was developed and distributed to all Accreditation Council for Pharmacy Education-accredited pharmacy schools. NAPLEX preparation course syllabi were also collected as part of this survey. Syllabus information was summarized into 4 elements: course structure, content, resources, and assessment strategies. RESULTS: Of 144 colleges/schools of pharmacy, 100 responded to the survey, 87 reported having a NAPLEX preparation program, and 47 reported having a NAPLEX preparation course. Twenty syllabi were collected. Most courses (14) were longitudinal through the Advanced Pharmacy Practice Experiences year, 16 were credit-bearing, and 19 included a vendor NAPLEX preparatory product. Fourteen courses were hybrid delivery, and 12 focused on licensure preparation and included test-taking strategies, calculations practice, case-based discussions, etc. All 20 courses reported using unproctored timed quizzes and practice examinations, half conducted proctored timed assessments, and 11 included written reflections and/or continuous professional development activities. Most courses were pass/fail (15), and high stakes (16) were defined by delayed or withheld graduation as a consequence for failure. Only 3 of 20 NAPLEX preparation courses were mapped to NAPLEX competencies. CONCLUSION: Although required NAPLEX preparation courses focus on assessments, the content is infrequently mapped to NAPLEX competencies. This project provides some information on how schools might create their own NAPLEX preparatory courses.

Examining Competency-Based Education Through the Lens of Implementation Science: A Scoping Review.

OBJECTIVES: This study aimed to identify evidence for the implementation and assessment of competency-based education (CBE) in health professions curricula using an implementation science framework. FINDINGS: Using the PRISMA framework, a systematic review of the literature applying a prespecified and piloted search strategy from 2017 to the present in PubMed and CINAHL was performed. References identified from the search strategy were imported into Covidence for title and abstract screening and full-text review by 2 researchers. A third researcher resolved discrepancies. Data were extracted and synthesized to identify key elements from the article related to implementation science, with a quality appraisal. A total of 25 studies out of 304 initially identified records were included. The studies covered a broad range of health professions and countries. Key findings were limited use of implementation science elements, including variability in CBE implementation, limited fidelity assessment, and partial examination of the process continuum. Programs with a more robust implementation approach have a team-based strategy to lead, implement, and support CBE. Motivation and training of faculty are also key components of successful CBE implementation. SUMMARY: Competency-based education is implemented differently across institutions, with variation among programs in their choice of elements of implementation science used. Further research is needed to examine CBE from an implementation science perspective and address remaining questions.

Parental Perceptions and Usage of Unlicensed Cannabidiol Products in Children With Anxiety and Neurodevelopmental Disorders.

OBJECTIVE: Data evaluating the use of unlicensed cannabidiol (CBD) products for the treatment of -symptoms associated with anxiety and neurodevelopmental disorders in children are limited despite increasing -product availability. The objectives of this study are to quantify the usage of unlicensed CBD products among pediatric patients diagnosed with anxiety and neurodevelopmental disorders and compare the -perceptions of CBD between parents who administer a CBD product to a child and parents who do not. METHODS: A survey containing 31 items was designed after pretesting with pediatric health care professionals. The refined survey was distributed using Qualtrics Panels to a representative sample of US parents of a child 7 to 18 years of age diagnosed with attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and/or generalized anxiety disorder (GAD). Responses were analyzed with descriptive -statistics and compared using a χ2 or Mann-Whitney U test. RESULTS: Of the 518 completed surveys, 162 parents (31.3%) reported the administration of an unlicensed CBD product to a child with ADHD, ASD, and/or GAD. The highest prevalence of use was found in the West geographic region and among children diagnosed with GAD or with 2 or more diagnoses (i.e., ADHD, ASD, GAD). Parents who administered CBD products had more positive views of product safety and higher -perceived community support for usage. CONCLUSIONS: Nearly one-third of parents have administered an unlicensed CBD product to a child with ADHD, ASD, and GAD. Health care providers should assess pediatric patients for CBD use and be prepared to engage parents in conversations regarding the safety of these products.

The Challenge of Curricular Overload in the Pharmacy Academy.

The American Association of Colleges of Pharmacy Council of Faculties commissioned a task force during the 2021-2022 academic year to examine the problem of curricular overload. As a result of this task force and the Academy-wide discussions around curricular overload, a consensus has formed around the significance of defining and addressing this challenge. Many institutions have begun work on identifying solutions to curricular overload. This theme issue will identify and describe current solutions to curriculum overload that can be implemented at the course, curricular, or Academy level. Future directions are also described. This introduction provides an overview of the theme issue.

NAPLEX Preparation Program Characteristics and Resources Associated With First-Time Exam Pass Rates.

OBJECTIVE: Pharmacy colleges and schools invest substantial faculty effort and financial resources in North America Pharmacist Licensure Exam (NAPLEX) preparation, including vendor products purported to improve NAPLEX pass rates. The objective of this project was to examine NAPLEX preparation program characteristics associated with first-time pass rates. METHODS: A national survey investigated which pharmacy schools provided a formal NAPLEX preparation program in the 2021/2022 academic year, and what resources students were required to use. Pharmacy school characteristics and the unique resources provided in NAPLEX preparation programs were separately analyzed for association with 2022 NAPLEX first-time pass rates. RESULTS: The survey response rate was 71% (100 pharmacy schools). Of the 6 pharmacy school characteristics analyzed, offering a formal NAPLEX preparation program and private status were both weakly correlated with a decrease in the 2022 NAPLEX pass rate, while founding year of 2000 or earlier was weakly correlated with an increase in the pass rate. In a generalized linear model, a decrease in 2022 NAPLEX pass rate was associated with offering a formal NAPLEX preparation program (-5.90% [-11.55 to -0.23]) and with a 3-year accelerated curriculum (-9.15% [-15.55 to -2.75]). Of 12 resources required in NAPLEX preparation programs, 3 were weakly correlated with a decrease in 2022 pass rate: a vendor question bank, vendor review book/materials, and a live, synchronous faculty-led review. In a generalized linear model, a decrease in 2022 NAPLEX pass rate was associated with a live, synchronous faculty-led review (-6.62% [-11.16 to -2.08]). Among schools without a formal preparation program, NAPLEX pass rates consistently exceeded the national average in 2020, 2021, and 2022, while the proportion of schools with NAPLEX preparation programs and first-time pass rates above the national average dropped from 59% in 2021 and 58% in 2020 to 44% in 2022. CONCLUSION: Simply implementing a NAPLEX preparation program is insufficient to overcome other systemic/programmatic influences of successfully passing the NAPLEX; programs should invest earlier resources to address NAPLEX competencies.

Reducing Student Workload Through Curricular Efficiency.

OBJECTIVE: This integrative review will examine the current literature assessing student workload, outcomes of increased workload and cognitive load, and approaches to evaluate and reduce student workload. Recommendations to better inform curriculum planning efforts will be presented along with a call to action to address the dilemma of student workload and curricular efficiency efforts. FINDINGS: Literature supports that perceptions of heavy workload can influence students' approach to learning and lead to the adoption of surface learning rather than a deep approach that involves higher-order processing and critical thinking. Additionally, ongoing evidence suggests that workload expansion affects student well-being and potential burnout in professional programs, and specifically that students perceive workload as directly related to their well-being and satisfaction. Intentional planning by faculty and programs can address this issue through streamlining classroom content, reducing lecture time, and modifying preclass work to allow for efficient learning. Even if the curriculum is lecture-based, workload perceptions can be affected by developing clearer guidance to set expectations for learners, intentionality in classroom design, and creating opportunities for student engagement. SUMMARY: Cognitive overload is multifactorial and complicated, given the increased standards of professional education accreditation and licensure requirements. As the Academy deliberately considers methods to improve curricular efficiency, there is an opportunity to focus on curriculum delivery with an appropriate balance of breadth and depth of instruction to ensure effective assessment and cognitive load.

An overview of Instructional approaches and decision-making strategies to curtail curricular overload.

OBJECTIVES: Curriculum overload often occurs when content is kept in the curriculum that may no longer be necessary to prepare students for professional practice. The overload becomes compounded by the addition of new content from the ever-changing professional practice needs and updates to accreditation standards. Challenges may occur when programs must first determine the "level" of proficiency a new graduate should attain and then determine the appropriate breadth and depth of educational outcomes in relation to proficiency, while examining what content should be retained from past curricula. Thus, the purpose of this manuscript is to summarize institutional approaches for making content delivery more effective and efficient with the goal of curtailing curriculum expansion. FINDINGS: Four key elements were consistently identified in the literature as important considerations to address curriculum overload - 1) communication and coordination among faculty, 2) incorporation of active learning strategies, 3) effective utilization of technology, and 4) minimizing faculty and student workload and cognitive burden. SUMMARY: Each pharmacy program will need to take an individualized approach in addressing curriculum overload; however, consideration of the aforementioned key elements can assist in making these decisions. With increased student engagement in the classroom, intentional design to reduce content and student workload, enhanced communication among faculty, and appropriate technology utilization, curriculum overload can be addressed at every level of pharmacy education.

Recommendations and Next Steps For Competency-Based Pharmacy Education.

In July 2021, the chairs of the American Association of Colleges of Pharmacy Council of Deans, Council of Faculties, and Council of Sections developed a task force to discuss potential ways to improve pharmacy education. The Competency-Based Education (CBE) Joint Task Force was created to explore the pros and cons of advancing a competency-based approach to pharmacy education (CBPE) and to determine ways to create more flexibility within pharmacy curricula to enable CBE. To achieve these goals, the Task Force systematically reviewed available resources and outlined the pros and cons of CBPE, best practices for implementation, strategies to minimize barriers, and recommendations on whether CBE should be implemented in pharmacy education. This commentary summarizes the Task Force's findings regarding whether CBPE is a suitable approach for pharmacy education and the next steps if implemented.

Advancing Pharmacy Education by Moving From Sequenced "Integration" to True Curricular Integration.

OBJECTIVES: Traditional pharmacy education focuses on teaching content, which is affectionately known as "silos". Each topic area or discipline includes a course or an individual class session designed to impart knowledge, skills, or abilities needed for the student pharmacist to become a practice-ready, team-ready pharmacist. With expanding content and educational standards, there have been calls to simplify and streamline content. Truly "integrated" curricula (sequenced, coordinated, and collaboratively taught) where silos are removed to foster student integrative learning and build connections across disciplines (foundational, clinical, and social or administrative sciences) could be one such approach. Thus, the objectives of this integrative review are to provide recommendations for decreasing curriculum overload by moving to truly integrated curricula, explore integrated approaches, discuss challenges and barriers, and propose next steps for creating integrated curricula that decrease content overload. FINDINGS: Although there are different approaches to curricular integration, most curricular integration occurs through sequenced courses or integrated cases. In order to truly streamline content and foster connections across disciplines, integration must move beyond simply sequencing of content to content that includes all the disciplines taught seamlessly. When taught together, curricular integration offers the opportunity to cover medication classes quickly and efficiently with multiple opportunities for reinforcement. SUMMARY: There remains limited data and examples of these types of true integration approaches. Thus, it is important for the Academy to determine if the integration of content improves curricular outcomes, positively affects students' learning, and addresses curriculum overload by increasing efficiency and streamlining curricula.