Retooling the Remediation Process: An Overview of One School's Process Overhaul.

OBJECTIVE: This article describes the process of review and modification of a Doctor of Pharmacy didactic course remediation process. A highlight of the new process includes early intervention with a Learning Specialist, creating the opportunity for students to address learning issues earlier in the courses. METHODS: Review of past remediation processes, student success, and pertinent literature related to remediation processes to allow for a new remediation process that supports students' learning and success. RESULTS: Creation of a new 2-phase process, including an early intervention and remediation process. The process includes a Learning Specialist position to focus on learning and barriers to academics. Remediation opportunities focus on proficiency in specific areas for each course. CONCLUSION: The new remediation policy provides greater support to students through the Learning Specialist. The new policy helps students connect with resources earlier in the program and provides multiple opportunities for assisting students during the semester. Over the past 4 years, the Learning Specialist has met with an average of 73 individual students per semester, while only an average of 25 students in the didactic portion of the curriculum (year 1-3) require remediation each semester.

Intervention and remediation: A descriptive study of practices in pharmacy education.

INTRODUCTION: This descriptive survey study was designed to collect specific data about intervention and remediation approaches used by schools and colleges of pharmacy (S/COPs) to meet the requirements of the Accreditation Council for Pharmacy Education Standard 17. METHODS: An electronic survey was developed and sent to all members of the American Association of Colleges of Pharmacy Curriculum and Student Services Personnel Special Interest Groups. The survey gathered details about institutional criteria and practices used in identification of students at risk of failure, steps of early intervention, and approaches to academic remediation. Descriptive data are presented. RESULTS: About 70% of accredited S/COPs responded with a complete survey. There was no statistically significant difference between public or private institutional practices. All respondents reported remediation approaches, but only 85% had structured intervention practices. There was marked variability in reports of specific details for both intervention and remediation. CONCLUSIONS: There is great diversity in approaches to both intervention and remediation. This study provides baseline data on which to build future research that might determine best practices to optimize student outcomes. A theoretical framework is provided.

A cross-sectional survey evaluating transgender-related care education in United States pharmacy school curricula.

INTRODUCTION: The objectives of this study are to evaluate the extent of transgender-related care in current pharmacy school curricula, identify where transgender-related care is covered in the curriculum, describe how the content is delivered to pharmacy students, and review how student knowledge of transgender-related care is evaluated. METHODS: This cross-sectional study utilized an online survey of curricular contacts of 142 pharmacy schools in the United States. Survey questions regarding transgender-related care were presented as multiple choice, ranking, and free-response. The survey inquired about transgender-related care information taught, teaching methods, hours of education, and student assessment. RESULTS: Of the 66 schools that responded to the survey, 53% indicated that transgender-related education is a topic that is currently addressed somewhere within the curriculum. Twenty-two pharmacy schools incorporate this topic into the didactic curriculum, two into the experiential curriculum, and 10 into both didactic and experiential. Transgender-related care is only taught in the required curriculum of 41.2% of schools that responded to the survey. CONCLUSION: Transgender-related care education is taught to variable degrees throughout US doctor of pharmacy programs. This study should serve as a call to action to incorporate this necessary transgender-related care education and training into pharmacy curricula to effectively reduce health disparities among this population that is increasingly seeking care.

Opioid overdose response training in pharmacy education: An analysis of students' perception of naloxone use for opioid overdose prevention.

BACKGROUND AND PURPOSE: Pharmacists in New Mexico have prescriptive authority to prescribe naloxone. However, no formal naloxone training has been provided for students at the University of New Mexico College of Pharmacy. EDUCATIONAL ACTIVITY AND SETTING: Training was incorporated into a pharmaceutical care laboratory course. First-year (P1) (n = 63) and third-year (P3) (n = 78) pharmacy students were asked to answer a pre- and post-training survey. The survey was designed to assess students' self-rated knowledge, clinical-type skills related to naloxone and opioids, and attitude toward prescribing naloxone. In class students reviewed the epidemiology of opioid overdose and risk assessment methods for patients, and the students practiced using an intranasal spray and an auto injector. FINDINGS: The pre-survey showed that P3 students had higher confidence levels in regards to naloxone therapy compared with P1 students. However, educational materials significantly increased confidence levels in drug knowledge, clinical-type skills, and patient counseling in both cohorts. The P3 cohort tended to be more likely to disagree with advertisements about the availability of naloxone therapy by pharmacists as compared to the P1 cohort. SUMMARY: P1 and P3 students demonstrated improved knowledge, skills, and attitudes in regards to naloxone therapy and dispensing. Naloxone training is essential to increase pharmacy students' knowledge about opioid overdose and naloxone benefits. Although the training helped increase students' confidence level, additional practical training and longitudinal instruction in a pharmacy curriculum would be valuable so that students could transfer the knowledge into practice as a pharmacist.

Evaluation of Liver Biomarkers as Prognostic Factors for Outcomes to Yttrium-90 Radioembolization of Primary and Secondary Liver Malignancies.

The objective of this study was to examine indicators of liver function and inflammation for prognostic value in predicting outcomes to yttrium-90 radioembolization (RE). In a retrospective analysis, markers of liver function and inflammation, biomarkers required to stage liver function and inflammation, and data regarding survival, tumor response, and progression after RE were recorded. Univariate regression models were used to investigate the prognostic value of liver biomarkers in predicting outcome to RE as measured by survival, tumor progression, and radiographic and biochemical tumor response. Markers from all malignancy types were analyzed together. A subgroup analysis was performed on markers from patients with metastatic colorectal cancer. A total of 31 patients received RE from 2004 to 2014. Median survival after RE for all malignancies combined was 13.6 months (95% CI: 6.7-17.6 months). Results from an exploratory analysis of patient data suggest that liver biomarkers, including albumin concentrations, international normalized ratio, bilirubin concentrations, and the model for end-stage liver disease score, possess prognostic value in predicting outcomes to RE.

Root Cause Analysis Design and Its Application to Pharmacy Education.

Objective. To evaluate third-year pharmacy students' ability to effectively design and apply root cause analysis (RCA) to a sentinel event and to analyze student responses for areas of proficiency and deficiency. Methods. This study involved a comprehensive review of RCA key assessments from 82 students in spring 2014. The performance assessments consisted of a review of each student's RCA worksheet and flow diagram as well as the 1-2 page narrative reflection. Results. The majority of students were able to successfully design an RCA, but had challenges with 3 components: fact-finding session, disclosure plan, and a flow diagram. Several students perceived challenges to conducting a formal RCA in certain health care settings, which included assembling an RCA team and gathering relevant facts, a lack of transparency/safe environment within organizations, and creating a plan for multiple/sequential errors. Conclusion. Most students were able to design an RCA process, but encountered difficulty with some components. Students also identified challenges in applying the approach in certain health care arenas.

Preceptor perceptions of the importance of experiential guidelines.

OBJECTIVES: To assess preceptors' perceptions of the importance of experiential guidelines and identify and compare differences in perceptions. METHODS: Active advanced and introductory pharmacy practice experience preceptors for the University of New Mexico were invited to participate in an anonymous electronic survey regarding the importance of specific tasks and abilities expected in new pharmacist practitioners as outlined in Appendix C of the Accreditation Council for Pharmacy Education (ACPE) Standards and Guidelines. RESULTS: While the majority of preceptors rated most tasks (eg, communication, patient counseling) as very important or important, emerging tasks (eg, health literacy, public health, physical assessment) were not rated as highly by a majority of preceptors. CONCLUSION: The deficiencies identified in the study suggest potential reductions in the transfer of learning from preceptors to experiential students. Preceptor training programs should be structured to raise the perceived level of importance of these tasks.

Current approaches to punitive action for medication errors by boards of pharmacy.

BACKGROUND: To increase disclosure of errors and lead to system improvements, publications recommend a nonpunitive approach to medication errors. To our knowledge there is no published information regarding the extent or bases on which boards of pharmacy invoke punitive action against pharmacists involved in medication errors. OBJECTIVE: To determine how often and on what bases boards of pharmacy determine punitive action to be taken against pharmacists involved in medication error events. METHODS: The policies, procedures, and practices regarding medication errors by pharmacists for 49 of the 50 US boards of pharmacy were reviewed by pharmacy students at the University of New Mexico as a Safe Medication Practices class assignment. RESULTS: Most boards of pharmacy invoke punitive action against pharmacists involved in medication errors. Most states do not have specific rules or regulations that stipulate errors as actual violations and most determinations are made on a case-by-case basis. The major determinants of punitive action were error severity, actual patient injury, patient complaints, and factors related to the pharmacist. The most common types of punitive action include license suspension, probation, or revocation, and fines. In at least 17 states, incarceration was also a possible punitive action. The most common bases for punitive action were to address public safety/health and public complaints. CONCLUSIONS: Despite the fact that punitive action is not recommended as best practice for addressing medication errors made by health care practitioners, most state boards of pharmacy use punitive measures against pharmacists involved in medication errors. Based on current recommendations, such actions would not be expected to lead to improvements in the health care system.

A course assessment process for curricular quality improvement.

OBJECTIVE: To describe a systematic assessment process that provides continuous improvement in the curriculum, supports faculty development, and enhances student learning outcomes. DESIGN: Teams of faculty members, students, and course instructors conducted course assessments, which consisted of monitoring the delivered instruction for agreement with planned content and course integration within the curriculum, and providing ongoing feedback for improving course content, course management, faculty teaching, and student learning experiences. ASSESSMENT: Areas needing improvement were identified and appropriate changes were made. Improvements were achieved in course policy standardization, course integration within the curriculum, faculty teaching behaviors, and student experiences. CONCLUSION: The curriculum assessment plan provides a structured method of monitoring and delivering continuous quality improvement.

Components of a curriculum for molecular imaging scientists.

Molecular imaging is the visualization, characterization, and measurement of biologic processes at the molecular and cellular levels in humans and other living systems (1). It comprises an emerging set of technologies that builds on advances in imaging procedures (e.g., PET, SPECT, MRI, ultrasound, optical, and photoacoustic), improved understanding of biology, and the development of molecularly targeted agents. These continuously expanding sets of imaging methods are often used in combination, and advances in data acquisition and analyses facilitate a more complete understanding of biology. Molecular imaging aims to improve our understanding of mammalian biology and lead to advances in patient care by providing targeted therapies that will enable personalized medicine and the imaging tools to assess outcome. Implementation of these new technologies in clinical care has many educational, technical, and regulatory challenges that must be overcome before molecular imaging reaches its full potential. The impact of molecular imaging has been significant in several disciplines, because it represents a paradigm shift in how scientists and clinicians can observe biology in real time and in a relatively noninvasive manner to enable the power of repeated measures in living organisms.

Alignment of pharmacotherapy course assessments with course objectives.

OBJECTIVE: To determine whether instructor-prepared classroom examinations for pharmacotherapy courses were aligned with course goals and objectives. DESIGN: Assessment items from examinations in 2 pharmacotherapy courses were evaluated. Four categories of alignment (depth of knowledge, categorical concurrence, range of knowledge, and balance of representation) were used to match course assessments with objectives. ASSESSMENT: While assessments met the criteria for acceptable alignment, there were areas for improvement. Goals and objectives were unevenly assessed, with 1 goal aligning with 45% of all assessment items. The assessments covered all content categories and the range of knowledge established by the objectives, but objectives under specific goals were not evenly assessed. CONCLUSION: This alignment study provided quantitative data useful for review and revision of pharmacotherapy course objectives and assessments and demonstrated the usefulness of alignment assessment as a tool for continuous quality improvement.