Adaptation and evaluation of a monopolar electrosurgical triangle-tip knife for transendoscopic ventriculocordectomy in healthy horses.

OBJECTIVE: To evaluate the efficacy and safety of a transendoscopic monopolar electrosurgical triangle-tip knife as instrumentation to perform unilateral ventriculocordectomy (VC) in healthy adult horses. STUDY DESIGN: In vivo experimental study. STUDY POPULATION: Nine horses donated for medical conditions unrelated to respiratory system. METHODS: The triangle-tip knife was applied in contact fashion. Left VC was performed under standing sedation. Endoscopic images of the upper airway were graded for inflammation by 2 masked surgeons preoperatively and immediately, 24 hours and, in 2 cases, 7 and 14 days postoperatively. Four larynxes were examined for histological evidence of inflammation and collagen deposition at 24 hours (n = 2) and at 14 days (n = 2) after surgery. RESULTS: Ventriculocordectomy was successfully performed in all horses. Endoscopic evidence of inflammation was scored as normal (preoperatively), mild (immediately postoperatively), mild (24 hours postoperatively), mild (7 days postoperatively), and normal (14 days postoperatively). According to histopathology, inflammation of the surgical site and ventricularis muscle was generally increased (variable is common and is present in most high-power fields) 24 hours and 14 days postoperatively. Fibrosis and collagen deposition also seemed increased at the surgical site 14 days postoperatively. CONCLUSION: Ventriculocordectomy was successfully performed with an electrosurgical triangle-tip knife and resulted in acceptable short-term outcomes. CLINICAL SIGNIFICANCE: The use of an electrosurgical triangle-tip knife alternative instrumentation may be offer an alternative option to perform VC in practices when diode laser is not available or is cost prohibitive. Longer term evaluation of the VC site is required to determine the effect on rima glottic cross-sectional area.

Tenotomy of the semitendinosus muscle under standing sedation versus general anesthesia: Outcomes in 20 horses with fibrotic myopathy.

OBJECTIVE: To compare outcomes after semitendinosus tenotomy performed under standing sedation versus general anesthesia. STUDY DESIGN: Retrospective case series. SAMPLE POPULATION: 20 horses with fibrotic myopathy of the semitendinosus muscle. METHODS: Medical records (2002-2015) of horses undergoing tenotomy of the semitendinosus muscle for the treatment of fibrotic myopathy were reviewed. Signalment, history, affected muscles, restrain method, surgical procedures, and short-term outcome as well as complications were retrieved from records. Long-term outcome (gait and athletic function) was assessed at least 6 months postoperatively by conversation with the owners. Pearson's χ2 statistical analysis was used to compare restrain method and affected muscles with overall outcome. Significance was set at P < .05. RESULTS: Tenotomy of the semitendinosus muscle was performed under standing sedation in 8 horses and under general anesthesia in 12 horses. Follow-up period ranged from 9 months to 10 years. Gait was improved to variable degrees in 8 of 14 horses when the semitendinosus muscle alone was affected and in 4 of 6 horses when both the semitendinosus and semimembranosus muscles were involved (P = .11). Six of 8 horses treated under standing sedation and 6 of 12 horses treated under general anesthesia exhibited some improvement in the characteristic fibrotic gait (P = .4473). Five of 6 athletic horses treated under standing sedation and 6 of 9 athletic horses treated under general anesthesia returned to their preinjury level of athleticism. Horses treated under standing sedation had no incisional complications; 2 of 12 horses treated under general anesthesia exhibited incisional drainage. CONCLUSION: Tenotomy of the semitendinosus muscle in horses with fibrotic myopathy leads to similar improvement in gait, whether performed under standing sedation or general anesthesia.

Why We Need to Pay Attention to Stereotype Threat.

Although "implicit bias" has been a major focus in diversity, equity, inclusion, and antiracism educational efforts, less attention has been directed to "stereotype threat." This commentary aimed to bring increased awareness to the pharmacy academy about stereotype threat phenomena as well as explore its impact in the areas of education, with a specific focus on health professions education. In addition, potential and practical strategies are discussed to mitigate its occurrence in pharmacy education.

Impact of COVID-19 on Pharmacy Education and Practice: Strategies to Boost Advocacy and Unity among Health Care Organizations.

The global COVID-19 pandemic impacted pharmacy education and changed the pharmacists' scope of practice at the federal and state levels. Based on the Amended Public Readiness and Emergency Preparedness Act, pharmacists were authorized to provide essential services, including testing, treatments, and immunizations at various practice settings. Specifically, the United States Food and Drug Administration issued emergency use authorization for several medications, vaccines, and medical devices. The pandemic also affected the regulatory landscape for pharmacists, pharmacy education, access to care, and delivery of pharmacy services in-person and through telehealth. The pandemic's specific impact on pharmacy education heightened awareness of the well-being of the Academy. This commentary will highlight the impact of COVID-19 on both pharmacy education and practice. It will also provide strategies that educators, researchers, and practitioners can take into future research and action to help promote advocacy and unity among pharmacy organizations.

Changing the foundations of faculty development by developing a quality learning environment.

INTRODUCTION: Faculty development should be based on the tenets of adult education, emphasizing active learning, engagement, relevance, and opportunities for application. The traditional approach, however, has focused on providing content in an instructor-centered fashion, relying predominantly on passive learning with infrequent learner engagement, minimal learner preparation, and poor use of performance assessment to drive growth. PERSPECTIVE: By modeling the principles of educational psychology and adult learning theory (including involving the learner in the design and outcomes of the learning experience, using active learning strategies, and facilitating relationship development between learners and facilitators), faculty development can be transformed into a growth focused Quality Learning Environment (QLE). IMPLICATIONS: Here, we call for a redesign of faculty development around the principles of a QLE as an investment in faculty growth and a healthier and more innovative faculty culture. A novel, four-stage approach is offered to support this transformation.

Guidelines for Assessing and Enhancing the Organizational Vitality of Pharmacy Educational Programs: A Call to Action!

Organizational vitality encompasses organizational mission and identity, organizational purpose and values, and employee engagement, cohesiveness, anxiety, and information sharing. Using the organizational vitality framework consisting of the following five pillars: (1) human, (2) knowledge, (3) intellectual, (4) financial capital, and (5) market value, we propose a reflection guide and specific calls to action for academic leaders including deans, department chairs, assistant/associate deans, and others within pharmacy and healthcare education systems. Our overall aim is to provide a blueprint for academic leaders to assess and enhance the organizational health, vitality, resiliency, and sustainability of their pharmacy educational programs using an established organizational vitality framework. This guide can help academic leaders at all levels to reflect on their organization's vitality and use the steps outlined here to renew conversations about faculty life, identities as leaders, the global pharmacy Academy's core mission and values, and the pursuit of work-life harmony in the context of their pharmacy schools' organizational vitality. All leaders within pharmacy educational programs should identify and embrace a holistic and guided framework that emphasizes organizational vitality.

Achieving Enrollment Outcomes by Aligning Applicant Recruitment and Selection with Unique Organizational Niches.

Several Doctor of Pharmacy programs have rescinded their requirement for applicants to complete the Pharmacy College Admissions Test, modified their requirements for prerequisite coursework, and reduced the minimum grade point average required for admission. As schools and colleges of pharmacy begin to use these and other more holistic approaches to recruitment and admission, the quantity and quality of students in the applicant pool will continue to shift. In alignment with their unique mission, values, and vision statements, pharmacy programs have also expanded aspects of their application and review process to increasingly focus on applicants' leadership skills, community service, teamwork, collaboration skills, and paid and volunteer work. These aspects allow them to look beyond a candidate's academic performance and instead emphasize skills and affective domain areas that are aligned with the Accreditation Council for Pharmacy Education standards and Center for the Advancement of Pharmacy Education outcomes. Ways in which pharmacy schools and colleges can refine their recruitment and admissions processes to better align with their unique curricular and programmatic niche areas are discussed.

Comparative Stiffness of an Equine Distal Sesamoid Bone Fracture Model Stabilized with 3.5-mm versus 4.5-mm Cortical Bone Screws in Lag Fashion.

OBJECTIVE: The aim of this study was to to determine the comparative stiffness following repair of an axial sagittal fracture model in equine distal sesamoid bones using either a single 3.5-mm or 4.5-mm cortical bone screw placed in lag fashion. STUDY DESIGN: The present study was an in vitro biomechanical study. RESULTS: The mean (±standard deviation) stiffness value for the 4.5-mm screw-bone construct (522.49 N/mm ± 168.21) was significantly greater than the 3.5-mm screw-bone construct (408.46 N/mm ± 131.13) (p = 0.047). This represents a 28% difference in mean stiffness. CONCLUSIONS: In vitro, the 4.5-mm screw-bone construct creates a stiffer repair of fractured distal sesamoid bones by a margin of 28%. The 4.5-mm cortical bone screw may better withstand forces imparted on the distal sesamoid bone sustained during anaesthetic recovery, normal weight bearing and athletic exercise, thereby minimizing the risk of implant failure.

A Comprehensive Reflective Journal-Writing Framework for Pharmacy Students to Increase Self-Awareness and Develop Actionable Goals.

Objective. To develop and evaluate the effectiveness of a structured model for reflective journal writing (RJW) and a grading rubric as part of a student portfolio designed to help Doctor of Pharmacy (PharmD) students create actionable goals. Methods. A structured, eight-domain format was developed to engage students in prioritization, identification, exploration, recollection, evaluation, and challenging/solidifying their own knowledge, while assembling an action plan for development (abbreviated using the acronym PIE-RECAP). After completing RJW using this model, students self-identified domains established by the Center for the Advancement of Pharmacy Education (CAPE) that corresponded to their entries. A grading rubric was designed and normalized to require minimal training for use. RJW and other elements of student portfolios were implemented simultaneously across three cohorts (N=296). Twenty-one faculty and staff graders each evaluated 10 to 15 student journal entries. Results. Of 771 journal entries, 648 (84%) met expectations, while 123 (16%) needed to be rewritten. Students identified experiences that were meaningful to them and shared in their RJW entry the knowledge and/or information that they did not know prior to the experience. Common themes identified in the students' RJWs included: curricular experiences (12.7%), cocurricular experiences (18.4%), and experiential training (68.6%). Conclusion. The PIE-RECAP method can be used to guide students in RJW and identify CAPE domains in their personal and professional experiences in pharmacy school. The associated grading rubric can be used to evaluate students' RJW entries and assess their growth in curricular, cocurricular and affective domains relative to their progression.

National Survey Exploring Drug Screening in Pharmacy Programs.

Objective. To explore drug screening programs, including requirements, policies, and procedures among pharmacy programs; frequency of drug-related incidents; and types of substances misused by pharmacy students. Methods. IRB-approved web-based and paper surveys were sent to pharmacy deans, experiential education faculty, and student affairs personnel at 135 US ACPE-accredited and candidate status programs. Descriptive statistics and chi-square test were used to analyze the data, identify relationships and draw conclusions. Results. Administrators from 98 programs responded (73% response rate). Sixty-one percent reported implementing a urine drug screen requirement for students, with a 10-panel screen as the most common required screen (72%). Ninety-three percent of programs require students to pay for the screen, with costs averaging $42 per screen. Programs reported an average of 2.2 substance-related events per 100 students annually, with alcohol, marijuana, amphetamines, opioids and benzodiazepines most commonly involved. Schools that do not screen reported twice as many incidents as those that screen. Conclusion. A drug screening program can deter pharmacy students from inappropriate substance use. The results from this study can assist pharmacy administrators in evaluating the need to institute or enhance a drug screening program at their school or college of pharmacy.

Evaluation of perceptions and knowledge of mental illness in the United States through crowdsourcing.

INTRODUCTION: Crowdsourcing is a method of data collection with possible benefits in assessing perceptions of mental illness in a large US population. METHODS: The objective was to describe perceptions and trends of stigma surrounding mental illness in the United States using crowdsourcing. An online survey was conducted evaluating adults in the United States recruited via the online resource Amazon Mechanical Turk. Questions evaluated demographics and perceptions of mental illness. Survey data were adjusted for demographic variables and compared via logistic regression. RESULTS: Respondents (n = 1422) were predominately 18 to 30 years of age (n = 743; 52.3%) and white (n = 1101; 77.4%). Over half reported an individual close to them had mental illness (n = 932; 65.5%), and more than one quarter (n = 397; 27.9%) reported having a current or previous mental illness. Non-whites were less likely to agree that: medications are effective (odds ratio [OR] 0.63); they would be comfortable around a coworker with mental illness (OR 0.66); and mental illness is inheritable (OR 0.74). They are also more likely to agree that mental illness is preventable (OR 1.49). Individuals reporting mental illness were more likely to agree that medications (OR 1.34; 95% confidence interval 1.03 to 1.74) and talk therapy (OR 1.46; 95% confidence interval 1.12 to 1.90) are effective. Those reporting some or no college were more likely to agree that the United States has good access to mental health treatment. DISCUSSION: Crowdsourcing may be an effective way to obtain information regarding demographics, stigma, and mental illness. Personal experiences with mental illness, ethnicity, and educational level appear to continue to impact perceptions of mental illness.

Integration of mentored self-directed learning (MSDL) through both group and individual presentations in an accelerated modified block program.

BACKGROUND AND PURPOSE: Project aim was to examine the feasibility and logistics of mentored self-directed learning (MSDL) through group and individual presentations in an accelerated modified block curriculum. Perspectives of students and faculty members toward the incorporation of MSDL were also explored. EDUCATIONAL ACTIVITY AND SETTING: During a two-week pharmacotherapy block, students made group presentations requiring two elements: a case presentation on curricular content (Element-1) and an inclusion of "novel" information students did not receive didactically (Element-2). Curricular content for Element-1 stemmed from a pharmacotherapy course on gastroenterology and nutrition, and individual presentations were scheduled during a semester-long skill-based course. Surveys on student perspectives were conducted at baseline, after group presentations, and after individual presentations. Faculty members also provided feedback and evaluations. FINDINGS: Whereas 58% of students considered a case presentation (Element-1) more valuable for their learning than inclusion of Element-2, 78% of faculty's responses indicated the incorporation of both Elements was valuable. For the following individual presentations, 73% of students were willing and able to present a topic not extensively addressed in the didactic curriculum by employing MSDL. Students improved their confidence in preparing and making presentations for peers and faculty/preceptors through the MSDL activities (p < 0.025). At the end of this project, the faculty determined 88% of students were ready to give a presentation considered appropriate for Advanced Pharmacy Practice Experience. DISCUSSION: MSDL through group and individual presentation activities were feasible and provided a valuable learning experience for students in an accelerated modified block curriculum.

Deliberate Integration of Student Leadership Development in Doctor of Pharmacy Programs.

The CAPE 2013 Outcomes answered the call for increased student leadership development (SLD) by identifying leadership as a desired curricular goal. To meet this outcome, colleges and schools of pharmacy are advised to first identify a set of SLD competencies aligned with their institution's mission and goals and then organize these competencies into a SLD framework/model. Student leadership development should be integrated vertically and horizontally within the curriculum in a deliberate and longitudinal manner. It should include all student pharmacists, begin at the point of admission, and extend beyond extracurricular activities. The school's assessment plan should be aligned with the identified SLD competencies so student learning related to leadership is assessed. To accomplish these recommendations, a positive environment for SLD should be cultivated within the school, including administrative backing and resources, as well as support among the broader faculty for integrating SLD into the curriculum.

Reframing our pursuit of life balance.

During our time in the 2013 Academic Leadership Fellows Program, we explored what it takes to achieve life balance through a framework presented in a Harvard Business Review article. In this Statement, we describe 5 different areas from the article that provide infrastructure for reflecting on how we have learned to approach life balance in academia. We also provide brief messages based on this reading and others to help academics' pursuit of life balance.

Practical Team-Based Learning from Planning to Implementation.

Team-based learning (TBL) helps instructors develop an active teaching approach for the classroom through group work. The TBL infrastructure engages students in the learning process through the Readiness Assessment Process, problem-solving through team discussions, and peer feedback to ensure accountability. This manuscript describes the benefits and barriers of TBL, and the tools necessary for developing, implementing, and critically evaluating the technique within coursework in a user-friendly method. Specifically, the manuscript describes the processes underpinning effective TBL development, preparation, implementation, assessment, and evaluation, as well as practical techniques and advice from authors' classroom experiences. The paper also highlights published articles in the area of TBL in education, with a focus on pharmacy education.