Integration of systematic clinical interprofessional training in a student-faculty collaborative primary care practice.

The changing healthcare environment and movement toward team-based care are contemporary challenges confronting health professional education. The primary care workforce must be prepared with recent national interprofessional competencies to practice and lead in this changing environment. From 2012 to 2014, the weekly Beth Israel Deaconess Crimson Care Collaborative Student-Faculty Practice collaborated with Northeastern University to develop, implement and evaluate an innovative model that incorporated interprofessional education into primary care practice with the goal of improving student understanding of, and ability to deliver quality, team-based care. In the monthly interprofessional clinic, an educational curriculum empowered students with evidence-based, team-based care principles. Integration of nursing, pharmacy, medicine, and masters of public health students and faculty into direct patient care, provided the opportunity to practice skills. The TeamSTEPPS® Teamwork Attitudes Questionnaire was administered pre- and post-intervention to assess its perceived impact. Seventeen students completed the post-intervention survey. Survey data indicated very positive attitudes towards team-based care at baseline. Significant improvements were reported in attitudes towards situation monitoring, limiting personal conflict, administration support and communication. However, small, but statistically significant declines were seen on one team structure and two communication items. Our program provides further evidence for the use of interprofessional training in primary care.

Interprofessional socialization as a way to introduce collaborative competencies to first-year health science students.

Interprofessional education (IPE) is the cornerstone of preparing future health care providers but remains to be a challenge for many health science programs. We aimed to develop and evaluate an interprofessional conference for first-year health science students with goals to provide students with interprofessional socialization opportunity and introduce IPE principles. A half-day conference was based upon core competencies for health professionals and involved 277 first-year health sciences, nursing, pharmacy, physical therapy, and speech language pathology and audiology students. Alcohol and substance misuse was chosen as a topic for its relevance to college students and health professionals. Results from program evaluation revealed that the conference was successful in exposing students to core interprofessional competencies and provided useful information about alcohol and substance misuse. This study advocates for early inclusion of IPE in the health professions curricula in the form of interprofessional socialization.

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.

A National Survey of Perceptions Around Conditions Associated With Pharmacy Faculty Workload Equity.

OBJECTIVE: To assess pharmacy faculty members' perceptions of conditions associated with workload equity and factors that can improve workload equity. METHODS: A 26-item survey instrument was developed and distributed via email to members of the American Association of Colleges of Pharmacy Council of Faculties. Questions pertained to the workload distribution, fairness in assignment, and perception of the conditions associated with workload equity (transparency, context, credit, clarity, norms, and accountability) as well as institutional and individual demographics. RESULTS: A total of 662 responses were obtained (response rate 15.9%). Respondents' demographics were comparable to available national data. Approximately 41% of respondents reported their institutions did not have a written faculty workload policy. Most respondents reported their workload assignment was fair (highest with research/scholarship) but reported only moderate alignment between assigned and actual workloads. The rating level for what domains the primary decision maker uses to assign workload was highest for context, followed by credit, clarity, and transparency. Transparency was reported as the most needed condition to improve faculty perception of workload equity. Respondents also rated increasing trust between leadership and faculty and increasing productivity and accountability as the most important reasons to minimize workload inequities. CONCLUSION: This was the first national survey of pharmacy faculty perceptions around the conditions associated with workload equity. Though additional research is needed in this area, programs can work to implement strategies associated with all of the conditions, particularly transparency, to improve faculty perceptions of equity.

Gaps and Opportunities for Faculty Workload Policies in Pharmacy and Health Professions Education.

Faculty workload is difficult to delineate and quantify equitably because of the various factors and diverse roles that define faculty positions. This is especially true in health professions education, including pharmacy. Nonetheless, ensuring fair and transparent distribution of faculty workload is necessary for equity and engagement of the faculty workforce. While it is impossible to develop a uniform policy for all faculty, there can be a guide for how workload is developed and measured, especially for promotion or awarding of tenure, focusing on equity and transparency. Developing clear definitions of workload, setting mutually agreed expectations, and sharing transparent workload assignments and distribution within the institution may be needed. It is imperative to discuss an optimal policy for equitable and transparent workload in each institution and in academic pharmacy as a whole; a lack of this effort can create undue hardship for faculty, decrease productivity, potentially worsen faculty morale, and ultimately impair faculty retention.

Perceptions and Practices for Evaluating Faculty Workload by Pharmacy Education Administration/Leadership.

OBJECTIVE: To assess how department chairs/administrators define, measure, and evaluate faculty workload to better understand practices within the Academy. METHODS: An 18-item survey was distributed to department chairs/administrators via American Association of Colleges of Pharmacy Connect. Participants identified if they are a primary decision maker for faculty workload, whether their program has a workload policy, how workload is calculated, and how faculty satisfaction with workload equity is measured. RESULTS: Of 71 participants initiating the survey, data from 64 participants from 52 colleges/schools were eligible for analysis. Leaders of practice departments reported that their faculty spend an average of 38% of their time on teaching (compared to 46% for non-practice departments), 13% on research (vs 37%), 12% on service (vs 16%), and 36% on clinical practice (vs 0%). Most survey participants (n = 57, 89%) are at schools/colleges with a tenure system, and about 24 participants reported that faculty workload metrics differ across departments/divisions. Teaching assignments and service are reportedly negotiable between faculty and supervisors, and workload expectations are widely variable. The majority indicated they do not analyze faculty satisfaction with workload fairness (n = 35) and faculty do not provide evaluative feedback on how supervisors assign faculty workload (n = 34). Of 6 priorities considered when determining workload, 'support college/school strategies and priorities' ranked highest (1.92) and 'trust between the chair and faculty' ranked lowest (4.87). CONCLUSION: Overall, only half of the participants reported having a clear, written process of quantifying faculty workload. The use of workload metrics may be needed for evidence-based decision-making for personnel management and resource allocation.

A Call for Simplification and Integration of Doctor of Pharmacy Curricular Outcomes and Frameworks.

Pharmacy education faces an upcoming revision of accreditation standards designed to outline degree program requirements for training the next generation of pharmacists. At the same time, pharmacy educators are increasingly expected to integrate multiple other educational frameworks and recommendations from distinct groups into their curricula. With this list of expectations constantly expanding and changing, education leaders are forced to spend valuable time and resources trying to satisfy "checklists" instead of enhancing their programs. The following commentary discusses concerns about the growing complexity of the standards and frameworks used in the accreditation process, overlap and redundancy in these various requirements, and relevant comparisons between pharmacy and medical education. We outline recommendations regarding purposeful integration of frameworks with the goal of simplifying accreditation requirements and enhancing program flexibility to deliver innovative, high-quality curricula.

Current State of and Opportunities for Enhancing Peer Evaluation Practices Across the Pharmacy Academy.

Objective. To examine and summarize policies and procedures for peer evaluation of teaching/instructional coaching (PET/IC) programs within departments, schools, and colleges of pharmacy and to identify opportunities for improving these based on best practices.Methods. A survey was sent to all Accreditation Council for Pharmacy Education (ACPE)-accredited pharmacy programs to collect information regarding procedures to support and evaluate PET/IC programs across institutions. Descriptive statistics were used to summarize the general features of PET/IC programs, and inferential statistics were used to make group comparisons based on institutional control (public, private) and institution age (0-10 years, older than 10 years).Results. Surveys for 91 institutions were completed (response rate=64.5%). Most institutions (78.4%) reported having a PET/IC program. Most institutions with PET/IC programs reported using a combination of formative and summative evaluations (57.4%). The top purposes for PET/IC programs were faculty development (35.8%) and improving teaching (35.8%). Almost half of the PET/IC programs (46.3%) were mandatory for all faculty at the institutions. Most institutions (66.7%) had one standardized instrument used in their PET/IC program. Few institutions (11.9%) reported evaluating or being in the process of evaluating the effectiveness or success of their PET/IC program. Private institutions were more likely to incentivize observers than public institutions (17.1% vs 0).Conclusion. Overall, PET/IC programs are needed to assess and provide feedback to instructors about their teaching practices. While most institutions report having a PET/IC program, wide variability exists in how the programs are implemented. Opportunities exist for institutions to evaluate the effectiveness of their program and identify best practices.

2020 rankings for US PharmD programs, research, and overall quality.

Background: US News and World Report (USNWR) publishes well-known rankings of graduate health programs. Medicine and nursing are ranked with weighted metrics using multiple criteria, and medical schools are ranked separately according to their focus (research or primary care). USNWR pharmacy school rankings are based on a single-question peer perception survey. Objective: The objective of this study was to develop a simple, transparent framework to rank US colleges and schools of pharmacy in overall quality and separately based on program quality and research quality, using data that are readily available to the academy. Methods: Data for three education quality and four research quality metrics were obtained for 2020. Each metric was standardized and ranked, and then each set was summed to determine separate ranks for education and research. Education and research scores were combined using equal weights to provide a single rank for overall quality. A sensitivity analysis was performed to determine the effect of assigning higher proportionate value to education, similar to USNWR medical school rankings. Results: Distinct ranks were produced for education, research, overall (education: research) 50:50, and overall 60:40. Sensitivity analysis suggests the more disproportionately the education and research factors are weighted, the more ranks change. Mid-ranked schools were most impacted when weightings changed due to relative strength in one factor and relative weakness in the other. When weighted 60:40, nine (7%) mid-ranked programs improved in rank, while 11 (11%) worsened in rank compared to the 50:50 model. Conclusion: Separately ranking education and research can highlight the diverse strengths of pharmacy schools. The proposed model is based on easily obtainable data and is easily reproducible, allowing for annual rankings. These rankings may be used by PharmD and PhD applicants when selecting schools and by pharmacy schools to benchmark true and aspirational peers.

Educational research and scholarship - Brainstorming, developing, and publishing together as teams.

INTRODUCTION: Collaborative educational research and scholarship is a powerful tool to help schools/colleges of pharmacy learn from and with each other to continuously improve by sharing best practices. COMMENTARY: There are significant advantages including developing projects with more generalizability and impact, leveraging different and complementary expertise, informal mentorship of junior faculty researchers, task sharing, and group accountability. There are also challenges such as managing multiple participants, sticking to productivity goals and timelines, and scheduling virtual meetings across multiple time zones. IMPLICATIONS: For a number of years, the American Association of Colleges of Pharmacy's Assessment Special Interest Group has intentionally created opportunities for new connections with the purpose of fostering scholarship projects to pursue interesting questions and engage in educational research with other like-minded colleagues. The purpose of this commentary is to share with members of the academy several practical tips for leading and engaging in group projects of educational scholarship.

Moving out of disciplinary silos - Integration of the Pharmacists' Patient Care Process.

INTRODUCTION: In order to better delineate the specific roles of the pharmacist in generating positive health outcomes, pharmacy programs have incorporated the Pharmacists' Patient Care Process (PPCP). However, there has been limited integration in disciplines outside of pharmacy practice. PERSPECTIVE: This article makes the case that schools need to commit to fully integrating the PPCP that is inclusive of all disciplines. By fostering such integration, all faculty can recognize their role in creating practice-ready, team-ready pharmacists that are consistent, collaborative, and drive positive patient health outcomes. There also is likely innovative integrative efforts being done related to the PPCP in non-practice disciplines, and this article provides some ideas for future scholarly efforts. IMPLICATIONS: If the academy embraces the PPCP fully, we can unite and demonstrate how pharmacists contribute value to the healthcare team.

Perceptions of programs that orient non-practice faculty to the pharmacy profession: A pilot study.

INTRODUCTION: Faculty collaboration across disciplines plays an important role in pharmacy education, and in particular, the American Association of Colleges of Pharmacy (AACP) faculty survey asks whether colleges/schools of pharmacy (C/SOPs) have programs available to orient non-practice faculty to the profession of pharmacy. The purpose of this pilot study was to characterize perceptions of the importance and effectiveness of such programs, and to examine barriers to their successful implementation. METHODS: An online survey was developed to collect demographic information and perceived importance, effectiveness, and barriers of programs designed to orient non-practice faculty to the pharmacy profession. The survey was posted to the AACP Connect Council of Deans and Council of Faculties listservs and responses were gathered and analyzed using descriptive statistics. RESULTS: Responses from 157 individuals representing 90C/SOPs were collected. While the majority (82%) of respondents rated programs that orient non-practice faculty to the pharmacy profession as extremely or very important, only 17% rated such programs as extremely or very effective. Lack of time was identified as the primary barrier. Differences were identified between various interest groups, including practice vs. non-practice disciplines and administrators vs. non-administrators. CONCLUSIONS: Programs to orient non-practice faculty to the pharmacy profession were perceived to be important; however, such programs were found to lack efficacy.

Inclusion of the Pharmacist Patient Care Process in Doctor of Pharmacy Curricula.

Objective. With the inclusion of the Pharmacists' Patient Care Process (PPCP) in the most recent Accreditation Council for Pharmacy Education standards, institutions must determine how best to vertically and horizontally integrate and assess the PPCP in the curriculum. The objective of this study was to identify the breadth and depth of PPCP implementation as well as faculty involvement in teaching the PPCP at ACPE-accredited institutions.Methods. A survey to address the study objectives was developed, piloted, and distributed electronically to all US pharmacy institutions in candidate or accredited status. Electronic reminders were implemented to improve response rates. The data were analyzed descriptively.Results. Approximately 70% of institutions responded to the survey. Integration of the PPCP was most often championed by an individual faculty member and/or a committee. Practice faculty taught PPCP at nearly all institutions, while only a third of survey respondents reported that foundational and social administrative faculty taught the PPCP. Development related to PPCP curricular integration mainly focused on preceptors. Most institutions integrated the PPCP through the didactic and experiential curriculum in an approach that allowed for reinforcement or mastery of concepts. There were limited integration efforts into interprofessional education. Institutions had a plan for assessing the effectiveness of the integration, but were varied in their approach.Conclusion. Institutions have embraced integrating the PPCP into their curricula, didactically and experientially. Progress still needs to be made regarding inclusion of all faculty in teaching the PPCP as well as integrating the PPCP into other key curricular areas, such as interprofessional learning. Faculty development efforts may be beneficial to address these aspects.

Improving and Restoring the Well-being and Resilience of Pharmacy Students during a Pandemic.

During times of stress, such as those experienced during the novel coronavirus identified in 2019 (COVID-19) pandemic, pharmacy students handle the experience differently. For some, the experience may negatively impact their sense of well-being; for others, being at home with family could actually improve their well-being. While students are completing academic work at home and after they finally return to campus, pharmacy schools need to be keenly aware of students' experiences and implement strategies to build their resilience and improve their well-being. One approach will not meet the needs of all students. Many of the challenges that pharmacy students have faced or will face when they return to the classroom are discussed along with some programs and activities that have proven successful.

An initial environmental scan of APPE readiness assessment.

INTRODUCTION: Standards 2016 require schools/colleges of pharmacy (s/cop) to assess students' readiness to enter advanced pharmacy practice experiences (APPEs). However, literature describing how schools are meeting this standard is limited. The purpose of this study was to conduct an environmental scan to describe how s/cop assess student readiness to enter APPEs. METHODS: A web-based survey was distributed to assessment leads at United States s/cop, regardless of accreditation status. Respondents answered questions related to their current approach to assessing student APPE readiness, existence of intentional assessment plans, competencies used, assessment methods, benchmarks, and remediation strategies. Aggregate data were analyzed using descriptive statistics. RESULTS: Fifty-two S/COP (36.1%) responded. The majority (90.1%) were fully accredited schools. Most respondents have an intentional APPE readiness plan (73.5%), although the duration since implementation varied. There was no consensus among schools on which competencies informed APPE readiness with 67.3% listing Center for the Advancement of Pharmacy Education (CAPE) 2013 outcomes, 61.2% Guidance for Standards 2016 Appendix A, 53.1% pre-APPE domains (Standards 2007), and 30.6% Entrustable Professional Activities. Twenty-eight S/COP (57.1%) reported having individual student-level data to assess student APPE readiness. The most common methods for validating student APPE readiness were preceptor (48.9%) and student (44.9%) surveys. CONCLUSIONS: This environmental scan begins to identify trends in how S/COP is approaching the assessment of student readiness to begin APPEs. Further research is needed to identify best practices and practical methods to ensure compliance with current accreditation standards.

Recommendations for integration of foundational and clinical sciences throughout the pharmacy curriculum.

INTRODUCTION: Pharmacy faculty have the often difficult task of translating and incorporating existing concepts and advances from the foundational sciences into the clinical sciences and practice. This commentary focuses on content integration as a curricular and educational strategy, outcomes data from integration, and recommendations for programs employing or considering curricular integration. COMMENTARY: Integration of foundational and clinical sciences across the curriculum has been emphasized in accreditation standards but met with mixed reactions by faculty across different disciplines in the academy. Many pharmacy programs have already incorporated some level of integration in didactic courses. However, most report coordination of curricular delivery rather than higher levels of integration in which different disciplines work together to design and deliver instructional materials across the entire curriculum. IMPLICATIONS: Curricular integration models should be optimized to minimize or eliminate the risks of marginalization of foundational sciences in pharmacy curricula. A significant problem in implementing curricular integration is determining the appropriate balance between foundational and clinical sciences. Well-designed curricular integration with ongoing reinforcement that builds in complexity over time could enhance knowledge retention, critical thinking abilities, and clinical decision making. Further research is needed into the outcomes achieved from various integrated curricular approaches in pharmacy education.

Lessons Learned from Evaluating a Process for Systematic Curriculum Review.

Objective. To describe an evaluation of and improvements made to a process of systematic curriculum review. Methods. The systematic curriculum review process was developed with the goal of continuous curriculum assessment and improvement. Information on impact and feedback on the processes were collected from curriculum committee experience and an anonymous web-based survey sent to instructors of courses offered by the pharmacy school, and current and past curriculum committee members. Results. Thirty (88%) participants completed the survey with 72% reporting course changes due to systematic curriculum review, such as changes to programmatic outcomes covered (77%), assessment strategies/grading (46%), course outcomes (38%), and content (38%). Based on feedback received, revisions were made to the process: changing the frequency of course review (from every 3 years to 4 years), including experiential and elective courses (supported by 63% of faculty), and streamlining the logistics of course review and presentation to the curriculum committee. Conclusion. The development of the systematic curriculum review process resulted in course improvements and a system to keep curricular mapping current. It was valuable in the most recent preparation of the self-study and could be readily transferred to other institutions.

Curricular and Co-curricular Coverage of Leadership Competencies and the Influence of Extracurricular Engagement on Leadership Development.

Objective. To evaluate coverage of leadership-related competencies in a Doctor of Pharmacy (PharmD) curriculum and the impact of co-curricular and extracurricular experiences on students' leadership perceptions and self-efficacy. Methods. Course syllabi were used to comprehensively map the PharmD curriculum to 11 competencies related to the Leadership CAPE outcome. A survey was developed and administered to all first year through fourth year pharmacy (P1-P4) students to evaluate their leadership experience and engagement, and to assess their attitudes and self-efficacy in 11 leadership competencies. Descriptive statistics were used to evaluate student level of engagement in leadership activities and the Mann-Whitney U test was used to compare students' attitudes and self-efficacy based on the extent of leadership engagement. Results. Curriculum mapping revealed that all competencies were covered in at least one course at the introductory or reinforce levels. There were 362 students (68% of all PharmD students) who completed the survey. When responses from students who reported active engagement in pharmacy student organizations (defined as e-board member or chair of committee, N=142 or 39% of respondents) were compared to the rest of the cohort, statistically significantly better attitudes and self-efficacy were seen in 7 of 11 competencies. Perceptions and self-efficacy of the 72 students (19.9%) who reported active engagement in non-pharmacy organizations did not significantly differ from those not actively involved in any organizations. Conclusion. The leadership competencies curriculum mapping exercise was useful in identifying gaps in coverage and depth of coverage, inconsistencies in course objectives accurately reflecting coverage of leadership topics and competencies, and considerations that should be given to co-curricular leadership development. Active leadership engagement in pharmacy student organizations should be encouraged because of associated improved leadership perceptions and self-efficacy.

A Review of Strategies for Designing, Administering, and Using Student Ratings of Instruction.

Objective. To review and recommend strategies for utilizing student ratings of instruction (course and instructor) including considerations regarding design, administration, and use and interpretation of results. Findings. Improving course delivery and pedagogy using student ratings of instruction requires programs to design evaluation instruments that are aligned with the following good, scholarly teaching criteria: offer 10-20 rating scale questions and at least one written response question, ensure that students understand what the questions are asking, use a standardized form for evaluating all faculty members, allow for additional tailored questions to be added to the form, and employ a four- or five-point rating scale with a "not applicable" option. When administering evaluations, programs should limit the number of faculty members evaluated to those teaching greater than or equal to five clock hours of lecture or schedule evaluations based on academic rank; use an online course evaluation tool; randomly select students to participate; offer the evaluation at the end of the term (and/or midpoint for team taught classes); offer the evaluation during scheduled class time; and allow for voluntary, anonymous student participation. Finally, programs should create an assessment plan that outlines the results' release timeline, a list of who will receive result summaries, and how the results will be used. Programs should also encourage faculty reflection, offer mentoring in results interpretation, coach faculty members to summarize and quantify comments and longitudinally track results using tables, and create an accountability action plan to address deficiencies. Summary. In order to better ensure that student ratings of instruction are used to improve teaching, colleges and schools should adopt intentional design, structured administration processes, and transparent reporting of results.

Quality Assurance and Improvement Practices of Experiential Education Programs in Schools of Pharmacy.

Objective. To identify common practices for measuring quality of experiential education (EE) programs at US schools and colleges of pharmacy. Methods. In-depth, semi-structured phone interviews were conducted with directors of experiential education or their equivalent, to identify elements of quality assurance (QA) processes for EE. To ensure representativeness from all fully accredited programs, purposeful sampling was used for participant solicitation and enrollment until both code and meaning saturation were reached. Participants were asked questions in six domain areas (preceptor and student performance, site quality, role of site visits, coursework, and achievement of learning outcomes). An iterative data coding and analysis process identified themes and notable practices within each domain area. Results. Interviews were conducted with representatives of 29 programs. All participants reported evaluating preceptor performance. Fewer participants identified a deliberate site assessment process, with most equating preceptor and site evaluation. Participants conducted site visits primarily to assess site quality and maintain relationships with preceptors. Few participants were able to provide details of a process used for evaluating experiential education coursework and student outcomes. All participants used student performance assessments to measure the quality of student performance. Overall, participants almost universally reported collecting data, less frequently described processes for data evaluation, and rarely shared outcomes arising from data collection and analysis. Conclusion. Themes and notable practices identified in this study provide initial benchmarks for QA programs for EE and will inform content and metrics of subsequent follow-up studies. A six-step process for QA for EE is proposed.