Research and Education Needs for Complex Generics.

Complex generics are generic versions of drug products that generally have complex active ingredients, complex formulations, complex routes of delivery, complex dosage forms, are complex drug-device combination products, or have other characteristics that can make it complex to demonstrate bioequivalence or to develop as generics. These complex products (i.e. complex generics) are an important element of the United States (U.S.) Food and Drug Administration's (FDA's) Generic Drug User Fee Amendments (GDUFA) II Commitment Letter. The Center for Research on Complex Generics (CRCG) was formed by a grant from the FDA to address challenges associated with the development of complex generics. To understand these challenges, the CRCG conducted a "Survey of Scientific Challenges in the Development of Complex Generics". The three main areas of questioning were directed toward which (types of) complex products, which methods of analysis to support a demonstration of bioequivalence, and which educational topics the CRCG should prioritize. The survey was open to the public on a website maintained by the CRCG. Regarding complex products, the top three selections were complex injectables, formulations, and nanomaterials; drug-device combination products; and inhalation and nasal products. Regarding methods of analysis, the top three selections were locally-acting physiologically-based pharmacokinetic modeling; oral absorption models and bioequivalence; and data analytics and machine learning. Regarding educational topics, the top three selections were complex injectables, formulations, and nanomaterials; drug-device combination products; and data analytics, including quantitative methods and modeling & simulation. These survey results will help prioritize the CRCG's initial research and educational initiatives.

Acceptance of interprofessional learning between medical and pharmacy students in a prescribing skills training workshop: pre-post intervention study.

BACKGROUND: The success of interprofessional collaboration in healthcare services requires a paradigm shift in the training of future health profession practitioners. This study aimed to develop and validate an instrument to measure Student Acceptance of Interprofessional Learning (SAIL) in Malaysia, and to assess this attribute among medical and pharmacy students using a prescribing skills training workshop. METHODS: The study consisted of two phases. In Phase 1, a 10-item instrument (SAIL-10) was developed and tested on a cohort of medical and pharmacy students who attended the workshop. In Phase 2, different cohorts of medical and pharmacy students completed SAIL-10 before and after participating in the workshop. RESULTS: Factor analysis showed that SAIL-10 has two domains: "facilitators of interprofessional learning" and "acceptance to learning in groups". The overall SAIL-10 and the two domains have adequate internal consistency and stable reliability. The total score and scores for the two domains were significantly higher after students attended the prescribing skills workshop. CONCLUSIONS: This study produced a valid and reliable instrument, SAIL-10 which was used to demonstrate that the prescribing skills workshop, where medical and pharmacy students were placed in an authentic context, was a promising activity to promote interprofessional learning among future healthcare professionals.

Training, education, and experience of active duty army pharmacy officers.

OBJECTIVE: To create a summary of training, education, and experience by pharmacy officer rank (colonel, lieutenant colonel, major, and captain) to produce information for senior pharmacy leaders to describe active duty army pharmacy officers and for junior army pharmacy officers to use for individual career planning. METHODS: A 32-question, anonymous, and voluntary survey was developed. Active duty army pharmacy officers were able to complete the survey via the government website, Intelink. The survey was open for 6 weeks during the summer of 2017. RESULTS: The survey was completed by 62% of active duty army pharmacy officers. The responses were used to create a summary of training, education, and experience by pharmacy officer rank. CONCLUSION: The survey was successful in capturing information relating to training, education, and experience by rank, thereby providing useful quantifiable information to describe army pharmacy officer careers. These results may prove valuable to those interested in pharmacy careers in the military, and they create an opportunity to illustrate the distinct profession of army pharmacy officers.

The actual conditions of traditional Japanese Kampo education in all the pharmacy schools in Japan: a questionnaire survey after the enforcement of the new national 2015 core curriculum.

BACKGROUND: To investigate the present status of Kampo education, which has still not been elucidated, after the introduction of the new core national curriculum of 2015 into nationwide pharmacy education, in all 74 pharmacy schools in Japan. METHODS: A postal questionnaire survey was conducted from August 2015 to January 2016. The completed questionnaires were returned by mail. Web-based syllabi were also investigated to ascertain the detailed lecture curricula in each school. Descriptive analyses were conducted without statistics. RESULTS: A total of 74 questionnaires were collected (response rate, 100%). In 2015, the numbers of clinical Kampo classes as required subjects during the 6 years of regular pharmacy school education ranged from 0 to 36 (median, 13; mean, 11.8 ± 7.6). Of the 74 schools, 49 schools (66%) provided Kampo education from a clinical standpoint. Pharmacists employed in pharmacies and physicians taught most of these classes. The major problems to be solved first are: selecting and retaining teachers to teach clinical Kampo medicine (43 of 74 schools, 58%), preparing standard textbooks (37 schools, 50%), and improving the environment for practical Kampo training (30 schools, 41%). CONCLUSIONS: Curricula for teaching Kampo medicine significantly differ at each of the 74 Japanese pharmacy schools. In addition to selecting teachers who can adequately teach clinical Kampo medicine, improving training environments, and nationwide standardization of the curricula and textbooks are critical.

Perceived preparedness for full-scope pharmacist services among recent Doctor of Pharmacy graduates from Ontario schools of pharmacy.

OBJECTIVES: To examine how recent Doctor of Pharmacy graduates feel about providing full-scope pharmacist services (such as prescribing and immunization) and whether characteristics such as recent graduates' institutional and personal demographics, practice setting (e.g., busyness of practice, time spent directly with patients), or additional education after graduation affect their perceptions of feeling able and sure to perform services. DESIGN: Cross-sectional survey. SETTING AND PARTICIPANTS: Recent graduates from 2 pharmacy schools in Ontario, Canada, who were licensed Ontario pharmacists and provided direct patient care in a community pharmacy setting. OUTCOME MEASURES: Dichotomous variables measured how able (less or more able) and sure (less or more sure) recent pharmacy graduates felt in performing 14 full-scope pharmacist services. RESULTS: Of the 231 survey respondents (23.2% response rate), 120 met the inclusion criteria. Overall, graduates felt prepared to perform these services in practice, although for many services, graduates felt more sure than able. Busier practice settings and services that were provided less frequently had a negative impact on new graduate's perceptions of being able and sure. Respondents who were younger or were pursuing further postgraduate training also felt less able and sure. CONCLUSION: It is important for employers of new graduates and academics who train pharmacy students to recognize and encourage new graduates' feelings of being sure and able to provide full-scope pharmacist services. However, new graduates were not immune to the impacts of busy practice settings on provision of these services and should be supported in their development and interest in further training.

What predicts medication therapy management completion rates? The role of community pharmacy staff characteristics and beliefs about medication therapy management.

OBJECTIVES: To model the association between pharmacy technicians' attitudes and planned behaviors toward participating in medication therapy management (MTM) and MTM completion rates. Secondary objectives included 1) to compare pharmacy technician and pharmacist attitudes and planned behaviors toward participating in MTM and 2) to identify respondent and pharmacy demographic factors associated with MTM completion rates. DESIGN: A 27-item survey, adapted from a previously published survey tool based on the Theory of Planned Behavior (TPB), was used to collect respondent perceptions of MTM. Study procedures were approved by the institutional review board. SETTING AND PARTICIPANTS: Pharmacy technicians and pharmacists representing 116 Midwestern community pharmacy locations within a national supermarket chain were eligible to complete a telephone survey during February to May 2017. MAIN OUTCOME MEASURES: MTM completion rates were recorded during the 6-month time frame before survey administration. Unique, nonmeaningful survey codes were used to link responses from respondents to their store's MTM completion rates. Multivariate linear regression analysis was used to model the association between survey responses, pharmacy and staff demographics, and MTM completion rates. RESULTS: Of the 116 eligible pharmacy technicians and 114 pharmacists, 77 pharmacy technicians and 99 pharmacists completed the survey yielding response rates of 66.4% and 86.8%, respectively. Pharmacy technicians held significantly more positive perceptions about MTM delivery, particularly regarding adequate time and support. However, pharmacy technicians reported having the necessary knowledge and skills significantly less frequently compared with pharmacists. TPB variables for pharmacy technicians were not significant predictors of MTM completion rates. However, pharmacist attitudes, pharmacy technician education, and number of technician hours worked per week were positively associated with MTM completion rates. CONCLUSION: Pharmacists' attitudes, pharmacy technician level of education, and number of technician hours worked per week were associated with MTM completion rates.

From workforce intelligence to workforce development: advancing the Eastern Mediterranean pharmaceutical workforce for better health outcomes.

BACKGROUND: The pharmaceutical workforce in the World Health Organization (WHO) Eastern Mediterranean Region plays a key role in improving health outcomes through responsible use of drugs and optimizing effective choice and use. Investment in this workforce's development and planning is fundamental to achieving universal health coverage. AIMS: To provide an overview of the pharmacy workforce capacity trends in the Region and emphasize the importance of workforce intelligence for strategic development. METHODS: A review of the literature and global pharmacy workforce studies conducted by the International Pharmaceutical Federation to identify trends and issues in the Region. RESULTS: The Region has high workforce production capacity compared to other WHO regions but challenges in workforce planning and intelligence strategies persist. Effective workforce planning relies not only on quality intelligence, but also on cross-sectoral coordination and stewardship, and the Pharmaceutical Workforce Development Goals provide countries within the Region with a framework for development. CONCLUSION: There is no workforce development without workforce intelligence.

Managerial skills of new practitioner pharmacists within community practice.

OBJECTIVES: To identify managerial skills required in community pharmacy practice, explore new practitioners' previous exposure to these skills, and assess new practitioners' perceived preparedness to take on managerial responsibilities. METHODS: A survey was developed with the use of Qualtrics and distributed by state pharmacy associations using a convenience sample of pharmacists from Iowa, Kentucky, Michigan, Ohio, and Pennsylvania. Pharmacists not practicing in a community pharmacy setting at the time of the study were excluded. New practitioners were defined as pharmacists practicing for no more than 10 years. RESULTS: A total of 168 pharmacists completed the survey. More than one-half (56%) of respondents self-reported being in a managerial position, and 90% of respondents thought that managerial skills were always or very often necessary. At graduation, 15% of respondents rated their managerial skill proficiency to be high to very high, with this increasing to 57% at current point in their career. When comparing managers versus non-managers, 78% of skills assessed showed higher utilization in managers. Interestingly, only 44% of skills showed a higher proficiency in managers. Finally, 88% of respondents thought that their managerial skills could be improved. CONCLUSION: New practitioners in community practice reported a high utilization of managerial skills, as well as improved proficiency throughout their careers. These skills are important in both community pharmacy training and practice. Managers reported higher utilization of managerial skills, but that utilization did not always correlate with proficiency. This highlights the need to further identify and improve managerial skills during pharmacy education and as part of ongoing continuing professional development.

Incorporation of a community pharmacy-based heart failure assessment tool by advanced pharmacy practice experience students.

OBJECTIVES: To incorporate a published clinical tool related to heart failure (HF) assessment into advanced pharmacy practice experiences in the community pharmacy setting to provide a meaningful and innovative learning experience for students. SETTING: Sixteen independent and chain community pharmacies that served as advanced pharmacy practice experience locations. PRACTICE DESCRIPTION: Sixteen community pharmacy locations served as rotation sites and participated in data collection (8 chain and 8 independent). PRACTICE INNOVATION: This was the first study in which pharmacy students used The One-Minute Clinic for Heart Failure (TOM-C HF) tool to assess HF within the community pharmacy setting. INTERVENTIONS: Trained student pharmacists identified patients who may have heart failure by evaluating medication dispensing records, interviewed the patient using the TOM-C HF tool, and made interventions as clinically appropriate. EVALUATION: The number of students using the TOM-C HF tool, the number and types of interventions made, and student perceptions about the educational and professional value of the patient interaction. RESULTS: Thirty-three of 83 (40%) students completed 63 patient assessments. Thirty-five percent of patients (22/63) were candidates for an intervention. Interventions were performed in 9 of 22 patients (41%). More than 65% of students found the patient interaction to have educational and professional value. CONCLUSION: Students were able to assess HF patients and make interventions in a community pharmacy setting. The majority of students also perceived some value in these assessments. The incorporation of a clinical tool in the community setting driven by fourth-year pharmacy students has been shown to be feasible and to provide both a novel advanced practice experience. In addition, it may be expandable to the services offered at community pharmacies.

Design and Refinement of a Faculty Workload Estimator.

OBJECTIVE: This paper describes the creation and refinement of a Workload Estimator to be used at Colleges/Schools of pharmacy to calculate faculty workload. METHODS: We describe the initial development of the Workload Estimator for pharmacy practice faculty, including the consensus-building methodology and the implementation process. Additionally, we describe the annual refinement and expansion of use to pharmaceutical and administrative sciences faculty. RESULTS: The final product is an Excel file with built-in multiplication factors used to estimate pharmacy faculty workload. CONCLUSION: This Workload Estimator was identified as the most comprehensive and readily adaptable tool to estimate pharmacy faculty workload in July 2023 by the American Association of Colleges of Pharmacy, Council of Faculties, and Council of Deans Task Force on Faculty Workload. The Workload Estimator is currently being studied in a multi-institutional implementation study across dozens of diverse programs across the country with norming data and qualitative perspectives on its use being collected and shared with the Academy in 2024.

Identification of Social Determinants of Education Among Pharmacy Students: Results From a Single-Institution Survey.

OBJECTIVE: To identify social determinants of education (SDOE) among pharmacy students enrolled in the entry-level Doctor of Pharmacy program at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences. METHODS: An original 28-item survey was developed and disseminated to first through fourth year students enrolled in the entry-level Doctor of Pharmacy program at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences during the spring 2023 semester. The survey evaluated student demographics, educational performance, and SDOE in 6 categories: physical health, psychosocial health, economic stability, self-motivation, social environment/community, and physical environment/community. RESULTS: A total of 133 students responded to the survey. Over half of the respondents acknowledged difficulties completing errands or self-care tasks owing to their physical, mental, or emotional health. Over half of respondents also reported concerns about covering expenses at the end of the month. Respondents also reported eating less because of financial restraints (20.0%), worrying about housing (22.9%), feeling unsafe in their neighborhood (29.0%), and feeling lonely or isolated (63.4%). In the secondary analysis, the respondents who had concerns with covering expenses, affording food, or losing housing had significantly lower academic performance. CONCLUSION: This study identified several SDOE among pharmacy students at our institution, suggesting that students at even the highest levels of education may be subject to disparities. The identification of SDOE provides insight into barriers that are potentially hidden but are highly likely to impact student engagement and success. Efforts toward reducing disparities and promoting equitable opportunities for students are necessary to ensure continued growth and diversification of the pharmacy profession.

Assessment of Academic Resilience and Its Associated Factors Among Pharmacy Students in Twelve Countries.

OBJECTIVE: Academic resilience, a critical determinant of academic achievement, is affected by various factors. There is a paucity of large-scale international assessments of academic resilience among pharmacy students. Therefore, this study aimed to assess academic resilience among pharmacy students in 12 countries and to evaluate factors associated with their academic resilience levels. METHODS: A cross-sectional online survey-based study was conducted among randomly selected pharmacy students in 12 countries: Egypt, Türkiye, Indonesia, Pakistan, Bangladesh, Iraq, Jordan, Nigeria, Malaysia, Saudi Arabia, Sudan, and the United Arab Emirates. After pilot testing, the validated 30-item academic resilience scale (ARS) was used for the assessment. The data were collected between November 1, 2022 and April 15, 2023. Descriptive and inferential statistics were performed, as appropriate. RESULTS: A total of 3950 were received from the 12 participating countries. The mean age was 21.68 ± 2.62 years. About two-thirds of the responses were from female participants and those studying for Bachelor of Pharmacy degrees. Overall, the findings show moderate academic resilience, which varied across countries. The median (IQR) of the total ARS-30 was 114 (103-124). Females exhibited lower negative affective and emotional response subscale levels than males. There were significant cross-country variations in the ARS-30 and all subscales. The highest overall levels were reported for Sudan, Pakistan, and Nigeria and the lowest were reported for Indonesia and Türkiye. Students in private universities tended to have higher overall ARS levels than public university students. Higher academic performance was significantly associated with ARS levels, whereas those with excellent performance exhibited the highest ARS levels. Students with exercise routines had higher ARS levels than those without exercise routines. Finally, students who were engaged in extracurricular activities had higher ARS levels than those who did not participate in these activities. CONCLUSION: The study offers insights into the factors affecting academic resilience in pharmacy students across several countries. The findings could guide interventions and support activities to improve resilience and academic outcomes.

A Cross-Sectional Study of Vaccination-Related Education in Pharmacy Programs in the Middle East.

OBJECTIVE: Pharmacists play pivotal roles in improving vaccination rates. However, absence of vaccination-related undergraduate education impedes their ability for these roles. The study aims were to scope vaccination-related education in pharmacy colleges in the Middle East (ME) and to describe potential facilitators and barriers to vaccination administration education using Consolidated Framework for Implementation Research. METHODS: A multinational survey of pharmacy faculty across 14 Arabic-speaking ME countries, involving 132 colleges, examined vaccination education. Data collection involved contacting deans for faculty nominations. Data was analyzed using Statistical Package for the Social Sciences. RESULTS: The questionnaire response rate was 64.7% (89/132), with 89.9% of colleges including vaccination in their curricula. The topics commonly covered included vaccine development (n = 44, 97.8%), vaccine routes of administration (n = 43, 97.7%), and vaccine indications (n = 38, 95%). Planning and marketing vaccination programs (n = 35, 77.8%), documentation and record-keeping of vaccinations (n = 33, 75.0%), and legal and regulatory issues related to vaccinations (n = 32, 69.6%) were the least adequately covered topics. Most common methods used in teaching were didactic lectures (n = 74, 92.5%). Overall, 53 of 87 respondents (60.9%) responded that their college does not currently teach "vaccination administration". Lack of resources, attitudes of other health professionals and not prioritizing vaccination were considered as barriers for implementing vaccination administration. CONCLUSION: Most pharmacy colleges in the ME cover vaccination-related topics in undergraduate curricula, yet they underemphasize vaccination administration and lack experiential learning methods. Implementing vaccination administration education requires addressing barriers related to the outer and inner settings, and planning, with stakeholder engagement.

Implementation of standard setting for high-stakes objective structured clinical examinations.

BACKGROUND AND PURPOSE: To describe one institution's approach to transformation of high-stakes objective structure clinical examinations (OSCEs) from norm-referenced to criterion-referenced standards setting and to evaluate the impact of these changes on OSCE performance and pass rates. EDUCATIONAL ACTIVITY AND SETTING: The OSCE writing team at the college selected a modified Angoff method appropriate for high-stakes assessments to replace the two standard deviation method previously used. Each member of the OSCE writing team independently reviewed the analytical checklist and calculated a passing score for active stations on OSCEs. Then the group met to determine a final pass score for each station. The team also determined critical cut points for each station, when indicated. After administration of the OSCEs, scores, pass rates, and need for remediation were compared to the previous norm-referenced method. Descriptive statistics were used to summarize the data. FINDINGS: OSCE scores remained relatively unchanged when switched to a criterion-referenced method, but the number of remediators increased up to 2.6 fold. In the first year, the average score increased from 86.8% to 91.7% while the remediation rate increased from 2.8% to 7.4%. In the third year, the average increased from 90.9% to 92% while the remediation rate increased from 6% to 15.6%. Likewise, the fourth-year average increased from 84.9% to 87.5% while the remediation rate increased from 4.4% to 9%. SUMMARY: Transition to a modified Angoff method did not impact average OSCE score but did increase the number of remediations.

Predictors of Success in Obtaining Postgraduate Residency or Fellowship.

OBJECTIVE: As more pharmacy students are pursuing postgraduate training, colleges of pharmacy are investigating ways to predict success in matching for residency or fellowship. While data have been published about characteristics predictive of matching, we sought to study student scores, rotation types, and rotation evaluations as predictors of success. METHODS: Data were collected from students in the graduating classes of 2021, 2022, and 2023. Students were surveyed on participation in mock interviews, numbers of programs to which they applied, and number of interviews received. In addition, data were collected on impostor phenomenon, grit, perceived stress, anxiety, grade point average (GPA), types of patient care rotations, and preceptor evaluations. RESULTS: Overall, 295 students were included, with 69 unsuccessful and 226 successful students. Successful students were more likely to have lower Perceived Stress Scale-10 scores in the final 3 semesters of school, a higher GPA, more elective patient care rotations, and more preceptors who answered "Yes" to "Would you hire this student?" after graduation. In the multivariate logistic regression analysis, final GPA and preceptors answering affirmatively to "Would you hire this student?" were independent predictors of success in obtaining a postgraduate position. CONCLUSION: As colleges of pharmacy prepare students for postgraduate residencies or fellowships, in addition to GPA, stress levels during the final 3 semesters of pharmacy school may be areas on which to focus. Given that willingness of a preceptor to hire a student after graduation was a predictor of success in securing a postgraduate position, this should be explored in future research.

Perceptions of Diversity, Equity, Inclusion, and Anti-Racism Among Pharmacy Faculty by Racial and Ethnic Identity.

OBJECTIVE: To compare perceptions of underrepresented minorities (URM), non-URM people of color (POC), and nonminoritized pharmacy faculty in academia in relation to workplace diversity, equity, inclusion, and anti-racism (DEIA) landscape in the United States. METHODS: This study utilized the DEIA Faculty Perceptions of College Climate (FPCC) scale, which was developed and validated by the authors. The FPCC scale was used to investigate perceptions of pharmacy faculty from the American Association of Colleges of Pharmacy membership directory regarding DEIA within their respective academic pharmacy institutions. Demographic differences were examined using a Pearson chi-square test, while response disparities in FPCC questions were analyzed with a one-way ANOVA. RESULTS: A total of 846 respondents met the inclusion criteria for the study and were included in the analysis. Results indicate disparities in perceptions within all 4 DEIA domains of the FPCC survey among the 3 demographic groups. CONCLUSION: This study uncovers significant differences in how pharmacy faculty perceive DEIA within pharmacy education, with nonminoritized faculty expressing more positive views compared to their URM and non-URM counterparts. These results emphasize the need for focused interventions and institutional support to bridge DEIA disparities, emphasizing the importance of fostering an inclusive academic environment to enhance faculty well-being and empower the pharmacy profession to meet diverse needs more effectively.

Correlating Advanced Pharmacy Practice Experience Exam Scores and Pharmacist Licensure Status in a Single Program.

OBJECTIVE: Pharmacist licensure exam first-time pass rates have declined for several years. Predictors of licensure exam performance, including the Pharmacy College Admission Test, are no longer required, necessitating alternative strategies. Our aim is to assess the relationship between numerical scores on advanced pharmacy practice experience (APPE) exams and pharmacist licensure exams first-time pass rates. METHODS: We conducted a single-center, retrospective, observational analysis. APPE examination results between May 2020 and November 2023 were analyzed for association with licensure information from the Texas State Board of Pharmacy. Exam scores were collected for student cohorts graduating from 2021 to 2022 as study cohort data. Correlation between exam scores and probability of successful licensure was assessed using logistic regression. A classification and regression tree analysis identified the most significant threshold. Predictive ability of the best-fit model was prospectively validated using the 2023 graduate cohort. RESULTS: The overall licensure success rate was 80.6% for the study cohort (2021-2022, n = 206). Exam scores were well correlated to the likelihood of licensing success. The most significant threshold was 77.8%. The success rate was 82.5% vs 16.7% for those scoring above and below the threshold, respectively. The observed and predicted licensure success rates were 91.0% and 88.8%, respectively, in the validation cohort (2023, n = 89). The positive and negative prediction values were 94.9% and 40.0%, respectively. CONCLUSION: The performances on APPE exams were reasonable in predicting the first-time licensure success rate for a graduating class. Our assessment appears promising as a risk-stratification tool for students in gaining successful pharmacist licensure.

Exploring the Impact of Generation Status on Pharmacy Admissions: A Comparative Study of First-Generation and Continuing-Generation College Students.

OBJECTIVE: First-generation college students (FGCSs) comprise a large demographic of health professions programs. Although FGCSs in pharmacy education have been studied, robust data describing FGCSs who pursue a Doctor of Pharmacy degree are sparse. The objective of this study was to describe the FGCS applicant population within pharmacy education from 2017 to 2023 and compare them with continuing-generation college student (CGCS) applicants. METHODS: We conducted a descriptive cross-sectional study using national Doctor of Pharmacy application data from the Pharmacy College Application Service between 2017 and 2023. RESULTS: Of the 83,446 applicants, 26% identified as an FGCS, with analysis demonstrating the breadth of differences between FGCS and CGCS. FGCSs were found to be older, more likely of minority status, and more likely to come from disadvantaged backgrounds. FGCSs also submitted a greater number of applications per student, were less likely to matriculate, and were more likely to be denied by at least 1 program. CONCLUSION: Important differences between FGCSs and CGCSs in the pharmacy school applicant pool were identified. These differences highlight the importance of studying recruitment strategies and support programs for FGCS pharmacy applicants, strategies to increase completed applications, and decrease melt in FGCSs once they are accepted into programs.

Development, implementation, and assessment of a tailored oral milestone remediation examination process for fourth-year pharmacy students.

Performance assessments for student pharmacists are required by the Accreditation Council for Pharmacy Education to monitor student knowledge, retention, and professional skill sets. Near the end of their Advanced Pharmacy Practice Experiences (APPEs), fourth-year pharmacy students (P4s) at the University of Texas at Austin College of Pharmacy must pass a milestone exam (P4ME) to graduate. The P4ME contains four sections: adult medicine, ambulatory care, community, and hospital. If a student fails one or more sections of the initial multiple-choice P4ME, they must retake that specific section(s) on the makeup P4ME. If a student fails the makeup multiple-choice P4ME, they participate in a case based oral exam designed to determine whether they meet minimal competencies to pass the P4ME. This report outlines the process undertaken by the faculty to develop a high-stakes P4 milestone oral exam. While only a few students have participated in the process, outcomes differentiated P4s eligible for graduation versus those who needed to repeat an APPE. Lessons learned about the oral exam process include minimizing the number of faculty in attendance, shortening the exam duration, and standardizing the exam process. Positive aspects include remediation led by a subject matter expert and implementation of a unique rubric to assess student performance. Overall, the authors find the P4 oral milestone exam to be a feasible assessment tool for students who perform poorly on the initial and makeup multiple-choice P4MEs.

Self-Reported Factors Involved in Attrition and Retention of Pharmacy Faculty.

OBJECTIVE: To evaluate factors associated with pharmacy faculty attrition and retention. METHODS: A cross-sectional survey was developed that consisted of 33 closed- and open-ended items related to reasons or potential reasons for leaving academia, motivating factors for staying in academia, and personal and professional demographic characteristics. The survey was distributed via Qualtrics to all current pharmacy faculty using the American Association of Colleges of Pharmacy email listserv and posted in American Society of Health-System Pharmacists and American Association of Colleges of Pharmacy online communities to recruit participants who were no longer in academia. Descriptive statistics were used to analyze the data using SPSS. RESULTS: A total of 1011 current and 79 former pharmacy faculty completed the survey, with the majority being female, white, full-time, nontenure track, pharmacy practice, and at associate rank. Of the current faculty, 21.5% intend to leave their current position within the next year and 37.4% of respondents think about leaving either daily or weekly. Faculty who are no longer in academia or potentially will leave their position cited an unmanageable workload as the most impactful reason, with other risk factors, including unsupportive/inadequate direct supervisors or senior leadership and inadequate work-life balance, compensation, and resources. The top reasons for staying in academia included having an adequate work-life balance, manageable workload, and meaningful relationships with students. CONCLUSIONS: The Academy and individual institutions must evaluate and address risk factors contributing to faculty attrition. Simultaneously, they should actively encourage conditions such as maintaining a manageable workload and promoting work-life balance to retain faculty members.