White coats, Black lives-racial trauma in Black pharmacists.

BACKGROUND: Race-based traumatic stress, or racial trauma, can negatively impact the health and wellbeing of Black health professionals. However, the effects of racial trauma among Black pharmacists have not been thoroughly explored. OBJECTIVE: The purpose of this study is to explore Black pharmacist experiences of race-based traumatic stress and its effects in the workplace. METHODS: This qualitative study utilized focus groups among a convenience sample of Black pharmacist attendees of a national convention for an organization dedicated to serving underserved communities and minoritized pharmacy professionals. The data were analyzed with inductive coding and thematic analysis as proposed by Braun and Clark. RESULTS: Three focus groups were conducted with a total of 22 participants. The majority of participants were female (77%), and the average age of the participants was 48.3 years old. Three themes related to racial trauma were identified. The participants described racial trauma as an ever-present phenomenon, tension with coworkers and institutions, and internal and external structures of support. The Black pharmacists in this study provided context and recommendations for employers to support their wellbeing. CONCLUSIONS: An awareness of the hidden wounds that Black pharmacists carry with them to work every day is an important factor in creating diverse and inclusive workplaces. The results of this study give Black pharmacists a voice and a chance to share with colleagues their distinct realities. Employers and institutions should assess individual needs and implement strategies to support Black pharmacists in creating more inclusive work and professional environments.

Improvement in Pharmacy Student Responses to Medication-Related Problems with and without Clinical Decision Support Alerts.

OBJECTIVE: To assess pharmacy student responses to medication problems with and without clinical decision support (CDS) alerts during simulated order verification. METHODS: Three classes of students completed an order verification simulation. The simulation randomized students to a different series of 10 orders with varying CDS alert frequency. Two of the orders contained medication-related problems. The appropriateness of the students' interventions and responses to the CDS alerts were evaluated. In the following semester for 2 classes, 2 similar simulations were completed. All 3 simulations contained 1 problem with and 1 without an alert. RESULTS: During the first simulation, 384 students reviewed an order with a problem and an alert. Students exposed to prior inappropriate alerts within the simulation had less appropriate responses (66% vs 75%). Of 321 students who viewed a second order with a problem, those reviewing an order lacking an alert recommended an appropriate change less often (45% vs 87%). Among 351 students completing the second simulation, those who participated in the first simulation appropriately responded to the alert for a problem more often than those who only received a didactic debrief (95% vs 87%). Among those completing all 3 simulations, appropriate responses increased between simulations for problems with (n = 238, 72-95-93%) and without alerts (n = 49, 53-71-90%). CONCLUSIONS: Some pharmacy students displayed baseline alert fatigue and overreliance on CDS alerts for medication problem detection during order verification simulations. Exposure to the simulations improved CDS alert response appropriateness and detection of problems.

Successful Development and Implementation of a Large Virtual Interprofessional Education Activity Applying the Social Determinants of Health.

Interprofessional education (IPE) activities provide students insight into healthcare teams, shared decision-making, and social determinants of health (SDOH). Virtual IPE activities with large student populations or across multicampus have not been evaluated. The study aimed to explore the interprofessional competency growth in students, across several disciplines, following participation in a large-scale, virtual IPE activity. Students from pharmacy, medicine, social work, and physician assistant programs across Tennessee participated in an IPE patient case and SDOH in fall 2020 and fall 2021. Pre- and postsurveys included Likert ranking of 16 statements based on the 2011 Interprofessional Education Collaborative (IPEC) framework. A total of 607 students completed surveys (overall response rate, 76%). Wilcoxon signed-rank tests were performed on the pre-/postsurvey data, in aggregate and by discipline. Significant increases in all IPEC competency statements were seen, both in aggregate (100% of statements with p < 0.001) and in pharmacy (100% of statements with p < 0.001) and medicine subgroups (94% of statements with p < 0.001). Implementing large virtual IPE activities involving a complex patient case and SDOH significantly increased student IPEC competency outcomes for participating students, whether in aggregate or on a discipline-specific basis.

A community-based partnership collaborative practice agreement project to disseminate and implement evidence-based practices in community pharmacy.

BACKGROUND AND PURPOSE: The objective of this study is to explore the impact of an educational intervention including (1) collaborative practice agreement (CPA)-focused lecture and (2) a student project in partnership with a community-based pharmacy on dissemination and implementation of CPAs in community pharmacy practice. EDUCATIONAL ACTIVITY AND SETTING: A CPA-focused classroom lecture and related project were given to five sequential years of second-year pharmacy students enrolled in a community pharmacy elective course. Community pharmacist feedback provided at the completion of the project was compared to present-day data collected via telephone survey. Responses for each survey question were summarized using frequencies, and chi-square analysis was conducted to assess the association between pharmacist perceptions at the time of the project vs. the present day. FINDINGS: Forty-seven projects representing 47 unique CPAs were completed over five sequential years of the course. The most commonly targeted disease states by CPAs were influenza/streptococcus pharyngitis (25.5%), therapeutic interchange (6.4%), oral contraceptives (6.4%), and tobacco cessation (6.4%). Pharmacists noted that students facilitated their progress toward CPA implementation by serving as a means for CPA law education (23.4%) and by saving time in CPA development (12.8%). SUMMARY: This study demonstrated that a student project partnering with a local community pharmacy improved knowledge dissemination but did not have any direct impact on implementation of CPAs in a community pharmacy. However, students may have a role in dissemination and implementation of evidence-based practices, such as CPAs, when appropriately matched to setting-specific implementation barriers.

Scaling technician product verification: Contextual analysis for developing an implementation strategy for a large community pharmacy chain.

OBJECTIVE: To identify facilitators and barriers of early implementation of a technician product verification (TPV) program in a large community pharmacy chain. METHODS: A mixed-methods (surveys, semistructured interviews, and nondisguised direct observation) approach was used to ascertain facilitators and barriers to implementation and to subsequently develop a scalable implementation strategy with the aim to accelerate TPV scalability across a large community pharmacy chain in states where it is permitted. One-on-one staff interviews and observations provided qualitative data to identify facilitators and barriers to TPV. A Web-based survey was used to gather perceptions on a variety of implementation strategies that would make use of identified facilitators and work to overcome identified barriers. RESULTS: During the mixed-method study, 3 key themes emerged: TPV is a complex intervention whose implementation is facilitated by both adaptability and trialability and is highly dependent on state practice regulations; the implementation climate of the pharmacy organization serves as a facilitator to TPV; and individual beliefs about TPV change over time as implementation experience increases. CONCLUSION: TPV is an expansion of the technician role that allows the profession of pharmacy to increase the provision of clinical activities by delegation of a nonclinical-based task. Early adopters of TPV recognize that verification is a task that is increasingly automated by mail-order pharmacies and that verification may no longer be considered a pharmacist task. Pharmacies in this study tended to revert to comfortable, traditional workflow at the first sign of distress. To be successful in the future, TPV should be thought of as the primary workflow procedure and not as an option. TPV is a service that will require staff buy-in, patience, and championship.

Screening for social determinants of health in community pharmacy: Identifying best practices, barriers, and strategies for success.

The social determinants of health (SDOH) play a key role in patients' access to health care and medications. There exists an area of opportunity to leverage community pharmacists to make a large impact in identifying and incorporating an understanding of a patient's SDOH into their treatment plan. Community pharmacies are accessible and trusted avenues for health care interventions. With the advancement of appointment-based models as well as the increased training of support personnel, community pharmacies may be well suited for this public health task. However, there are major challenges such as paradigm shifts in workflow, reimbursement, and training that must be addressed to make this endeavor successful. This commentary explores the sparse literature related to community pharmacists conducting screening for social risk factors to identify best practices and barriers to implementation and outlines how screening for social needs aligns with the Pharmacists' Patient Care Process.

A survey to assess experiences and social support of underrepresented minority doctor of pharmacy students.

INTRODUCTION: There is little data regarding the experiences of underrepresented minorities in pharmacy school. The objectives of this project were to describe the perceived racial and social climate at a diverse college of pharmacy (COP) and to determine areas of opportunity to improve the experiences of underrepresented minority students. METHODS: An electronic survey was administered to students from all four professional years at a COP in Houston, Texas. Students anonymously self-identified demographic information along with perceptions of racial climate using modified versions of previously validated survey instruments. The institution's social climate was assessed via several measures comprising composite survey scores. RESULTS: A total of 126 students completed the survey. Overall, Black students had more negative racial experiences and fewer positive social experiences as compared to their peers. Hispanic/Latino student perceptions of the racial and social climate at our institution were more positive than average. Student recommendations were also captured. CONCLUSIONS: Not all students experienced the same level of inclusion in the college of pharmacy. The diversity and inclusion initiatives undertaken at this COP appear to have been effective in the Latino student population. There is a need for further investigation and qualitative research to determine the best strategies for inclusion of Black students in COPs with diverse populations.

Knowledge and self-perception comparisons between students with and without prior technician experience in community pharmacy lab courses.

INTRODUCTION: It is unknown if students with previous pharmacy technician experience benefit from a community pharmacy dispensing lab. Anecdotally, students with previous technician experience often do not feel a substantial benefit from the course. The purpose of this project was to evaluate pharmacy practice knowledge and perceptions of those with and without prior technician experience in a community lab course. METHODS: Doctor of pharmacy students enrolled in the lab course were included in the study. All students were administered a pre- and post-course self-perceptions survey and knowledge assessment (20 scenario-based multiple-choice questions). The knowledge assessment evaluated understanding of community pharmacy law, workflow, inventory, insurance, and prescription verification. Survey variables analyzed included length of experience, confidence, and course expectations. Results were analyzed using student's t-tests. RESULTS: A total of 216 students completed the pre- and post-assessments and were included for analysis. Students with previous technician experience scored statistically significantly higher on the knowledge assessment than students without experience (pre: 57% vs. 33%, post: 67% vs. 53%, respectively). Students without prior technician experience had many statistically significant increases in perceptions of knowledge and confidence, while those with prior technician experience had few. CONCLUSIONS: There is a baseline knowledge gap between students with technician experience and those without in a community pharmacy simulation lab. Results of this study have identified specific gaps which may be useful for course structure and design. This data supports investigation into 'testing out' or providing separate tracks in a community lab for experienced and non-experienced students.

Implementation of Flipgrid as a Self-Reflection Tool for Student Engagement- A Pilot Study.

BACKGROUND: Self-reflection is important for professional development, critical thinking, and engagement. However, self-reflection is not habitual or instinctive, and reflection assignments are often met with resistance from students. While written reflections are popular, other self-reflection mediums should be investigated. INNOVATION: Flipgrid by Microsoft, an online video response tool, was used in an elective course for self-reflection and student engagement. To assess the impact of Flipgrid on the student experience in the course, two cohorts of students were evaluated. Overall 96% of respondents reported satisfaction with Flipgrid as an educational tool, however engagement was not significantly increased over the use of written reflection. IMPLICATIONS: The results of this pilot study suggest that Flipgrid appears to have potential as a self-reflection tool, but may not be a "magic-bullet" to increase student engagement. Recommendations and considerations for implementing Flipgrid into a course to facilitate student engagement are provided.