Building Interprofessional Competencies Through a Collaborative Prescribing Activity With Osteopathic, Pharmacy, and Physician Assistant Students.

Introduction: Medication errors can lead to significant adverse events. Nearly 50% of medication errors occur during the prescription-writing stage of the medication use process, and effective interprofessional collaboration and communication are key to reducing error in this process. Methods: We developed a three-part, 60-minute, interprofessional education activity providing medical, physician assistant, and pharmacy students the opportunity to practice collegial interprofessional communication surrounding prescribing practices. Learners met virtually initially as a large group and divided into small groups facilitated by a health professional. Part 1 involved reviewing two prescriptions prepared by learners; part 2 was a discussion about the education, roles, and responsibilities of each profession; and part 3 focused on identifying prescription errors in examples provided by faculty. Students completed a post-pre survey measuring their perception of learning the Interprofessional Collaborative Competency Attainment Survey (ICCAS) areas. Results: Of 317 participants (151 doctor of osteopathy, 68 master of physician assistant studies, and 98 doctor of pharmacy students), 286 completed the post-pre survey, for a 90% response rate. Students reported statistically significant (p < .001) increases in all 20 questions spanning the six ICCAS areas. Discussion: The virtual format allowed multiple institutions to participate from various locations. It broadened the learners' experience by fostering interaction among those with varied perspectives and allowed collaboration between locations and programs that otherwise could not have participated. The activity introduced students to virtual collaboration and key telehealth skills, enhancing their confidence and familiarity with virtual interactions in a professional setting.

Curricular addition of pharmacy robbery education.

BACKGROUND AND PURPOSE: Pharmacy robberies are a common occurrence. From 2010 to 2019, there were over 7500 prescription drug-related armed robbery incidents in the United States. A lecture on pharmacy robbery was added to the pharmacy curriculum in 2017 at Butler University. The primary objective of this study was to assess whether the pharmacy robbery lecture given during the first year of the pharmacy program is adequate, with a secondary objective comparing the results of this survey to one conducted prior to the curricular addition. This information provides an opportunity for schools of pharmacy to consider adding or enhancing drug diversion content into their curriculum. EDUCATIONAL ACTIVITY AND SETTING: A cross-sectional survey of all students enrolled in each professional year of the Doctor of Pharmacy program was conducted spring 2022 to collect information on pharmacy students' knowledge and experience regarding community pharmacy robberies and their perceptions of the pharmacy robbery education in the curriculum. FINDINGS: A total of 285 of 407 students responded for a 70% response rate. More than half (53.5%) feel the pharmacy robbery education received is adequate and 63.9% feel prepared to properly manage a pharmacy robbery situation. The survey asked two pharmacy robbery knowledge-based questions and most students selected the correct response to both (89.9% and 97.8%). More than one-fourth (27.1%) of the respondents reported that the pharmacy they work/worked at had been robbed. When asked if students considered changing their career path because of pharmacy robberies, 9% responded yes. SUMMARY: Pharmacy robbery still exists, and having proper education helps students prepare for and handle community pharmacy robbery situations.

Making "Fast Friends" Online in Middle Childhood and Early Adolescence.

Close peer relationships are critical to children's and adolescents' healthy development and well-being, yet youth sometimes struggle to make friends. The present work tested whether an online version of the Fast Friends procedure could engender closeness among 9- to 13-year-old youth. Participant dyads (N = 131), matched in age and gender, were randomly assigned to answer personal questions that encourage self-disclosure and play a collaborative game (Fast Friends condition) or to engage in similar activities without self-disclosure or collaboration (control condition). Fast Friends dyads reported feeling closer and expressed more interest in future contact than control dyads. The discussion addresses potential future uses and implications of an online Fast Friends procedure.

Randomized controlled trial demonstrates novel tools to assess patient outcomes of Indigenous cultural safety training.

BACKGROUND: Health care routinely fails Indigenous peoples and anti-Indigenous racism is common in clinical encounters. Clinical training programs aimed to enhance Indigenous cultural safety (ICS) rely on learner reported impact assessment even though clinician self-assessment is poorly correlated with observational or patient outcome reporting. We aimed to compare the clinical impacts of intensive and brief ICS training to control, and to assess the feasibility of ICS training evaluation tools, including unannounced Indigenous standardized patient (UISP) visits. METHOD: Using a prospective parallel group three-arm randomized controlled trial design and masked standardized patients, we compared the clinical impacts of the intensive interactive, professionally facilitated, 8- to10-h Sanyas ICS training; a brief 1-h anti-bias training adapted to address anti-Indigenous bias; and control continuing medical education time-attention matched to the intensive training. Participants included 58 non-Indigenous staff physicians, resident physicians and nurse practitioners from family practice clinics, and one emergency department across four teaching hospitals in Toronto, Canada. Main outcome measures were the quality of care provided during UISP visits including adjusted odds that clinician would be recommended by the UISP to a friend or family member; mean item scores on patient experience of care measure; and clinical practice guideline adherence for NSAID renewal and pain assessment. RESULTS: Clinicians in the intensive or brief ICS groups had higher adjusted odds of being highly recommended to friends and family by standardized patients (OR 6.88, 95% CI 1.17 to 40.45 and OR 7.78, 95% CI 1.05 to 58.03, respectively). Adjusted mean item patient experience scores were 46% (95% CI 12% to 80%) and 40% (95% CI 2% to 78%) higher for clinicians enrolled in the intensive and brief training programs, respectively, compared to control. Small sample size precluded detection of training impacts on clinical practice guideline adherence; 100% of UISP visits were undetected by participating clinicians. CONCLUSIONS: Patient-oriented evaluation design and tools including UISPs were demonstrated as feasible and effective. Results show potential impact of cultural safety training on patient recommendation of clinician and improved patient experience. A larger trial to further ascertain impact on clinical practice is needed. TRIAL REGISTRATION: Clinicaltrials.org NCT05890144. Retrospectively registered on June 5, 2023.

Children's evaluations of and reactions to racial discrimination.

Despite the potential benefits of children's confrontations of other children's racial biases-especially for targets of bias-little is known about how young children react upon observing instances of racial discrimination. In the present research, child participants completed a novel measure designed to test their reactions to another child's racially discriminatory behavior. The measure presented scenarios in which a protagonist who matched the participant's race (Asian, Latinx, or White) repeatedly excluded Black children from different social activities. Participants evaluated the protagonist's behavior and had an opportunity to confront the protagonist. Both a pilot study and a full preregistered study revealed that the novel measure had high reliability within participants and substantial variability across participants (pilot study: N = 54 U.S. White 5-7-year-olds, 27 girls, 27 boys, median household income range of $125,001-$150,000; full study: N = 126 U.S. 4-10-year-olds, 33.33% Asian, 33.33% Latinx, 33.33% White, 56 girls, 70 boys, median household income: $120,001-$125,000). In the full study, older children and children whose parents reported more racial socialization rated the protagonist's behavior more negatively; older children were also more likely to confront the protagonist. Neither participants' own race nor their prior exposure to racial diversity impacted their evaluations or confrontations of discrimination. The results have implications for understanding children's potential to serve as agents of social change by regulating other children's racial biases and behaviors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A historical overview of IPPE program administrators' roles and responsibilities at US colleges and schools of pharmacy.

INTRODUCTION: The objective of this research was to determine changes in introductory pharmacy practice experience (IPPE) program administrators' demographics, roles, and responsibilities over time, and reflect on internal and external forces resulting in these shifts. This information provides an opportunity for schools to improve functioning of their IPPE administrative offices. METHODS: A 2020 web-based questionnaire was sent to IPPE program administrators at 141 fully accredited and candidate status colleges and schools of pharmacy (hereafter referred to as schools). The responses were compared to previously published results from similar surveys in 2008 and in 2013. RESULTS: One hundred thirteen IPPE administrators responded to the 2020 questionnaire for an 80% response rate. A comparative analysis of the data from 2008, 2013, and 2020 revealed a decrease in average class size and changes over time in six administrative areas. These areas included IPPE administrator responsibilities, position types, primary administrator's time devoted to IPPE administration, utilization of a programmatic decision-making committee, inclusion on the school's executive committee, and the number of clerical fulltime equivalents utilized in managing IPPE programs. CONCLUSIONS: A comparison of data from three studies revealed significant trends in six areas of IPPE administration over time. The primary drivers of change appear to be workload, fluctuating class sizes, and programmatic costs.

Racism: Eroding the health of Black communities.

ABSTRACT: Even in the context of major advances in medicine, racial minorities continue to suffer worse medical outcomes. Although race is defined as a social, nonscientific construct, researchers have continued to use it as proxy to explain genetic and evolutionary differences among patients. Poorer health outcomes among Black Americans are known to be related to the psychosocial and physiological stress of racism. Black communities experience premature health deterioration because of the cumulative effects of social, economic, and political oppression and marginalization. Additionally, recent assertions that racism is best seen as a chronic disease has added value to understanding the effect of racism on the health of Black people. Using evidence-based information to assess the health of Black patients is a key step to assist clinicians in promptly addressing this chronic threat to the health of Black patients.

Engaging White parents to address their White children's racial biases in the Black-White context.

Multiple studies (n = 1065 parents, 625 females, 437 males, 3 nonbinary, 99.06% White; n = 80, 5 to 7-year-old children, 35 girls, 45 boys, 87.50% White; data collection September 2017-January 2021) investigated White U.S. parents' thinking about White children's Black-White racial biases. In Studies 1-3, parents reported that their own and other children would not express racial biases. When predicting children's social preferences for Black and White children (Study 2), parents underestimated their own and other children's racial biases. Reading an article about the nature, prevalence, and consequences of White children's racial biases (Study 3) increased parents' awareness of, concern about, and motivation to address children's biases (relative to a control condition). The findings have implications for engaging White parents to address their children's racial biases.

Untested assumptions perpetuate stereotyping: Learning in the absence of evidence.

In the present work, we set out to assess whether and how much people learn in response to their stereotypic assumptions being confirmed, being disconfirmed, or remaining untested. In Study 1, participants made a series of judgments that could be influenced by stereotypes and received feedback that confirmed stereotypes the majority of the time, feedback that disconfirmed stereotypes the majority of the time, or no feedback on their judgments. Replicating past work on confirmation bias, patterns in the conditions with feedback indicated that pieces of stereotype-confirming evidence exerted more influence than stereotype-disconfirming evidence. Participants in the Stereotype-Confirming condition stereotyped more over time, but rates of stereotyping for participants in the Stereotype-Disconfirming condition remained unchanged. Participants who received no feedback, and thus no evidence, stereotyped more over time, indicating that, matching our core hypothesis, they learned from their own untested assumptions. Study 2 provided a direct replication of Study 1. In Study 3, we extended our assessment to memory. Participants made judgments and received a mix of confirmatory, disconfirmatory, and no feedback and were subsequently asked to remember the feedback they received on each trial, if any. Memory tests for the no feedback trials revealed that participants often misremembered that their untested assumptions were confirmed. Supplementing null hypothesis significance testing, Bayes Factor analyses indicated the data in Studies 1, 2, and 3 provided moderate-to-extreme evidence in favor of our hypotheses. Discussion focuses on the challenges these learning patterns create for efforts to reduce stereotyping.

Structural racism, health disparities, and opportunities for PA practice.

ABSTRACT: Social determinants of health are rooted in structural racism. The healthcare community has long recognized the existence of significant race- and ethnicity-related health disparities. Yet pervasive disparities persist despite ongoing calls for institutions and healthcare professionals to promote health equity by addressing bias, discrimination, and social determinants of health. All PAs must take responsibility for the various ways in which we may unwittingly reinforce racism in our profession, and must shift our focus from treating the effects of racism to preventing them.

Diversity Training Goals, Limitations, and Promise: A Review of the Multidisciplinary Literature.

In this review, we utilize a narrative approach to synthesize the multidisciplinary literature on diversity training. In examining hundreds of articles on the topic, we discovered that the literature is amorphous and complex and does not allow us to reach decisive conclusions regarding best practices in diversity training. We note that scholars of diversity training, when testing the efficacy of their approaches, too often use proxy measures for success that are far removed from the types of consequential outcomes that reflect the purported goals of such trainings. We suggest that the enthusiasm for, and monetary investment in, diversity training has outpaced the available evidence that such programs are effective in achieving their goals. We recommend that researchers and practitioners work together for future investigations to propel the science of diversity training forward. We conclude with a roadmap for how to create a more rigorous and relevant science of diversity training.

Parents' Role in Addressing Children's Racial Bias: The Case of Speculation Without Evidence.

Children begin displaying racial biases early in development, which has led many authors of popular-press articles to generate suggestions for preventing and decreasing such biases. One common theme in the popular press is that parents should play a role in addressing children's biases. In the present article, we analyze the current recommendations parents receive about addressing their children's biases and consider their utility. We conclude that the evidence base supporting the effectiveness of parental intervention to reduce children's biases is scant. Next, we offer suggestions for how to construct a useful evidence base from which good recommendations could be drawn. In so doing, we issue a call to action for researchers to conduct research that will yield empirically supported, specific, shareable suggestions for parents who are seeking advice about how to engage with their children in this important domain. We also suggest that researchers become actively involved in the dissemination of the research findings so as to improve the lives of those who receive and express biases.

Improving health disparities in PA practices: A quality improvement initiative.

OBJECTIVE: To assess a quality improvement initiative designed to highlight awareness of health disparities and improve healthcare practices among participants. METHODS: Data were collected from 102 clinically practicing PAs over a 2-year timespan via the quality improvement initiative Outside the Box: Reducing Health Disparities. As part of the program, participants reviewed 10 random charts in their practice, documenting how they identified and/or managed common health disparities. Then, participants reviewed the educational materials provided and implemented practice-specific interventions. Thirty days after the initial review, a second random review of charts was executed. RESULTS: Postintervention results showed statistically significant moderate- to large-sized quality improvement across most categories. CONCLUSIONS: This study demonstrates that Outside the Box participation was associated with practice quality improvements among participants in several domains that are known to experience health disparities. Results suggest that increasing awareness of ideal professional behaviors can result in quality improvements in practices.

Parents' Expectations for and Reactions to Children's Racial Biases.

How do parents think about and react to their children's racial biases? Across three studies (N = 519) we investigated whether and how parents' Internal Motivation to Respond without Prejudice Scale (IMS) predicted standards for their children's race-related behavior, and tested parents' affective reactions to imagining their children violating their standards. Studies 1 and 2 demonstrated that parents (of 4- to 12-year-old children) with high IMS set more stringent standards for their children's race-related behavior than their low IMS counterparts. Upon considering their children expressing racial bias, high IMS parents reported negative self-directed affect (i.e., guilt; Studies 2 and 3), an affective response that motivates prejudice reduction in adults. The results have implications for involving parents in prejudice interventions targeting children's biases.

A meta-analysis of procedures to change implicit measures.

Using a novel technique known as network meta-analysis, we synthesized evidence from 492 studies (87,418 participants) to investigate the effectiveness of procedures in changing implicit measures, which we define as response biases on implicit tasks. We also evaluated these procedures' effects on explicit and behavioral measures. We found that implicit measures can be changed, but effects are often relatively weak (|ds| < .30). Most studies focused on producing short-term changes with brief, single-session manipulations. Procedures that associate sets of concepts, invoke goals or motivations, or tax mental resources changed implicit measures the most, whereas procedures that induced threat, affirmation, or specific moods/emotions changed implicit measures the least. Bias tests suggested that implicit effects could be inflated relative to their true population values. Procedures changed explicit measures less consistently and to a smaller degree than implicit measures and generally produced trivial changes in behavior. Finally, changes in implicit measures did not mediate changes in explicit measures or behavior. Our findings suggest that changes in implicit measures are possible, but those changes do not necessarily translate into changes in explicit measures or behavior. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

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.

Little race or gender bias in an experiment of initial review of NIH R01 grant proposals.

Many granting agencies allow reviewers to know the identity of a proposal's principal investigator (PI), which opens the possibility that reviewers discriminate on the basis of PI race and gender. We investigated this experimentally with 48 NIH R01 grant proposals, representing a broad range of NIH-funded science. We modified PI names to create separate white male, white female, black male and black female versions of each proposal, and 412 scientists each submitted initial reviews for 3 proposals. We find little to no race or gender bias in initial R01 evaluations, and additionally find that any bias that might have been present must be negligible in size. This conclusion was robust to a wide array of statistical model specifications. Pragmatically, important bias may be present in other aspects of the granting process, but our evidence suggests that it is not present in the initial round of R01 reviews.

A Gender Bias Habit-Breaking Intervention Led to Increased Hiring of Female Faculty in STEMM Departments.

Addressing the underrepresentation of women in science is a top priority for many institutions, but the majority of efforts to increase representation of women are neither evidence-based nor rigorously assessed. One exception is the gender bias habit-breaking intervention (Carnes et al., 2015), which, in a cluster-randomized trial involving all but two departmental clusters (N = 92) in the 6 STEMM focused schools/colleges at the University of Wisconsin - Madison, led to increases in gender bias awareness and self-efficacy to promote gender equity in academic science departments. Following this initial success, the present study compares, in a preregistered analysis, hiring rates of new female faculty pre- and post-manipulation. Whereas the proportion of women hired by control departments remained stable over time, the proportion of women hired by intervention departments increased by an estimated 18 percentage points (OR = 2.23, dOR = 0.34). Though the preregistered analysis did not achieve conventional levels of statistical significance (p < 0.07), our study has a hard upper limit on statistical power, as the cluster-randomized trial has a maximum sample size of 92 departmental clusters. These patterns have undeniable practical significance for the advancement of women in science, and provide promising evidence that psychological interventions can facilitate gender equity and diversity.

Value-Based Standards Guide Sexism Inferences for Self and Others.

People often disagree about what constitutes sexism, and these disagreements can be both socially and legally consequential. It is unclear, however, why or how people come to different conclusions about whether something or someone is sexist. Previous research on judgments about sexism has focused on the perceiver's gender and attitudes, but neither of these variables identifies comparative standards that people use to determine whether any given behavior (or person) is sexist. Extending Devine and colleagues' values framework (Devine, Monteith, Zuwerink, & Elliot, 1991; Plant & Devine, 1998), we argue that, when evaluating others' behavior, perceivers rely on the morally-prescriptive values that guide their own behavior toward women. In a series of 3 studies we demonstrate that (1) people's personal standards for sexism in their own and others' behavior are each related to their values regarding sexism, (2) these values predict how much behavioral evidence people need to infer sexism, and (3) people with stringent, but not lenient, value-based standards get angry and try to regulate a sexist perpetrator's behavior to reduce sexism. Furthermore, these personal values are related to all outcomes in the present work above and beyond other person characteristics previously used to predict sexism inferences. We discuss the implications of differing value-based standards for explaining and reconciling disputes over what constitutes sexist behavior.

Breaking the prejudice habit: Mechanisms, timecourse, and longevity.

The prejudice habit-breaking intervention (Devine et al., 2012) and its offshoots (e.g., Carnes et al., 2012) have shown promise in effecting long-term change in key outcomes related to intergroup bias, including increases in awareness, concern about discrimination, and, in one study, long-term decreases in implicit bias. This intervention is based on the premise that unintentional bias is like a habit that can be broken with sufficient motivation, awareness, and effort. We conducted replication of the original habit-breaking intervention experiment in a sample more than three times the size of the original (N = 292). We also measured all outcomes every other day for 14 days and measured potential mechanisms for the intervention's effects. Consistent with previous results, the habit-breaking intervention produced a change in concern that endured two weeks post-intervention. These effects were associated with increased sensitivity to the biases of others and an increased tendency to label biases as wrong. Contrasting with the original work, both control and intervention participants decreased in implicit bias, and the effects of the habit-breaking intervention on awareness declined in the second week of the study. In a subsample recruited two years later, intervention participants were more likely than control participants to object on a public online forum to an essay endorsing racial stereotyping. Our results suggest that the habit-breaking intervention produces enduring changes in peoples' knowledge of and beliefs about race-related issues, and we argue that these changes are even more important for promoting long-term behavioral change than are changes in implicit bias.