Utilizing Flip® as a platform to facilitate a group project in a socially distanced environment.

BACKGROUND AND PURPOSE: This study evaluated the perceived impact of using Flip (Microsoft Corp.) to facilitate a group project in a socially distanced environment. EDUCATIONAL ACTIVITY AND SETTING: Student groups were assigned a self-care scenario, and students independently traveled to local pharmacies to identify a pertinent nonprescription product. Students individually recorded a review of the product using Flip. Subsequently, students reviewed and replied to group member videos to compare products. Students worked as a group to develop consensus regarding the most appropriate product recommendation for their scenario. At semester end, students completed a questionnaire about their experiences using Flip for the project. FINDINGS: Sixty-eight students (91%) completed the perceptions questionnaire at course conclusion. Students found Flip enjoyable (68%) and easy to use (74%). The majority of students (82%) viewed all of their group members' Flip videos, and most (88%) agreed or strongly agreed Flip facilitated group work in a socially distanced environment. SUMMARY: Students overall perceived Flip as enjoyable and easy to use. Though utilization of Flip was initially due social distancing requirements, the positive student feedback encouraged continued use of this platform asynchronously. Flip provides a unique mechanism for facilitating group projects in multiple different environments.

Impact of two methods for assigning groups in a team-based learning self-care course.

INTRODUCTION: Studies have examined the impact of team formation strategies to performance on team assessments and perceptions of team dynamics. This study assessed the impact of intentional vs. randomized team formation strategies on a semester-long self-care pharmacotherapy course taught using team-based learning. METHODS: Students were intentionally assigned to teams in fall 2018 and randomized to teams in fall 2019. Performance on team readiness assessment tests (TRATs) was compared. Student perceptions regarding team dynamics were evaluated using a questionnaire. RESULTS: The were no significant differences in TRAT scores between the intentional (n = 91; average 99.8%) and randomized (n = 68; average 99.9%) cohorts (P = .33). Response rates for the student perception questionnaires for the intentional and randomized cohorts were 85.7% and 77.9%, respectively. No significant differences existed between cohorts for any questionnaire items. CONCLUSIONS: The type and number of criteria used to intentionally develop teams has varied across the literature and has generally failed to show significant differences in performance on team assessments regardless of team formation strategy. There have been varied findings with respect to the impact of team formation criteria on student perceptions related to team dynamics. In this study, intentionally assigning teams in a single semester-long course primarily using community pharmacy experience and significant relationships did not produce significant differences in team performance or student perceptions compared to randomization. For teams in a single semester course, randomization may be an efficient way of assigning students to teams without negatively impacting team performance or perceptions of team dynamics.

A simulated patient experience in the self-care aisle utilizing Flipgrid as a platform for sharing nonprescription product information.

BACKGROUND AND PURPOSE: Students visiting local pharmacies can enhance their learning about nonprescription products while improving their understanding of the patient self-care experience. This study was designed to examine student perceptions of an activity utilizing Flipgrid to share a simulated patient experience in the nonprescription aisle. EDUCATIONAL ACTIVITY AND SETTING: Student groups traveled to local pharmacies to review available products pertaining to a self-care scenario. Students submitted brief video recordings with product recommendations and counseling points via the Flipgrid platform. Following the activity, students submitted brief reflections. At course conclusion, students completed a questionnaire regarding perceptions of Flipgrid. FINDINGS: Sixty-eight students completed the activity. Response rates were 91.2% for the project reflection and 79.4% for the Flipgrid questionnaire. In the reflections (n = 62), the majority of students (87.1%) found it easy or extremely easy to locate pertinent nonprescription products; no student found it extremely difficult. All except four students indicated the assignment helped develop empathy, and all except two indicated a greater likelihood to help a patient in the aisle. In the Flipgrid questionnaire (n = 54), most students found the platform enjoyable (74.1%) and easy to use (79.6%). SUMMARY: Students perceived that the project increased empathy for assisting patients with selection of nonprescription products. Students found the Flipgrid platform enjoyable and easy to use. This activity can be utilized to simulate a patient self-care experience, and the Flipgrid platform is a novel way to share information between student groups in pharmacy education.

Developing a process to manage challenges encountered by experiential education administrators.

INTRODUCTION: This study explored preceptor and student related issues reported in pharmacy experiential education settings and solutions that experiential education administrators (EEAs) applied to inform a process to manage these challenges. METHODS: This mixed-methods study was conducted in two phases. In phase one, five EEAs from three schools of pharmacy collected quantitative and qualitative data over a two-year period on issues reported by students and preceptors and the solutions EEAs employed. Descriptive statistics and content analysis were used to analyze quantitative and qualitative data, respectively. Interviews with six EEAs from four schools were completed in phase two. An additional school was added in phase two. Open coding, pattern coding, and summative analysis were completed on interview data. RESULTS: Preceptors and students reported 156 and 65 issues, respectively. The most common issues reported were student reliability/responsibility (22, 14%) and preceptor communication (13, 20%). The most frequently applied solutions were coach preceptor (51, 24%) and meet with student (20, 24%). Interviews revealed more information about the strategies EEAs used. Approaches included reactive responses such as talking to and coaching preceptors or students. Preventative strategies were desired, such as tracking data and training. CONCLUSIONS: Results informed two approaches that EEAs can employ to resolve student and preceptor issues. In the proactive process, issues are tracked to inform student and preceptor development. The reactive approach involves meeting with the preceptor or student, gathering information from both parties, coaching the preceptor or student, and involving other administrators as needed for serious concerns.

Changes in Pharmacy Students' Metacognition Through Self-Evaluation During Advanced Pharmacy Practice Experiences.

Objective. To explore whether metacognition can be improved in Doctor of Pharmacy (PharmD) students through routine self-assessment over a year-long advanced pharmacy practice experience (APPE) sequence. Methods. Differences between self-assessment scores and preceptors' scores for three cohorts of pharmacy students between 2015 and 2018 were compared between the first, second, and third trimester to determine whether students more accurately evaluated their performance over time. The primary endpoint was change in the absolute difference between student and preceptor evaluation (rubric and composite scores) between trimesters. Results. Of 2577 student and preceptor evaluations eligible for inclusion, 1713 were completed, matched, and analyzed. Using the same rubric as preceptors, students overestimated their performance by an average of 16 points during the first trimester, followed by 14 and 12 points during the second and third trimester, respectively. This reflected a significant improvement over time. No significance difference was found between student and preceptor composite scores. Faculty preceptorship, students' pre-APPE grade point average, and type of APPE were not associated with any difference in rubric or composite scores. Conclusion. This analysis revealed that the difference between student self-evaluation grades and preceptor evaluation grades was greatest during the first trimester and significantly decreased in the second and third trimesters. This could reflect students' development of metacognitive processes over time. Metacognition is a vital skill for pharmacy students to learn, and opportunities to develop this skill should be incorporated throughout the pharmacy curricula.

The Status and Adequacy of Preceptor Orientation and Development Programs in US Pharmacy Schools.

Objective. To identify current preceptor orientation and development programs at US colleges and schools of pharmacy and propose future initiatives for preceptor programs. Methods. An anonymous 28-item survey was administered in January 2017 to 128 experiential education personnel at accredited US schools and colleges of pharmacy. Data from completed survey instruments were tabulated and qualitative responses to open-ended questions were examined using thematic analysis. Results. Eighty-five experiential education administrators participated in the survey (response rate=67%). Most preceptor orientation programs met the majority of requirements as outlined within the Accreditation Council for Pharmacy Education's Standard 20.3, although only 42% of programs mandated preceptor orientation prior to student placement. Two-thirds of respondents offered annual, live preceptor development, and 75% of programs used commercially available online products. Nearly 40% of respondents collaborated with other schools or professional organizations to offer preceptor training. Only 29% of programs had specific requirements for pharmacists to maintain their active preceptor status. Seventy percent of respondents reported spending over $2500 and 39% over $5000 annually on preceptor development. Programs with the highest monetary investment (>$10,000/year) in preceptor development offered multiple venues (live and online) for preceptor training. Programs with significant personnel commitment (≥0.5 FTE devoted to preceptor development) frequently had dedicated site visitors. Conclusion. Preceptor orientation programs at US schools of pharmacy are generally similar, but development programs vary significantly across the Academy. Highly invested programs featured live and online training or site visitors who provided individualized feedback or training. Future studies should explore the cost-effectiveness of program options and their impact on preceptor learning and behaviors.

Flipped classroom versus a didactic method with active learning in a modified team-based learning self-care pharmacotherapy course.

BACKGROUND AND PURPOSE: To examine the educational outcomes comparing flipped classroom method versus a didactic method with active learning in two semesters of a modified team-based learning (TBL) self-care pharmacotherapy course and explore student-identified preferences for teaching modality. EDUCATIONAL ACTIVITY AND SETTING: Grade performance on readiness assurance processes, both individual (iRAP) and team (tRAP), and exam questions were compared in two semester-long course offerings. Additionally, students were surveyed pre- and post-course. FINDINGS: The mean iRAP scores were 81.9% for the didactic method and 80.7% for the flipped method (p = .092). The mean tRAP scores were 93.6% for both didactic and flipped methods (p = .979). Mean exam performance for content taught using didactic and flipped methods were 83.3% and 83.5%, respectively (p = .730). Pre-course respondents indicated the following preferences: didactic (27.7%), flipped (9%), combination (58.2%), no preference (5.1%). Post-course, 46.8% preferred didactic, 5.7% preferred flipped, and 47.5% preferred a combination. Respondents perceived the didactic method helped develop deeper understanding, stimulated greater interest, and improved retention; however, they felt the flipped method improved critical thinking and application. SUMMARY: There were no statistically significant differences in student outcomes comparing teaching methods while student preference for the flipped classroom decreased.

Perceived value of partnerships between schools of pharmacy and health systems.

INTRODUCTION: This study sought to quantify opinions of statewide health systems stakeholders regarding the value of partnerships with schools of pharmacy. Being better able to meet the needs of preceptors and their employers will allow schools to increase capacity of high-quality pharmacy practice experiences. METHODS: A brief survey was developed and administered to statewide contacts from systems currently partnering with member schools of the North Carolina Experiential Education Consortium. Respondents were asked to rate, using a Likert scale, 15 incentive statements relating to potential benefits provided by schools in exchange for experiential rotations. RESULTS: Forty-one responses were received from 53 invitees (77% response rate). The two most highly-valued incentives per survey respondents were continuing education (CE) accreditation by the school (74% essential), and access to school resources (74% essential). The lowest scoring incentives included system-wide committee involvement by faculty (26% essential), co-funded faculty positions (29% essential), and resident precepting by faculty (34% essential). CONCLUSIONS: Incentive ratings differed significantly from previous reports describing value, which primarily focus on clinical interventions and cost savings provided by student pharmacists. Experiential staff at schools of pharmacy should consider a similar study to ascertain how best to meet the needs of their local partners and maximize commitments for pharmacy practice experiences.

Health professions students' attitudes and perceptions of interprofessional biases.

OBJECTIVE: The purpose of this study was to examine attitudes toward interprofessional, team-based care in first-year health professions students. METHODS: A cross-sectional questionnaire was administered to all first-year health professions students in their first semester at one university using the Interprofessional Attitudes Scale (IPAS). Kruskal-Wallis tests were used to analyze the data. KEY FINDINGS: Results indicated only two significant differences among students in IPAS subdomains: teamwork (χ2  = 13.11, df = 3, P = 0.004) and patient-centredness (χ2  = 40.75, df = 3, P < 0.0001). CONCLUSIONS: Not all health professions students come into their formal education with the same level of attitudes toward team-based care. Educators should consider this when designing IPE activities.

A Characterization of Student Reflections in an Introductory Pharmacy Practice Experience Discussion Course.

Objective. To characterize weekly student reflections in an introductory pharmacy practice experience (IPPE) discussion course meeting concurrently with IPPE rotations in institutional pharmacy. Methods. A qualitative analysis was conducted to identify themes within weekly reflective statements submitted by second year pharmacy students (P2) enrolled in an IPPE rotation and concurrent discussion course. Weekly reflections from the 2015-2016 offering of the course were reviewed by investigators to identify common themes via an iterative process. Subsequently, investigators coded each submission into one of the identified categories. Initial agreement between investigators was assessed using the Cohen kappa coefficient. Discrepancies between coding were resolved through discussion to reach consensus. Results. A total of 402 reflection assignments were reviewed from 85 P2 students enrolled in the IPPE course. Ten themes were identified, with the most common themes being interprofessional teamwork, pharmacist and technician roles and responsibilities, and policies and procedures. Substantial initial agreement between investigators was found, with the most discrepancies arising within the themes of medication distribution and pharmacy administration/organizational structure. Conclusion. Student reflections on IPPEs centered on 10 key topics, primarily related to distributive, legal, and regulatory functions of institutional pharmacy practice. Structuring an IPPE rotation longitudinally in an academic term, with a concurrent discussion course, builds a framework for regular student reflection.

Development and Assessment of the Multiple Mini-Interview in a School of Pharmacy Admissions Model.

OBJECTIVE: To describe the development, implementation, and evaluation of the multiple mini-interview (MMI) within a doctor of pharmacy (PharmD) admissions model. METHODS: Demographic data and academic indicators were collected for all candidates who participated in Candidates' Day (n=253), along with the score for each MMI station criteria (7 stations). A survey was administered to all candidates who completed the MMI, and another survey was administered to all interviewers to examine perceptions of the MMI. RESULTS: Analyses suggest that MMI stations assessed different attributes as designed, with Cronbach alpha for each station ranging from 0.90 to 0.95. All correlations between MMI station scores and academic indicators were negligible. No significant differences in average station scores were found based on age, gender, or race. CONCLUSION: This study provides additional support for the use of the MMI as an admissions tool in pharmacy education.

Early Introduction to Professional and Ethical Dilemmas in a Pharmaceutical Care Laboratory Course.

OBJECTIVE: To study the effects of an early professional development series in a pharmaceutical care laboratory (PCL) course on first-year pharmacy students' perceptions of the importance of professional attitudes and action. DESIGN: Three hundred thirty-four first-year students enrolled in a PCL course participated in a new required learning activity centered on development of professional attitudes and behaviors. Students discussed situational dilemmas in pharmacy practice in small groups, highlighting application of the Oath of a Pharmacist and the Pharmacists' Code of Ethics. ASSESSMENT: Students completed an optional questionnaire at the beginning and end of the semester to assess change in their attitudes and behaviors related to professionalism in pharmacy practice. CONCLUSION: While students entered their training with a strong appreciation for professionalism, they felt more confident in applying the Oath of a Pharmacist and the Pharmacists Code of Ethics to dilemmas in practice following the new learning activity.

A prescription analysis exercise in a pharmaceutical care laboratory course.

OBJECTIVE: To assess the impact of a new prescription analysis exercise in a second-year pharmaceutical care laboratory course. DESIGN: A new prescription analysis exercise was created and implemented that shifted the focus from strictly identifying errors and omissions to identifying and correcting them. Students used electronic label templates and mock prescription materials to correct various errors and omissions commonly seen in practice. ASSESSMENT: Forty-one percent of students received full credit for the exercise using the new method compared to the previous method where 9.1% of students received full credit. Ninety-four percent of respondents preferred the new method versus the original method, with reasons given including the new method seemed more practical, applicable, and realistic. CONCLUSION: The new prescription analysis exercise addressed many inconsistencies noted with the original method. Students performed better on graded assessments using the new method and preferred it over the old method of prescription analysis.

A Spanish language module in a first-year pharmaceutical care laboratory course.

OBJECTIVE: To assess the impact of incorporating Spanish language lectures and activities in a required Pharmaceutical Care Laboratory course on first-year doctor of pharmacy (PharmD) students' perceptions of and comfort level with Spanish-speaking patients and basic knowledge of Spanish pharmacy terms. DESIGN: The 6-week module consisted of attendance at a 1-hour lecture on medical Spanish and Hispanic culture, and completion of 4 small-group activities: drug and product information, patient information, counseling and side effects, and a written scenario that involved filling a prescription for and counseling a Spanish-speaking patient. ASSESSMENT: All students enrolled in the Pharmaceutical Care Laboratory course in fall 2008 (153) and fall 2009 (152) completed a pre- and post-intervention questionnaire (100% response rate). Less than 4% of students considered themselves fluent in Spanish prior to participating in the Spanish language module. Students agreed or strongly agreed that it was important for pharmacists to be able to translate common pharmacy label instructions from English to Spanish (89.8%) and Spanish to English (73.8%). Student-reported confidence in their ability to pronounce common pharmacy and medical terms in Spanish significantly increased, as did their ability to correctly interpret pharmacy label instructions. CONCLUSIONS: While incorporation of a Spanish language module in a first-year Pharmaceutical Care Laboratory course did not result in students achieving fluency in Spanish, it was a beneficial method of exposing students to Spanish language and culture.