Residents' assessment of mentoring received on lecture performance in a teaching and learning curriculum program.

INTRODUCTION: This study evaluated residents' assessment of the mentorship received and how it impacted lecture performance as part of a teaching and learning curriculum (TLC) program. METHODS: An anonymous survey was emailed to residents completing the Virginia Commonwealth University (VCU) School of Pharmacy's TLC during 2018-2019 and 2019-2020. The survey collected information about: the type of mentorship received, residents' self-perceived lecture performance, and residents' desire to be involved in academia post-residency. Data were summarized using descriptive statistics. Fisher's exact tests investigated the association between residents' self-perceived lecture enhancement due to mentorship and: mentors' involvement, residents' confidence in understanding the lecture topic, mentors' affiliation with VCU, and semester when the lecture occurred. Responses to open-ended questions were analyzed using thematic analysis. RESULTS: Forty-two of 86 residents (48.8%) completed the survey. Residents who were part of the TLC but did not deliver a lecture (n = 7) or taught practitioners instead of students (n =  2) were excluded, resulting in 33 participants. The majority of residents (87.9%) agreed or strongly agreed that mentorship enhanced their lecture. Mentors' level of involvement was significantly associated with residents' perception that the mentorship they received enhanced their lecture (P < .008). Residents' confidence in understanding the lecture topic, mentor affiliation, and semester when the lecture occurred were not associated with residents' self-perceived lecture enhancement due to mentorship. CONCLUSIONS: Active mentorship was associated with better self-perceived lecture performance. The best criteria for lecture mentorship should be established in the future to help prepare residents to give lectures.

Clinical Guidance for Managing Statin and Antimicrobial Drug-Drug Interactions.

PURPOSE OF REVIEW: This review discusses potential drug-drug interactions between statins and antimicrobials and provides clinician's guidance on how to manage these interactions. RECENT FINDINGS: In addition to statin utilization increasing in recent years, there is greater emphasis on using moderate to high-intensity statin doses. Statin-related adverse effects are often dose-dependent; therefore, patients may be at increased risk. Antimicrobial use has also increased in recent years, and various efforts have been implemented to ensure appropriate use of antimicrobials. Commonly used antimicrobials, such as macrolide antibiotics and azole antifungals, interact significantly with the CYP3A4 enzyme pathway similarly to lovastatin, simvastatin, and atorvastatin. Consequently, the potential for significant drug-drug interactions is increasing. In 2012, the US Food and Drug Administration strengthened warning labels for statins and dose adjustments related to drug-drug interactions. As such, it is imperative that clinicians are comfortable identifying drug-drug interactions between statins and antimicrobials and making appropriate therapy modifications as clinically warranted. Statins and antimicrobials are frequently coprescribed, and the available pharmacokinetic data supports the potential for clinically significant drug-drug interactions. Macrolides and selected antifungals can significantly increase drug levels of select statins, particularly those metabolized by the CYP3A4 pathway. Contrarily, rifampin can significantly reduce drug levels of statins, limiting their efficacy. Future research efforts should identify interventions to improve clinician recognition of these drug-drug interactions and the prevention of unwarranted statin-related adverse effects.