Principles for Continuing Professional Development (CPD) Programs: A Statement by the ACPE CPD Advisory Committee.

Continuing Professional Development (CPD) has received increased attention within the pharmacy profession in the United States and is recognized as a potential pathway for ongoing professional development and practice transformation. Despite potential benefits of CPD, adoption in the United States has remained limited. A CPD program accreditation pathway, including principles, guidance, and a credit system for CPD programs, has recently been approved by the Accreditation Council for Pharmacy Education Board of Directors. This commentary reviews existing literature regarding pharmacy CPD, introduces CPD program principles and guidance for CPD program providers, and describes the model for awarding CPD units.

Characteristics of Successful International Pharmacy Partnerships.

Recommendations for global pharmacy collaborations are predominately derived from US institutions. This study utilized semi-structured interviews of global collaborators to assess important partnership components. Interviewees stated personal connections and understanding of each other's programs/systems were key components. Additionally, collaborators indicate that mutual benefits between partners can exist without the requirement for bidirectional exchange of learning experiences, and request and value partners and learners who are culturally aware, global citizens. This structured interview approach provided key insight into how to develop mutually beneficial, sustainable partnerships and provides additional confirmation that the five pillars of global engagement align with an international audience.

Predicting the Success of International Pharmacists in a Distance-Based US Doctor of Pharmacy (PharmD) Program: Results from a 5-Year Cohort.

Background: To establish the predictors of success in an international-trained PharmD (ITPD) program between admission criteria and academic performance. Methods: The primary outcome of this study was the correlation of admission criteria with didactic and experiential grade point averages (GPA) for the first 5 years. Candidates meeting the minimum criteria completed a competency exam or the US-Foreign Pharmacy Graduate Equivalency Exam (US-FPGEE). Tests of English language proficiency (TOEFL(R) and ACTFL's Oral Proficiency Interview) plus interview with faculty, students, and alumni were also required. Scores were correlated with both didactic and experiential GPAs. Results: The 23 students admitted to the ITPD program had a cumulative GPA of 3.72. There was a significant correlation between total admissions score and the median pharmacy and healthcare course category GPA (ρ 0.53), but not other categories. The composite TOEFL did not predict any performance but TOEFL writing and speaking did correlate with advanced pharmacy practice experience (APPE) performance. The OPI scores were associated with higher GPAs overall, in advanced integrated clinical sciences, and APPEs. The admission interview scores consistently and significantly correlated with preceptor-rated APPE GPA, practitioner skills, and professionalism (ρ > 0.5; p < 0.05). Performance in early courses significantly predicted the performance in advanced courses and experiential performance (ρ 0.48−0.61). Conclusion: The correlations between early and late course performance demonstrated the cohesiveness of this program. Further study is needed between the predictors of success using non-cognitive admission criteria.

Developing a Leadership and Practice Advancement Training Curriculum for Intern Pharmacists in Nigeria Using the ADDIE Model.

The Problem: Leadership and clinical-pharmacy advancement training are lacking during post-graduate pharmacy internships in Nigeria. Objective: To design and develop a leadership and clinical-pharmacy advancement training curriculum for intern pharmacists. Innovation: The curriculum was designed to include leadership development, process improvement, and project management, with a culminating capstone project, using the analysis, design, development, implementation, and evaluation (ADDIE) model. Twelve intern-pharmacists were selected representing three pharmacy schools and four hospitals in Nigeria. Baseline assessments included previous exposure to module topics, beliefs, and level of comfort with module skills. Findings: The leadership curriculum was developed and tested on 12 intern pharmacists. Their average age±SD was 23.4±1.9 years and 7(58.3%) of the participants were males. The participants had received previous training in leadership (33.3%), project management (16.7%), and process improvement (16.7%). In addition, 91.6% believed intern pharmacists could be leaders in advancing clinical pharmacy practice. Conclusion: The leadership and clinical-pharmacy advancement training curriculum was designed and developed using the ADDIE model for intern-pharmacists, who were highly prepared.

Critical moments in student learning on international advanced pharmacy practice experiences.

INTRODUCTION: The purpose of this study was to evaluate self-perceived critical moments that were transformative to learning in students who participated in an international advanced pharmacy practice experience (APPE). METHODS: Twenty-two pharmacy students from Purdue University College of Pharmacy, the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, and the University of North Carolina Eshelman School of Pharmacy who went on an international APPE participated in a one-hour focus group evaluating self-perceived critical moments that impacted their learning. Focus groups were coded using a conventional content analysis approach and went through a two-cycle open coding process to identify major themes according to country income classification. RESULTS: Twenty-two students participated in the focus groups with 18% going to a high-income country (HIC) and 82% going to a low-to-middle income country (LMIC) location. Major themes identified within HIC locations included witnessing an innovative patient care technique and experiencing interprofessional healthcare team dynamics. Major themes identified within LMIC locations included engaging in a sensitive patient interaction, experiencing healthcare system barriers, going out of their comfort zone, and making a difference. CONCLUSIONS: International APPEs in both HIC and LMICs provided students with disorienting experiences that facilitated transformative learning and led to changes in their perspectives on patient care and pharmacy practice. While critical moments were different across country income locations, both provided valuable experiences that could be translated into local context.

Development of a Global Health Learning Progression (GHELP) Model.

There has been a steady increase in global health experiential opportunities offered within healthcare professional training programs and with this, a need to describe the process for learning. This article describes a model to contextualize global health learning for students who complete international advanced pharmacy practice experiences (APPEs). Students from University of North Carolina at Chapel Hill, Purdue University, and the University of Colorado completed a post-APPE survey which included open-ended questions about knowledge, skills, and attitudes one week after completing an international APPE. Students were also invited to participate in a focus group. All 81 students who participated in an international APPE completed the open-ended survey questions and 22 students participated in a focus group discussion. Qualitative data from both the survey and focus groups were coded in a two-cycle open coding process. Code mapping and analytic memo writing were analyzed to derive to a conceptual learning model. The Global Health Experience Learning Progression (GHELP) model was derived to describe the process of student learning while on global health experiences. This progression model has three constructs and incorporates learning from external and internal influences. The model describes how students can advance from cultural awareness to cultural sensitivity and describes how student pharmacists who participate in international experiential education develop global health knowledge, skills, and attitudes.

Advancing Pharm. D. Training in Egypt through a Structured Preceptor Development Program.

The Children's Cancer Hospital of Egypt (CCHE) and the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences (SSPPS) collaborate to offer a Doctor of Pharmacy (Pharm.D.) degree to international pharmacists holding a bachelor's degree in pharmacy. The experiential training is provided by CCHE's clinical pharmacist preceptors at CCHE. Clinical pharmacists at CCHE had prior experience precepting baccalaureate pharmacy students, but not Pharm.D. students when this program commenced. Therefore, the SSPPS faculty provided a live preceptor development program for select CCHE clinical pharmacists in 2017. Primary deliverables of the program included the preparation of individual preceptor development plans and experiential syllabi for program participants. Preceptor development plans and experiential syllabi were evaluated by the SSPPS faculty. Program participants were also evaluated on their assessment of learner case scenarios using introductory pharmacy practice experience (IPPE) and advanced pharmacy practice experience (APPE) assessment tools created for the CCHE program. Participant performance on submitted preceptor development plans and experiential syllabi, and performance on the learner cases were all utilized for participant selection as Pharm.D. preceptors in the CCHE Pharm.D. program. This paper describes this preceptor development program, the process utilized to determine selection of Pharm.D. preceptors, and plans for providing continuing preceptor development for preceptors at CCHE.

Global Health Learning Outcomes by Country Location and Duration for International Experiences.

Objective. To determine the impact of country income classification and experience duration on learning outcomes for student pharmacists participating in international advanced pharmacy practice experiences (APPEs). Methods. A mixed-methods, longitudinal study evaluated 81 fourth-year student pharmacists participating in an international APPE through one of three US universities. A pre-post survey was administered to evaluate students' self-perceived growth across 13 competencies established by the Consortium of Universities for Global Health (CUGH). The survey included four additional open-ended questions. Student pharmacists were also invited to participate in a focus group. Paired and independent t tests and multiple linear regression were conducted. Qualitative survey and focus group data underwent a two-cycle, open-coding process using conventional content analysis. Results. Students who completed their APPE in a low- to middle-income country had greater growth in all CUGH competency statements compared to those who completed their APPE in a high-income country. Completing the APPE in a low- to middle-income country and prior travel for non-vacation purposes were significant predictors of student growth. Students who went to a low- to middle-income country demonstrated increased cultural sensitivity, more patient-centered care, and skill development, while students who went to a high-income country displayed increased knowledge regarding differences in health care system components, pharmacy practice, pharmacy education, and an appreciation for alternative patient care approaches. Conclusion. Learning outcomes differed between students who completed an APPE in a high-income rather than a low- to middle-income country, with both types of locations providing valuable educational opportunities and professional and personal development.

Development and implementation of a remotely precepted, interprofessional advanced pharmacy practice experience in rural Guatemala.

BACKGROUND AND PURPOSE: It is well-established that interprofessional experiences in the international setting provide students with additional skills in cultural humility and adapting to specific patient circumstances. Though these experiences are integral to the development of students, they are difficult to establish due to a lack of in-country preceptorship. This manuscript describes the development and implementation of an interprofessional advanced pharmacy practice experience (APPE) and outlines the interventions students have made to advance patient care, build trust, and improve the education of patients and providers in rural Guatemala. EDUCATIONAL ACTIVITY AND SETTING: The APPE in rural Guatemala was developed to include pharmacy distribution activities, education (patient, technician, provider, community), and clinical pharmacy services in an interprofessional environment. Pharmacy faculty served remotely as the primary preceptors using FaceTime, WhatsApp, and email. FINDINGS: A total of 12 APPE pharmacy students have completed the six-week Guatemala rotation since implementation. Students reported that they spent the majority of their time (60% to 70%) seeing patients and training the technician. The remaining time was split between assisting United States and Guatemalan providers during clinic visits and conducting home visits with community nurses. Students made 1191 patient care recommendations, of which 969 were accepted (81.4%). Students completed 17 patient education and quality improvement projects. SUMMARY: This APPE in Guatemala meets the needs of underserved populations, establishes effectiveness of distance precepting by pharmacy faculty, and provides international, interprofessional opportunities for fourth year pharmacy students.

Global Health Learning Outcomes in Pharmacy Students Completing International Advanced Pharmacy Practice Experiences.

Objective. To examine the global health learning outcomes of Doctor of Pharmacy (PharmD) students from three US schools who participated in international advanced pharmacy practice experiences (APPEs). Methods. A mixed-methods, prospective study was used to assess fourth-year PharmD students at three US pharmacy schools who participated in an international APPE during the 2017-2018 academic year and a matched cohort (control group) of PharmD students who did not participate in an international APPE. To evaluate students' self-perceived growth in the Consortium of Universities for Global Health (CUGH) competencies, all students completed a 13-item retrospective pre-post instrument using a five-point Likert scale. The students who had completed an international APPE were invited to participate in a focus group (N=22). Paired and independent t tests and multiple linear regression were used to analyze data. Qualitative open-ended questions and focus group data were mapped to knowledge, skills, and attitudes themes. Results. The students who completed an international APPE (N=81) showed significantly more growth in CUGH competencies than students who did not (mean improvement in total score of 10.3 [7.0] vs 2.4 [6.0]). International APPE participation was the only significant predictor of growth in CUGH competencies. The international APPE students reported improvements in cultural awareness and appreciation, communication skills, problem-solving skills, adaptability, self-awareness, personal and professional outlook, and global health perspective. Conclusion. Pharmacy students' participation in international APPEs led to significant improvement in all CUGH competencies. The CUGH competency framework appears to be a suitable instrument to assess pharmacy students' global health learning outcomes.