Analysis of pharmacy student communication self-evaluation skills during standardized patient encounters.

INTRODUCTION: The objective of this study was to evaluate pharmacy students' communication self-evaluation skills by comparing student self-evaluations with those completed by course graders and standardized patients (SP). METHODS: As part of a required communications course, third-year pharmacy students completed a medication counseling encounter with a SP during a midpoint encounter and final assessment. Students' communication skills were evaluated by course graders and SPs. Students used the same assessment rubric to also complete self-evaluations immediately after each event and after reviewing a recording of their midpoint encounter. Agreement among student, SP, and course grader ratings on individual items were examined using the kappa statistic. RESULTS: A total of 206 students completed the midpoint encounter, and 208 completed the final assessment. Agreement between students' and SPs' evaluations was high during both the midpoint and final encounters, with >90% agreement on 14 out of 17 items at the midpoint encounter and 16 out of 17 during the final assessment. There were diffiences in scoring for the use of verbal distractors/fillers, with SPs' evaluations showing more favorable scores when differences existed [at midpoint 69 (33.7%) SP vs. 7 (3.4%) student; at final 31 (15%) SP vs. 3 (1.5%) student]. Agreement improved from the midpoint to final assessment (62.9% vs. 83.7%, respectively). CONCLUSIONS: Self-evaluation of communication skills may be an acceptable alternative to faculty or SP evaluations, when appropriate for the purpose of the activity, based on the high agreement observed among communication skills evaluations completed by students, course graders, and SPs.

A comparison of medication counseling evaluation tools utilized in colleges of pharmacy to three recognized guidance documents.

INTRODUCTION: A universal tool to assess proficiency in patient counseling has not been developed. The objectives of this project were to assess current practices in evaluating patient counseling at colleges of pharmacy and compare the results with three nationally recognized reference standards: the Omnibus Budget Reconciliation Act of 1990, the American Pharmacists Association Academy of Student Pharmacists National Patient Counseling Competition Evaluation Form, and the American Society of Health-System Pharmacists Guidelines on Pharmacist Conducted Patient Education and Counseling. METHODS: A cover letter and questionnaire were sent to all members of the American Association of Colleges of Pharmacy Laboratory Instructors Special Interest Group with an invitation to submit an evaluation tool. Descriptive statistics were used to examine the questionnaire items. An inductive approach was used to analyze the evaluation tools, which was completed independently by two members and then compared to build consensus to establish common content categories. RESULTS: Five major categories emerged with variability in content. More than 75% of tools included an introduction, almost 59% included collecting information, most included drug information (94%) and counseling points (88%), and most included verification of understanding (94%) and communication skills (94%). CONCLUSION: Although there was variability, most evaluation tools incorporated aspects of all three guidance documents. A limitation of this study was that data may be subject to non-response bias, as the response rate was limited to 17.8%. Future work should focus on creating and validating a standardized evaluation tool to ultimately promote consistency among student pharmacists.

American Pharmacists Attitudes and Behaviors Regarding Medication Error Disclosure.

BACKGROUND: Patient safety places emphasis on full disclosure, transparency, and a commitment to prevent future errors. Studies addressing the disclosure of medication errors in the profession of pharmacy are lacking. OBJECTIVE: This study examined attitudes and behaviors of American pharmacists regarding medication errors and their disclosure to patients. METHODS: A 4-page questionnaire was mailed to a nationwide random sample of 2,002 pharmacists. It included items to assess pharmacists' knowledge of and experience with medication errors and their disclosure. The data was collected over three months and analyzed using IBM SPSS 22.0. The study received IRB exempt status. RESULTS: The response rate was 12.6% (n = 252). The average pharmacist respondent was a 57-year old (+ 12.1 years), Caucasian (79.8%), male (59.9%), with a BS Pharmacy degree (73.8%), and licensed for 33 years (+ 12.8 years). Most respondents were employed in a hospital (26.4%) or community (31.0 %) setting and held staff (30.9%), manager (29.1%), or clinical staff (20.6%) positions. Respondents reported having been involved in a medication error as a patient (31.0%) or a pharmacist (95.5%). The data suggest that full disclosure is not being achieved by pharmacists. Significant differences in some attitudes and behaviors were uncovered when community pharmacists were compared to their hospital counterparts. CONCLUSION: There is room for improvement regarding proper medication error disclosure by pharmacists.

Development of a pharmacy referral protocol to enhance interprofessional services in a university-affiliated dental medicine clinic.

OBJECTIVE: To discuss the process of developing pharmacy consult services within a university-affiliated dental clinic. Secondary objectives are to describe the frequency of pharmacy consults provided when comparing the initial to the modified protocol and interventions, over time. SETTING: A university-affiliated student-driven dental medicine clinic in the Midwest. PRACTICE DESCRIPTION: The dental clinic consists of third- and fourth-year dental students who provide dental services and are supervised by dental faculty. Pharmacy consults are prompted due to patient criteria met on the protocol, patient-specific factors, drug information, or other reasons. Pharmacists are present to provide consults directly with dental students or patients. PRACTICE INNOVATION: Since October 2013, pharmacy services have been implemented into a dental clinic. A protocol is established to identify dental patients with high risk medications and medical conditions that may interfere with dental treatment. The initial protocol has been modified to include additional high-risk medications and conditions that the pharmacy team was being consulted for outside the protocol criteria. EVALUATION: A retrospective chart review was completed to evaluate the frequency of use of the original pharmacy protocol and the interventions provided. After the protocol was modified to include additional high-risk criteria, a second chart review was completed to assess changes in frequency of protocol use and interventions provided. RESULTS: Pharmacists undergo extensive self-learning to understand the dental-related concerns of the high-risk criteria as well as the dental workflow. The original pharmacy protocol accounted for 42.3% (n = 113) of the overall pharmacy consults (n = 267). After protocol modifications, utilization increased to 76.4% (n = 352, total n = 461). CONCLUSION: Pharmacists are successfully integrated into a dental medicine clinic to provide services to enhance dental patient care. The approximate 30% increase in the use of the pharmacy consult protocol demonstrated that the modified version was more effective.

Traditional matriculation vs an early assurance program: Effect on elected student leadership positions and academic performance.

INTRODUCTION: The objective of this study was to compare leadership and academic performance among students admitted by traditional pathways vs. a dual acceptance program (DAP). METHODS: A list of students admitted to the Midwestern University Chicago College of Pharmacy (MWUCCP) DAP was cross-checked with students elected to serve in leadership positions and students on the MWUCCP Dean's List for their first professional year from 2010 to 2015. The proportion of students serving in leadership positions and those on the Dean's List were compared to students that matriculated via the traditional route. RESULTS: In total, 1069 students were analyzed (n = 937 traditional; n = 132 DAP). DAP students were more likely to have an elected leadership role (n = 61, 46.2% vs. n = 314, 33.5%, p < 0.01) and achieve Dean's List for their first professional year (n = 64, 48.5% vs. n = 292, 31.2%, p < 0.01) compared to traditional students. DISCUSSION AND CONCLUSIONS: DAP students were more likely to hold an elected leadership position than traditional students. Further study of DAP student motivation is needed to potentially assist in the success of other students.

Comparison of community and hospital pharmacists' attitudes and behaviors on medication error disclosure to the patient: A pilot study.

OBJECTIVES: To determine pharmacists' attitudes and behaviors on medication errors and their disclosure and to compare community and hospital pharmacists on such views. METHODS: An online questionnaire was developed from previous studies on physicians' disclosure of errors. Questionnaire items included demographics, environment, personal experiences, and attitudes on medication errors and the disclosure process. An invitation to participate along with the link to the questionnaire was electronically distributed to members of two Illinois pharmacy associations. A follow-up reminder was sent 4 weeks after the original message. Data were collected for 3 months, and statistical analyses were performed with the use of IBM SPSS version 22.0. RESULTS: The overall response rate was 23.3% (n = 422). The average employed respondent was a 51-year-old white woman with a BS Pharmacy degree working in a hospital pharmacy as a clinical staff member. Regardless of practice settings, pharmacist respondents agreed that medication errors were inevitable and that a disclosure process is necessary. Respondents from community and hospital settings were further analyzed to assess any differences. Community pharmacist respondents were more likely to agree that medication errors were inevitable and that pharmacists should address the patient's emotions when disclosing an error. Community pharmacist respondents were also more likely to agree that the health care professional most closely involved with the error should disclose the error to the patient and thought that it was the pharmacists' responsibility to disclose the error. Hospital pharmacist respondents were more likely to agree that it was important to include all details in a disclosure process and more likely to disagree on putting a "positive spin" on the event. CONCLUSION: Regardless of practice setting, responding pharmacists generally agreed that errors should be disclosed to patients. There were, however, significant differences in their attitudes and behaviors depending on their particular practice setting.