Impact of Collaborative Testing on Academic Performance in Pharmacy Education.

OBJECTIVE: To determine the impact of 2-stage collaborative testing (CT) on academic performance of pharmacy students and to characterize pharmacy student perceptions of CT. METHODS: Two-stage CT was piloted in a 2-course patient assessment sequence within a Doctor of Pharmacy program. Students were randomly allocated into 2 groups and further divided into teams of 4 to 5 students. Student teams alternated taking section examinations in a traditional 1-stage (individual) and 2-stage CT (individual then team) format to establish an experimental design. Near the end of each semester, students individually took a post-test to facilitate assessment of CT on academic performance. A 12-item, anonymous survey instrument assessed student perceptions of 2-stage CT. The group differences in academic performance and survey responses were analyzed statistically. RESULTS: There were 128 students enrolled in the course sequence, 123 of whom met the inclusion criteria for assessment of academic performance and 100 of whom completed the survey (response rate = 83%). Generally, students performed better on post-test items initially assessed through 2-stage CT (retention marker) and on post-test items that were answered incorrectly under 2-stage CT conditions (learning marker). Approximately 9 in 10 survey respondents preferred 2-stage CT over traditional 1-stage individual testing, with an equivalent proportion reporting it helped them learn from their mistakes and retain what they learned. There was high-level agreement among respondents that 2-stage CT improved their ability to work as a team and think critically. CONCLUSION: The implementation of 2-stage CT in a patient assessment course sequence was associated with improved learning and retention and was well-received by students.

A Mixed Methods Study of Resources Available for the Professional Development of Mid-Career Faculty.

OBJECTIVE: To determine what resources are available and useful for the professional development of mid-career faculty (MCF) in pharmacy education to foster career advancement. METHODS: A 37-question survey was sent to 7236 members of the American Association of Colleges of Pharmacy, an estimated 4640 of whom represented the target population of associate professors, full professors, and administrators. Semi-structured focus groups involving these 3 groups of faculty were held to provide additional insight. RESULTS: Of 4640 targeted pharmacy faculty, 825 completed the survey (18% response rate). At least one response was received from 98% of colleges and schools of pharmacy. Over 75% of MCF indicated a goal to advance to full professor, of whom only 55% were very or extremely confident they would be promoted. Clarity in expectations for advancement was identified as the most important factor for advancement; however, only 57% of MCF respondents agreed that their department/division has clearly delineated expectations for promotion. Protected time for research/scholarship was perceived by MCF as another important factor for advancement but was not provided as a resource to 61% of faculty. Thematic analysis of 7 focus groups including 31 faculty revealed 10 themes reinforcing the survey results. CONCLUSION: This study identified misalignment between the needs of MCF and the resources available to facilitate development/advancement.

Implementation and Evaluation of a Residency Preparation Program for Fourth-Year Doctor of Pharmacy Students.

OBJECTIVE: To describe the impact of a formal residency preparation program on student match rates, and to evaluate student-reported advisement activities and perceptions of the residency application process. METHODS: An optional, noncredit-bearing, residency preparation program was implemented in professional year 4 (PY4) of the Doctor of Pharmacy curriculum. The program consisted of 4 residency preparation presentations and/or workshops: curriculum vitae writing, navigating the residency application process and American Society of Health-Systems Pharmacy Midyear Clinical Meeting, letter of intent writing, and interview skills. Students attended either virtually or in person, with 3 of the 4 sessions including small group breakout sessions. The program also included dedicated, 1-on-1 residency advisement with residency-experienced advisors. RESULTS: Residency match rates following program implementation increased from 74.3% (comparison group) to 87.5% (intervention group). More students in the intervention group reported that their advisor assisted them with curriculum vitae review, letter of intent review, and interview skills. In addition, the intervention group reported significantly more time spent meeting with their advisor during PY4 than the comparison group. Students found the program to be beneficial to their professional development, indicated that it helped them to obtain a residency position, and expressed that they would participate in the residency preparation program again. CONCLUSION: Implementation of a formal residency preparation program for PY4 students that included 1-on-1 dedicated residency advisement increased match rates and interaction between students and their residency advisor.

A Call to Action for the Professional Development of Mid-Career Faculty.

Despite taking on heavier teaching and service loads, an expanding research program, and serving as mentors to junior faculty, mid-career faculty often feel unsupported. Providing a solid foundation through resource allocation and sharing between and within institutions can facilitate establishment or improvement of faculty development initiatives, workload equity, transparent policies, routine performance evaluation, a process for faculty recognition, and a system of mentoring to create an environment where this essential group of faculty can continue to grow. The following discussion, which includes suggested methods to achieve these goals with a focus on mid-career faculty, serves as a call to action for pharmacy school administrators to assess the state of mid-career faculty at their institution, and if indicated, implement systems that promote success among this group.

Clinical and economic effectiveness of a pharmacy and primary care collaborative transition of care program.

BACKGROUND: Primary care pharmacists are uniquely positioned to improve care quality by intervening within care transitions in the postdischarge period. However, additional evidence is required to demonstrate that pharmacist-led interventions can reduce health care utilization in a cost-effective manner. The study's objective was to evaluate the clinical and economic effectiveness of a pharmacy-led transition of care (TOC) program within a primary care setting. METHODS: This cluster randomized trial was conducted between 2019 and 2021 and included three primary care practices. Eligible patients were ≥18 years of age and at high risk of readmission. The multifaceted pharmacy intervention included medication reconciliation, comprehensive medication review, and patient and provider follow-up. The primary composite endpoint included hospital readmissions and emergency department (ED) visits within 30 days of discharge. Differences in outcomes were modeled using a generalized estimated equations approach and outcomes were assumed to be distributed as a Poisson random variable. A cost-benefit analysis was embedded within the study and estimated economic outcomes from a provider group/health system perspective. Cost measures included: net benefit, benefit to cost ratio (BCR), and return on investment (ROI). RESULTS: Of 300 eligible patients, 36 were in the intervention group and 264 in the control group. The intervention significantly reduced the primary composite outcome of all-cause readmissions and ED visits within 30 days (adjusted incidence rate ratio [aIRR], 0.54; 95% CI, 0.44-0.66; P < 0.001). There were significant reductions in both 30-day all-cause readmissions (aIRR, 0.64; 95% CI, 0.60-0.67; P < 0.001) and ED visits (aIRR, 0.25; 95% CI, 0.20, 0.31; P < 0.001) between groups. The net benefit of the intervention was $9,078, with a BCR of 2.11 and a ROI of 111%. Sensitivity analyses were robust to changes in economic inputs. CONCLUSION: This care transition program had positive clinical and economic benefits, providing further support for the essential role pharmacists demonstrate in providing TOC services.

Reviewing Promotion Dossiers as a Professional Responsibility.

Promotion is accompanied by additional responsibility, few more important than serving as a formal external reviewer of promotion dossiers. Promotion and tenure committees rely on external peer review to provide an outside perspective regarding the impact of the candidate's work and how they compare to peers with the same or higher academic rank. What the external reviewer writes and opines impacts the promotion and/or tenure decision. When presented with this opportunity, a faculty member needs to respond to the request, familiarize themselves with the candidate and their promotion and/or tenure criteria, conduct a critical read of the dossier, and write an evaluative letter. This commentary serves as a call for faculty members at the rank of associate and full professor to engage as a reviewer when called upon, provides advice about how to approach an external review and write the letter, and discusses how schools and professional organizations can participate in this process.

The Five Most Important Lessons I Learned Along the Path to Clinical Professor.

Data from the Academy indicate that non-tenure track (NTT) faculty are not ascending academic ranks to the same extent as tenured/tenure-track faculty. The reasons for this are likely multifactorial but may include a lack of direction, purpose, and resources. While there is more than one way to arrive at a particular destination in academia, it seems wise to listen and learn from those who have traveled the path. In this Commentary, which is directed to new and mid-career NTT faculty, I discuss the five most important lessons I learned along the path to becoming a clinical professor. This includes the importance of humility and serving others, setting goals (and advocating for the time you need to reach them), working smart (not simply hard), taking an active role in advancing the profession, and finally, taking time away from work and seeking alternative work arrangements that promote work-life balance.

Transitions of care education in US colleges and schools of pharmacy.

INTRODUCTION: Pharmacist-led transitions of care (TOC) services have demonstrated a positive impact on patient care and professional pharmacy organizations recommend integration of TOC-related education into doctor of pharmacy (PharmD) curricula. The objective of this study is to determine the extent to which TOC is taught in United States (US) colleges and schools of pharmacy and to characterize the educational content and the instructional methods used. METHODS: An 18-question electronic survey about TOC education was sent to US school of pharmacy faculty. One survey response per school was requested. Schools with an accredited or candidate-status PharmD program were included and duplicate responses from schools were adjudicated and combined. RESULTS: The survey response rate was 54.6% (n = 77). Of the responding schools, 92.2% reported incorporating TOC content into their required didactic curriculum and 43.1% reported incorporating TOC content in their elective didactic curriculum. Of the 11 TOC-related topics included in the survey, 3 were covered universally in the required or elective didactic curricula of responding schools. Both lecture and active-learning pedagogies were used to teach TOC. Introductory pharmacy practice experiences and advanced pharmacy practice experiences that incorporate TOC were offered at 85.3% and 98.5% of schools, respectively. CONCLUSION: Most schools of pharmacy who responded to this survey included TOC-related content in their curricula. Research into best practices for educating students on this topic is needed to help ensure graduates are prepared to contribute to this area of practice.

Remote Work in Pharmacy Academia and Implications for the New Normal.

Objective. To determine the extent to which pharmacy faculty engaged in remote work during the first two years of the COVID-19 pandemic and, secondarily, to characterize pharmacy faculty and administrator perceptions of remote work.Methods. A 28-question online survey was sent to 6548 members of the American Association of Colleges of Pharmacy (AACP). Questions centered on the extent of remote work and perceptions of its impact on productivity, effectiveness, and work-life balance. Focus groups were held to provide additional insight, and data were analyzed statistically.Results. In total, 6322 AACP members met inclusion criteria, of whom 1293 responded to the survey (21% response rate). At least one faculty member responded from 139 schools (99% response rate), and at least one administrator responded from 126 schools (89% response rate). During the pandemic, 97% of faculty were permitted to work remotely, 94% of whom did so at least some of the time. Most faculty indicated no change or an improvement in productivity (85%) and effectiveness (80%). Similarly, most administrators indicated no change or an increase in their unit's productivity (81%) and effectiveness (85%). More than half of respondents indicated better work-life balance while working remotely.Conclusion. Nearly all respondents were permitted to work remotely at least some of the time during the pandemic. Considering that most faculty and administrators believe productivity and effectiveness were not compromised and that there appear to be benefits to work-life balance, schools of pharmacy in the United States should consider permitting faculty to work remotely some of the time as we navigate the pandemic and thereafter.

Enhancing Pharmacy Faculty Well-Being and Productivity While Reducing Burnout.

Objective To explore methods that pharmacy programs can use to redefine their work environment to reduce stress, improve well-being, and increase faculty productivity.Findings To demonstrate a culture of support, organizations should consider a five-fold approach to enhancing and maintaining faculty well-being, including optimizing faculty and staff support, establishing a faculty development and mentoring program, permitting flexibility in work schedules, improving productivity of meetings, and managing communication tools. Individuals can also take measures to improve their well-being, including controlling email, giving attention to faculty citizenship, implementing stress reduction and coping techniques, and maintaining boundaries between work and home.Summary This article discusses approaches that have been shown to reduce burnout and provides strategies organizations and individuals can implement to improve productivity and faculty well-being. While certain areas, such as faculty wellness and productivity, have been well-studied in the pharmacy and health professions literature, significant gaps were identified in other areas, including alternate work arrangements. In some cases, data from the business sector can be extrapolated to pharmacy education; however, inferences from effective corporate strategies may not be transferable to the culture and expectations of academia. While there is significant overlap between institutional and individual strategies, a culture of communication, collaboration, support, and citizenship is foundational. There is no single strategy that will work for everyone, and flexibility is important to develop an individualized approach.

Implementation and Assessment of a Heart Failure Virtual Patient Simulation in a Required Pharmacotherapy Course.

Objective. To assess second year Doctor of Pharmacy students' academic performance in and perceptions of a heart failure (HF) virtual patient simulation used in a required pharmacotherapy course.Methods. A heart failure virtual patient simulation was created to augment heart failure pharmacotherapy course material at the University at Buffalo School of Pharmacy and Pharmaceutical Sciences in the fall of 2019. This was a retrospective, pre-post observational cohort study. The primary objective was to compare student performance on heart failure pharmacotherapy examination questions in a cohort of students who completed a virtual patient simulation in 2019 compared to a control cohort who completed a paper-based case activity in 2018. Student perceptions of the simulation experience were assessed via electronic survey.Results. Students completed either the virtual patient simulation (n=122) or a paper-based case activity (n=123). Overall, the proportion of correctly answered heart failure pharmacotherapy examination questions was 83.3% in the virtual simulation group compared to 79.2% in the paper-based case group. Survey results indicated that students would prefer that the virtual patient simulation be incorporated in the pharmacotherapy curriculum.Conclusion. Use of a heart failure virtual patient simulation was associated with improved examination performance and was well received by students.

Ascending the Levels of Leadership in Pharmacy Academia.

The influence of a leader depends on their position, the quality of their relationships with those they are striving to lead, what they have done for the organization, what they have done for their colleagues, and who they are and what they represent. Strong academic leaders who continually refine their leadership style can advance through the levels of leadership: position, permission, production, people development, and ultimately, personhood. To do so, one must build relationships, invest in others, and center activities on serving the needs of the people, the organization, and key partners. This necessitates approaching the situation with a strategic question: "How can administrators, faculty/staff, students, alumni, and site leadership work together in a way that encourages both individual and collective success?" In the end, we, as leaders, should strive to positively impact our profession, our organization, and the lives of those we have been entrusted to lead: ascending the levels of leadership helps us do just that.

Health information technology utilization and impact on COVID-19 vaccination.

The use of health information technology (HIT) during the coronavirus disease 2019 (COVID-19) pandemic has rapidly increased. During the pandemic, HIT has been used to provide telehealth services, education on the severe acute respiratory syndrome coronavirus 2 disease, updates on epidemiology and treatments, and most recently, access to scheduling systems for the COVID-19 vaccines. Disparities and health equity, with higher rates of illness, hospitalization, and death, during the pandemic has been documented in Hispanic or Latinx, black, and Native American or Alaska Native persons. Social determinants of health affect these persons disproportionately, including having lower socioeconomic status, lack of reliable transportation, lack of good quality broadband, being employed as an "essential worker," lack of quality housing, and access to and distrust of the government and health care setting. Patients who have limited or low health literacy will also be at risk for inequitable access to the COVID-19 vaccine owing to the complexities associated with the current vaccine distribution models and the heavy reliance on HIT.

Joint Statement on Pediatric Education at Schools of Pharmacy.

Providing health care for children is a unique specialty, and pediatric patients represent approximately 25% of the population. Education of pharmacy students on patients across the lifespan is required by current Accreditation Council for Pharmacy Education standards and outcomes; thus, it is essential that pharmacy students gain a proficiency in caring for children. A collaborative panel of pediatric faculty members from schools and colleges of pharmacy was established to review the current literature regarding pediatric education in Doctor of Pharmacy curricula and establish updated recommendations for the provision of pediatric pharmacy education. This statement outlines five recommendations supporting inclusion of pediatric content and skills in Doctor of Pharmacy curricula.

Assessment of a Scholars Program Designed to Enhance Pharmacy Students' Competitiveness for Postgraduate Residency Training.

Objective. To assess pharmacy residency match/placement rates and student perceptions of a program designed to enhance Doctor of Pharmacy (PharmD) student competitiveness for postgraduate residency positions. Methods. The Scholars Program was developed to provide advanced training to select PharmD students who had an interest in postgraduate residency training and was completed during the third and fourth professional years. The program consisted of mentoring; elective coursework encompassing clinical practice, teaching, and leadership; modified experiential education; journal club meetings; teaching assistant duties; conducting research and/or scholarship; and delivering professional presentations. Residency match/placement rates of students who had completed the program were compared to national data and to students in the school who were not enrolled in the program. Perceptions of the program were assessed using an online survey. Results. Sixty-four students enrolled in and completed the Scholars Program from 2013 to 2019. Of these, 58 (91%) pursued postgraduate residency training. Students enrolled in the program had a higher combined phase 1/phase 2 match rate (91.4% vs 67.4%) than students in other PharmD programs across the United States. Similarly, students enrolled in the Scholars Program had a higher combined phase 1/phase 2 match rate (91.4% vs 62.9%) and overall residency placement rate (96.6% vs 67.0%) compared to students in the school who were not enrolled in the program. More than 85% of students enrolled in the Scholars Program who pursued residency training agreed that the program prepared them for and helped them attain a postgraduate residency. Conclusion. Pharmacy students enrolled in the Scholars Program experienced high residency match/placement rates and viewed the program as valuable preparation for postgraduate training.

Facilitating Wellbeing in a Turbulent Time.

The novel coronavirus 2019 (COVID-19) pandemic has changed the way we live, work, and study. As faculty members, staff members, and students attempt to create and maintain a new normal because of this pandemic, the preservation of wellbeing becomes the responsibility of each and every one of us. The pandemic has taught us not to presume the importance of wellbeing and has allowed us time to reflect on establishing new assumptions and beliefs about how and when we work and study; how to be more efficient in our work and home responsibilities; and above all, what is most important. We must support ourselves and our students by maintaining a routine, modifying work and coursework expectations, and seeking psychosocial support if needed. Focusing on promoting wellbeing through leadership will move our institutions forward to a brighter future beyond COVID-19.

Facilitating Advancement of Clinical-Track Pharmacy Faculty Members.

Clinical faculty members in most pharmacy practice departments are expected to engage in practice, teaching, research and scholarship, and service. Although new clinical faculty members are typically well equipped to engage in the clinical practice aspect of their position, they generally lack experience in the other academic pillars and, depending on the institution, may not have dedicated time to engage in each area of effort, particularly research and scholarship. Consequently, achieving balance and realizing success in the tripartite mission of academia can be challenging. A multimodal approach can be used to facilitate advancement among clinical faculty members through faculty development and mentoring, attention to workload, clear expectations, and provision of feedback on performance and progression toward goals. This approach, which has been well received, has been associated with higher rates of promotion among clinical faculty members at one institution. Schools and colleges of pharmacy that value research and scholarship and are struggling to facilitate advancement among clinical faculty members may consider adopting some or all aspects of this program.

Implementation of a Pharmacist-Led Transitions of Care Program within a Primary Care Practice: A Two-Phase Pilot Study.

Pharmacists in primary care settings have unique opportunities to address the causes of ineffective care transitions. The objective of this study is to describe the implementation of a multifaceted pharmacist transitions of care (TOC) intervention integrated into a primary care practice and evaluate the effectiveness of the program. This was a two-phase pilot study describing the development, testing, and evaluation of the TOC program. In Phase 1, the TOC intervention was implemented in a general patient population, while Phase 2 focused the intervention on high-risk patients. The two pilot phases were compared to each other (Phase 1 vs. Phase 2) and to a historical control group of patients who received usual care prior to the intervention (Phase 1 and Phase 2 vs. control). The study included 138 patients in the intervention group (Phase 1: 101 and Phase 2: 37) and 118 controls. At baseline, controls had a significantly lower LACE index, shorter length of stay, and a lower number of medications at discharge, indicating less medical complexity. A total of 344 recommendations were provided over both phases, approximately 80% of which were accepted. In adjusted models, there were no significant differences in 30-day all-cause readmissions between Phase 2 and controls (aOR 0.78; 95% CI 0.21-2.89; p = 0.71) or Phase 1 (aOR 0.99; 95% CI 0.30-3.37; p = 0.99). This study successfully implemented a pharmacist-led TOC intervention within a primary care setting using a two-phase pilot design. More robust studies are needed in order to identify TOC interventions that reduce healthcare utilization in a cost-effective manner.

Comparative Effectiveness of Vancomycin Versus Linezolid for the Treatment of Acute Pulmonary Exacerbations of Cystic Fibrosis.

Background: Data are limited regarding the preferred antibiotics for treatment of acute pulmonary exacerbations (APEs) of cystic fibrosis (CF), when methicillin-resistant Staphylococcus aureus (MRSA) is suspected. Objective: To compare the rate of return to baseline lung function among individuals with APEs of CF treated with either vancomycin or linezolid. Methods: This retrospective study included individuals hospitalized for APEs of CF from May 1, 2015, to April 30, 2017 who were infected with MRSA and treated with vancomycin or linezolid. The primary outcome was the return to baseline lung function, as measured by forced expiratory volume in 1 s (FEV1). Descriptive and inferential statistics were used. All tests were 2-tailed with α set at 0.05. Results: A total of 122 encounters were included (vancomycin: n = 66; linezolid: n = 66). No difference existed in return to baseline FEV1 between vancomycin (53 [80.3%]) and linezolid (50 [75.8%]; P = 0.53); nor was there a difference in median percentage change in FEV1 from admission to follow-up between vancomycin (24.7%) and linezolid (20.7%; P = 0.61). Adverse drug events occurred more frequently in patient encounters treated with vancomycin (10 [15.2%]) compared with linezolid (2 [3%]; P = 0.002). Conclusion and Relevance: Our study observed no difference in the effectiveness of vancomycin compared with linezolid in terms of change in lung function for APEs of CF. The rate of adverse drug events was low. In individuals with CF infected with MRSA who are experiencing an APE, either vancomycin or linezolid appear to be viable treatment options.

Immunization Education in US Pharmacy Colleges and Schools.

Objective. To determine the extent to which immunization is covered at US colleges and schools of pharmacy and to characterize what immunization- and vaccine-related content is taught. Methods. An invitation to complete a 23-question online survey instrument was sent to 128 accredited US pharmacy colleges and schools. Frequency and descriptive statistics were used to characterize the data, and the Fisher exact test was used to compare opportunities for students to engage in introductory and advanced pharmacy practice experiences (IPPEs and APPEs) at schools located in states that did or did not allow pharmacy students and interns to vaccinate. Results. Eighty accredited US pharmacy schools responded to the survey (62.5% response rate). The APhA Pharmacy-Based Immunization Delivery Program was offered by 73 (91.3%) schools, while a different immunization certificate program was offered by 5 (6.3%) schools. Sixty-nine (86.3%) and 36 (45%) of the schools had integrated immunization topics into their required core curriculum (mean 8.4 contact hours) and elective curriculum, respectively. Of the 27 immunization-related topics identified, 23 (85.2%) were covered by at least 80% of schools. More than 80% of schools offered IPPEs and more than 90% offered APPEs that provided opportunities for students to engage in immunization-related activities. Schools located in states that permitted pharmacy students and interns to vaccinate more commonly offered immunization-related opportunities through IPPEs (86.5% vs. 0%) and APPEs (97.3% vs. 20%) than those schools in states that did not. Conclusion. Immunization curricula at US colleges and schools of pharmacy appear to align with ACPE standards, as well as the recommendations of the American Association of Colleges of Pharmacy and the American College of Clinical Pharmacy. Furthermore, nearly all of the schools are using the APhA Program to do so.