Analysis of Gender and Race in Pharmacy Faculty and Administrators.

OBJECTIVE: The objective of this report is to identify and characterize the relative likelihood of women and racially minoritized pharmacy faculty being promoted, advancing within leadership roles, and earning comparable salaries. METHODS: Data from the 2010-2021 American Association of Colleges of Pharmacy Profile of Pharmacy Faculty surveys were analyzed to compare odds ratios for promotion, leadership roles, and salary gaps of pharmacy faculty according to race and gender. Changes in the odds ratios over time were characterized by linear regression and predictions about when and if equality would be achieved according to current trends were calculated. RESULTS: Compared to White male counterparts, faculty identifying as women, Black, Hispanic, or Asian had a significantly lower odds ratio of promotion to associate or full professor. Women and Asian faculty also had a lower likelihood of promotion from assistant to associate or Chief Executive Officer (CEO) dean. No demographics studied were more likely than White men to advance in rank or attain associate or CEO dean leadership positions. Furthermore, negative salary gaps for women emerge after promotion from assistant professor, becoming significant and continuing to widen at the associate (-$20,419) and CEO dean (-$37,495) level. CONCLUSION: Despite attention to matters of diversity, equity, and inclusion, female and racially minoritized faculty continue to experience lower rates of promotion, leadership advancement, and wages compared to White male colleagues. These results have negative consequences for recruiting and retaining talented faculty and students, and compromise the benefits that a diverse faculty is known to provide on student learning outcomes.

Improving Equity for Women in Pharmacy Academia.

Previous studies have identified that gender inequities exist in pharmacy academia. The inequities that women in academic pharmacy face are lower job satisfaction, ability to achieve higher ranks in faculty and administration, and salary. To date, considerations of why these inequities exist and what measures can be taken to address them remain relatively unexplored. This Commentary explores possible causes of gender inequities in pharmacy academia and potential solutions to improve equity between women and men. Potential causes include underlying sexism that still exists in society and academia today, promotion and tenure and the tenure clock, the concept of overwork, and the impact of the role of motherhood on female faculty. Suggestions to help improve gender inequity include both structural and cultural changes to the pharmacy academic environment.

How Debate Could Facilitate Group Function in Pharmacy Schools.

Objective. To study how a debate format could be a helpful tool to enhance group functionality and decision-making in schools of pharmacy.Methods. This study examines the potential of a debate format to facilitate discussion and shift viewpoints. Changes in viewpoint and feedback from the Academic Leadership Fellows Program (ALFP) Cohort 16 debates at the February 2020 American Association of Colleges of Pharmacy (AACP) Interim Meeting generated two data sets for each discussion topic to analyze debate effectiveness. Pre- and post-debate audience viewpoints were compared to determine the extent to which debates influenced viewpoints. Continuing pharmacy education (CPE) evaluations of the debate learning objectives provided information on participants' views of the debate format.Results. The debate format appeared to shift opinions on all three topics discussed. In addition, audience members responded in agreement or strong agreement that the debate format was of benefit to both leadership interactions and team environments.Discussion. While group functionality is an important aspect of effective decision-making, it is not always considered in pharmacy school operations. Incorporating debate components could improve the quality of group functionality, thereby positively impacting decision-making in schools of pharmacy.

A classroom-based patient case activity as a potential formative indicator of pre-advanced pharmacy practice experience readiness.

BACKGROUND AND PURPOSE: Pharmacy programs must assess student readiness for advanced pharmacy practice experiences (APPEs). This study evaluated: (1) if a relationship exists between student performance on a classroom-based patient case activity (Rx Review) and (2) performance on direct patient care and perceptions of the transferability of Rx Reviews to the APPE setting. EDUCATIONAL ACTIVITY AND SETTING: Rx Reviews are timed, independent, prospective reviews of a patient's medical record intended to simulate pre-rounding activities common in acute and ambulatory care settings. Students complete 12 Rx Reviews across a skills laboratory course sequence. Rx Review scores were compared to performance on acute care and ambulatory care APPEs for students in the Class of 2019 using descriptive statistics for student scores and bivariate logistic regression for the association between Rx Review scores and performance outcomes on patient care APPEs. Student perceptions of the Rx Reviews were assessed through a survey. Descriptive statistics and qualitative responses were used to analyze responses to the multiple-choice survey questions and open-ended question, respectively. FINDINGS: One hundred twenty-two students participated in the study. A relationship was found between students' Rx Review scores and performance in certain direct patient care APPEs, with students performing in the bottom 50% on Rx Reviews being more likely to perform poorly on those APPEs. Over 93% of students identified Rx Reviews as at least somewhat helpful in preparing them for APPEs. SUMMARY: This study indicated that a classroom-based patient case activity could be used as a formative measure of APPE readiness.

Leadership Lessons and Career Advice From the Musical Hamilton.

The musical Hamilton, written by Lin-Manuel Miranda, creatively depicts the life and career of founding father Alexander Hamilton. While Hamilton is the primary focus, highlights of the career and personal journeys of other leaders, such as George Washington, Thomas Jefferson, and Aaron Burr, are interjected throughout the production. Often the musical numbers in Hamilton focus on aspects of leadership and career development that Hamilton and his contemporaries were learning or needed to learn. These lessons are applicable to the challenges that faculty members in academic pharmacy face today at different stages of a career. These include the importance of maximizing opportunities, listening, self-reflection, compromise, patience, empathy, prioritizing, tending relationships, making difficult decisions, knowing when to say goodbye, and managing a legacy.

Combining rhetoric and role-play to introduce and develop patient presentation skills in third year pharmacy students.

BACKGROUND AND PURPOSE: To implement a mock rounds activity designed to introduce and develop patient presentation skills in pharmacy students. EDUCATIONAL ACTIVITY AND SETTING: The sample population included third-year pharmacy students enrolled at the University of New Mexico (UNM) and Virginia Commonwealth University (VCU) during Fall 2011, 2012, and 2013. A mock rounds activity was developed and implemented in the Pharmaceutical Care Lab setting. Students were assigned an infectious disease case and asked to create an assessment and plan to present orally to an acting preceptor in a small group laboratory setting. Summative assessment of student performance was evaluated using a standardized rubric. FINDINGS: A total of 621 students (VCU: 371; UNM: 250) from both universities participated in the mock rounds activity. Data was collected using the rubric. Students scored highest in the areas of respectfulness (94.8% exceeds expectations) and completion time (86.9% exceeds expectations). The lowest ratings were in the areas of logical flow and organization (73.7% exceeds expectations) and ability to answer preceptors' questions (73.3% exceeds expectations). DISCUSSION AND SUMMARY: A simulated mock rounds activity enabled students to practice patient case presentation skills and receive summative feedback prior to Advanced Pharmacy Practice Experiences.

Incorporation of an Explicit Critical-Thinking Curriculum to Improve Pharmacy Students' Critical-Thinking Skills.

Objective. The Health Sciences Reasoning Test (HSRT) is a validated instrument to assess critical-thinking skills. The objective of this study was to determine if HSRT results improved in second-year student pharmacists after exposure to an explicit curriculum designed to develop critical-thinking skills. Methods. In December 2012, the HSRT was administered to students who were in their first year of pharmacy school. Starting in August 2013, students attended a 16-week laboratory curriculum using simulation, formative feedback, and clinical reasoning to teach critical-thinking skills. Following completion of this course, the HSRT was readministered to the same cohort of students. Results. All students enrolled in the course (83) took the HSRT, and following exclusion criteria, 90% of the scores were included in the statistical analysis. Exclusion criteria included students who did not finish more than 60% of the questions or who took less than 15 minutes to complete the test. Significant changes in the HSRT occurred in overall scores and in the subdomains of deduction, evaluation, and inference after students completed the critical-thinking curriculum. Conclusions. Significant improvement in HSRT scores occurred following student immersion in an explicit critical-thinking curriculum. The HSRT was useful in detecting these changes, showing that critical-thinking skills can be learned and then assessed over a relatively short period using a standardized, validated assessment tool like the HSRT.

Complementary and Alternative Medicine and Therapy Use in a Diverse New Mexican Population.

OBJECTIVE: To describe differences, attitudes, and experiences in use of complementary and alternative medicines and therapy (CAMT) in people living in New Mexico (NM). DESIGN: Cross-sectional survey study. SETTING: Clinics staffed by the University of New Mexico College of Pharmacy faculty between September 2009 and August 2011 in Albuquerque, NM. PARTICIPANTS: Patients 18 years of age or older or parents of patients younger than age 18 years. OUTCOME MEASURES: Descriptive statistics for survey results and mean scores for attitudinal items. Chi-square, t-test, and analysis of variance were used to compare differences between groups across demographic variables. RESULTS: A convenience sample yielded 263 completed surveys. Of the respondents, 62% were male, 39% were single, and 50% were Hispanic. Nearly 56% of respondents used CAMT in the previous 6 months; 38% used CAMT in addition to and 11% used CAMT instead of prescription medications. Average number of CAMT used per respondent was 2.3 ± 1.6. A majority of respondents indicated that their CAMT use in the previous 6 months was useful, a good idea, easy to use, and likely to continue. CAMT use was significantly higher in female respondents (p = 0.03), those with a higher education level (p < 0.01), and those with a higher household income level (p = 0.03). CONCLUSION: Prevalence of CAMT is high in a diverse population of patients. Older respondents were more likely to use CAMT in addition to prescription medications, and younger respondents were more likely to use CAMT instead of prescription medications. Providers need to consider CAMT use when discussing treatment options with patients.

Comparison of Inpatient Glycemic Control with Insulin Vials Versus Insulin Pens in General Medicine Patients.

BACKGROUND: The Institute for Safe Medication Practices has recommended against routine use of insulin pen devices for inpatients, but the quality of inpatient glycemic control that is achieved with insulin pens versus insulin vials and syringes has not been compared. OBJECTIVE: To evaluate the quality of glycemic control achieved with insulin vials versus insulin pens in type 2 diabetic general medicine patients. METHODS: This retrospective cohort study compared glycemic control between 2 groups of patients on rapid-acting insulin protocols: those receiving insulin via patient-specific pen devices and those receiving insulin from patient-specific vials. Patients on a prespecified subacute care floor with a diagnosis of type 2 diabetes and at least 24 hours of glucose monitoring while on an insulin protocol with insulin lispro were included. Glycemic control was compared by area under the curve (AUC) estimations of average overall glucose and average glucose above, below, and within goal range (70-180 mg/dL). Percentages of time above, below, and within goal range were also compared. RESULTS: The mean ± SD AUC-estimated average glucose for pens was 160 ± 39 mg/dL compared to 158 ± 45 mg/dL for vials (P = .752). The mean ± SD percentage time within goal range was 68.2% ± 28.1% in the pen group versus 69.4% ± 31.8% percent in the vial group (P = .825). No statistically significant differences were detected between those receiving pens or vials for any outcome before and after adjusting for baseline differences and significant covariates. CONCLUSION: Glycemic control did not differ based on insulin delivery system.

Root Cause Analysis Design and Its Application to Pharmacy Education.

Objective. To evaluate third-year pharmacy students' ability to effectively design and apply root cause analysis (RCA) to a sentinel event and to analyze student responses for areas of proficiency and deficiency. Methods. This study involved a comprehensive review of RCA key assessments from 82 students in spring 2014. The performance assessments consisted of a review of each student's RCA worksheet and flow diagram as well as the 1-2 page narrative reflection. Results. The majority of students were able to successfully design an RCA, but had challenges with 3 components: fact-finding session, disclosure plan, and a flow diagram. Several students perceived challenges to conducting a formal RCA in certain health care settings, which included assembling an RCA team and gathering relevant facts, a lack of transparency/safe environment within organizations, and creating a plan for multiple/sequential errors. Conclusion. Most students were able to design an RCA process, but encountered difficulty with some components. Students also identified challenges in applying the approach in certain health care arenas.

Preceptor perceptions of the importance of experiential guidelines.

OBJECTIVES: To assess preceptors' perceptions of the importance of experiential guidelines and identify and compare differences in perceptions. METHODS: Active advanced and introductory pharmacy practice experience preceptors for the University of New Mexico were invited to participate in an anonymous electronic survey regarding the importance of specific tasks and abilities expected in new pharmacist practitioners as outlined in Appendix C of the Accreditation Council for Pharmacy Education (ACPE) Standards and Guidelines. RESULTS: While the majority of preceptors rated most tasks (eg, communication, patient counseling) as very important or important, emerging tasks (eg, health literacy, public health, physical assessment) were not rated as highly by a majority of preceptors. CONCLUSION: The deficiencies identified in the study suggest potential reductions in the transfer of learning from preceptors to experiential students. Preceptor training programs should be structured to raise the perceived level of importance of these tasks.

Instructional scaffolding to improve students' skills in evaluating clinical literature.

OBJECTIVE: To implement and assess the effectiveness of an activity to teach pharmacy students to critically evaluate clinical literature using instructional scaffolding and a Clinical Trial Evaluation Rubric. DESIGN: The literature evaluation activity centered on a single clinical research article and involved individual, small group, and large group instruction, with carefully structured, evidence-based scaffolds and support materials centered around 3 educational themes: (1) the reader's awareness of text organization, (2) contextual/background information and vocabulary, and (3) questioning, prompting, and self-monitoring (metacognition). ASSESSMENT: Students initially read the article, scored it using the rubric, and wrote an evaluation. Students then worked individually using a worksheet to identify and define 4 to 5 vocabulary/concept knowledge gaps. They then worked in small groups and as a class to further improve their skills. Finally, they assessed the same article using the rubric and writing a second evaluation. Students' rubric scores for the article decreased significantly from a mean pre-activity score of 76.7% to a post-activity score of 61.7%, indicating that their skills in identifying weaknesses in the article's study design had improved. CONCLUSION: Use of instructional scaffolding in the form of vocabulary supports and the Clinical Trial Evaluation Rubric improved students' ability to critically evaluate a clinical study compared to lecture-based coursework alone.

Alignment of pharmacotherapy course assessments with course objectives.

OBJECTIVE: To determine whether instructor-prepared classroom examinations for pharmacotherapy courses were aligned with course goals and objectives. DESIGN: Assessment items from examinations in 2 pharmacotherapy courses were evaluated. Four categories of alignment (depth of knowledge, categorical concurrence, range of knowledge, and balance of representation) were used to match course assessments with objectives. ASSESSMENT: While assessments met the criteria for acceptable alignment, there were areas for improvement. Goals and objectives were unevenly assessed, with 1 goal aligning with 45% of all assessment items. The assessments covered all content categories and the range of knowledge established by the objectives, but objectives under specific goals were not evenly assessed. CONCLUSION: This alignment study provided quantitative data useful for review and revision of pharmacotherapy course objectives and assessments and demonstrated the usefulness of alignment assessment as a tool for continuous quality improvement.