Compounding Education in US PharmD Curricula.

OBJECTIVE: To determine the extent of compounding education (CE) offered in United States (US) doctor of pharmacy curricula. METHODS: A 24-item survey instrument addressing various aspects of CE was developed and validated. An email containing the link to the survey instrument was shared with instructors of compounding at 122 of 141 accredited schools and colleges of pharmacy in the US. RESULTS: Of these, 112 schools and colleges responded, rendering a survey response rate of 91.8%. Survey results indicate that CE is offered to a similar extent either as a required standalone course or as integrated instruction as part of a standard course. Whereas 70.8% of programs reported mostly hands-on training in CE in their curricula, there were about 11% programs that mostly offered didactic instruction in CE. Dispersed systems and semisolid formulations are the most prepared in nonsterile compounding, while proper hand washing, garbing, and gloving are the most taught techniques in sterile compounding. Compounding education is delivered principally by pharmaceutics faculty (62.3%) compared to practice faculty (32.1%). CONCLUSION: The survey determined the extent to which CE is addressed across different schools and colleges of pharmacy in the US. Although some institutions lack minimal nonsterile or sterile compounding facilities, they may improve by modeling the established programs in the country. Leadership at pharmacy institutions may need to allocate funds for CE, and support faculty who instruct in compounding.

An Update on the Progress Toward Gender Equity in US Academic Pharmacy.

Objective. To evaluate the status of gender equity in US pharmacy education since the two previous publications on the topic in 2004 and 2014.Methods. Data were gathered from existing national databases, internal American Association of Colleges of Pharmacy (AACP) databases, AACP meeting minutes, published reports, scholarly articles, pharmacy association websites, individual school websites, and LinkedIn profiles. Differences between men and women were evaluated on degree completion, discipline, rank, tenure status, research, leadership development, leadership positions, salaries, and professional awards. Comparisons were also made to academic medicine and dentistry.Results. Fifty-one percent of full-time faculty members across all academic pharmacy disciplines are women. The percentage of women at the rank of professor was 36.6%, compared to 25% in 2014. Of the 2992 tenured or tenure track pharmacy faculty, 39.2% were women. Out of 388 department chairs, 146 were women. Throughout 2014-2021, there were 121 chief executive officer (CEO) dean permanent appointments, with men holding 91 (75.2%) and women holding 30 (24.8%). Women received 29.7% of the National Institutes of Health grants awarded to pharmacy schools compared to men (70.3%), although women's funding amount was higher. In both the pharmacy practice discipline and all sciences disciplines, the total salary across all ranks and years in rank was significantly higher for men than women, even for department chairs, but there were no differences for CEO deans. To date, women have received 13% of four national pharmacy organizations' top 13 awards.Conclusion. Since 2014, some achievement gaps have narrowed, but areas of concern still exist and need continued attention and resources so inequities can be eliminated. Women in academic pharmacy need mentoring and support to extend throughout the trajectory of their careers in areas such as academic advancement, grant applications, salary negotiation, leadership pursuit, and award applications.

Creation and implementation of a pharmacy-led meds-to-beds program at a large teaching hospital.

BACKGROUND: "Meds-to-beds" programs are a quality improvement intervention that is gaining wider implementation throughout the United States. The University of Oklahoma hospital system did not have this program and sought to implement one. There are sufficient data on the benefits of meds-to-beds programs, but there is a lack of literature on describing the development and implementation process. OBJECTIVES: The objective of this article is to describe the planning process, implementation, and barriers encountered during the organization of a pharmacy-led meds-to-beds program operating within 2 large teaching hospitals. PRACTICE DESCRIPTION: The University of Oklahoma Health Sciences Center campus has 7 colleges, multiple primary care and specialty clinics, and 2 hospitals. In addition, there are 3 on-campus outpatient pharmacies operated by the University of Oklahoma College of Pharmacy (OUCOP). PRACTICE INNOVATION: The college implemented a meds-to-beds program primarily serving 2 on-campus hospitals, The Oklahoma Children's Hospital and University of Oklahoma College of Pharmacy Medical Center. The program operated out of The Children's Pharmacy, an outpatient pharmacy located within the Children's Hospital. EVALUATION METHODS: A Plan-Do-Study-Act model was used, which allowed for adaptation in response to barriers encountered throughout the process. Frequent meetings among stakeholders were held to continuously evaluate progress (e.g., awareness and utilization of the program and prescription counts) and make necessary changes. RESULTS: Implementation of the program required changes in workflow both within the pharmacy and within the registration and discharge processes of medical teams. In addition, after the initiation of the meds-to-beds program, the daily prescription count more than doubled. The program averages 40 deliveries per day and 3 prescriptions per delivery and continues to grow, providing evidence of a successful meds-to-beds implementation. CONCLUSION: The Plan-Do-Study-Act model allowed for many adjustments to be made throughout the process, including the conversion from an opt-in to an opt-out model to increase program utilization.

An Updated National Profile of Curriculum Committees at US Schools and Colleges of Pharmacy.

Objective. To assess how curriculum committees at US schools and colleges of pharmacy have evolved since 2011 regarding their responsibilities, structures, functions, charges, and activities.Methods. A total of 133 fully accredited schools and colleges of pharmacy were included in the survey. Data collection occurred between March and September 2020, and survey questions pertained to academic year 2019-2020. Data were collected on committee membership, leadership, functions, and charges. New questions explored ties to assessments and Standards 2016. Analysis included descriptive statistics and comparisons to the 2011 survey results.Results. The response rate was 80%; one partial response was excluded from analysis. Most schools and colleges (93%) rely on a curriculum committee to provide curriculum oversight. Faculty and students remain the most frequent types of members, but increases have occurred in the number of committees with members from other areas, including experiential programs, staff, directors, librarians, and pharmacy residents. Committee charges have increased beyond the traditional activities of curriculum planning, mapping, and review to include newer tasks. In one-third of the institutions, the primary responsibility for various assessment activities is shared by both committees.Conclusion. Curriculum committees remain a key part of pharmacy education but continue to evolve to meet their responsibilities related to new and increasing numbers of charges and to find ways to communicate and share duties with their assessment counterparts. Based on these findings, recommendations include having clear guidance for curriculum committees and reducing the frequency of their scheduled work to ensure they will be able to address new challenges as they emerge.

Challenges and Lessons Amid the COVID-19 Pandemic at One College of Pharmacy.

The administrative response to the coronavirus identified in 2019 (COVID-19) pandemic for a variety of units housed in the University of Oklahoma College of Pharmacy is described. Continuity of operations, essential vs nonessential personnel, distance learning, online testing procedures for the Doctor of Pharmacy degree program, and the impact on development are discussed.

Longitudinal Outcomes of an Elective Academic and Administrative Advanced Pharmacy Practice Experience.

Objective. To evaluate the impact of an academic and administrative advanced pharmacy practice experience (APPE) on participants' career choice and long-term retention of teaching knowledge. Methods. Participants in an academic and administrative APPE from 2009 to 2016 completed a questionnaire about the experience and a 20-item knowledge test covering the five APPE modules. In addition, a retrospective review of graduates from the same timeframe was conducted to determine their faculty and preceptor status. Results. Of the 17 APPE participants, 16 completed the study and 100% reported that the experience helped them understand what it means to be a faculty member and an effective preceptor. The study participants completed the APPE knowledge test over the five modules. Participants passed four of the five module tests, including that for the instructional design module. A greater proportion of participants (75%) obtained faculty positions than did graduates who had not completed the APPE (9%). Seventy-one percent of students became active preceptors compared to 53% of students who did not complete the academic and administrative APPE, but this difference was not significant as the study was not powered to detect a difference. Conclusion. A longitudinal analysis of an academic and administrative APPE found that 75% of participants pursued a faculty position and retained their knowledge over time. A majority of the APPE participants (71%) and nonparticipants (53%) obtained a preceptor license. The outcomes support continued offering of the academic and administrative APPE to fourth-year pharmacy (P4) students. Requiring all P4 students to complete the APPE could help make them "preceptor ready."

Predicting Pharmacy Curriculum Outcomes Assessment Performance Using Admissions, Curricular, Demographics, and Preparation Data.

Objective. To determine the factors, including a preparation test, that best predict pharmacy students' performance on the Pharmacy Curriculum Outcomes Assessment (PCOA). Methods. Two cohorts of third-year pharmacy students completed a 100-item locally created PCOA pre-test, the PCOA Prep. This PCOA Prep was a cumulative knowledge test that was administered in the fall semester. In the spring semester, the students completed the 200-item PCOA and a separate survey on study habits and confidence. A retrospective review of students' demographics data, pre-pharmacy admission variables, and pharmacy school factors were collected. Correlation and regression analyses were conducted to evaluate which factors predicted students' PCOA total scaled score as well as scores in areas 1-4. Results. One hundred seventy-nine students were included in the study. The majority were female (55%), white (54%), and 28 (SD=5.4) years old on average. Students' average score on the PCOA Prep test was 80.7% (SD=7.8). The stepwise multiple linear regression model for the PCOA total scaled score included the PCOA Prep test, cumulative GPA at the end of the didactic curriculum, race/ethnicity, Pharmacy College Admission Test (PCAT) Verbal, PCAT Biology, and a class identifier. Including the PCOA Prep test explained more variance than the model without the test. Conclusion. This study revealed that student performance on a locally created cumulative knowledge test best predicted the PCOA Total Scaled Score. These results offer insights into additional contributing factors that influence students' PCOA performance and how colleges and schools of pharmacy could identify at-risk students who may need knowledge remediation prior to beginning advanced pharmacy practice experiences.

Issues and Opportunities on Implementing an Online Faculty Review System.

Intensifying accountability pressures have led to an increased attention to assessments of teaching, but teaching generally represents only a portion of faculty duties. Less attention has been paid to how evaluations of faculty members can be used to gather data on teaching, research, clinical work, and outreach to integrate clinical and academic contributions and fill in information gaps in strategic areas such as technology transfer and commercialization where universities are being pressed to do more. Online reporting systems can enable departments to gather comprehensive data on faculty activities that can be aggregated for accreditation assessments, program reviews, and strategic planning. As detailed in our case study of implementing such a system at a research university, online annual reviews can also be used to publicize faculty achievements, to document departmental achievements, foster interdisciplinary and community collaborations, recognize service contributions (and disparities), and provide a comprehensive baseline for salary and budgetary investments.

The use of think-aloud protocols to identify a decision-making process of community pharmacists aimed at improving CMS Star Ratings scores.

BACKGROUND: The Center for Medicare and Medicaid Services (CMS) created the Star Rating system based on multiple measures that indicate the overall quality of health plans. Community pharmacists can impact certain Star Ratings measure scores through medication adherence and patient safety interventions. OBJECTIVE: To explore methods, needs, and workflow issues of community pharmacists to improve CMS Star Ratings measures. METHODS: Think-aloud protocols (TAPs) were conducted with active community retail pharmacists in Oklahoma. Each TAP was audio recorded and transcribed to documents for analysis. Analysts agreed on common themes, illuminated differences in findings, and saturation of the data gathered. Methods, needs, and workflow themes of community pharmacists associated with improving Star Ratings measures were compiled and organized to exhibit a decision-making process. Five TAPs were performed among three independent pharmacy owners, one multi-store owner, and one chain-store administrator. RESULTS: A thematically common 4-step process to monitor and improve CMS Star Ratings scores among participants was identified. To improve Star Ratings measures, pharmacists: 1) used technology to access scores, 2) analyzed data to strategically set goals, 3) assessed individual patient information for comprehensive assessment, and 4) decided on interventions to best impact Star Ratings scores. Participants also shared common needs, workflow issues, and benefits associated with methods used in improving Star Ratings. CONCLUSION: TAPs were useful in exploring processes of pharmacists who improve CMS Star Ratings scores. Pharmacists demonstrated and verbalized their methods, workflow issues, needs, and benefits related to performing the task. The themes and decision-making process identified to improving CMS Star Ratings scores will assist in the development of training and education programs for pharmacists in the community setting.

Community pharmacists' beliefs regarding improvement of Star Ratings scores using the Theory of Planned Behavior.

OBJECTIVES: The Centers for Medicare and Medicaid Services (CMS) is moving toward a value-based model, which includes the Five-Star Quality Rating System (Star Ratings). Prescription Drug Plans include multiple pharmacy measures associated with adherence and patient safety that contribute to CMS Star Ratings scores. This study, using the Theory of Planned Behavior (TPB), explored factors associated with community pharmacists' beliefs to improve Star Ratings scores. DESIGN: Exploratory, qualitative, use of focus groups, and the TPB. SETTING AND PARTICIPANTS: Focus groups were performed in conference rooms at the College of Pharmacy main and satellite campuses. Participants were community retail pharmacists with an active Oklahoma license and 1 year of work experience. MAIN OUTCOME MEASURES: Each focus group was audio recorded and the recording transcribed to documents and analyzed with the use of a hybrid deductive and inductive qualitative approach rooted in a constant comparative framework. Coding of the data back to the TPB constitutes a deductive approach. The generation of themes and subthemes from other coded nodes constitutes an inductive approach. Analysts agreed on common themes, differences in findings, and saturation of the data gathered. RESULTS: Four focus groups were conducted with 26 participants in 2 categories: pharmacists with and without experience improving Star Ratings. Pharmacists shared and contrasted in salient, normative, and control beliefs about patient outcomes, data, financial implications, staff, technology, and other stakeholders associated with performance of improving Star Ratings. Themes regarding medication adherence, patient safety, and intention were also found. CONCLUSION: The TPB was used to explore beliefs of community pharmacists about improving Star Ratings scores. Themes that were identified will assist in future research for measuring intention to improve CMS Star Ratings scores and the development of training and education programs.

Needs assessment for developing a program to help train advanced-practice pharmacists for research.

PURPOSE: Results of a needs assessment to determine priority topics and preferred formats for research training in pharmacy residency programs are reported. SUMMARY: For pharmacists seeking advanced-practice positions in academia, the ability to conduct practice-based research is expected. Pharmacy residency programs are a primary recruitment source for these positions, but research training varies by residency site and available expertise. To help define the optimal content and format of resident research training, ASHP and the ASHP Research and Education Foundation conducted a needs assessment targeting postgraduate year 1 (PGY1) pharmacy residency directors (RPDs). The response rate was 36.5% (271 of 743 invitees); the information obtained was used to guide development of a Web-based training series. Only 12% of the RPDs who participated in the survey indicated that currently available research training resources within their residency programs were sufficient. Sixty-seven percent of surveyed RPDs agreed that a Web-based training program would be a useful resource, and 81% agreed that the target audience should be pharmacy residents. Training topics of greatest interest to RPDs included (1) components of a resident research plan, (2) identifying research questions, (3) study design and sample selection, (4) project management, (5) data acquisition, cleaning, management, and analysis, and (6) presenting and publishing project results. CONCLUSION: This needs assessment clearly identified opportunities for improving the infrastructure and content of PGY1 residency research training. At a minimum, training programs should focus on practice-based research concepts using readily accessible health-system data systems and provide universal accessibility and sufficient flexibility to allow residency programs to integrate the training in a manner that works best for the program.

Developing and improving residency research training.

PURPOSE: Peer-reviewed literature on pharmacy residency research training is reviewed with an emphasis on innovative strategies for research training enhancement. SUMMARY: There is a persistent gap between institutional expectations regarding the entry-level research skills of advanced-practice pharmacists and the research training experiences provided to pharmacy residents. This gap is especially problematic because pharmacy residency programs have become a primary source for recruitment of advanced-practice pharmacists. A literature review was conducted to characterize the current state of pharmacy residency research training and identify strategies to better prepare pharmacists for involvement in practice-based research. The 30 articles selected for review addressed four broad topic areas: residency stakeholder perceptions of research training, approaches to effective pharmacy residency research training, scholarly output resulting from resident research, and proposals and professional organization directives for advancement of pharmacy residency research training. Overall, the reviewed literature suggested four broad themes: (1) The extent and quality of research training provided to residents vary according to the limits imposed by the available expertise and resources of individual residency programs, (2) a formalized training approach is essential for research skills development, (3) proper training can improve scholarly output from resident research projects, and (4) guidelines alone are insufficient to ensure adequate development of research skills. CONCLUSION: A review of the literature identified three strategies that can enhance residency research training: formalizing the process, engaging expertise and collaboration, and formatting the training for use across all pharmacy residency programs.

A Progressive, Collaborative Process to Improve a Curriculum and Define an Assessment Program.

OBJECTIVE: To revise the University of Oklahoma College of Pharmacy's professional program outcomes and create an assessment map using results from previous peer review and mapping of all professional courses and curricular streams of knowledge, skills, and attitudes (KSAs). DESIGN: After consolidating 15 original program outcomes into 11 more precise outcome statements, defining KSAs for each, and getting faculty approval of them, the committee detailed measurable program expectations upon graduation for each outcome and created an assessment map identifying where KSAs were taught, how they were to be assessed, and the expected ability level (novice, competent, proficient) for each across the curriculum. ASSESSMENT: The committee's work identified deficits, inconsistencies, and disproportionalities in professional program assessment. It recommended assessments to capture student achievement of each outcome, identified performance levels and criteria to measure outcomes progressively in each professional year, and outlined a process to provide students periodic reports on their progress in achieving each outcome. CONCLUSION: This work establishes a firm foundation for ongoing efforts to measure effectiveness of the professional program, especially in light of Accreditation Council for Pharmacy Education's (ACPE) revised accreditation standards.

The status of women in US academic pharmacy.

OBJECTIVE: To describe the status of women in pharmacy education with particular focus on a 10-year update of a previous study. METHODS: Information was obtained from national databases, published reports, scholarly articles, and association websites. Comparisons were made between men and women regarding degree completion, rank, tenure status, leadership positions, research awards, salaries, and career advancement. RESULTS: There have been modest gains in the number of women serving as department chairs and deans. Salary disparities were found between men and women at several ranks within pharmacy practice. Men were more apt to be tenured or in tenure-track positions and received 89.4% of the national achievement awards tracked since 1981. CONCLUSION: The problem cannot be simply attributed to the pipeline of those entering academia. Barriers to advancement differ between men and women. We recommend that individuals, institutions, and associations implement strategies to decrease barriers and reduce bias against women.

Incremental development of an integrated assessment method for the professional curriculum.

OBJECTIVE: To incrementally create and embed biannual integrated knowledge and skills examinations into final examinations of the pharmacy practice courses offered in the first 3 years of the pharmacy curriculum that would account for 10% of each course's final course grade. DESIGN: An ad hoc integrated examination committee was formed and tasked with addressing 4 key questions. Integrated examination committees for the first, second, and third years of the curriculum were established and tasked with identifying the most pertinent skills and knowledge-based content from each required course in the curriculum, developing measurable objectives addressing the pertinent content, and creating or revising multiple-choice and performance-based questions derived from integrated examination objectives. An Integrated Examination Review Committee evaluated all test questions, objectives, and student performance on each question, and revised the objectives and questions as needed for the following year's iteration. Eight performance objectives for the examinations were measured. ASSESSMENT: All 8 performance objectives were achieved. Sixty-four percent of the college's faculty members participated in the integrated examination process, improving the quality of the examination. The incremental development and implementation of the examinations over a 3-year period minimized the burden on faculty time while engaging them in the process. Student understanding of expectations for knowledge and skill retention in the curriculum also improved. CONCLUSIONS: Development of biannual integrated examinations in the first 3 years of the classroom curriculum enhanced the college's culture of assessment and addressed accreditation guidelines for formative and summative assessment of students' knowledge and skills. The course will continue to be refined each year.

The importance of survey research standards.

Every discipline within fields of research has instituted guidelines and templates for research endeavors and subsequent publications of findings, with the ultimate result being an increase in quality and acceptance by researchers within and across disciplines. These significant efforts are by nature ongoing, as well they should. These enhancements and guideline developments have been instituted in basic science disciplines, clinical pharmacy, and pharmacy administration relevant and related to subsequent scholarly publication of research findings. Specific research endeavors have included bench research, clinical trials and randomized clinical trials, meta analyses, outcomes research, and large scale database analyses. A similar need for quality and standardization also exists for survey research and scholarship. The purpose of this paper is to clarify why this is important and crucial for the Journal and our academy.

Identifying psychological contract breaches to guide improvements in faculty recruitment, retention, and development.

OBJECTIVE: To identify pharmacy faculty members' perceptions of psychological contract breaches that can be used to guide improvements in faculty recruitment, retention, and development. METHODS: A list of psychological contract breaches was developed using a Delphi procedure involving a panel of experts assembled through purposive sampling. The Delphi consisted of 4 rounds, the first of which elicited examples of psychological contract breaches in an open-ended format. The ensuing 3 rounds consisting of a survey and anonymous feedback on aggregated group responses. RESULTS: Usable responses were obtained from 11 of 12 faculty members who completed the Delphi procedure. The final list of psychological contract breaches included 27 items, after modifications based on participant feedback in subsequent rounds. CONCLUSION: The psychological contract breach items generated in this study provide guidance for colleges and schools of pharmacy regarding important aspects of faculty recruitment, retention, and development.