Development and Assessment of Integrated Virtual Escape Rooms to Reinforce Cardiology Content and Skills.

Objective. To describe the development and assessment of an integrated virtual escape room in a cardiology course.Methods. A virtual escape room was developed to reinforce therapeutics, pharmacology, pharmacokinetics, medicinal chemistry, pharmacogenomics, and calculations related to cardiology in an integrated pharmacy course and was completed by two student cohorts. Groups of four to five students had 40 minutes to complete virtual escape room puzzles, and each puzzle had to be solved correctly prior to advancing. After completion of the activity, learners met with facilitators to debrief. Students completed pre- and postsurveys to assess knowledge changes and their perceptions of the experience.Results. One hundred twenty-six second-year Doctor of Pharmacy (PharmD) students completed the escape room, and 79% (n=55) and 93% (n=52) of students completed pre- and postsurveys for the 2020 and 2021 cohorts, respectively. Results showed a significant improvement in student knowledge on pre- to postsurvey knowledge questions (2020 presurvey mean [SD]=43.1 [22.6], postsurvey mean [SD]=74.1 [19.6]; 2021 presurvey mean [SD]=52.0 [15.8], postsurvey mean [SD]=67.1 [19.2]). Most students in both cohorts (88%) agreed that logistics of the escape rooms were amenable to learning and applying information, and 86% enjoyed working through puzzles.Conclusion. The virtual escape room was well received by students and served as an effective tool for reinforcing and integrating cardiology concepts. The virtual nature of the activity makes it practical and easily replicable to implement at other institutions, which can benefit from using the format, logistics, and materials described in this study to decrease faculty workload and costs associated with implementing this educational technique.

Establishment and evaluation of scalable COVID-19 vaccine clinics at a large university.

BACKGROUND: Previous large-scale vaccination clinics have been successful before the coronavirus disease 2019 (COVID-19) pandemic; however, owing to the strict storage requirements and pharmaceutical preparation needed for the COVID-19 vaccines, careful thought and planning were necessary to successfully deploy these clinics immediately after vaccine availability. The focus of this manuscript is to describe the development and implementation of COVID-19 vaccination clinics in a large public university, using professionals from within and outside of its health sciences schools. OBJECTIVES: The primary objective of this project was to (1) implement COVID-19 vaccination clinics for university faculty, staff, students, and community members. Additional objectives of the clinics were to (2) actively incorporate pharmacy, nursing, and medical students into the clinic workflow; (3) promote interprofessional collaboration among faculty and students; and (4) assess patient satisfaction. PRACTICE DESCRIPTION: The School of Pharmacy faculty, in conjunction with the Office of Strategic Initiatives, planned and coordinated COVID-19 vaccination clinics from December 2020 to July 2021. Students and faculty from schools of pharmacy, nursing, and medicine were used. COVID-19 vaccinations were offered to university faculty, staff, and students and community members based on the Centers for Disease Control and Prevention priority groups. The clinic processes were designed such that they could be scaled from 100 to 2,000 participants per day. PRACTICE INNOVATION: The School of Pharmacy led approach was adjustable depending on the number of patients, continuously monitored and adaptable. The importance of pharmacists as part of the interprofessional health care team was exemplified by faculty and students involved. EVALUATION METHODS: All patients receiving COVID-19 vaccinations at the clinics were e-mailed anonymous surveys for assessment of the quality of the vaccination encounter after completion of their primary vaccine series. RESULTS: More than 15,000 COVID-19 vaccinations were provided through the clinics from December 2020 to July 2021. Professional staffing totaled 3352 hours for the 48 clinics. Thirty-eight percent of the vaccinated patients responded to the clinic satisfaction survey with predominately excellent ratings. CONCLUSION: COVID-19 vaccination clinics can be successfully planned and implemented in a scalable fashion in a large university setting using an interprofessional team approach.

Suggested pharmacy practice laboratory activities to align with pre-APPE domains in the Doctor of Pharmacy curriculum.

OUR SITUATION: The Accreditation Council for Pharmacy Education outlines ability statements that pharmacy students should be able to demonstrate prior to beginning their Advanced Pharmacy Practice Experiences (APPEs). Practice laboratory courses offer extensive opportunities for students to participate in activities and assessments that enable them to meet the objectives outlined in the Pre-APPE Core Domains in Standards 2016. This review identifies selected published literature, activities, and assessment methods that can be adapted and implemented in practice laboratory courses to help achieve the abilities outlined within the Pre-APPE Core Domains. METHODOLOGICAL LITERATURE REVIEW: The Medline database and journals related to pharmacy education were searched to identify activities and assessments for each domain. Search terms for each core domain were extracted from the domain titles, ability statements, and performance competencies and coupled with "laboratory" or "lab." "Pharmacy" was also added as a search term when searching the Medline database. Preference was given to example activities published in the last 15 years. Abstracts and activities based on author experience were also included. OUR RECOMMENDATIONS AND THEIR APPLICATIONS: Specific examples of how activities and assessments can be included in practice laboratories to develop or refresh skills identified in the pre-APPE core domains were described. POTENTIAL IMPACT: The practice laboratory setting is an ideal place for students to learn and practice the skills necessary to demonstrate readiness for APPEs. This paper serves as a resource for instructors, curriculum committees, or pharmacy programs looking for ideas to expand specific training or develop particular skill areas.

Implementation of a skills practical to first-year pharmacy students.

BACKGROUND AND PURPOSE: Objective structured clinical examinations (OSCEs) are being implemented in pharmacy schools across the country. As part of a new curriculum, a practical with an OSCE component was implemented for the first time at the West Virginia University School of Pharmacy. EDUCATIONAL ACTIVITY AND SETTING: A practical with an OSCE component was developed for first-year professional pharmacy students in a foundational pharmacy skills course. The OSCE component assessed insulin and inhaler counseling and blood pressure skills. A written exam covered material from throughout the semester. FINDINGS: A total of 76 students completed the practical. The average grade was a 27.8 out of 30 points. A total of 62 faculty hours were needed for the implementation of this OSCE. DISCUSSION AND SUMMARY: An OSCE that assessed a variety of foundational pharmacy skills was designed and implemented to first year pharmacy students using limited faculty time and resources.

Medication Discrepancies During Transitions of Care: A Comparison Study.

PURPOSE: Concerns surround discontinuity of care and poor communication during transitions of care between inpatient and outpatient settings. This study was designed to examine the differences in medication discrepancies during these transitions between an outpatient clinic with admitting privileges (PCP-AD) and another without admitting privileges (PCP-NOAD). METHODS: Retrospective, chart review of patients admitted to the hospital between January and July 2009, who stated their primary care provider (PCP) was from either one of the outpatient clinics. Charts were evaluated for medication discrepancies on admission and discharge and follow-up with PCP after discharge. RESULTS: On both admission and discharge, PCP-AD had a rate of unacceptable discrepancies less than that of PCP-NOAD, 63.4% versus 90.3% (p < .001) and 44.9% versus 84.1% (p < .001) respectively. Patients prescribed more than 10 medications were more likely to have a medication discrepancy compared with those on fewer medications (p = .003). Additionally, 85% of patients from PCP-AD followed up after discharge compared with 62.7% from PCP-NOAD (p < .001). CONCLUSIONS: The differences between the two groups in medication discrepancies and follow-up are suggestive of increased continuity of care with fewer discrepancies when PCPs are directly involved in inpatient care. A comprehensive and accurate medication history is imperative regardless of practice model.

Continuity of care between family practice physicians and hospitalist services.

PURPOSE: Hospitalist services are increasing in popularity and fewer primary care providers (PCPs) are caring for patients while hospitalized. Due to concerns with discontinuity of care, this study evaluated communication and medication discrepancies on admission and discharge between PCPs without admitting privileges and hospitalist physicians. METHODS: This retrospective analysis evaluated patients from a PCP office admitted to hospitalist services from January 2009 through July 2009. Patient charts were evaluated for PCP, age, gender, insurance, modes and timeliness of PCP notification, medications on admission and discharge, and medication discrepancies. RESULTS: A total of 120 charts were evaluated. Physicians were contacted by receipt of admission summaries for 93% of patients and by phone for 5.8% of patients. Twenty-one percent of admission summaries were received by the PCP after the patient was discharged from the hospital and 7% of discharge summaries were received after the first hospital follow-up with the PCP. Medication errors occurred frequently and the rate increased in patients at least 65 years old, if they had Medicare, Medicaid, or were without insurance coverage. CONCLUSION: Better communication and documentation of medication regimens are needed to improve continuity of care of patients between outpatient and inpatient settings and avoid potentially harmful medication errors.

A critical analysis of the (near) legendary status of vitamin D.

Labels such as food constituent, nutrient and supplement do not convey a sense of being essential. Yet these rather mundane descriptors, even if correct, belie the true significance of vitamin D. Long believed to be merely a functioning cofactor akin to vitamin C, deficiency of this secosteroid hormone is clearly associated with morbid complications of calcium and bone mineral metabolism, and because the hormonal effects are mediated by nuclear receptors that regulate the expression of many subordinate genes, the vitamin's pleiotropic mode of action can influence numerous metabolic pathways and, possibly, a number of different diseases. Although the vitamin is under intensive investigation, much still remains unknown, even in bone health, as the identity of osteoporosis susceptibility genes remains uncertain. This article focuses on various aspects of the basic science and molecular biology of the vitamin D endocrine system. The primary goal is to critically examine the evidence supporting its role in bone metabolism, diabetes and cancer.