The intersection of Growth Mindset and Accreditation in Pharmacy Education.

OBJECTIVE: To describe existing growth mindset literature within pharmacy and healthcare education, describe how a growth mindset can be beneficial in the accreditation process, and propose potential ways to promote a growth mindset in faculty, preceptors, students, and staff within pharmacy education. FINDINGS: To help pharmacy learners develop a growth mindset, existing literature emphasizes the need for a shift toward and aligning assessment with growth mindset, helping to create self-directed adaptive learners, leading to healthcare providers who can adjust their practice to tackle expected and unexpected challenges throughout their careers. Strategies to create a culture of growth mindset identified include training faculty and learners on growth mindset and developing new assessments that track a learner's growth. Recommendations for pharmacy educators include encouraging educators to assess their own growth mindset and use a variety of teaching methods and provide feedback on learner effort that encourages the process of learning rather than focusing on individual attributes, traits, and results. SUMMARY: Growth mindset intersects with accreditation standards for both professional degree programs and providers of continuing pharmacy education. Continuing professional development process (CPD) is one way to encourage faculty, staff, and students to develop a growth mindset. While a growth mindset can have many positive impacts on pharmacy accreditation, it is essential to recognize that achieving and maintaining accreditation is a multifaceted process involving numerous factors. A growth mindset can positively influence pharmacy education accreditation by fostering a culture of continuous improvement, innovation, resilience, student-centeredness, data-driven decision-making, collaboration, and effective leadership.

Moving AACP Curriculum Quality Survey Results from Good to Great.

Although the American Association of Colleges of Pharmacy (AACP) Curriculum Quality Surveys (CQS) are required for programs to distribute and utilize as part of accreditation standards, programs face challenges in survey administration and timing, interpreting data and results, and following up on action plans. Because the CQS surveys are standardized, they can allow for greater comparison among institutions, yet interpretation of the items can vary considerably. Programs have flexibility in determining samples for administration and timing of administration (ie, number of years), but some participants (such as preceptors) can suffer from survey overload if multiple institutions administer in the same year. Determining thresholds for action and providing feedback to stakeholders on improvements made based on data triangulations can be daunting. These are a few of the elements that programs must consider when determining their own approach to the AACP CQS. Thus, the purpose of this Commentary is to describe good practices for using the AACP CQS, discuss challenges associated with the surveys, and recommend how to move the utilization of the surveys from good to great.

Taking Action Towards Equity, Diversity, and Inclusion in the Pharmacy Curriculum and Continuing Professional Development.

Increased awareness of social injustices and inequities highlight the relevance and importance of diversity, equity, inclusion, and accessibility (DEIA) in health care. Former and recent graduates of pharmacy schools remain deficient in their knowledge of DEIA topics such as unconscious bias, which can directly influence health outcomes in an undesirable manner. Particular DEIA areas that are pertinent to pharmacy practice include: race, gender, sexual orientation, gender identity, ability status, religion, socioeconomic status, and political beliefs. The American Association of Colleges of Pharmacy (AACP) affirmed its commitment to DEIA as a priority. However, existing gaps in knowledge of pharmacy graduates in this area have the potential to contribute to health disparities and inequities, which are significant public health issues. We call on academic pharmacy institutions and professional pharmacy organizations to elevate DEIA topics and to designate them as essential to both addressing health equity and improving care for underserved populations. We also implore licensing boards to require continuing education related to DEIA as a foundational step to closing the knowledge gap for pharmacists in this area.

Effects of Advanced Pharmacy Practice Experience Characteristics on Postgraduate Year 1 Residency Match Rates.

BACKGROUND: Mentors often provide advice to students regarding selection of Advanced Pharmacy Practice Experience (APPE) rotations to strengthen their candidacy for a residency position. However, the impact of APPE characteristics on the chances of matching is unknown. OBJECTIVE: To determine the impact of APPE characteristics on Post Graduate Year-1 (PGY1) residency match rates at a Midwest US college of pharmacy. METHODS: Graduates from a single college of pharmacy who participated in the PGY1 match in 2015 or 2016 were included. Match data were obtained from National Matching Services. APPE characteristics (e.g., rotation timing relative to the Midyear Clinical Meeting [MCM], rotation type, and setting) were stratified by matched status. Independent predictors were identified using multivariate logistic regression and tree-based models. RESULTS: Ninety-nine students were included with 57 matching (57.6%). Students completing an infectious diseases rotation (75 vs. 51%; p = 0.028), a hospital rotation before the MCM (67 vs. 47%; p = 0.039), or a rotation in an ambulatory care clinic (67 vs. 47%; p = 0.045) were more likely to match. Students completing an independent community pharmacy rotation were less likely to match (8.3 vs. 64%; p < 0.001). After multivariate adjustment, all of these factors were associated with the likelihood of matching except completion of an infectious diseases (p = 0.077) or ambulatory care rotation (p = 0.073). CONCLUSION: A hospital rotation prior to the MCM was positively associated with matching while completion of an independent community pharmacy rotation was associated with non-matched status. The utility of these findings in guiding APPE selections for students pursing residency should be explored.

An Online, Self-directed Pharmacy Bridging Course for Incoming First-Year Students.

Objective. To evaluate the short-term effectiveness of an online bridging course to increase the knowledge of struggling incoming students' in crucial content areas within the Doctor of Pharmacy (PharmD) curriculum. Methods. An assessment was administered to all incoming first-year pharmacy students (N=180) during orientation to determine their foundational knowledge in key areas. Students who scored <70% on the assessment (N=137) were instructed to complete a 10-module, online, self-directed bridging course focusing on physiology, biochemistry, math, and medical terminology during the first two weeks of the quarter to prepare them for first-quarter coursework. After completing the bridging course, participants completed the same assessment to determine content knowledge acquisition and retention. At the end of the quarter, the assessment was again administered to all first-year students, regardless of whether they had completed the bridging course. Results. The average assessment score of students who completed the bridging course modules improved significantly (53% vs 76%). All students demonstrated significant improvement in assessment scores between orientation and the end of the quarter; however, bridging course participants achieved a greater increase in assessment scores (53% vs 73%) than nonparticipants (76% vs 81%). Significant relationships were found between assessment scores following completion of the bridging course and pass rates in first-quarter courses. Conclusion. The online, self-directed bridging course offered at Midwestern University, Chicago College of Pharmacy proved successful as a method of knowledge acquisition and as a system for early identification (within the first two weeks of the quarter) of students in need of additional academic support.

The Current Landscape of College-Sponsored Postgraduate Teaching and Learning Curriculum Programs.

Objective. To describe the landscape of teaching and learning curriculum (TLC) programs sponsored by US schools and colleges of pharmacy and evaluate their adoption of best practice recommendations. Methods. A 28-item electronic survey instrument was developed based on best practice recommendations published by the American Association of Colleges of Pharmacy (AACP), American Society of Health-System Pharmacists (ASHP), and American College of Clinical Pharmacy (ACCP) for the conduct of TLC programs. The survey instrument was electronically distributed to 137 accredited colleges and schools of pharmacy in the United States. Results. Eighty-eight institutions responded, resulting in a response rate of 64%. Sixty-one TLC programs were included in the final analysis. Seventy-five percent of TLC programs reported using best practice recommendations; however, 10% of respondents indicated they were not aware of the published recommendations. Inconsistencies among programs were noted in required teaching experiences, participant evaluation, and ongoing programmatic assessment. Conclusion. Most institutions offering TLC programs are aware of published best practice guidelines and have adopted a majority of the published best practices. However, considerable variability exists across the country. Development of a formal external validation process for TLC programs is necessary to ensure consistent quality.

Mapping Pharmacy Student Learning During Cocurricular Activities to National Standards and Institutional Outcomes.

Objective. To assess pharmacy student learning from co-curricular activities and map this to Accreditation Council of Pharmacy Education (ACPE) standards and the institution's curricular outcomes.Methods. Student representatives of professional organizations at one college of pharmacy were asked to complete a 16-item questionnaire on behalf of their members about each cocurricular activity their organization completed. Descriptive statistics were used to characterize the results. Content analysis was conducted on open-ended questions, and resulting codes were mapped to ACPE Standards 2016 and curricular outcomes.Results. The majority (74%) of the 152 unique cocurricular activities reported were designated as community outreach events and an average of 15 (SD=43) student members participated in each activity. The most frequently selected domain by student representatives was "promoted professionalism" for 86% of activities. Upon distilling student representatives' open-ended responses regarding their members' learning, each response was assigned to one or more of 34 codes. The most frequently assigned codes to learning descriptions (36%) were for patient education and counseling.Conclusion. Representatives of student organizations characterized their members' participation in cocurricular activities as opportunities for learning. The results from the content analysis aligned with the quantitative data collected. Cocurricular activities provide opportunities for Doctor of Pharmacy students to enhance their skills, knowledge, and attitudes in both pharmacy practice and personal areas that map to ACPE Standards 2016 and the college's own curricular outcomes.

Analysis of PGY-1 Pharmacy Resident Candidate Letters of Recommendation at an Academically Affiliated Residency Program.

BACKGROUND: Letters of recommendation (LORs) are a critical component for differentiating among similarly qualified pharmacy residency candidates. These letters contain information that is difficult to ascertain from curricula vitae and pharmacy school transcripts. LOR writers may use any words or phrases appropriate for each candidate as there is no set framework for LORs. OBJECTIVE: The objective of this study was to characterize descriptive themes in postgraduate year 1 (PGY-1) pharmacy residency candidates' LORs and to examine which themes of PGY-1 pharmacy residency candidates' LORs are predictive of an interview invitation at an academically affiliated residency program. METHODS: LORs for candidates from the Pharmacy Online Residency Centralized Application System (PhORCAS) from 2013 and 2014 for the Midwestern University PGY-1 Pharmacy Residency were analyzed. LOR characteristics and descriptive themes were collected. All scores for candidate characteristics and overall PhORCAS recommendation were also recorded. RESULTS: A total of 351 LORs for 111 candidates from 2013 (n = 47 candidates) and 2014 (n = 64 candidates) were analyzed; 36 (32.4%) total candidates were offered an interview. Themes that were identified as predictors of an interview included a higher median (interquartile range) number of standout words (3 words [1.3-4] vs 3.8 words [2.5-5.5], P < .01) and teaching references (3.7 words [2.7-6] vs 5.7 words [3.7-7.8], P = .01). CONCLUSION: For this residency program, standout words and teaching references were important when offering interviews.

Effect of application score strategy on interviews offered to postgraduate year 1 pharmacy residency applicants.

OBJECTIVES: Residency programs may need to spend a large amount of time on the application review process in order to invite the best candidates for interviews. By using a different scoring strategy, this process could be made more efficient while still resulting in selection of the most appropriate candidates to interview. The objective of this study was to explore hypothetical scoring strategies for past residency applicants and to determine the percentage of these applicants that would have received an interview offer compared with the program's standard scoring strategy. METHODS: Two years of residency applications to a postgraduate year 1 (PGY1) program providing the majority of clinical experience in ambulatory care were analyzed. Four models were explored: 1) standard model (original method); 2) simplified model (derived from statistical methods); 3) intuition model (criteria thought to best exemplify program success); and 4) objective model (criteria easy to objectively record, e.g., grade point average). All 3 new models were compared with the standard model to determine the percentage of candidates who would have received an interview if their applications had been scored according to the new model. RESULTS: A total of 110 applications were reviewed (42 interviews offered). After a multivariable analysis, academics, leadership, interest in ambulatory care, and professionalism were included in the simplified model, which predicted 81% of the interviews offered through the standard model. The intuition and objective models predicted 71% and 48% of interviews offered through the standard model, respectively. CONCLUSION: Models scoring only 4 of the initial 12 criteria would have likely predicted 71% to 81% of original interview offers. Residency programs should consider periodically reviewing their application review processes to determine areas for improved efficiency.

Student Characteristics Associated with Successful Matching to a PGY1 Residency Program.

Objective. To identify predictors for postgraduate matching success. Methods. In April 2014, a survey was distributed to students at five schools of pharmacy in the United States assessing organizational involvement, research and work experience, postgraduation plans, match status, and demographics. Results. Five hundred seventy-seven students (82%) completed the survey. Applicants who matched had a higher median number of interview offers compared to those who did not match. Significantly more females than males applied for a residency program. Those who matched had a higher median pharmacy school grade point average (GPA) compared to those who did not. No differences were observed in the rates of matching when leadership positions, student organizational membership, or previous work experience were considered. Conclusion. For pharmacy students in this study, number of applications and interviews, pharmacy school GPA, and female gender were associated with a higher likelihood of matching.

Examining Health Care Students' Attitudes toward E-Professionalism.

Objective. To compare pharmacy, osteopathic medicine, dental medicine, and physician assistant (PA) students' perceptions of e-professionalism. Methods. A 20-item questionnaire was developed and administered to four cohorts of health care professions students early in their first professional year. The questionnaire contained 16 scenarios in which a hypothetical health care student or professional shared information or content electronically and students were asked to indicate how much they agreed that the scenario represented professional behavior. Results. Ninety-four percent of students completed the questionnaire. More female students were in the pharmacy and PA cohorts. There were statistical differences in students' perceptions of e-professionalism in five of 16 scenarios. Specific differences were most often between the osteopathic medicine students and the other cohorts. Conclusions. The health care professions students surveyed had similar perceptions of e-professionalism. Of the four cohorts, osteopathic medicine students appeared less conservative in their approach to e-professionalism than the other cohorts.

An analysis of motivation factors for students' pursuit of leadership positions.

OBJECTIVE: To identify factors that influence student involvement and leadership within organizations and to assess the impact of involvement in organizations on professional skill development. METHODS: A printed survey was administered to fourth-year pharmacy students at one college of pharmacy (N=202). RESULTS: Most students (82%) indicated they were involved in at least one organization during pharmacy school and 58% reported holding a leadership position at some point. Factors with the largest impact on involvement in organizations were desire to present a well-rounded image to employers, ability to network, and interest in the activities sponsored by the organization. Involvement in professional organizations had a strong influence on their leadership, teamwork, confidence, and time-management skills. CONCLUSION: That presenting a well-rounded image to employers and having the ability to network with mentors and peers drove student involvement in professional organizations may be reflective of increasing competition for residencies and jobs.

Residency Information Preferences of Recent Pharmacy Residency Applicants.

Background: The increasing number of both postgraduate year (PGY)-1 and PGY-2 residency programs and applicants requires all parties to discriminate among the many options available in the marketplace. Studies assessing the information preferences of pharmacy students searching for residencies, including the utility and popularity of information sources (eg, school brochures, program Web sites, etc), are lacking. Objective: The preferences of recent residency applicants for types and sources of residency program information were assessed to improve the recruitment strategies of residency programs. Methods: A survey was distributed to 1515 residency program directors (RPDs). Questions solicited information regarding use of electronic resources and preference of information used to discriminate between residency programs prior to and during the application/interviewing process. Results: One hundred ninety-two RPDs responded and forwarded the survey to 522 PGY-1 residents and 207 PGY-2 residents. Completed surveys were submitted by 75.7% (n = 395) of PGY-1 residents and 57.5% (n = 119) of PGY-2 residents (overall response rate 71.3%). Participants ranked the program's Web site followed by a flash drive containing information about the program as the most preferred sources of information. Participants noted that required (n = 464) and elective learning experiences (n = 463) and current positions of past residents (n = 310) were very important information when deciding to apply to a program. Overall, 68.3% (n = 341) of participants indicated that they agreed or strongly agreed that electronic information sources were preferred over paper information sources. Conclusion: Residency programs should dedicate resources to ensuring that their Web site includes information regarding learning experiences and the current positions of past residents.

Graduating pharmacy students' perspectives on e-professionalism and social media.

OBJECTIVE: To determine the use patterns of social media among graduating pharmacy students, characterize students' views and opinions of professionalism on popular social media sites, and compare responses about social media behavior among students seeking different types of employment. METHODS: All graduating pharmacy students (n=516) at Purdue University, The University of Findlay, Butler University, and Midwestern University were invited to complete a survey instrument during the fall semester of 2011. RESULTS: Of 212 (41%) students who responded to the survey, 93% (194/209) had a social media profile. Seventy-four percent (120/162) of participants felt they should edit their social media profiles prior to applying for a job. CONCLUSIONS: Many graduating pharmacy students use social media; however, there appears to be a growing awareness of the importance of presenting a more professional image online as they near graduation and begin seeking employment as pharmacists.

Impact of a student response system on short- and long-term learning in a drug literature evaluation course.

OBJECTIVE: To evaluate the effectiveness of a student response system on short- and long-term learning in a required second-year pharmacy course. METHOD: Student volunteers enrolled in the course Drug Literature Evaluation were blinded and randomized to 1 of 2 groups. Group 1 attended a lecture in which the instructor used a student response system. Group 2 attended the same lecture by the same instructor an hour later, but no student response system was used. A 16-point unannounced quiz on the lecture material was administered to both groups at the end of class. Approximately 1 month later, both groups were given another unannounced quiz on the same material to test long-term student learning. RESULTS: One hundred seventy-nine (92.3%) students participated in both quizzes. Students who attended the class in which the student response system was used scored an average 1 point higher on quiz 1 than students who were assigned to the control group (10.7 vs. 9.7; p = 0.02). No significant difference was seen between the quiz 2 scores of the 2 groups (9.5 vs. 9.5; p = 0.99). CONCLUSIONS: The use of a student response system can positively impact students' short-term learning; however, that positive effect did not appear to last over time. Faculty members may want to consider the use of student response systems to enhance student learning in large lecture classes.

Faropenem medoxomil.

OBJECTIVE: To review the literature concerning the in vitro activity, pharmacokinetic properties, in vivo efficacy, and adverse events associated with a new penem antibiotic, faropenem medoxomil. DATA SOURCES: We conducted a search of MEDLINE/PubMed and International Pharmaceutical Abstracts databases for articles or abstracts using the terms faropenem, faropenem daloxate, faropenem medoxomil, SUN5555, SY5555, WY49605, RU67655, ALP201, BLA 857, and YM 044 and published through July 2007. Information on poster presentations was obtained from the drug's manufacturer. Additional articles were identified from citations in the bibliographies of review articles. Articles written in languages other than English were excluded. STUDY SELECTION AND DATA EXTRACTION: All published reports that evaluated faropenem (or its chemical synonyms) and faropenem medoxomil were used in this review. Abstracts subsequently published as full reports were excluded, and only the resulting reports were included. Abstracts without subsequently published reports were included. DATA SYNTHESIS: The in vitro activity of faropenem has been evaluated extensively against respiratory pathogens and less extensively against aerobic gram-positive, gram-negative, and anaerobic organisms. Prospective, randomized, multicenter clinical trials have demonstrated noninferiority of faropenem to comparators for the treatment of acute bacterial sinusitis, community-acquired pneumonia, acute exacerbation of chronic bronchitis, and uncomplicated skin and skin structure infections. Adverse events associated with faropenem appear to be minimal and include nausea, vomiting, and diarrhea. CONCLUSIONS: Faropenem has demonstrated excellent in vitro activity against common respiratory pathogens, many aerobic gram-positive organisms, and anaerobes. Activity against gram-negative organisms is more reserved. In vivo data suggest that faropenem is efficacious in treating community-acquired infections including uncomplicated skin and skin structure infections; however, more data may help to characterize faropenem's place in antimicrobial therapy. Replidyne, Inc., the manufacturer of faropenem, is conducting studies to address the Food and Drug Administration's concerns that resulted in a nonapprovable letter in October 2006.

Perceived value of a pharmacy resident teaching certificate program.

OBJECTIVE: To determine the value of completing a pharmacy resident teaching certificate program on graduates' current positions of employment. DESIGN: Annually from 2003 to 2007, program graduates of the Indiana Pharmacy Teaching Certificate (IPTeC) program were invited to take a 13-question Web-based survey 1 year after completing the program. ASSESSMENT: Fifty-three of the 62 graduates (85%) surveyed responded. Almost half of the respondents strongly agreed or agreed that having completed the IPTeC program helped them obtain their current position. More than 90% of respondents agreed or strongly agreed that the seminar participation and teaching experience from the IPTeC program helped them in their current position. About 80% of respondents would recommend the program to others. CONCLUSION: Completing a pharmacy resident teaching certificate program helped some graduates obtain and excel in their current position.

Investigating the potential influence of established multiple-choice test-taking cues on item response in a pharmacotherapy board certification examination preparatory manual: a pilot study.

OBJECTIVE: To determine the prevalence of established multiple-choice test-taking correct and incorrect answer cues in the American College of Clinical Pharmacy's Updates in Therapeutics: The Pharmacotherapy Preparatory Course, 2005 Edition, as an equal or lesser surrogate indication of the prevalence of such cues in the Pharmacotherapy board certification examination. METHODS: All self-assessment and patient case question-and-answer sets were assessed individually to determine if they were subject to selected correct and incorrect answer cues commonly seen in multiple-choice question writing. If the question was considered evaluable, correct answer cues-longest answer, mid-range number, one of two similar choices, and one of two opposite choices-were tallied. In addition, incorrect answer cues- inclusionary language and grammatical mismatch-were also tallied. Each cue was counted if it did what was expected or did the opposite of what was expected. Multiple cues could be identified in each question. RESULTS: A total of 237 (47.7%) of 497 questions in the manual were deemed evaluable. A total of 325 correct answer cues and 35 incorrect answer cues were identified in the 237 evaluable questions. Most evaluable questions contained one to two correct and/or incorrect answer cue(s). Longest answer was the most frequently identified correct answer cue; however, it was the least likely to identify the correct answer. Inclusionary language was the most frequently identified incorrect answer cue. Incorrect answer cues were considerably more likely to identify incorrect answer choices than correct answer cues were able to identify correct answer choices. CONCLUSIONS: The use of established multiple-choice test-taking cues is unlikely to be of significant help when taking the Pharmacotherapy board certification examination, primarily because of the lack of questions subject to such cues and the inability of correct answer cues to accurately identify correct answers. Incorrect answer cues, especially the use of inclusionary language, almost always will accurately identify an incorrect answer choice. Assuming that questions in the preparatory course manual were equal or lesser surrogates of those in the board certification examination, it is unlikely that intuition alone can replace adequate preparation and studying as the sole determinant of examination success.

Methamphetamine: putting the brakes on speed.

In only recent history, illicit use of methamphetamine, once isolated to urban areas on the West Coast, has spread into rural areas of the Midwest and southern United States. Although past and current methamphetamine legislation has increased penalties for methamphetamine manufacturers and tightened restrictions on sales of known precursors, the problem still persists. In fact, a 2004 survey indicates that an alarming 6.2% of high school seniors have tried methamphetamine. A number of biological, genetic, and environmental factors influence children's and adolescents' paths to substance abuse. Nurses should recognize the symptoms of methamphetamine abuse, which include agitation; aggressive behavior; rapid mood swings; hypertension; tachycardia; and eventually lesion-marked skin, clinical depression, and paranoid psychosis. Treatment for methamphetamine addiction includes behavioral therapy. Research on pharmacologic therapy is lacking. Educating youth on methamphetamine prevention appears to be the best approach to curb the spreading use of this addictive and deadly drug.