Adjunct Preceptor Perceptions of Motivation, Understanding, and Support for the Precepting Role.

OBJECTIVE: To determine adjunct pharmacist preceptor perceptions of their precepting role related to three domains: motivation to precept, understanding the precepting role, and support for precepting. METHODS: An online cross-sectional survey of 2429 adjunct preceptors for four schools of pharmacy was conducted. Participants ranked their agreement with 81 statements regarding the three domains, including eleven subdomains. RESULTS: Mean scores for the three domains were slightly below the positive response level, with lower scores found for the subdomains of workload, precepting norms, and extrinsic benefits/rewards. Individual statements indicated increased workload due to precepting, need for more preceptor recognition and appreciation, perceptions that precepting was stressful or draining, and a preference for one concurrent learner. More frequent need for extra coaching for APPE students negatively impacted all domains, including nine subdomains. CONCLUSION: This study provides a formal evaluation of adjunct preceptor perceptions of their precepting role. Compared to previous studies, these results may indicate lower satisfaction with precepting, suggesting opportunities exist to improve the adjunct precepting experience. Actions by schools/colleges of pharmacy are necessary to ensure experiential education capacity including addressing workload concerns, increasing preceptor recognition and appreciation, and supporting preceptors when students need extra coaching.

Impact of a Simulation Exercise on Student Perceptions of Poverty and Interprofessional Socialization.

OBJECTIVE: This study aimed to evaluate the impact of an interprofessional poverty simulation exercise by determining if participating students demonstrated changes in attitude toward poverty (ATP) and perceptions of interprofessional socialization. METHODS: The Community Action Poverty Simulation from the Missouri Community Action Network was provided to 512 interprofessional health care students during 9 simulation exercises over a 3-year period. Primary participating professions were pharmacy, occupational therapy, and nursing. Student simulation roles were assigned to ensure a mix of professions in simulated families and debriefing groups. Debriefing sessions included questions related to interprofessional interactions. Students completed surveys before and following participation in the simulation, which included the ATP Short Form scale and the Interprofessional Socialization and Valuing Scale-9A. RESULTS: Statistically significant improvements in ATP were demonstrated for the overall score and 15 items of the 21-item ATP Short Form scale. The domains of stigma and structural perspective showed statistically significant improvement, while the personal deficiency domain did not. Statistically significant improvements in student perceptions related to interprofessional socialization were demonstrated for the overall score and 7 items of the 9-item Interprofessional Socialization and Valuing Scale-9A scale. CONCLUSION: This interprofessional poverty simulation positively altered student ATP and enhanced interprofessional socialization. The Community Action Poverty Simulation augmented with debriefing questions related to interprofessional interactions served as an effective interprofessional education experience for pharmacy, occupational therapy, and nursing students.

The Impact of Cocurricular Engagement on Doctor of Pharmacy Students' Personal and Professional Development.

OBJECTIVE: To explore how third-year students in 4-year Doctor of Pharmacy programs make meaning of their participation in cocurricular activities relative to their personal and professional development, and to determine the extent to which any perceived learning outcomes identified by the students align with the personal and professional development skills required for new Doctor of Pharmacy graduates, as identified in Standard 4 of the Accreditation Council for Pharmacy Education Standard 4. METHODS: Seventy third-year Doctor of Pharmacy students across 4 schools/colleges of pharmacy were interviewed and completed a preinterview survey to gather demographic data. Data were analyzed through an inductive, iterative process, which was completed multiple times until theoretical ideas were formulated through a deductive process. RESULTS: Eight themes were identified through the interview process, each intersecting with 1 or more of the Key Elements identified in Standard 4 as desired learning outcomes (self-awareness, leadership, innovation, and professionalism), suggesting a strong connection between students' perception of their cocurricular engagement and their personal and professional development. CONCLUSION: This study broadens the scope of knowledge relative to students' perceived learning outcomes resulting from their cocurricular involvement beyond the prior scope of related literature. Results point to multiple action items for educators to better support students in their personal and professional development through cocurricular engagement.

Relationship between advanced pharmacy practice experience grading schemes and pharmacy residency match rates.

PURPOSE: To determine the relationship of advanced pharmacy practice experience (APPE) grading schemes and other pharmacy program variables (ie, program age and funding) with pharmacy residency match rates. SUMMARY: A 12-question survey was disseminated to experiential administrators of pharmacy programs in October 2018. Respondents identified their program's APPE grading scheme (pass/fail, letter grades, or other) and associated pros and cons. Responding programs were categorized by age and funding status. Survey responses were correlated with the American Society of Health-System Pharmacists residency match rates for 2016 through 2018. Data were analyzed using descriptive statistics and logistic regression models as well as by attributes via thematic analysis. Most pharmacy programs (62%) reported using letter grades for APPEs compared to pass/fail (30%) or other (8%) schemes. Pharmacy programs using pass/fail grading were more likely to have students match to postgraduate year 1 (PGY1) (P < 0.001) and postgraduate year 2 (PGY2) (P = 0.0074) residencies. Older pharmacy programs for each grading scheme were more likely to have higher match rates; however, for PGY1 match rates, older programs utilizing letter grades correlated to lower match rates than those utilizing pass/fail grading (P < 0.0001). Likewise, both public and private pharmacy programs using pass/fail grading had higher PGY1 match rates than those using letter grades (P = 0.0006 and P = 0.0014). CONCLUSION: Pass/fail grading in APPEs does not hinder PGY1 or PGY2 residency placement compared to other grading schemes both overall and in combination with certain pharmacy program variables. Grading scheme strengths and weaknesses should be considered when deciding on optimal assessment strategies for APPEs and when evaluating candidates for residencies.

Impact of Advanced Pharmacy Practice Experiences on Residency Interview Invitations.

Objective. To determine how postgraduate year one (PGY1) pharmacy residency program directors perceive factors related to advanced pharmacy practice experiences (APPEs) when selecting candidates for residency interviews. Methods. An online cross-sectional nationwide survey of 1,280 PGY1 residency program directors was conducted. Participants were asked to rank the overall influence of five APPE categories, including location, structure, elective type, timing, and preceptor references, as well as the desirability and necessity of APPE-related variables representing the five categories, in their assessment of residency candidates. Results. Program demographics and survey data were collected from 375 participants (29% response rate). The category most influential to program directors' decisions was APPE preceptor reference letters, while the category that was the least influential was APPE timing factors. An APPE's location, structure, and elective type ranked second, third, and fourth, respectively, as the most influential categories. Respondents perceived factors similar to their own residency environment as desirable, supporting the study's conceptual framework of person-environment fit. The variables that the majority of residency directors specifically desired were two reference letters from APPE preceptors and letter grades for each APPE completed. Completion of inpatient elective APPEs was considered more desirable than completion of a balanced mix of elective APPEs. Participants rarely indicated that a specific APPE variable was a necessity for a candidate to be considered. Conclusion. Applicants to pharmacy residency programs should consider the importance of person-environment fit when selecting APPEs and preparing applications as program directors desire candidates who possess attributes compatible with their organization and complete APPEs in settings similar to that of their organization. Conversely, the absence of desired APPE-related variables does not necessarily exclude an applicant from consideration.

Essential Elements for Core Required Advanced Pharmacy Practice Experiences.

Since 2004, concerns and calls for greater quality assurance in experiential education have been published. The Accreditation Council for Pharmacy Education (ACPE) "Standards 2016" provide limited differentiation across the four required practice experiences, and, as such, schools interpret them differently. Both schools and accreditation site visit teams would benefit from a common set of guidance for the required Advanced Pharmacy Practice Experiences (APPEs), so that they can ensure consistency and quality in student experiences across practice sites. To address this need for greater standardization, a taskforce of the American Association of Colleges of Pharmacy (AACP) Experiential Education (EE) Section conducted a peer-reviewed, consensus-building process, including experiential faculty and staff across multiple colleges and schools of pharmacy, to determine a common set of elements that could be used to bring consistency to the experiences and expectations for student learning in practice. Over a two year period, the taskforce reviewed the relevant literature and then drafted and revised the elements through an iterative process which allowed for established EE consortia and members of the EE section to review the draft and provide input for revision. The resulting essential elements presented here can be used to guide faculty and staff within experiential education programs in their quality assurance processes in ensuring students receive consistent experience as part of their education prior to graduation.

Physiological characterization of the emergence from diapause: A transcriptomics approach.

Organisms inhabiting high-latitude environments have evolved adaptations, such as diapause to time reproduction and growth to optimize their survival. However, the physiological regulation of the timing of complex life histories is poorly understood, particularly for marine copepods, that diapause at depth. A member of the pelagic community of the sub-Arctic Pacific Ocean, Neocalanus flemingeri enters diapause in June. Egg production occurs in winter/spring. In order to characterize the transition from diapause to egg release, females were collected in late September from 400-700 m depth, incubated in the dark at 4-5 °C and sampled for RNASeq at weekly intervals. The diapause phenotype showed down-regulation of protein turnover and up-regulation of stress genes. Activation of the reproductive program was marked by the up-regulation of genes involved in germline development. Thereafter, progress through phases of oocyte development could be linked to changes in gene expression. At 5 weeks, females showed up-regulation of spermatogenesis, indicating that stored sperm had been in a quiescent stage and completed their maturation inside the female. Gene expression profiles provide a framework to stage field-collected females. The 7-week progression from diapause to late oogenesis suggests that females typically spawning in January initiated the reproductive program in November.

Preceptor Perceptions of Virtual Quality Assurance Experiential Site Visits.

Objective. To determine preceptor perceptions of the value of experiential quality assurance site visits between virtual and onsite visits, and to gauge preceptor opinions of the optimal method of site visits based on the type of visit received. Methods. Site visits (12 virtual and 17 onsite) were conducted with 29 APPE sites located at least 200 miles from campus. Participating preceptors were invited to complete an online post-visit survey adapted from a previously validated and published survey tool measuring preceptor perceptions of the value of traditional onsite visits. Results. Likert-type score averages for survey questions ranged from 4.2 to 4.6 in the virtual group and from 4.3 to 4.7 in the onsite group. No statistically significant difference was found between the two groups. Preceptors were more inclined to prefer the type of visit they received. Preceptors receiving onsite visits were also more likely to indicate no visit type preference. Conclusion. Preceptors perceived value from both onsite and virtual site visits. Preceptors who experienced virtual site visits highly preferred that methodology. This study suggests that virtual site visits may be a viable alternative for providing experiential quality assurance site visits from a preceptor's perspective.

Impact of a Simulation Exercise on Pharmacy Student Attitude toward Poverty.

Objective. To evaluate the impact of a simulation on pharmacy student attitudes toward poverty using the Attitude toward Poverty (ATP) Short Form scale. Methods. Second-year pharmacy students participated in the 3-hour Missouri Association for Community Action Poverty Simulation. Students completed a survey of the ATP Short Form scale prior to and following participation in the simulation. Results. Significant improvements in attitude were noted in 15 of 21 ATP Short Form items. Improvements in the stigma and structural domains were significant while improvement in the personal deficiency domain was not significant. Conclusions. This poverty simulation exercise positively altered pharmacy student attitudes toward poverty. When combined with didactic and experiential curriculum, this simulation may enhance student achievement of the 2013 Center for the Advancement of Pharmacy Education (CAPE) outcome subdomain of cultural sensitivity.

Introduction: "Where Would I Be Without You".

Where Would I Be Without You, the first and only poetry recording from Olivia Records, offers a glimpse into the powerful friendship and artistic collaboration between poets Pat Parker and Judy Grahn. Grahn and Parker met in Oakland, California in 1970, beginning an artistic collaboration and a powerful friendship that endured through Parker's death in 1989. Grahn's and Parker's work spread the good news of poetry; they were integral to how we lesbians imagined our voices in the world. The articles in this special issue reconsider and pay tribute to their work.

An Industrial Engineering Approach to Cost Containment of Pharmacy Education.

A 2-semester project explored employing teams of fourth-year industrial engineering students to optimize some of our academic management processes. Results included significant cost savings and increases in efficiency, effectiveness, and student and faculty satisfaction. While we did not adopt all of the students' recommendations, we did learn some important lessons. For example, an initial investment of time in developing a mutually clear understanding of the problems, constraints, and goals maximizes the value of industrial engineering analysis and recommendations. Overall, industrial engineering was a valuable tool for optimizing certain academic management processes.

An introductory pharmacy practice experience to improve pertussis immunization rates in mothers of newborns.

OBJECTIVE: To implement an introductory pharmacy practice experience (IPPE) involving discharge counseling on postpartum pertussis immunization recommendations and evaluate its impact on student learning and patient immunization rates. DESIGN: Seventeen pharmacy students provided verbal and written information based on Centers for Disease Control and Prevention (CDC) recommendations regarding pertussis immunization for mothers and caregivers of newborns. ASSESSMENT: Educational and clinical outcomes were evaluated using student documentation and pharmacy records. Students completed 615 IPPE hours and provided 1,263 consultations. Students reported that 52% of mothers requested immunization, 27% were undecided, 11% had previously been immunized, and 10% declined. Following counseling, immunization rates, as a percentage of total births, significantly increased by 18.5%. Learning objectives of enhanced counseling and documentation skills were achieved. CONCLUSIONS: IPPE students provided patient counseling in an institutional setting that contributed to healthcare team efforts to increase pertussis immunization rates in mothers of newborns. This IPPE may serve as a potential model for additional student involvement in discharge counseling.