The cognitive apprenticeship model as a framework for desired precepting qualities to inform preceptor development.

INTRODUCTION: Positive learner perceptions of learning experiences have been linked to better learning outcomes. More information is needed on learners' desired qualities of preceptors and learning experiences to inform preceptor development. Aligning learners' perceptions with a teaching framework, such as the Cognitive Apprenticeship (CA) framework, may be useful to guide preceptor self-assessment and development. However, information is lacking regarding whether the CA framework is consistent with learners' expectations. The purpose of this study was to determine pharmacy learner perspectives on desired preceptor behaviors and qualities and to evaluate their alignment with the CA framework to inform preceptor development. METHODS: Twenty-two learners (nine residents and 13 introductory and advanced pharmacy practice students) participated in nine focus group interviews. Data were analyzed qualitatively by inductive coding and pattern coding and then condensed into themes. After initial analysis, the CA framework was adapted into codes and applied to the data to explore the alignment of quality preceptor characteristics with CA. RESULTS: Learners identified desired general preceptor characteristics, teaching behaviors, and qualities of sites and experience structure in their discussion. All four CA dimensions (Methods, Sociology, Sequencing, and Content) were represented in the described desired preceptor qualities. Most comments were connected to the Methods dimension. CONCLUSIONS: This study supports the use of CA as a framework to guide preceptor development and assessment for desired precepting qualities, preceptor behaviors, and learning environments. Additional research is needed for best practices in implementing CA in preceptor assessment and professional development.

Lessons learned from a non-traditional application process: Integrating user experiences to inform admission application design.

PURPOSE: The research aim was to gather applicant expectations and perspectives with a user-centered approach during a pilot application process for a new dental school. The goal was to inform future admissions practices at our institution and for programs broadly. METHODS: The High Point University admission team developed an electronic application external to current centralized services that was launched from May to August 2022. Participants who completed the application were requested to complete an electronic survey of closed- and open-ended questions about the factors influencing their application decisions, feedback about how to optimize the experience, and their overall satisfaction using a Net Promoter Score. RESULTS: A total of 303 applicants (79% response rate) completed the survey about their application experience. The most influential reason for applying to the program was the optional Dental Admissions Test requirement (43%). Participants frequently referenced a need for a more human-centered process focused on the candidate rather than their numerical values and that the process should be smooth, straight-forward, short, easy, and simple. Participants requested that experiences should be weighed the most in the application process followed by letters of recommendation. Most applicants were "promoters" (68%) for the program with a Net Promoter Score of 62. Moreover, 32% and 45% rated the application process as the best or better application experience compared to other programs. CONCLUSION: Programs can benefit from collecting applicant's (i.e., users) opinions and feedback about their expectations and experiences to inform more user-centered application processes.

Exploring user experience (UX) research methods in health professions education.

OUR ISSUE: Researchers often design interventions or experiences to meet the needs of a specific user. However, the user's perspective is often excluded in the process, which can minimize effectiveness due to a lack of understanding about the user, their perspective, and/or their needs. User experience (UX) research methods offer an opportunity to capture additional information about the user that can inform the design of these solutions. METHODOLOGICAL LITERATURE REVIEW: UX research became prominent during the 1990s to describe the complexity of human interactions with technological solutions. UX research methods emerged in other disciplines as strategies for describing user perspectives, needs, challenges, and potential impact of proposed solutions-these may be useful in health professions education research. OUR RECOMMENDATIONS AND THEIR APPLICATIONS: Those interested in UX research methods should define the user, establish focused research questions, and select applicable strategies cognizant of time and resource constraints. UX research often requires a clear outline of research activities, how they address the questions, and techniques to engage representative users for data collection. Researchers can optimize data collection by creating inclusive spaces that emphasize active listening. Researchers should compile insights regularly and remember UX research emphasizes an iterative approach to design. POTENTIAL IMPACT: UX research can support deeper insights into users, their perspectives, their needs, and offers opportunities to co-construct solutions with their experiences in mind. These methods may help educators design impactful experiences that better achieve targeted outcomes in collaboration with their users (e.g., learners, faculty, teams).

Design, Implementation, and Outcomes of an Interprofessional Mobile Web Application for Preceptors for Challenging Issues.

OBJECTIVE: The purpose of this study was to develop and assess an easily accessible interprofessional mobile web application to assist preceptors with challenging teaching and learning situations. METHODS: Phase 1 was a modified Delphi process of 48 advanced practice nursing, dentistry, medicine, and pharmacy preceptors to determine the content of the application. Phase 2 consisted of 12 preceptors from the 4 disciplines piloting a prototype to refine the tool using design-thinking principles. Feedback was analyzed using inductive coding and thematic analysis. Phase 3 evaluated the impact of the final tool on 80 preceptors' satisfaction, knowledge, self-efficacy, and perception of behavior change. RESULTS: Consensus on 10 topics was reached in the following 3 themes: feedback and communication, clinical and professional development of learners, and precepting efficiency. Preceptors rated the tool as efficient and applicable. Features perceived as useful included concise and applicable content that was easy to navigate with practical video examples. Features to improve included academic jargon, length of content, and lack of connectivity with other preceptors. Knowledge and self-efficacy improved after the use of the refined tool. Change in perceptions of behavior after 1 month was mixed, with a significant change in accessing resources to address challenging situations and regularly reflecting on challenging situations and no significant change in awareness, frequency, or success in managing challenging situations. CONCLUSION: An interprofessional mobile web application for challenging teaching and learning situations developed through a modified Delphi process was deemed efficient and relevant and demonstrated positive knowledge and self-efficacy change.

Methodological Challenges in Studies of Personal and Professional Identity Formation.

Demographic information about the identities of faculty, staff, students, and trainees is frequently collected in pharmacy education. A wide range of identities and characteristics can influence the choices and experiences of students as they progress through curricula and develop their professional goals. Understanding personal and professional identity formation within dynamic and complex environments is critical to promoting the success of pharmacy education and practice. Emerging research efforts highlight the importance of considering identity development from varying perspectives, and offer new methods for collecting and analyzing data. The objective of this commentary is to reflect on the methodological challenges of identity formation research in pharmacy education and offer recommendations for those interested in this work.

Assessing the Use of Microlearning for Preceptor Development.

The objective of this study was to evaluate microlearning as a preceptor development method compared to a traditional method of learning. Twenty-five preceptor participants volunteered to engage in a learning intervention about two preceptor development topics. Participants were randomized 1:1 to either a thirty-minute traditional learning experience or a fifteen-minute microlearning experience; participants then crossed over to the other intervention for comparison. Primary outcomes were satisfaction, changes in knowledge, self-efficacy, and perception of behavior, confidence scale, and self-reported frequency of behavior, respectively. One-way repeated measures ANOVA and Wilcoxon paired t-tests were used to analyze knowledge and self-efficacy, and Wilcoxon paired t-tests were utilized to assess satisfaction and perception of behavior. Most participants preferred microlearning over the traditional method (72% vs. 20%, p = 0.007). Free text satisfaction responses were analyzed using inductive coding and thematic analysis. Participants reported that microlearning was more engaging and efficient. There were no significant differences in knowledge, self-efficacy, or perception of behavior between microlearning and the traditional method. Knowledge and self-efficacy scores for each modality increased compared to the baseline. Microlearning shows promise for educating pharmacy preceptors. Further study is needed to confirm the findings and determine optimal delivery approaches.

Measuring the Impact of a Pharmacist-Driven Blood Factor Education Program: A Prospective, Single-Center Observational Study.

Introduction: Patients with bleeding disorders are best served by multidisciplinary teams. Pharmacists can play a critical role in the optimal management of patients with bleeding disorders through blood factor stewardship strategies and programs. An educational program was developed and implemented wherein a hematology pharmacist provided brief recorded lectures to an entire department of pharmacists in a multi-site health-system with the goal to improve the knowledge base and confidence among this population of general practitioners. Methods: The primary objective of this study was to evaluate the educational outcomes of a blood factor education program for pharmacists. The impact of the educational program was determined by measuring the difference in mean test scores between the pre- and post-program surveys. Results: The final analysis included 214 participants. The primary endpoint of mean competency test score was significantly improved in the post-test compared to pre-test (78.33% vs 52.83%; P < .0001). Any degree of test score improvement was observed in 99% (n = 212) of participants. Pharmacist confidence was significantly improved in all 20 domains of bleeding disorders and blood factor product verification and management. Conclusion: This program identified that most pharmacists in a large multi-site health-system were not familiar with bleeding disorders to a satisfactory degree, commonly because of the relative rare encounters with bleeding disorder-related orders, and that despite systems-based support there was an opportunity to improve practice through education. Such educational programming could be beneficial for the development of pharmacist-provided care and is a measure that could be implemented as part of blood factor stewardship initiatives.

Nanocellulose reinforced lightweight composites produced from cotton waste via integrated nanofibrillation and compounding.

Cotton is a natural fiber containing more than 95% of cellulose. With worldwide cotton consumption continuously increasing, the amount of cotton waste generated is enormous. Most of the cotton waste ends up in landfill or incinerators, resulting in a huge waste of this excellent natural resource. In this project, cotton waste was recycled to produce polypropylene nanocomposites. Instead of using the traditional two-step nanofiber extraction and compounding technique, an integrated process was adopted to combine nanofibrillation and compounding into one step. Results showed that cotton fibers with a slight prefibrillation and hydrophobic surface modification were successfully fibrillated into tens to hundreds of nanometers in width during compounding. The nanofibers reinforced polypropylene composites exhibited significantly enhanced tensile and flexural strength and moduli. For instance, when 30% fibers from bleached white and indigo-dyed denim fabrics were introduced, the tensile moduli of the resultant composites reached 4.57 and 4.59 GPa, respectively, compared to 1.60 GPa, the modulus of neat PP. Meanwhile, denim fabrics had a remarkable reinforcing effect on the composites' impact strength attributing to the hydrophobic indigo dyes that improved the interfacial bonding between cotton fibers and the matrix. The highest impact strength of denim reinforced composites was 4.96 kJ/m2 with 20% fiber loading; while the impact strength of neat polypropylene was 2.46 kJ/m2. The low water uptake of the composites further indicated the excellent adhesion at the filler/matrix interface. In general, a very promising processing technique to recycle cotton waste for high-value products was demonstrated.

Lessons From Using Design Thinking to Develop the 2021 AACP Teachers' Seminar.

Objective. To describe and evaluate how a design thinking approach aided the creation of the 2021 American Association of Colleges of Pharmacy (AACP) Teachers' Seminar.Methods. The design thinking framework (ie, inspiration, ideation, and implementation) was used to structure the seminar development process from July 2020 to July 2021. Nine committee members engaged in a persona activity (ie, inspiration), a brainstorming activity (ie, ideation), and a prototyping activity (ie, implementation) to create a user-centered learning experience. Twenty-five small group facilitators were then recruited to create and deliver breakout session content. After the seminar, the team was invited to debrief their experience in a focus group and an electronic survey to evaluate the perceived impact of using design thinking in the planning process.Results. Twenty-one (62%) of the 34 committee members and small group facilitators attended the focus group, and 28 (82%) completed the electronic survey. Most agreed that design thinking was a useful approach to support the Teachers' Seminar, and they were generally positive about the experience. There was a significant increase in self-reported creative self-efficacy for coming up with novel ideas, ability to solve problems, and helping expand others' ideas. Team members identified positive attributes about the seminar and planning process as well as areas for improvement. Team members also acknowledged challenges and potential solutions for professional organizations and program developers to consider when creating user-centered experiences.Conclusion. Design thinking can be a useful framework for seminar planning and implementation to create engaging, meaningful, and valuable educator development experiences.

Simulation-Based Training to Improve Clinical Pharmacist Self-Efficacy in the Management of a Rapidly Decompensating Patient.

Background: The optimal training method to prepare pharmacists as an integral rapid response team or cardiopulmonary arrest responders is poorly described. This study assessed the utility of simulation-based training (SBT) as a training technique for clinical pharmacists. Objective: This study aimed to determine if attending SBT is associated with an improvement in self-efficacy. Methods: This single-center, prospective, interventional cohort study offered three simulations to clinical pharmacists over the course of seven months at a 957-bed quaternary care academic medical center. Pharmacists who participated in at least one simulation were categorized in the intervention group and were compared to pharmacists who did not attend a simulation. All participants were asked to complete a 19-question self-efficacy survey in the form of a 100-point scale, a 15-question multiple-choice knowledge assessment, and a perception survey in the form of 4-point Likert scale administered at baseline and following the conclusion of the SBT. Results: Forty-four clinical pharmacists participated; 20 in the intervention group and 24 in the control group. Median change in self-efficacy score improved significantly in the intervention group compared to the control group (14.3 vs 2.3, P = .009). Median change in perception score improved significantly (2 vs 0, P = .046). Knowledge score did not change significantly from baseline. Conclusion: Simulation-based training improved clinical pharmacist self-efficacy and perceptions in the care of rapidly decompensating patients. These findings support SBT as a viable modality of training clinical pharmacists for the management of rapidly decompensating patients.

The Relationship Between a Multiple Mini-interview and Situational Judgment Test for Admissions.

Objective. To explore the relationship between a multiple mini-interview (MMI) and situational judgment test (SJT) designed to evaluate nonacademic constructs.Methods. A 30-question ranked-item SJT was developed to test three constructs also measured by MMIs during a pharmacy school's admissions process. First-year pharmacy students were invited to complete the SJT in fall 2020. One hundred four students took the SJT (82.5% response rate), with 97 (77% of possible participants) having MMI scores from the admissions process. Descriptive statistics and other statistical analyses were used to explore the psychometric properties of the SJT and its relationship to MMI scores.Results. Seventy-four percent of students identified as female (n=72), and 11.3% identified with an underrepresented racial identity (n=11). The average age, in mean (SD), was 21.8 (2.1) years. Students' mean (SD) scores were 85.5 (3.1) (out of 100 points) on the SJT and 6.1 (1.0) (out of 10 points) on the MMI. Principal components analysis indicated that the SJT lacked construct validity and internal reliability. However, reliability of the entire SJT instrument provided support for using the total SJT score for analysis (α=.63). Correlations between total SJT and MMI scores were weak (r p<0.29).Conclusion. Results of this study suggest that an SJT may not be a good replacement for the MMI to measure distinct constructs during the admissions process. However, the SJT may provide useful supplemental information during admissions or as part of formative feedback once students are enrolled in a program.

Impact of chitin nanofibers and nanocrystals from waste shrimp shells on mechanical properties, setting time, and late-age hydration of mortar.

Every year ~ 6-8 million tonnes of shrimp, crab, and lobster shell wastes are generated, requiring costly disposal procedures. In this study, the chitin content of shrimp shell waste was oxidized to produce chitin nanocrystals (ChNC) and mechanically fibrillated to obtain chitin nanofibers (ChNF) and evaluated as additives for mortar. ChNF (0.075 wt%) and ChNC (0.05 wt%) retarded the final setting time by 50 and 30 min, likely through cement dispersion by electrostatic repulsion. ChNF (0.05 wt%) with a larger aspect ratio than ChNC resulted in the greatest improved flexural strength and fracture energy by 24% and 28%. Elastic modulus increased by up to 91% and 43% with ChNC and ChNF. Solid-state nuclear magnetic resonance (NMR) showed ChNF (0.05 wt%) enhanced calcium-silicate-hydrate structure with a 41% higher degree of polymerization, 9% more silicate chain length, and a 15% higher degree of hydration at 28 days. Based on the findings, chitin seems a viable biomass source for powerful structural nanofibers and nanocrystals for cementitious systems to divert seafood waste from landfills or the sea.

Item response theory in high-stakes pharmacy assessments.

OUR SITUATION: Classical test theory (CTT) and item response theory (IRT) are two measurement models used to evaluate results from examinations, questionnaires, and instruments. To illustrate the benefits of IRT, we compared how results from multiple-choice tests can be interpreted using CTT and IRT. METHODOLOGICAL LITERATURE REVIEW: IRT encompasses a collection of statistical models that estimate the probability of providing a correct response for a test item. The models are non-linear and generate item characteristic curves that illustrate the relationship between the examinee's ability level and whether they answered the item correctly. Several models can be used to estimate parameters such as item difficulty, discrimination, and guessing. In addition, IRT can generate item and test information functions to illustrate the accuracy of ability estimates. OUR RECOMMENDATIONS AND THEIR APPLICATIONS: Researchers interested in IRT should gather the necessary resources early in the research process and collaborate with those experienced in quantitative and advanced statistical models. Researchers should confirm IRT is the optimal choice and select the model ideal for their needs. Once data are acquired, confirm model assumptions are met and model fit is appropriate. Lastly, researchers should consider disseminating the findings with accompanying visuals. POTENTIAL IMPACT: IRT can be a valuable approach in assessment design and evaluation. Potential opportunities include supporting the design of computer adaptive tests, creating equivalent test forms that evaluate a range of examinee abilities, and evaluating whether items perform differently for examinee sub-groups. Further, IRT can have noteworthy visuals such as test information and functions.

Considerations for writing and including demographic variables in education research.

OUR SITUATION: At many points within pharmacy education, we collect demographic information about faculty, staff, students, and trainees. Admissions procedures and surveys, for example, typically categorize participants based on various identities such as race and ethnicity as well as gender and sex. In this article, we interrogate the complex nature of capturing participant identities through demographic variables, using race and ethnicity, gender and sex, sexual orientation and identity, and disability status as specific examples. METHODOLOGICAL LITERATURE REVIEW: Various approaches to defining demographic characteristics can be seen in pharmacy education research. To help readers understand why certain characteristics and categories are commonly utilized, we describe common influences of demographic variables, such as federal laws and professional guidelines. We also review several common demographic variables to illustrate the complexity of this issue. OUR RECOMMENDATIONS AND THEIR APPLICATION(S): Seven recommendations for improving demographic data collection and use are provided. Examples include respecting and honoring lived student experiences, defining demographic data more precisely, and channeling institutional resources toward specific student needs. POTENTIAL IMPACT: Collecting demographic information more accurately and thoughtfully could help pharmacy education improve its educational practice and research. The provided recommendations provided will help researchers and educators measure and utilize demographic variables more effectively.

Designing an Inclusive Learning Training Series for Pharmacy Educators.

This article describes the design, implementation, and evaluation of five faculty development sessions focused on inclusive teaching strategies in pharmacy education. Inclusive strategies ensure that every student can clearly understand and engage in meaningful learning opportunities. Three sessions were implemented in fall 2020 and two in spring 2021. Sessions focused on experiential, didactic, and graduate education. A convergent parallel mixed methods evaluation was conducted using descriptive statistics and thematic analysis. Sessions were highly rated, and participants provided suggestions for curriculum improvement (e.g., creating resources, surveying students, and peer auditing syllabi for aspects of inclusiveness). Given the increasing emphasis on inclusion in pharmacy education, this work is timely for sharing strategies aimed at faculty development and teaching practices.

Interested in situational judgment tests? Preparing pharmacy educators for potential challenges.

PURPOSE: There is a growing interest in situational judgment tests (SJTs) for assessments and the authors offer their insights to help others develop and utilize these instruments while navigating common challenges. DESCRIPTION: This manuscript provides important considerations to those interested in SJTs using the "What? So What? Now What?" reflection framework. The authors offer their experience developing, implementing, and evaluating SJTs designed to measure empathy, adaptability, and integrity. ANALYSIS/INTERPRETATION: Effective SJT design can be organized around five key steps: attribute definition, item design, key development and scoring, test administration, and data analysis and interpretation. There are general recommendations to optimize SJT design to enhance reliability and validity of the results; however, there are often other challenges that have not been previously described. CONCLUSIONS: SJTs offer an exciting tool for measuring social and behavioral attributes; however, their infancy in health professions education warrants caution. Like any assessment, there are several challenges to consider when designing, implementing, and evaluating SJTs in pharmacy education. IMPLICATIONS: Individuals interested in SJTs are encouraged to ensure the construct measured is well-defined, there are clear and supported decisions around item and key design, and the appropriate psychometric analyses are conducted.

Preparing for implementation of an entrustable professional activity assessment framework.

Following the adoption of competency-based education in dentistry in the 1990s, entrustable professional activities (EPAs) were introduced in the field of medicine in the mid-2000s to help educators better determine the competence of trainees. More recently, the field of dental education has begun exploring EPAs as a framework for assessing competence while ensuring compliance with accreditation standards. This paper explores one dental school's process of preparing for implementation of a major curriculum change using an EPA assessment framework, shifting away from the use of singular assessments for competency determination to a global and longitudinal approach using a constellation of data to determine practice readiness. This paper describes how the EPA framework was developed, including the complementary capacities, assessment tool development and programming, and data reporting to follow learner progression and determine practice readiness. We discuss lessons learned leading up to implementation, and we position this perspective as a space to describe opportunities and complexities to consider when using a longitudinal assessment system. We attend to the tension between the current language of Commission of Dental Accreditation Standards as "competencies" and the evolving conversation of operationalizing EPAs while addressing accreditation Standards. To do this, we describe the process of finalizing our EPA framework and preparing for initial implementation in a new curriculum.

Responding to emerging oral healthcare needs with CARE: Design of the CARE curriculum model.

The release of the National Institutes of Health report, Oral Health in America: Advances and Challenges, in 2022 identified a pressing concern about oral healthcare and that "the job is far from finished." The High Point University Workman School of Dental Medicine utilized this report as inspiration to facilitate the design of the Clinician-Advocate-Researcher-Entrepreneur Curriculum. The aspiration was to create a novel curriculum and experiential model to prepare learners for the future of dental medicine, including addressing these public oral healthcare needs. This article describes how we conducted this process in three steps: defining the curriculum philosophy, outcomes, and structure. We present this example for those interested in curriculum design and modifications. Our goal is to encourage educators to explore opportunities to enhance dental education as a critical component of the complex system that impacts oral healthcare broadly.