Medicinal chemistry curriculum and pedagogical practices at Canadian pharmacy schools: Towards standardization of practice.

INTRODUCTION: Medicinal chemistry instruction in PharmD programs at Canadian universities is considered an important foundational science. However, with few guidelines for the required content most programs have observed a decrease in hours of medicinal chemistry instruction. A Medicinal Chemistry Special Interest Group (SIG) was formed to address these issues nationally and initiated a pan-Canadian environmental scan to better understand the depth and breadth of medicinal chemistry instruction. METHODS: The SIG carried out an environmental scan to identify medicinal chemistry content, delivery and assessments in PharmD programs in Canada. RESULTS: Core medicinal chemistry concepts across the PharmD programs are in general agreement with those listed by the Accreditation Council for Pharmacy Education. Medicinal chemistry was typically taught as didactic lectures either as a standalone course or within a pharmacology course, although one program integrated some medicinal chemistry within therapeutics focused problem-based learning. There was no consistent time in program where medicinal chemistry occurred. CONCLUSIONS: The SIG found that similar medicinal chemistry content is taught across all Canadian PharmD programs, but incorporation of medicinal chemistry in therapeutics courses was minimal. Core concepts within six high-level overarching themes that guide our collective instruction were identified. The core concepts require developing high-level cognitive processes such as knowledge application and synthesis that practicing pharmacists are expected to possess for entry to practice. We the authors posit that in addition to providing a unique tool for pharmacists to employ in therapeutic decision-making, medicinal chemistry also provides early practice of important problem-solving and critical thinking skills.

Interrogating Our Views on the Impact of Education-Related Scholarship.

From junior faculty members to seasoned full professors, pharmacy educators have likely all felt pressure to focus on peer-reviewed publication. Although publication is an important part of an academician's work, have we missed something critical by not focusing greater attention on a more inclusive conceptualization of education-related scholarship's impact? How can we describe the full impact of our education-related scholarship beyond traditional metrics (ie, publications, presentations, and grant funding) if the issue is not critically examined? With the growing expectations for scholarly teaching and interest in the Scholarship of Teaching and Learning in academic pharmacy in both the United States and Canada, this commentary examines and questions the current, often narrow, views on pharmacy educators' scholarly impact. In addition, it provides a new definition of education-related impact to encourage a more expansive view.

"My UC Story": A Qualitative Descriptive Study Describing the Patient Journey for Ulcerative Colitis.

Background: Personal perspectives of patients are seldomly reported in the literature, most notably their journey to diagnosis. Literature is heavily focused on the patient journey from a healthcare professional's point of view during the treatment process. The objective of this study is to conduct a qualitative study on a video-sharing site, YouTube, to determine if the patient journey from a subjective perspective is truly linear for those who suffer from ulcerative colitis. Methods: Phrases searched on YouTube included "ulcerative colitis story" and "ulcerative colitis diagnosis story". Video monologues chronicling the patient journey before diagnoses were transcribed using the YouTube transcription function to identify patterns amongst users' experiences. Thematic analysis was used to identify whether certain themes were present in the monologues. Analysis was performed using NVivo 12 QRS International and used line-by-line coding to create an initial codebook that represented the concepts covered in the monologues. Results: We viewed a total of 48 videos and included 29 videos from 2010 to 2020 for qualitative analysis. Overall, three major themes were identified in the patient journey prior to ulcerative colitis diagnosis:1) initial symptoms, 2) initial encounter with the healthcare system, and 3) gastroenterologist referral. Conclusions: The literature depicts the patient journey as a linear path. This qualitative study discovers that the reality of the patient journey is, in fact, non-linear. Many creators did not identify pharmacists in their patient journey; however, we know from the literature that pharmacists are the most accessible healthcare professional. With the appropriate tools, pharmacists can help guide patients in prioritizing signs and symptoms to streamline the non-linear path that patients experience.

Exploring student perceptions of the learning environment in four health professions education programs.

The desire to support student learning and professional development, in combination with accreditation requirements, necessitates the need to evaluate the learning environment of educational programs. The Health Education Learning Environment Survey (HELES) is a recently-developed global measure of the learning environment for health professions programs. This paper provides evidence of the applicability of the HELES for evaluating the learning environment across four health professions programs: medicine, nursing, occupational therapy and pharmaceutical sciences. Two consecutive years of HELES data were collected from each program at a single university (year 1 = 552 students; year 2 = 745 students) using an anonymous online survey. Reliability analyses across programs and administration years supported the reliability of the tool. Two-way factorial ANOVAs with program and administration year as the independent variables indicated statistically- and practically-significant differences across programs for four of the seven scales. Overall, these results support the use of the HELES to evaluate student perceptions of the learning environment multiple of health professions programs.

Factor Structure Analysis of Pharmacy Students' Performance on the Health Education Learning Environment Survey.

Objective. While high-quality learning environments are increasingly recognized as vital for health professions education programs and student success, no tools to assess such environments have been validated for use within the pharmacy education context. This study seeks to assess whether the six-factor structure of the Health Education Learning Environment Survey (HELES) will replicate in a sample of pharmacy students.Methods. The study was conducted in a Doctor of Pharmacy program offered at a Western Canadian university. Across two years of data collection, a sample of 288 pharmacy students completed the 35-item HELES as an anonymous and online survey.Results. While the six-factor model of the HELES did not replicate through confirmatory factor analysis, a follow-up examination of unidimensionality for the individual subscales of the HELES showed that five of the six subscales met this requirement. One subscale, the work-life balance subscale, was better represented by the dimensions of time management and emotional well-being.Conclusion. These results provide preliminary support for the use of the HELES among pharmacy students, with additional research being needed to explore the work-life balance subscale and its appropriateness for this student group. In Canada, the HELES has the potential to fill an existing local and national gap in program evaluation tools, which are needed to gather evidence on pharmacy programs' quality, strengths, and weaknesses and to inform continuous quality improvement efforts and accreditation standards.

A Tool for Creating Snapshots of Faculty Contributions to Pharmacy Education.

Most faculty members' contributions to pharmacy education are significant but often challenging to document and describe. In addition, contributions may go unrecognized or rewarded unless the work results in a publication or presentation. Drawing on a metaphor of the importance of a fisher taking a photo to capture memories of a successful fishing trip, this commentary examines methods for faculty to identify and organize their academic contributions. Frameworks and a visual tool are presented to assist pharmacy educators in thinking systematically about the full breadth of education contributions. Using the frameworks and visualization tool provided, a more complete picture of education contributions can be developed, allowing educators to create visual "snapshots" of their work for others to see and appreciate.

Guiding Ethics Review in Pharmacy Education Research and Scholarship at UBC: Clarifying the Unclear.

While it goes without saying that ethically sound practices are imperative for high-quality educational scholarship, institutional ethics guidance is often unclear about how to treat educational scholarship generally, and quality improvement/assurance studies and the scholarship of teaching and learning, specifically. Amongst health profession education researchers, including those in pharmacy, this lack of clarity has led to confusion regarding existing ethics governance and ambivalence regarding ethics requirements. Drawing on the experiences of one pharmacy school in western Canada, this commentary describes an ethics vetting guide developed explicitly to address current uncertainty about ethics requirements for pharmacy education scholarship. Clarifying the problem, describing the guide, and exploring what was learned along the way provide a basis for re-centering ethics in the development of scholarly projects and decision-making regarding formal ethics review. The importance of instilling ethical intelligence, delineating research from quality improvement/assurance work, and addressing current gaps in ethics oversight and governance of educational scholarship are among key lessons learned during guide development along with suggestions for new institutional ethics guidance directly targeting educational scholarship to supplement current national guidelines.

Lecture capture in pharmacy education at UBC: Updating our understanding.

INTRODUCTION: Lecture capture is a contemporary learning technology used to improve the quality of professional programs such as pharmacy. Building on our 2014 study, the objective of this study was to reexamine the value of lecture capture for student and faculty users and make decisions about its continuance and optimization. METHODS: Survey methodology was used to gather student and faculty perspectives on the lecture recordings. Collected data focused on usage, learning impacts, and attendance. Lecture capture software provided analytics on student viewing patterns. The constant comparative method was used to analyze student and faculty comments for underlying themes and data discrepancies. RESULTS: Following an evolutionary development path, lecture capture has become a mainstream learning resource for students and faculty. Student usage has increased dramatically and strategically. In addition to enhancing in-class experiences, study effectiveness, and overall learning, students continue to claim minimal impacts on attendance. Faculty perspectives remain modest. While faculty recognize the learning benefits for students and are prepared to continue using lecture recordings, issues related to absenteeism are increasingly troublesome. Faculty are also using lecture recordings for faculty development purposes. CONCLUSIONS: Faculty have renewed their commitment to the lecture capture program going forward. Importantly, the study has helped refocus the evolution of the program away from binary questions such as whether or not to use lecture recordings and the impacts of lecture capture on attendance and towards specific guidance for students and faculty on the best use of the resource and deeper questions about student learning.

Creating a pharmacy elective course in Indigenous health.

BACKGROUND AND PURPOSE: There is a critical need for greater Indigenous health education and cultural safety training for pharmacists. The objective of this paper is to describe the creation, development, and impact of Canada's first offering of an undergraduate elective course specific to pharmaceutical care in Indigenous health. EDUCATIONAL ACTIVITY AND SETTING: A three-credit elective course was developed and offered to bachelor of science pharmacy students at the University of British Columbia. A variety of pedagogical approaches including reflection, educational trips, video conferencing with Indigenous communities, and Indigenous community-based projects were used. Evaluation of student learning impact included quantitative and qualitative post-course survey data, student enrollment, and student work. FINDINGS: From course inception in 2012 to 2017, 101 students participated. Survey respondents rated an average of 4.7 out of 5 on the five core elements of the curriculum design and pedagogical practice (i.e. learning objectives, instructional methods, assessments, organization, and workload). Thematic analysis identified three themes: 1) the qualities of the course instructors, 2) the unique curriculum design and pedagogical practices, and 3) significant personal and professional impact on students. SUMMARY: This course is one of few opportunities for pharmacy students to learn about cultural safety as it relates to the pharmaceutical care of Indigenous peoples. Extensive engagement with stakeholders and utilization of various teaching and assessment techniques were beyond the expected requirements of course offerings. Students highly rated this course as having personal and professional impact. This course plays a critical role in the overall Indigenization of pharmacy curricula.

Medication adherence teaching activity for first year pharmacy students in a Canadian university: Description and evaluation.

BACKGROUND AND PURPOSE: Medication non-adherence is a significant health problem in Canada and pharmacists are ideally positioned to help patients adhere to their regimens. There is an urgent need for pharmacy schools to ensure graduates receive training in this area. In this paper, we describe a medication taking simulation activity for first year pharmacy students using a multi-method approach to evaluation. EDUCATIONAL ACTIVITY AND SETTING: Students were provided with placebo capsules and instructed to take one capsule twice per day for two weeks, complete the Beliefs About Medications Questionnaire (BMQ) before the activity, and provide a pill count and reflection on their experiences afterwards. Quantitative analysis involved calculation of percent adherence from pill counts and establishing beliefs about medications from BMQ scores. Perceptions of the teaching activity were determined using qualitative inductive content analysis of a sub-set of student reflections. FINDINGS: All 224 students participated and complete pill count and BMQ data was obtained from 190 students (85%). Applying a cut-off of 80% to categorize adherence status, 51.8% of students were adherent. BMQ analyses indicated collective student uncertainty in three BMQ sub-scales (specific-necessity, specific-concern, and general-overuse) and a significant difference between adherent and non-adherent students in the specific-necessity sub-scale. Qualitative analyses of a set of student reflections resulted in two major themes: (1) developing empathy and (2) learning about adherence. SUMMARY: This activity provided opportunities for students to experience the challenges involved in medication-taking from the patient's perspective and to realize the pharmacist's role to facilitate medication adherence.

A Cost-Benefit Analysis of Teaching and Learning Technology in a Faculty of Pharmaceutical Sciences.

Objective. To conduct a cost-benefit analysis (CBA) of investment in teaching and learning technology (TLT) by a college of pharmacy in a large, research-intensive university in Canada. Methods. Document analysis was used to determine the goals and objectives of the university and college for TLT use. Semi-structured interviews were conducted with faculty members to understand their perspectives on the value of technology for teaching and learning, their metrics to assess value, and an estimate of social value using a willingness to pay (WTP) exercise. A CBA was used to compare the social value against the cost of the investment in TLT. Results. Twenty-one faculty members participated in semi-structured interviews. National, university, and college goals for TLT were diffuse and nonspecific in terms of the intended use or the metrics by which implementation and impacts on the quality of teaching could be assessed. The mean WTP for this technology was Can$4.38M and the cost of investment was Can$4.25M. The primary analysis showed a small positive net benefit of the investment (Can$134,456), although this difference was not significant. All dollar figures are given in Canadian dollars (CAD). Conclusion. The college's monetary investment in TLT was approximately equal to the social value placed on TLT by faculty users. Conducting a CBA on technology can bring greater understanding among faculty members of the college's curriculum and pedagogical practices as well as financial decision-making. Greater clarity about the goals and objectives for TLT could help to maximize the value of investment in this area.

Searching the Literature: A Simple Step-Wise Process for Evidence-Based Medicine.

Sifting and sorting through the literature and research on health care is an important skill for practicing pharmacists. It is vital for staying current and, most important, helping with the critical task of avoiding adverse drug events in the optimal care of patients. Today, searching this literature efficiently and effectively is increasingly difficult at a time when clinical knowledge is growing exponentially. This article aims to provide a systematic process for going through the literature in an evidence-based manner.

Student and faculty member perspectives on lecture capture in pharmacy education.

OBJECTIVES: To examine faculty members' and students' use and perceptions of lecture recordings in a previously implemented lecture-capture initiative. METHODS: Patterns of using lecture recordings were determined from software analytics, and surveys were conducted to determine awareness and usage, effect on attendance and other behaviors, and learning impact. RESULTS: Most students and faculty members were aware of and appreciated the recordings. Students' patterns of use changed as the novelty wore off. Students felt that the recordings enhanced their learning, improved their in-class engagement, and had little effect on their attendance. Faculty members saw little difference in students' grades or in-class engagement but noted increased absenteeism. CONCLUSION: Students made appropriate use of recordings to support their learning, but faculty members generally did not make active educational use of the recordings. Further investigation is needed to understand the effects of lecture recordings on attendance. Professional development activities for both students and faculty members would help maximize the learning benefits of the recordings.

Informed shared decision making: An exploratory study in pharmacy / Toma de decisones informadas compartidas: estudio exploratorio en farmacia

Introduction: A study was undertaken to examine the feasibility of using the physician-based Informed Shared Decision Making (ISDM) framework for teaching pharmacy students competencies to effectively develop therapeutic relationships with patients. Objectives: To: (1) assess the relevance and importance of the physician-developed ISDM competencies for pharmacy practice, (2) determine which competencies would be easiest and hardest to practice, (3) identify barriers to implementing ISDM in pharmacy practice, and (4) identify typical situations in which ISDM is or could be practiced. Methods: Twenty pharmacists representing 4 different practices were interviewed using a standardized interview protocol. Results: Pharmacists acknowledged that majority of the physician-based competencies were relevant to pharmacy practice; although not all competencies were considered to be most important. Competency #1 (Develop a partnership with the patient) was found to be the most relevant, the most important and the easiest to practice of all the competencies. While no one competency was identified as being hard to practice, there were several barriers identified to practicing ISDM. Finally, pharmacists expressed that patients with chronic conditions would be the most ideal for engaging in ISDM. Conclusion: While pharmacists believed that the ISDM model could provide a framework for pharmacists to develop therapeutic relationships with their patients, the group also identified obstacles to engaging successfully in this relationship (AU)

Introducción: Se realizó un estudio para examinar la factibilidad de usar un entorno de Toma de Decisiones Informadas Compartidas (TDIC) de los médicos para enseñar a los estudiantes de farmacia competencias para desarrollar relaciones con los pacientes de modo efectivo. Objetivo: (1) evaluar la relevancia y la importancia de la TDIC de los médicos para el ejercicio de la farmacia, (2) determinar que competencias serían las más fáciles y las más difíciles para la farmacia, (3) identificar barreras para la implantación de la TDIC en el ejercicio de la farmacia, y (4) identificar situaciones típicas en las que la TDIC se ejerce o podría. Métodos: Se entrevistó a 20 farmacéuticos de diferentes ejercicios utilizando un protocolo estandarizado. Resultados: Los farmacéuticos reconocieron que la mayoría de las competencias de los médicos eran relevantes al ejercicio de la farmacia; aunque no todas las competencias fueron consideradas como las más importantes. La competencia #1 (Desarrollar una colaboración con el paciente) fue calificada como las más relevante, la más importante y la más fácil para el ejercicio de todas las competencias. Mientras que ninguna competencia fue considerada como difícil de ejercer, se identificaron varias barreras para el ejercicio de la TDIC. Finalmente, los farmacéuticos expresaron que los pacientes con enfermedades crónicas serían los ideales para incorporar en la TDIC. Conclusión: Aunque los farmacéuticos creyeron que el modelo TDIC podría proporcionar un marco para desarrollar relaciones terapéuticas con sus pacientes, el grupo también identificó obstáculos para iniciar con éxito esta relación (AU)

Informed shared decision making: An exploratory study in pharmacy.

INTRODUCTION: A study was undertaken to examine the feasibility of using the physician-based Informed Shared Decision Making (ISDM) framework for teaching pharmacy students competencies to effectively develop therapeutic relationships with patients. OBJECTIVES: TO: (1) assess the relevance and importance of the physician-developed ISDM competencies for pharmacy practice, (2) determine which competencies would be easiest and hardest to practice, (3) identify barriers to implementing ISDM in pharmacy practice, and (4) identify typical situations in which ISDM is or could be practiced. METHODS: Twenty pharmacists representing 4 different practices were interviewed using a standardized interview protocol. RESULTS: Pharmacists acknowledged that majority of the physician-based competencies were relevant to pharmacy practice; although not all competencies were considered to be most important. Competency #1 (Develop a partnership with the patient) was found to be the most relevant, the most important and the easiest to practice of all the competencies. While no one competency was identified as being hard to practice, there were several barriers identified to practicing ISDM. Finally, pharmacists expressed that patients with chronic conditions would be the most ideal for engaging in ISDM. CONCLUSION: While pharmacists believed that the ISDM model could provide a framework for pharmacists to develop therapeutic relationships with their patients, the group also identified obstacles to engaging successfully in this relationship.

Using remote access to scientific instrumentation to create authentic learning activities in pharmaceutical analysis.

OBJECTIVES: To pilot test and evaluate a gas chromatography-mass spectrometry (GCMS) case study as a teaching and learning tool. DESIGN: A case study incorporating remote access to a GCMS instrument through the Integrated Laboratory Network (ILN) at Western Washington University was developed and implemented. Student surveys, faculty interviews, and examination score data were used to evaluate learning. ASSESSMENT: While the case study did not impact final examination scores, approximately 70% of students and all faculty members felt the ILN-supported case study improved student learning about GCMS. Faculty members felt the "live" instrument access facilitated more authentic teaching. Students and faculty members felt the ILN should continue to be developed as a teaching tool. CONCLUSION: Remote access to scientific instrumentation can be used to modify case studies to enhance student learning and teaching practice in pharmaceutical analysis.