How Debate Could Facilitate Group Function in Pharmacy Schools.

Objective. To study how a debate format could be a helpful tool to enhance group functionality and decision-making in schools of pharmacy.Methods. This study examines the potential of a debate format to facilitate discussion and shift viewpoints. Changes in viewpoint and feedback from the Academic Leadership Fellows Program (ALFP) Cohort 16 debates at the February 2020 American Association of Colleges of Pharmacy (AACP) Interim Meeting generated two data sets for each discussion topic to analyze debate effectiveness. Pre- and post-debate audience viewpoints were compared to determine the extent to which debates influenced viewpoints. Continuing pharmacy education (CPE) evaluations of the debate learning objectives provided information on participants' views of the debate format.Results. The debate format appeared to shift opinions on all three topics discussed. In addition, audience members responded in agreement or strong agreement that the debate format was of benefit to both leadership interactions and team environments.Discussion. While group functionality is an important aspect of effective decision-making, it is not always considered in pharmacy school operations. Incorporating debate components could improve the quality of group functionality, thereby positively impacting decision-making in schools of pharmacy.

Determination of Interrater Reliability of a Universal Evaluator Rubric to Assess Student Pharmacist Communication Skills.

Objective. To evaluate the interrater reliability of a universal evaluator rubric used to assess student pharmacist communication skills during patient education sessions.Methods. Six US schools and colleges of pharmacy each submitted 10 student videos of a simulated community pharmacy patient education session and recruited two raters in each of the five rater groups (faculty, standardized patients, postgraduate year one residents, student pharmacists, and pharmacy preceptors). Raters used a rubric containing 20 items and a global assessment to evaluate student communication of 12 videos. Agreement was computed for individual items and overall rubric score within each rater group, and for each item across all rater groups. Average overall rubric agreement scores were compared between rater groups. Agreement coefficient scores were categorized as no to minimal, weak, moderate, strong, or almost perfect agreement.Results. Fifty-five raters representing five rater groups and six pharmacy schools evaluated student communication. Item agreement analysis for all raters revealed five items with no to minimal or weak agreement, 10 items with moderate agreement, one item with strong agreement, and five items with almost perfect agreement. Overall average agreement across all rater groups was 0.73 (95% CI, 0.66-0.81). The preceptor rater group exhibited the lowest agreement score of 0.68 (95% CI, 0.58-0.78), which significantly deviated from the overall average.Conclusion. While strong or almost perfect agreement scores were not observed for all rubric items, overall average interrater reliability results support the use of this rubric in a variety of raters to assess student pharmacist communication skills during patient education sessions.

Leadership Lessons and Career Advice From the Musical Hamilton.

The musical Hamilton, written by Lin-Manuel Miranda, creatively depicts the life and career of founding father Alexander Hamilton. While Hamilton is the primary focus, highlights of the career and personal journeys of other leaders, such as George Washington, Thomas Jefferson, and Aaron Burr, are interjected throughout the production. Often the musical numbers in Hamilton focus on aspects of leadership and career development that Hamilton and his contemporaries were learning or needed to learn. These lessons are applicable to the challenges that faculty members in academic pharmacy face today at different stages of a career. These include the importance of maximizing opportunities, listening, self-reflection, compromise, patience, empathy, prioritizing, tending relationships, making difficult decisions, knowing when to say goodbye, and managing a legacy.

Expert Consensus to Finalize a Universal Evaluator Rubric to Assess Pharmacy Students' Patient Communication Skills.

Objective. To use an expert consensus-building process to develop a rubric used by multiple evaluator types to assess Doctor of Pharmacy students' patient communication skills.Methods. Faculty and staff members from six schools and colleges of pharmacy collaborated on a multi-step expert consensus-building process to create the final version of a communication rubric. First, faculty and patient content experts evaluated each item in the rubric for its relevance, criticality, and global comprehensiveness using a five-point Likert scale (0=not at all, 4=to a high extent). Descriptive statistics were used to analyze the resulting data. Faculty members evaluated the results and came to a consensus on the second version of the rubric. A corresponding codebook was developed and refined through a two-phase process.Results. The initial communication rubric was evaluated by 13 expert reviewers. Mean global comprehensiveness on the rubric was 3.83 for faculty experts and 3.5 for patient experts. After evaluating results from the expert consensus-building process, 14 items on the rubric did not change, five items were revised, three items were removed, and two items were added. The second version of the instrument included 20 items in six topic areas. A codebook was finalized to increase scoring consistency for the 20 communication items.Conclusion. Overall, content experts concluded that the rubric had high global comprehensiveness. Collaboration involving faculty members from multiple schools of pharmacy resulted in a 20-item communication rubric and codebook that can be used to increase consistency in scoring student pharmacists' patient communication skills.

Naloxone Administration for Opioid Overdose Reversal in the Prehospital Setting: Implications for Pharmacists.

BACKGROUND: Fatalities from opioid overdose have risen by 117% over the past 10 years. Increasing access to the opioid antagonist, naloxone can combat this trend and saves lives. This study investigates the various routes of naloxone administration for opioid reversal in the prehospital setting. METHODS: PubMed, Ovid, and Google Scholar were searched for references that included the words naloxone and prehospital. Inclusion criteria were peer reviewed publications after 1995, English language, studies conducted in an outpatient setting, and intramuscular, intranasal, intravenous, or subcutaneous formulations; exclusion criteria were review articles or editorials. RESULTS: 8 articles met the inclusion criteria: intramuscular, intranasal, intravenous, and subcutaneous dosage forms of naloxone were analyzed to compare their time to administration, time to efficacy, financial impact, administrator safety, and administrator preference. CONCLUSION: There is little consensus on the optimal route of naloxone administration in the prehospital setting. Little training is required for proper administration of the intramuscular auto-injector; however, the high price of this device is a barrier to access. Intranasal naloxone appears to be the optimal dosage form when considering cost, effectiveness, and administrator safety. Pharmacists must be aware of trends in naloxone use, dosage forms, and administration when caring for patients and their communities.

Awareness of state legislation on naloxone accessibility associated with willingness to prescribe naloxone.

BACKGROUND: Increasing rates of opioid-related deaths, state naloxone legislation changes, and negativity prompted investigation of predictive factors associated with willingness to prescribe naloxone to populations at risk of overdose, including knowledge of risk factors, assessment of persons at risk, awareness of legislative changes, perceptions of professional responsibility, and confidence around naloxone prescribing and distribution. METHODS: Cross-sectional, Web-based, anonymous, voluntary survey to prescribers of 2 regional health care systems serving urban and rural North Dakota, northern Minnesota, and northwestern Wisconsin. Human subject research was approved by university and health care systems' institutional review boards. RESULTS: Overall, 203 of 1586 prescribers responded; however, not all prescribers completed each survey item. A majority (89.4%, n = 127/142) of respondents had never prescribed naloxone for overdose prevention. Willingness to prescribe naloxone for 4 patient care scenarios involving substantial opioid overdose risk ranged from 43.4% to 70.5%. Knowledge mean score was 15.5 (SD = 2.9) out of 22 with median 15 (range: 5-22). Naloxone legislation awareness score was 8.8 (SD = 3.8) out of 15 with median 8 (range: 3-15). There was a statistically significant but modest correlation between willingness to prescribe naloxone and the other variables, including awareness of state naloxone-related legislation (r = 0.43, P < .0001), level of self-confidence about dosing, prescribing, and writing protocols for naloxone (r = 0.37, P < .0001), general knowledge (r = 0.24, P = .0032), and perception of professional responsibility (r = 0.19, P = .03). Multivariate regression analysis indicated willingness to prescribe naloxone was associated with statistically significant predictors, including awareness of the naloxone laws (P = .0016) and self-confidence about dosing, prescribing, and writing protocols (P = .0011). CONCLUSIONS: Prescribers who are more aware of state laws regarding naloxone and confident in their knowledge of dosing, administration, and writing protocols may be more willing to prescribe naloxone.

Perceptions of pharmacists' role in the health care team through student-pharmacist led point-of-care screenings and its future application in health care.

INTRODUCTION: The public is largely unaware of changing pharmacy roles and continues to underutilize pharmacists as mainly a dispensing service, often overlooking direct patient care components. This paper evaluates the public perceptions of pharmacists' through student led point-of-care screenings and comprehensive medication reviews. METHODS: An IRB approved longitudinal retrospective study design was used to survey participants who attended College of Pharmacy sponsored health fairs in 2013. The survey contained questions related to patient understanding of the current pharmacy scope of practice, patient's reported level of comfort with the expanding roles of pharmacy, insurance coverage, demographics, income and whom the patients report that they seek first for medical related advice. RESULTS: One hundred participants were surveyed. By a large majority, the health care practitioner that patients reported that they currently sought out for general health information was a physician. All of the participants reported that they considered pharmacists as reliable sources of general health information. Of the 96 participants that completed the survey question regarding their willingness to seek out a pharmacist in the future to have their blood pressure, blood sugar, cholesterol, and/or bone density checked, 89 (92.7%) surveyed answered yes. Only 50 patients (50%) reported being aware that pharmacists have the capability to perform these point-of-care screenings. Participants responded that they felt "comfortable" (78 patients, 83.4%) followed by "trusting" (36 patients, 38.7%). DISCUSSION: The patients surveyed recognized pharmacists as the medication experts; however, many did not understand the capacity to which pharmacists' scope of practice allows them to deliver care to patients. In this study, almost all of the patients stated that they would consider seeking out a pharmacist to receive point-of-care screenings, but only half were aware that a pharmacist is capable of conducting these screenings. All felt that pharmacists are a reliable source of general health information and medication related needs, regardless of the patients' education level or household income. CONCLUSION: With the shortage of primary care providers, expansion of the scope of pharmaceutical practice is necessary. Although the public may not fully understand pharmacists' scope of practice, they are comfortable with pharmacists' knowledge related to general health needs outside of medications. The reported public comfort and trust of pharmacist knowledge and skills justify expanding the scope of pharmaceutical practice.

Comparing the Accuracy of 2 Point-of-Care Lipid Testing Devices.

BACKGROUND: Device manufacturers have improved technology since studies were last published, thus warranting an updated analysis. OBJECTIVE: Two point-of-care (POC) cholesterol testing devices were directly compared to a venous sample to determine device accuracy. METHODS: Institutional review board (IRB)-approved study collected finger-stick blood samples analyzed by Cholestech LDX (Cholestech Corporation, Hayward, California) and CardioChek Plus (Polymer Technology Systems Inc, Indianapolis, Indiana) devices and compared to venous blood for 30 study participants. Statistical analyses were completed using StatisPro. Intraclass correlation coefficients were generated, and the average difference expected to be within the industry standards of total cholesterol (TC; ±10%), high-density lipoprotein (HDL) cholesterol (±12%), and triglycerides (TG; ±15%). RESULTS: The POC devices produced clinically equivalent values when compared to the same patients' samples analyzed in a reference laboratory. The average difference calculated from the actual individual paired percentage bias with the Integra analyzer: venous-TC -3.8%, HDL -6.9%, TG -1.8%; CardioChek-TC -7.8%, HDL -6.2%, TG 5.1%; and Cholestech-TC 0.5%, HDL -4.5%, TG -3.3%. The average of the actual paired percentage bias with the Roche Cobas analyzer: CardioChek-TC -4.2%, HDL 0.8%, TG 7.0% and Cholestech-TC 4.6%, HDL 2.6%, TG -1.6%. CONCLUSION: Both screening devices operated within industry accuracy standards.

Pilot study of patient perception of pharmacists as care providers based on health screening encounters with student pharmacists.

OBJECTIVES: To assess how patient perceptions of the clinical role of pharmacists may be affected by use of the AIDET communication tool during student-led health fairs, as well as how such events can help promote pharmacy practice. SETTING: 12 community health fair screenings throughout northeastern Minnesota and northwestern Wisconsin, from February to November 2012. PRACTICE DESCRIPTION: University of Minnesota-College of Pharmacy students trained in the use of AIDET employed the tool's techniques in their communication with health fair patient attendees. Project participants were those patients aged 18 years and older who successfully completed a health fair survey. PRACTICE INNOVATION: The AIDET communication tool is designed to provide consistency in patient encounters through the use of key words at key times. AIDET is a mnemonic acronym that stands for acknowledge, introduce, duration, explanation, and thank you. University of Minnesota-College of Pharmacy students are taught how to use the AIDET framework in classroom and laboratory settings prior to their interactions with patients at area health fairs. INTERVENTION: Health fair attendees were asked to complete a survey to determine their satisfaction level with student pharmacist-delivered pharmacy services. EVALUATION: 87 patients were surveyed, with a response rate of 22.5% and a completion rate of 91.6%. The average age of the patient population for the study cohort was 52 years, with greater than 50% being 65 years or older. Patient ages ranged from 24 to 89 years. RESULTS: When AIDET techniques were employed in a health fair setting, patients reported high levels of satisfaction with pharmacy services and said they felt "happy, comfortable, and trusting." CONCLUSION: The AIDET framework provides a consistent process for patient-centered care delivery because it places emphasis on patient needs and expectations. Use of the technique is capable of enhancing student and pharmacist engagement with patients.

Evolution of self-care education.

During the past 15 years, the curriculum content for nonprescription medication and self-care therapeutics has expanded significantly. Self-care courses ranging from stand-alone, required courses to therapeutic content and skills laboratories, have evolved in colleges and schools of pharmacy to accommodate rapid changes related to nonprescription medications and to meet the needs of students. The design of and content delivery methods used in self-care courses vary among institutions. Teaching innovations such as team-based learning, role playing/vignettes, videos, and social media, as well as interdisciplinary learning have enhanced delivery of this content. Given that faculty members train future pharmacists, they should be familiar with the new paradigms of Nonprescription Safe Use Regulatory Expansion (NSURE) Initiative, nonprescription medications for chronic diseases, and the growing trends of health and wellness in advancing patient-care initiatives. This paper reviews the significant changes that may be impacting self-care curriculums in the United States.

Point-of-care screenings at the University of Minnesota: mechanism for civic engagement.

OBJECTIVES To describe Wellness Initiative of the Northland (WIN) screening events; present participant results from those events; discuss the benefits of pharmacist-conducted, community-based point-of-care (POC) testing to medically underserved patients and to the profession of pharmacy; and describe logistical considerations in launching disease screening services. SETTING Pharmacist-led community health fairs in a variety of settings, including shopping malls, churches, community pharmacies, senior residence facilities, critical-access hospitals, and clinics. PRACTICE DESCRIPTION Disease screenings for economically disadvantaged residents of northeastern Minnesota and northwest Wisconsin, held between 2005 and 2012, through WIN. PRACTICE INNOVATION Mobile POC screenings for dyslipidemia, diabetes, hypertension, and osteoporosis. MAIN OUTCOME MEASURE Percentage of screenings with out-of-range readings. RESULTS Since 2005, WIN screenings have served more than 2,000 individuals, providing 4,152 POC screenings. Out-of-range readings were obtained for 40.3% of fingerstick cholesterol tests, 24.8% of fingerstick blood glucose tests, 24.3% of blood pressure tests, and 38.7% of quantitative ultrasound heel bone density readings. CONCLUSION Community-conducted POC testing functions both as an important public health service and a mechanism by which pharmacists and student pharmacists can become involved in civic engagement.