Organizational values: Essential substrate for professional identity formation.

Core organizational values are essential for any organization, including academic institutions. Formal and informal leaders can have a positive, or negative, impact on shaping their culture through the core values. Members of an organization, including students, can be shaped by the organizational values in ways that strengthen, or impede, their professional identity formation. Here, we discuss the use of organizational values as vital substrates needed to shape the desired behaviors and attitudes that will help describe the organizational culture and identity. We define and discuss various types of core values, identify the benefits and challenges of core values alignment, and offer strategies for leaders at all levels to reflect on their own organization's core values and their current approach to their contribution to an effective and sustainable workplace that supports the professional identity formation of all members.

A Qualitative Approach to Investigating Developmental Opportunities Among Leaders and Followers.

Objective. To understand and identify developmental opportunities by exploring students' evolving views of leadership, including the emergence of leadership and self-identification, among students considered to be leaders and those considered to be followers.Methods. An exploratory qualitative study using semi-structured interviews was conducted, investigating developmental differences among leaders and followers. Fourteen students/residents were selected to participate in interviews. Student responses were analyzed using qualitative thematic analysis.Results. In discissions, four themes surfaced: motivations for exploring and engaging in leadership, perceptions of ideal leaders and followers, the value of coalition building, and a leader's role in sustainability. Leader respondents indicated that a potential barrier to helping others develop was their difficulty in delegation. Further, stress on leaders may contribute to a self-serving perspective on their responsibilities to help others develop.Conclusion. In comparison to their leader counterparts, followers may require a more individualized approach to their development and may become more deeply attached to their responsibilities, giving them a greater desire to promote sustainability in an organization or endeavor. Schools of pharmacy should be poised to support faculty, advisors, mentors, and student leaders with the tools to identify and develop active followers who may not seek out traditional leadership experiences.

Preparing student pharmacists to care for patients exposed to intimate partner violence.

INTRODUCTION: Intimate partner violence (IPV) is a serious public health problem. Little is known about pharmacists' IPV knowledge and awareness. This study assessed student pharmacists' knowledge, attitudes, and awareness of IPV and examined the impact of a brief curricular unit on these factors. METHODS: The Physician Readiness to Manage Intimate Partner Violence Survey was adapted for use with student pharmacists and administered at two pharmacy schools, one private (n = 88) and one public institution (n = 104). Students at one institution were exposed to a curricular unit on IPV tailored for pharmacy practice and completed a post-assessment. RESULTS: Students at both institutions had low levels of IPV-related knowledge, answering <60% of items correctly. Students reported low levels of perceived knowledge and preparation. After exposure to the educational intervention (n = 60), knowledge scores increased on a matched post-assessment. Students across both institutions (n = 29) provided comments indicating that they believed IPV is an important issue, that this topic was novel and that pharmacists should address IPV, that pharmacists should be trained on IPV and a desire for training, and that there are barriers to addressing IPV in the pharmacy setting. CONCLUSIONS: Preparing student pharmacists to care for patients exposed to IPV may improve patient outcomes and positively impact the lives of the patients they serve. A brief educational intervention improved students' knowledge about IPV and confidence in screening patients for IPV.

Preparing Pharmacists to Care for Patients Exposed to Intimate Partner Violence.

Intimate partner violence (IPV) is a serious, highly prevalent public health problem associated with poor health outcomes, negative impacts on medication behavior, and increased health care utilization and costs. Pharmacists, the most accessible health care providers, are the only provider group not required to be trained on this topic. Training can prepare pharmacists to safely and appropriately care for patients experiencing IPV. This project evaluated a pharmacy-specific continuing professional development module on IPV utilizing a quasi-experimental pretest-posttest study design. Practicing community pharmacists were recruited from a market research panel to complete the online module. A novel method for managing IPV disclosures, the Care, Assess for safety, Refer, and Document (CARD) method, was included in the training. A total of 36 pharmacists completed the study, including a three-month follow-up assessment. Participants reported increased perceived preparedness and knowledge, workplace and self-efficacy, staff preparation, and legal requirements, but not actual knowledge. Practice changes, including identification of legal reporting requirements (19.4%) and development of protocols for managing IPV disclosures (13.9%), were reported at follow-up. This is the first examination of an educational module on the topic of IPV for pharmacists and it positively impacted pharmacists' preparedness and practice behaviors related to IPV over an extended follow-up period.

Blend your passion with your craft: Artisanal habits in academic writing.

INTRODUCTION: The artisanal dimension of writing, as highlighted in Helen Sword's BASE model, is explored in the context of pharmacy education. Positing that "technical" and "artisanal" are adjectives on a continuum, this viewpoint suggests that pharmacy academicians may be writers embodying a blend of both. COMMENTARY: Perspectives and pearls from a variety of Mississippi artists and artisans are suggested as ways for academics to embrace artisanal habits as they apply creativity to their scientific writing. IMPLICATIONS: If authors have employed artisanal habits, it is likely that the readers will ultimately come away with an appreciation for the care that the writer took, and the initiative implicit in the writing to share with others-regardless of whether readers find the content itself to be in line with or counter to their expectations and assumptions.

Influence of the Fear of Missing Out in Student Pharmacists' Decision to Pursue Residency Training.

Objective. To examine the influence of the fear of missing out (FOMO) on student pharmacists' postgraduate career decisions, specifically on whether to pursue a residency. Methods. A 14-item FOMO scale was designed to examine the influence of this factor on student pharmacists' residency decision. A survey was distributed to second-, third-, and fourth-year student pharmacists at four participating universities. Average FOMO scores were compared based on residency intentions. Logistic regression analysis was used to predict residency intentions based on students' average FOMO scores. Results. The survey response rate was 74%. Of the 833 respondents, 42% indicated an intention to pursue residency training. Students indicated the FOMO items were "slightly" true of them, as evidenced by the overall FOMO mean score of 2.0 on a 5-point scale. Comparison among classes revealed a higher mean FOMO score among students in the second year of the pharmacy curriculum than among students in the third and fourth years. Logistic regression analysis indicated that FOMO score can reliably distinguish between students with residency intentions and those without. Conclusion. This study supports the existence of FOMO in the decision to pursue a pharmacy residency, although more research and scale refinement is needed to better identify its impact.

Assessing Quality of Pharmacist-Led Education for Patients with COPD Using the Lung Information Needs Questionnaire: A Pilot Study.

BACKGROUND: Transitioning a patient from the hospital to home is an area of vulnerability for patients with Chronic Obstructive Pulmonary Disease (COPD). Patients with COPD frequently readmit as they often do not understand their disease state, medications or when to seek medical attention. OBJECTIVES: The objective of this study is to determine the impact that pharmacist-led education has on a patient's understanding of their disease state by assessing the results of the Lung Information Needs Questionnaire (LINQ). METHODS: This study uses a quasi-experimental design to formally assess pharmacist-led education provided to patients with COPD using the LINQ. The LINQ was used to assess knowledge of the disease state and medications before and after receiving education on disease state management, smoking cessation and proper medication use. RESULTS: A total of 17 patients completed the LINQ. The survey results showed a statistically significant improvement in patient understanding in 4 of the 6 targeted areas. CONCLUSION: Results from the formal assessment using the LINQ suggest that pharmacist-lead education for COPD patients is beneficial and reliable. This study presents a continued need for patient education and research in this high-risk patient population.

The role of perceived impact on relationship quality in pharmacists' willingness to influence indication-based off-label prescribing decisions.

Little is known about factors that affect pharmacists' roles in off-label prescribing. This study examined the effect of perceived impact on relationship quality (IRQ) on hospital pharmacists' willingness to influence a physician's decision regarding an indication-based off-label medication order (WTIP) (i.e., beyond FDA-approved indications) and the moderating roles of the appropriateness of the medication order and the relative expert power of the pharmacist. Pharmacists practicing in U.S. hospitals, recruited from membership rolls of state affiliates of the American Society of Health-System Pharmacists, were sent an electronic link to a questionnaire via their respective affiliates. A cross-sectional, randomized, 2 × 2 experimental design was used; participants were assigned to one of the indication-based off-label medication order scenarios. Relative expert power (i.e., power differential between the pharmacist and the physician) and appropriateness of the prescription were manipulated. Perceived IRQ was measured with multiple items. Pharmacists' WTIP in the scenario was the outcome variable. A total of 243 responses were included in multiple linear regression analyses. After controlling for dependence power, information power, communication effectiveness, perceived responsibility, and attitude, pharmacists' WTIP was negatively affected by perceived IRQ (estimate = -0.309, P < 0.05). This effect was more pronounced in groups exposed to the scenario where the pharmacist had lower relative expert power (estimate = -0.438, P < 0.05) and where the medication was less appropriate (estimate = -0.503, P < 0.05). Although willing to ensure rationality of off-label prescribing, pharmacists' WTIP was affected by a complex array of factors - the perceived impact of influence attempts on relationship quality between the pharmacist and the prescriber, the pharmacist's relative expert power, and the appropriateness of the off-label prescription. Increasing pharmacists' expert power and collaboration with physicians and promoting pharmacists' multifaceted contribution, collaborative or independent, to patient care may facilitate pharmacist services in off-label pharmaceutical care.

The influence of symbols on the short-term recall of pharmacy-generated prescription medication information in a low health literate sample.

The effect of symbols on conveying health information has been studied in a variety of contexts and populations. This investigation assessed whether short-term recall of prescription medication information could be enhanced in a low health literate population through the use of symbols. Participants recruited from various nonpharmacy educational service locations were randomly assigned to receive a prescription medication information leaflet in either a text-only, text with symbols, or symbols-only format and then administered the Rapid Estimate of Adult Literacy in Medicine (REALM). Only those with REALM scores indicative of a sixth grade or lower reading level were included in data analysis. An 8-item, interviewer-administered questionnaire was used to assess participants' recall of information contained in the leaflet. A fictitious medication was used to control for participants' past experiences with medications. Results of statistical testing revealed that the three groups did not differ with respect to their ability to recall the medication information, F(2, 157) = 0.943, p = .392. The symbols used in this investigation were not found to enhance the short-term recall of the medication information presented. These findings should not be considered a wholesale indictment of the use of symbols within health care and in pharmacies. Rather, they should serve as a caution to their widespread use without careful consideration.

Health literacy in the pharmacy setting: defining pharmacotherapy literacy / Alfabetismo en salud en el entorno de la farmacia: definiendo el alfabetismo en farmacoterapia

Objective: All currently available definitions of health literacy may be considered quite general. Given the complex nature of the patient-pharmacy encounter and the varying tasks required to properly and successfully consume or administer medication or to adhere to a pharmaceutical care regimen, these available definitions may describe inadequately a patient's health literacy for the purpose of pharmacotherapy and pharmacist intervention. Therefore, the objective of this research was to conceptualize the Pharmacotherapy Literacy construct. Methods: Licensed pharmacists (n=2,368) were mailed a questionnaire providing them with the Healthy People 2010 definition of health literacy and asked, «Given this definition, how would you define Pharmacotherapy Literacy?». A total of 420 usable surveys were returned of which 176 (42%) included responses to the open-ended question concerning pharmacotherapy literacy. Responses were reviewed independently and collectively by the authors. Common themes were identified, compared and discussed until consensus was reached. An initial definition was formulated and distributed to six doctoral-trained academicians and practicing pharmacists who were asked to offer their opinions of the definition as well as suggestions for its improvement. The definition was modified and subjected to further review from 15 additional doctoral-trained academicians and practicing pharmacists who provided feedback concerning its improvement.Results: Based on the recommendations received from the academicians and pharmacists, the following, definition was formulated by the authors: Pharmacotherapy Literacy - An individual's capacity to obtain, evaluate, calculate, and comprehend basic information about pharmacotherapy and pharmacy related services necessary to make appropriate medication-related decisions, regardless of the mode of content delivery (e.g. written, oral, visual images and symbols). Conclusions: As the ever-changing pharmacy environment continues to advance and become more complex in nature, a definition of health literacy specific to the pharmacy setting-thereby providing a name and a focus-may improve medication consumption, medication safety, and the patient-pharmacist relationship (AU)

Objetivo: Todas las definiciones actualmente disponibles de alfabetismo en salud (literacia en salud) pueden considerarse bastante generales. Dada la naturaleza compleja del encuentro farmacéutico-paciente, y las diversas tareas necesarias para consumir o administrar medicamentos con éxito y para cumplir con los regímenes terapéuticos, estas definiciones disponibles pueden describir inadecuadamente la literacia en salud de un paciente con el propósito de la intervención farmacéutica en farmacoterapia. Por tanto, el objetivo de esta investigación fue conceptualizar el constructo del alfabetismo en farmacoterapia. Métodos: Se envió por correo un cuestionario a farmacéuticos en ejercicio (n=2,368) proporcionándoles la definición de alfabetismo en salud del Healthy People 2010 y se les preguntó «Dada esta definición, cómo definiría el alfabetismo en farmacoterapia?». Se recibieron un total de 420 cuestionarios utilizables, de los que 176 (42%) incluían respuestas a la pregunta abierta relativa al alfabetismo en farmacoterapia. Las respuestas fueron revisadas independiente y colectivamente por los autores. Se identificaron los temas comunes, y se compararon y discutieron hasta que se llegó a un consenso. Se formuló una definición inicial y se distribuyó a seis académicos doctorados que ejercen en farmacia a los que se les pidió que dieran sus opiniones sobre la definición e hiciesen sugerencias para su mejora. La definición fue modificada y sometida a nueva revisión de otros 15 académicos doctorados y ejercientes en farmacia que proporcionaron un retorno en relación a la mejora. Resultados: Basados en las recomendaciones recibidas de los académicos y de los farmacéuticos, los autores formularon la siguiente definición: Alfabetismo en farmacoterapia (literacia en farmacoterapia) - La capacidad individual de obtener, evaluar, calcular y comprender información básica sobre farmacoterapia y servicios relacionados con farmacia necesarios para tomar decisiones apropiadas relativas a medicamentos, independientemente del modo en que se recibe el contenido (p.e. escrito, oral, imágenes visuales, y símbolos). Conclusiones: Como el entorno siempre cambiante de la farmacia continúa a avanzar y hacerse más complejo, una definición de alfabetismo en salud específica para el medio farmacéutico- por tanto, que proporcione un nombre y un foco - puede mejorar el consumo de medicación, la seguridad de los medicamentos y la relación pacientefarmacéutico (AU)

Health literacy in the pharmacy setting: defining pharmacotherapy literacy.

OBJECTIVE: All currently available definitions of health literacy may be considered quite general. Given the complex nature of the patient-pharmacy encounter and the varying tasks required to properly and successfully consume or administer medication or to adhere to a pharmaceutical care regimen, these available definitions may describe inadequately a patient's health literacy for the purpose of pharmacotherapy and pharmacist intervention. Therefore, the objective of this research was to conceptualize the Pharmacotherapy Literacy construct. METHODS: Licensed pharmacists (n=2,368) were mailed a questionnaire providing them with the Healthy People 2010 definition of health literacy and asked, "Given this definition, how would you define Pharmacotherapy Literacy?" A total of 420 usable surveys were returned of which 176 (42%) included responses to the open-ended question concerning pharmacotherapy literacy. Responses were reviewed independently and collectively by the authors. Common themes were identified, compared and discussed until consensus was reached. An initial definition was formulated and distributed to six doctoral-trained academicians and practicing pharmacists who were asked to offer their opinions of the definition as well as suggestions for its improvement. The definition was modified and subjected to further review from 15 additional doctoral-trained academicians and practicing pharmacists who provided feedback concerning its improvement. RESULTS: BASED ON THE RECOMMENDATIONS RECEIVED FROM THE ACADEMICIANS AND PHARMACISTS, THE FOLLOWING, FINAL DEFINITION WAS FORMULATED BY THE AUTHORS: Pharmacotherapy Literacy - An individual's capacity to obtain, evaluate, calculate, and comprehend basic information about pharmacotherapy and pharmacy related services necessary to make appropriate medication-related decisions, regardless of the mode of content delivery (e.g. written, oral, visual images and symbols). CONCLUSIONS: As the ever-changing pharmacy environment continues to advance and become more complex in nature, a definition of health literacy specific to the pharmacy setting - thereby providing a name and a focus - may improve medication consumption, medication safety, and the patient-pharmacist relationship.

Instrument to measure psychological contract violation in pharmacy students.

OBJECTIVES: To adapt and evaluate an instrument that measures perceived psychological contract violations in pharmacy students by schools and colleges of pharmacy. DESIGN: A psychological contract violations measure was developed from existing literature and the 1997 ACPE Guidelines and pilot-tested with second-year pharmacy students at 2 schools of pharmacy. A revised measure then was administered to second-year pharmacy students at 6 schools of pharmacy. Using a 5-point Likert-type scale, participants were asked to indicate the level of obligations they received compared to what was promised by the school of pharmacy. RESULTS: Exploratory factor analysis on the psychological contract violations measure was conducted using principal components analysis resulting in 7 factors, which led to a revised measure with 26 items. Using a sample of 339 students, the proposed 7-factor measurement model was tested using confirmatory factor analysis. In general, the results supported the hypothesized model. The final 23-item scale demonstrated both reliability and validity. Some students perceived certain aspects of the psychological contract that exists with their school of pharmacy were being violated. CONCLUSION: The psychological contract violations measure may serve as a valuable tool in helping to identify areas where their students believe that schools/colleges of pharmacy have not fulfilled promised obligations.

Recognition of teaching excellence.

The 2008-2009 Task Force for the Recognition of Teaching Excellence was charged by the AACP Council of Faculties Leadership to examine teaching excellence by collecting best practices from colleges and schools of pharmacy, evaluating the literature to identify evidence-based criteria for excellent teaching, and recommending appropriate means to acknowledge and reward teaching excellence. This report defines teaching excellence and discusses a variety of ways to assess it, including student, alumni, peer, and self-assessment. The task force identifies important considerations that colleges and schools must address when establishing teaching recognition programs including the purpose, criteria, number and mix of awards, frequency, type of award, and method of nominating and determining awardees. The report concludes with recommendations for the academy to consider when establishing and revising teaching award programs.

Pharmaceutical product withdrawal: attributions of blame and its impact on trust.

BACKGROUND: Six major pharmaceutical products were withdrawn from the market from 2000 to 2006. Little evidence exists in understanding consumer reactions to such events and the influence the withdrawal has on its competitors. OBJECTIVE: To explore consumers' attribution of blame after pharmaceutical product market withdrawal (PPMW) and its effect on trust. METHODS: Subjects were assigned randomly to 4 groups and provided a unique hypothetical PPMW scenario and asked to imagine themselves in the situation described. Each scenario represented a different "distance" from the PPMW (eg, whether subjects were asked to assume they were taking the withdrawn drug or a therapeutic substitute). Blame of and trust in several key professionals/groups were measured. RESULTS: Closer "distance" to the PPMW resulted in higher blame attributions for the Food and Drug Administration (FDA), pharmaceutical company (Pharma), and the physician. Although the pattern of trust scores did not differ based on "distance," insurance companies and Pharma suffered from low trust, whereas pharmacists and physicians received higher trust ratings. Blaming appeared to be no different between consumers on a withdrawn product and those consumers on a product in the same therapeutic class ("substitute" product). CONCLUSION: Substitute products (drugs in the same therapeutic class) appear to be affected in the event of a PPMW, although drugs used to treat the same disease do not appear to be so affected. The difficult-to-explain findings with respect to trust may be accounted for by the fact that trust is more downstream than blame (based on the scenario presentations) and that trust is a complex construct with multiple antecedents. Although the bonds of interpersonal trust remain stronger than those of institutional trust, the likelihood of situational trust versus overall trust may complicate this picture of understanding trust. It may be possible that trust is impervious to this one negative instance versus many positive interactions.

"Blogging" about course concepts: using technology for reflective journaling in a communications class.

OBJECTIVE: Web log technology was applied to a reflective journaling exercise in a communication course during the second-professional year at the University of Mississippi School of Pharmacy, to encourage students to reflect on course concepts and apply them to the environment outside the classroom, and to assess their communication performance. DESIGN: Two Web log entries per week were required for full credit. Web logs were evaluated at three points during the term. At the end of the course, students evaluated the assignment using a 2-page survey instrument. ASSESSMENT: The assignment contributed to student learning and increased awareness level for approximately 40% of the class. Students had few complaints about the logistics of the assignment. CONCLUSION: The Web log technology was a useful tool for reflective journaling in this communications course. Future versions of the assignment will benefit from student feedback from this initial experience.

Patient evaluations of pharmacist performance with variations in attire and communication levels.

OBJECTIVE: To determine whether the attire of a pharmacist has any effect on how he is evaluated when a patient also considers the pharmacist's performance and to assess whether attire and performance interact to influence patients' evaluations. DESIGN: Randomized, cross-sectional, three-factor design. SETTING: Community pharmacy settings were portrayed. PARTICIPANTS: 179 university staff members. INTERVENTIONS: Videos of pharmacist-patient interactions were encoded and placed on a Web site to be viewed by participants. MAIN OUTCOME MEASURES: Service encounter satisfaction, perceptions of overall service quality, trust in the service provider, and behavioral intentions based on two levels of pharmacist communication performance (high or adequate), three levels of dress style (casual, business casual, formal), and two levels of white coat (wearing or not). RESULTS: Of the three independent variables, only communication performance was found to significantly influence the dependent variables. High communication performance resulted in higher satisfaction scores, higher perceptions of quality, higher levels of trust, and behavioral intention scores that reflected a greater willingness to use and recommend the pharmacist. CONCLUSION: Style of dress or whether the pharmacist was wearing a white coat did not significantly influence participants' evaluations of the pharmacist in this study. Rather, the level of the pharmacist's communication performance was the most important cue used by participants in their ratings of service encounter satisfaction, perceptions of overall service quality, and trust in the service provider.