Teaching About Racism in Medical Education: A Mixed-Method Analysis of a Train-the-Trainer Faculty Development Workshop.

BACKGROUND AND OBJECTIVES: Curriculum addressing racism as a driver of inequities is lacking at most health professional programs. We describe and evaluate a faculty development workshop on teaching about racism to facilitate curriculum development at home institutions. METHODS: Following development of a curricular toolkit, a train-the-trainer workshop was delivered at the 2017 Society of Teachers of Family Medicine Annual Spring Conference. Preconference evaluation and a needs assessment collected demographic data of participants, their learning communities, and experience in teaching about racism. Post-conference evaluations were completed at 2- and 6-month intervals querying participants' experiences with teaching about racism, including barriers; commitment to change expressed at the workshop; and development of the workshop-delivered curriculum. We analyzed quantitative data using Statistical Package for the Social Sciences (SPSS) software and qualitative data, through open thematic coding and content analysis. RESULTS: Forty-nine people consented to participate. The needs assessment revealed anxiety but also an interest in obtaining skills to teach about racism. The most reported barriers to developing curriculum were institutional and educator related. The majority of respondents at 2 months (61%, n=14/23) and 6 months (70%, n=14/20) had used the toolkit. Respondents ranked all 10 components as useful. The three highest-ranked components were (1) definitions and developing common language; (2) facilitation training, exploring implicit bias, privilege, intersectionality and microaggressions, and videos/podcasts; and (3) Theater of the Oppressed and articles/books. CONCLUSIONS: Faculty development training, such as this day-long workshop and accompanying toolkit, can advance skills and increase confidence in teaching about racism.

A Didactic Community Pharmacy Course to Improve Pharmacy Students' Clinical Skills and Business Management Knowledge.

Objective. To create, implement and evaluate a Doctor of Pharmacy (PharmD) course on clinical services in community pharmacy settings. Methods. A 2-credit hour elective course was offered to second- and third-year pharmacy (P2 and P3) students. The course was developed using integrated course design principles. Community pharmacists were featured prominently in the course. Student performance on quizzes was evaluated and compared between groups (2014 and 2015 cohort). A survey with a pretest posttest design was used to assess students' self-rated knowledge and self-efficacy. Results. Twenty students enrolled in the elective course and 18 students completed the pre/post survey. There was no difference in performance scores on each of the three quizzes between students in the 2014 and 2015 courses. There was a significant increase seen for knowledge of the majority of course competencies. Students indicated improvement in their confidence to perform a variety of clinical services after course completion. Conclusion. Participation in this elective course allowed students to improve their knowledge of community pharmacy practice competencies and increased their ability to deliver clinical services in community pharmacy settings.

Use of the Muddiest Point Technique as an exam review in an integrated pharmacotherapy course.

BACKGROUND AND PURPOSE: The objective of this study was to evaluate the impact in student pharmacists' exam performance learning outcomes and satisfaction after integrating the Muddiest Point assessment technique into exam reviews. EDUCATIONAL ACTIVITY AND SETTING: In 2016, the Muddiest Point, a formative assessment tool, was used to develop exam review sessions for second-year student pharmacists in an integrated pharmacotherapy course focused on the cardiovascular system. Performance scores on all four exams were compared between students in the 2015 and 2016 courses. Students' complexity of learning was categorized using a taxonomy of learning structure. A survey was used to evaluate student perceptions of exam reviews and the Muddiest Point technique (MPT). FINDINGS: Scores were higher on the second exam for the 83 students in the 2016 course (78.0% vs. 86.0%, p<0.001). There was no difference on other exam scores or overall course failures. Muddiest points submitted by students demonstrated a variety of taxonomy of learning levels. Student pharmacists surveyed at the conclusion of the course agreed that exam reviews were helpful for their preparation for exams and that the MPT was a valuable use of class time. SUMMARY: Incorporating the MPT into exam reviews maintained exam scores and supported evaluation of student learning. In addition, student pharmacists were satisfied with this exam review method.

Development, implementation, and evaluation of a service-learning series for pharmacy students using a public health tool.

BACKGROUND AND PURPOSE: The purpose of this article is to describe the utility of the Assessment, Development, Assurance: Pharmacist's Tool (ADAPT) during the design, delivery, and assessment of service-learning events by pharmacy students. EDUCATIONAL ACTIVITY AND SETTING: The ADAPT instrument was used to develop a series of five service-learning events that featured a health promotion program delivered by 19 pharmacy students and attended by over 200 senior citizens at local senior centers. Student competence was assessed prior to participating in the service-learning activities and each student completed a reflection following the event. Senior center directors evaluated both the quality of the health promotion program as well as the interaction with the sponsoring college of pharmacy. FINDINGS: Pharmacy students reported achievement of health promotion learning objectives based on self-evaluations. Responses to reflections also indicate that students gained insight to and appreciation for several of the public health essential services, which are the basis of the ADAPT instrument. Feedback from the senior center directors was consistently positive. DISCUSSION AND SUMMARY: Use of the ADAPT instrument helped to facilitate the delivery of a high-quality, comprehensive service-learning series at local senior centers that had a solid public health foundation. Colleges and schools of pharmacy should strongly consider consulting the tool prior to planning any future health promotion activities for students.

Race as a factor for intensification of diabetes medications.

PURPOSE: The purpose of this study was to investigate if patients of nonwhite race are less likely to receive insulin therapy for treatment of poorly controlled diabetes than patients of white race. METHODS: A retrospective review was performed of patients with an A1C >10%. The primary objective was to determine any difference in the initiation of insulin between white and nonwhite patients. Secondary outcomes measured the impact of clinic type and provider specialty on the initiation of insulin therapy. Exclusion criteria included those patients with type 1 diabetes mellitus, those who were previously receiving insulin, and those without an outpatient clinic visit within 14 days of an A1C >10%. RESULTS: A total of 277 patients were included. Of these patients, 132 (47.7%) were white, followed by 95 (34.2%) black non-Hispanic patients and 30 (10.8%) Hispanic/Latino patients. No difference was found in receipt of insulin therapy for nonwhite patients as compared to white patients (12.5 vs 21.4, P = .117). Neither clinic type nor provider specialty impacted initiation of insulin therapy. No changes to medication regimen were made at 35% of clinic visits. CONCLUSIONS: Failure to intensify diabetic medications was common in this outpatient setting. There were no disparities in the receipt of insulin therapy between white and nonwhite patients.