Motivating Language and Social Provisions in the Inculcation of Pharmacy Students' Professional Identity.

Professional identity formation in pharmacy students is a multifaceted, dynamic process stimulated through a variety of experiences, including those in structured classrooms, laboratories, experiential settings, and during interprofessional education. Meaningful faculty communications with students are a critical element in the development process.This commentary situates research findings from studies on communication practices within the frameworks of motivating language theory and social provisions theory to demonstrate how specific language from instructors can impact the formation of students' professional identity. Our objective is to review and extrapolate findings from professional pharmacy literature on communication, as well as literature from outside the profession, to demonstrate how specific strategies can aid in the development and reinforcement of pharmacy students' professional identity. Clear, specific, tailored, empathetic communication by instructors during pharmacy student training promotes students' ability to think, act, and feel like valued contributors during the provision of patient care and interprofessional experiences.

A historical overview of IPPE program administrators' roles and responsibilities at US colleges and schools of pharmacy.

INTRODUCTION: The objective of this research was to determine changes in introductory pharmacy practice experience (IPPE) program administrators' demographics, roles, and responsibilities over time, and reflect on internal and external forces resulting in these shifts. This information provides an opportunity for schools to improve functioning of their IPPE administrative offices. METHODS: A 2020 web-based questionnaire was sent to IPPE program administrators at 141 fully accredited and candidate status colleges and schools of pharmacy (hereafter referred to as schools). The responses were compared to previously published results from similar surveys in 2008 and in 2013. RESULTS: One hundred thirteen IPPE administrators responded to the 2020 questionnaire for an 80% response rate. A comparative analysis of the data from 2008, 2013, and 2020 revealed a decrease in average class size and changes over time in six administrative areas. These areas included IPPE administrator responsibilities, position types, primary administrator's time devoted to IPPE administration, utilization of a programmatic decision-making committee, inclusion on the school's executive committee, and the number of clerical fulltime equivalents utilized in managing IPPE programs. CONCLUSIONS: A comparison of data from three studies revealed significant trends in six areas of IPPE administration over time. The primary drivers of change appear to be workload, fluctuating class sizes, and programmatic costs.

Communication in Pharmacy Higher Education to Improve Work-life and Mitigate Burnout.

Objective. To identify the content, style, timing, tone, and initiation of communication that best connotes "reassurance of worth" from peers and supervisors in pharmacy academia.Methods. This study employed semi-structured interviews to acquire in-depth information from pharmacy faculty through a purposive sampling process. Academicians who had published in the area of work-life and/or were deemed likely to make substantial contributions to the interview were asked to participate. Participants represented a cross section of pharmacy faculty in terms of discipline, institution, and demographic characteristics. An interview guide was constructed based on motivating language theory and provisions of social relationships theory. Interviews were conducted via Zoom and transcribed verbatim. Themes were gleaned using open coding, then audited and checked.Results. Data saturation occurred after eight interviews. Two primary themes emerged: guidance, particularly related to professional development and tenure; and reassurance of worth through invited participation, praise, and/or rewards. Interviewees highlighted the importance of empathetic yet practical language among peers, and supervisor-initiated, meaning-making language rather than generic platitudes.Conclusion. Empathetic, personal language that provides guidance and reassurance of worth can enhance pharmacy faculty contributions and mitigate burnout. Invitations to collaborate are seen by faculty as collegial and engaging. This study demonstrated the usefulness of motivating language theory and social provisions in guiding communications among pharmacy academicians.

Faculty Burnout in Pharmacy Education.

Burnout negatively affects health care faculty members, their professions, and patient care. Academic institutions are culpable in regard to establishing reasonable expectations and a supportive work culture. Together, the health professions must proactively evaluate, develop, and implement strategies to minimize faculty burnout. This commentary suggests multiple ways to address faculty burnout.

Challenges to Pharmacy School Enrollment Management Caused by a Global Pandemic.

Academic institutions work diligently each year to recruit, retain, and graduate Doctor of Pharmacy (PharmD) students who will be positive contributors to our healthcare system. The immergence of a novel coronavirus in 2019 (COVID-19) has threatened these systems. This commentary is a discussion of the effects of the COVID-19 pandemic on the enrollment management processes of PharmD degree programs, including recruitment, admissions, orientation, retention, and graduation. The authors highlight enrollment management processes that may forever be changed by the COVID-19 pandemic. This commentary is intended to assist pharmacy administrators as they reflect on the impact of the COVID-19 pandemic on their own programs and develop strategies to minimize the negative effects.

The Status and Adequacy of Preceptor Orientation and Development Programs in US Pharmacy Schools.

Objective. To identify current preceptor orientation and development programs at US colleges and schools of pharmacy and propose future initiatives for preceptor programs. Methods. An anonymous 28-item survey was administered in January 2017 to 128 experiential education personnel at accredited US schools and colleges of pharmacy. Data from completed survey instruments were tabulated and qualitative responses to open-ended questions were examined using thematic analysis. Results. Eighty-five experiential education administrators participated in the survey (response rate=67%). Most preceptor orientation programs met the majority of requirements as outlined within the Accreditation Council for Pharmacy Education's Standard 20.3, although only 42% of programs mandated preceptor orientation prior to student placement. Two-thirds of respondents offered annual, live preceptor development, and 75% of programs used commercially available online products. Nearly 40% of respondents collaborated with other schools or professional organizations to offer preceptor training. Only 29% of programs had specific requirements for pharmacists to maintain their active preceptor status. Seventy percent of respondents reported spending over $2500 and 39% over $5000 annually on preceptor development. Programs with the highest monetary investment (>$10,000/year) in preceptor development offered multiple venues (live and online) for preceptor training. Programs with significant personnel commitment (≥0.5 FTE devoted to preceptor development) frequently had dedicated site visitors. Conclusion. Preceptor orientation programs at US schools of pharmacy are generally similar, but development programs vary significantly across the Academy. Highly invested programs featured live and online training or site visitors who provided individualized feedback or training. Future studies should explore the cost-effectiveness of program options and their impact on preceptor learning and behaviors.

Pharmacy Faculty Burnout: Cause for Concern that Requires Our Support and Use of Best Evidence.

Recent attention has been afforded to the concept of burnout and other quality of worklife issues among pharmacy faculty, underscoring the importance of organizational culture, citizenship, collegiality, and support. Support comes from the larger academic institution, the college/school, and individual colleagues. Evidence points to reassurance of worth, guidance, and positive affirmation as being among the most salient factors in mitigating burnout of faculty, who are caught in the midst of increasing demands and higher administrative burdens. A supportive culture that reassures worth of individual faculty is not a unidimensional typology, but rather, is one that permeates through all components of a multifaceted and strong culture that encourages citizenship. There is a growing body of research and evidence on faculty burnout and related factors. This commentary calls for the use of such evidence in guiding policies, creating mentoring programs, and carrying out daily activities in much the same manner that scholars use the best available evidence in their own specific lines of inquiry in teaching and research.

National Survey Exploring Drug Screening in Pharmacy Programs.

Objective. To explore drug screening programs, including requirements, policies, and procedures among pharmacy programs; frequency of drug-related incidents; and types of substances misused by pharmacy students. Methods. IRB-approved web-based and paper surveys were sent to pharmacy deans, experiential education faculty, and student affairs personnel at 135 US ACPE-accredited and candidate status programs. Descriptive statistics and chi-square test were used to analyze the data, identify relationships and draw conclusions. Results. Administrators from 98 programs responded (73% response rate). Sixty-one percent reported implementing a urine drug screen requirement for students, with a 10-panel screen as the most common required screen (72%). Ninety-three percent of programs require students to pay for the screen, with costs averaging $42 per screen. Programs reported an average of 2.2 substance-related events per 100 students annually, with alcohol, marijuana, amphetamines, opioids and benzodiazepines most commonly involved. Schools that do not screen reported twice as many incidents as those that screen. Conclusion. A drug screening program can deter pharmacy students from inappropriate substance use. The results from this study can assist pharmacy administrators in evaluating the need to institute or enhance a drug screening program at their school or college of pharmacy.

Student observations of medication error reporting practices in community pharmacy settings.

BACKGROUND: Medication safety practices and methods for reporting errors in community pharmacies are relatively unknown. OBJECTIVE: (s): The primary objective of this study was to describe student-reported data on medication safety and error reporting practices in community pharmacies, and secondarily describe student learning from this assignment. METHODS: Second professional year pharmacy students enrolled at Purdue University College of Pharmacy in the United States observed and recorded medication safety and error reporting practices as part of an experiential assignment. Data were collected from 170 unique pharmacy settings between the years 2016-2018 and analyzed using descriptive statistics and a paired t-test to assess student learning. RESULTS: 51% of students reported documentation of 1-10 errors or near misses annually, with an additional 30% reporting 11-30. Near misses were only reported 26% of the time. Errors were most commonly reported to a pharmacy-specific reporting system (84%) and the Institute for Safe Medication Practices National Medication Errors Reporting Program (84%). The most frequently reported error types included wrong directions (34%), wrong drug (14%), wrong strength (13%), and wrong patient (12%). Pharmacists were observed to be interrupted approximately 19 times every hour. Anonymous error reporting was typically not allowed to the pharmacy's preferred error reporting system (71%). A policy requiring that the prescriber is contacted about errors was observed at 77% of the sites. The most common consequences of committing an error were education/training (72%) or progressive discipline (41%). Students reported a statistically significant increase in understanding of medication safety practices and methods for reporting errors in community pharmacies. (p < 0.01). CONCLUSION: This data supplements existing literature on medication safety practices and error reporting in community pharmacy settings, as well as highlights knowledge gaps outside the scope of this study.

Comparison of Student and Patient Perceptions for Medication Non-adherence.

Objective. To compare pharmacy students' perceptions with patients' reasons for medication non-adherence. Methods. Pharmacy students completing an experiential rotation recruited patients exhibiting medication non-adherence from community pharmacies and asked them to respond to statements about reasons for their medication non-adherence. Patient responses were ranked in order of prevalence and compared to self-reported student perceptions on reasons for non-adherence. Results. There was a significant difference between patients' and students' rankings of reasons for medication non-adherence. Significant factors for patients included medications that interfere with lifestyle, sexual health and drinking alcohol; whereas, students believed that cognitive-related issues were patients' primary reasons for non-adherence to their medications. Conclusion. Educational opportunities to reflect on and discuss differing perspectives should be provided in the pharmacy curriculum to better equip students to address medication adherence issues and improve patient care.

National trends in IPPE programs at US schools of pharmacy from 2008-2013.

OBJECTIVE: To determine trends and challenges in introductory pharmacy practice experience (IPPE) programs from 2008-2013. METHODS: In 2013, a web-based survey was sent to IPPE program administrators at 107 fully accredited colleges and schools of pharmacy. The survey addressed administrative personnel, program structure, and quality assurance issues. RESULTS: Sixty-nine IPPE administrators responded to the survey (64.5% response rate). Within the past 5 years, 4 significant trends occurred in the area of administrative personnel, 7 trends in program structure, and 6 in quality assurance. CONCLUSION: Clarifications of ACPE Standards through new guidelines and policy statements likely influence many of the 17 trends. Understaffed programs, competition for institutional sites, difficulty conducting site visits, preceptor training, program assessment, documentation maintenance, and individual site requirements are all challenges. The results of this study can be used as a stimulus to address ongoing issues and to enhance the quality of IPPE programs.

An introductory pharmacy practice experience on improving medication adherence.

OBJECTIVE: To evaluate the impact of a medication adherence activity on introductory pharmacy practice experience students' perceptions of patient adherence as well as student development of empathy and confidence in patient counseling. DESIGN: Students participated in a personal medication simulation using an automated medication dispenser. Students then identified a patient with nonadherence and provided counseling on use of the dispenser. After 4 to 6 weeks, students interviewed the patient about their experience with the dispenser and assessed changes in adherence. ASSESSMENT: One hundred fifty-three students completed the assignment and 3 surveys instruments. Following the experience, the majority of students agreed or strongly agreed that they developed more empathy for patients with multiple medications and felt confident counseling a patient in the use of a dispenser (92.0% and 88.2%, respectively). Most students (91.4%) reported feeling that their patient education session was successful. CONCLUSION: An introductory pharmacy practice experience involving an automated medication dispenser and patient counseling to improve medication adherence resulted in the development of empathy and improved student confidence.

Patient safety instruction in US health professions education.

OBJECTIVE: To describe patient safety instruction in health professional curricula, including medicine, nursing, pharmacy, and dentistry. METHODS: A systematic review of the literature from 1966 through 2010 was conducted using 6 databases and based on 3 search criteria: safety management, patient safety, and curriculum. RESULTS: One hundred fifty-four articles were identified and 23 met inclusion criteria. A variety of educational methods have been used in health profession curricula to promote patient safety including lectures, workshops, objective structured clinical examinations, standardized patients, simulation exercises, root cause analysis, quality assurance projects, and other interactive learning methods. The development of patient safety curricula has been primarily discipline-specific, with little interdisciplinary research found. CONCLUSIONS: Safe, patient-centered care is directly influenced by the quality of education that healthcare professions students receive. From this literature review, research is needed to guide curricular change, specifically focusing on instructional methods and interdisciplinary collaborations.

Laboratory session to improve first-year pharmacy students' knowledge and confidence concerning the prevention of medication errors.

OBJECTIVES: To implement a laboratory session into the first-year pharmacy curriculum that would provide active-learning experiences in the recognition, resolution, and prevention of medication errors. DESIGN: Students participated in medication error-prone prescription processing and counseling simulations, role-played communication strategies after a medication error occurred, and discussed an introductory pharmacy practice experience focused on prescription processing and prevention of medication errors. ASSESSMENT: Students completed an assessment prior to and after completion of the laboratory on their knowledge of and confidence in identifying medication errors. Students' knowledge and awareness of medication errors improved as did confidence in their ability to (1) recognize and avoid errors, (2) utilize methods to prevent errors, (3) communicate about errors with involved parties, and (4) select and report medication errors on an appropriate form. CONCLUSION: Students' awareness of the pharmacist's role in medication error reduction improved and confidence in their ability to recognize, prevent, and communicate medication errors increased.

Active-learning laboratory session to teach the four M's of diabetes care.

OBJECTIVE: To implement an active-learning methodology for teaching diabetes care to pharmacy students and evaluate its effectiveness. DESIGN: Laboratory instruction was divided into 4 primary areas of diabetes care, referred to by the mnemonic, the 4 M's: meal planning, motion, medication, and monitoring. Students participated in skill-based learning laboratory stations and in simulated patient experiences. A pretest, retrospective pretest, and posttest were administered to measure improvements in students' knowledge about diabetes and confidence in providing care to diabetes patients. ASSESSMENT: Students knowledge of and confidence in each area assessed improved. Students enjoyed the laboratory session and felt it contributed to their learning. CONCLUSION: An active-learning approach to teaching diabetes care allowed students to experience aspects of the disease from the patient's perspective. This approach will be incorporated in other content areas.