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.

An Opportunity to Integrate Cultural Sensitivity Training Into the Doctor of Pharmacy Curriculum.

Instructors of pharmacy skills-based laboratory courses are positioned to prepare students to be practice-ready practitioners through use of hands-on instructional activities essential for pharmacists. This commentary explores an approach to developing cultural sensitivity in pharmacy students, a skill which is reflected in Accreditation Council for Pharmacy Education (ACPE) Standard 3.5 and viewed by the authors as a critical skill for all healthcare practitioners. This commentary challenges the Academy to develop best practices for promoting cultural sensitivity in student-learners with the goal of producing students aware of how their own experiences may influence health inequities. The authors propose, using the model of self-efficacy theory as a framework, that skills-based pharmacy education is an ideal platform for cultural sensitivity skill development and engagement because of its ability to go beyond knowledge attainment and influence student abilities, behaviors, and attitudes. The authors' recommendations include that members of the Academy self-assess personal and institutional cultural sensitivity, ensure integration of cultural sensitivity in curriculum, use self-efficacy theory as a guide to integrate best practices for providing culturally sensitive care in laboratory activities, and develop best practices.

A faculty and staff workshop on microaggression and implicit bias: Knowledge and awareness of student, faculty, and staff experiences.

BACKGROUND AND PURPOSE: This paper describes the context and experiences of a workshop to raise knowledge and awareness of a college of pharmacy's faculty and staff about microaggressive behaviors and implicit biases. The workshop was intended to provide a non-threatening, interactive, and informative professional development program to demonstrate the cumulative marginalizing effects on students, faculty, and staff who may perceive themselves as targets. EDUCATIONAL ACTIVITY AND SETTING: A half-day workshop was conducted during July 2018. Participants were initially provided with definitions and categories of microaggression and implicit bias. To bring the subject matter "alive" and foster receptivity, interactive videos were shown with scenarios depicting situations reflective of microaggressions and implicit biases. College faculty, staff, and students made these relatable. To foster objectivity, an outside consultant was hired to facilitate the ensuing roundtable and plenary discussions. FINDINGS: Sixty-eight participants responded to a pre-survey designed by the workshop team, and 78% indicated never having attended a training/seminar on microaggression and/or implicit bias. Sixty-two individuals responded to the post-survey with 92% indicating increased knowledge gained from workshop. Anecdotal reports suggested that the workshop had an ongoing impact, as faculty and staff continued the discussions in subsequent months and requested additional training sessions. SUMMARY: The workshop heightened awareness and increased faculty and staff knowledge on microaggressive behaviors, implicit biases, and the potential consequences thereof. It also demonstrated the importance of addressing conversations that are perceived as difficult, in order to create a diverse and inclusive workplace and learning environment for all.

Student Pharmacists' Ability to Organize Complex Medication Regimens According to the Universal Medication Schedule.

Objective. To assess student pharmacists' ability to impact the administration of complex prescription regimens using the universal medication schedule in a standardized laboratory exercise. Methods. First and third professional year (P1 and P3) student pharmacists at three colleges of pharmacy completed a required activity to simplify and organize a complex medication regimen. Using a medication box, students planned how and when they would advise a patient to take seven fictitious medications over a 24-hour period. Picture documentation of each students' activity was used for data analysis. Descriptive statistics were used to compare P1 and P3 students' performance, and an independent t test was used to assess the frequency of daily dosing. A chi-square analysis was used to compare differences between P1 and P3 students, and analysis of variance was used to compare differences among individual institutions. Results. Of 842 students invited, 459 P1 and 372 P3 students (98.7%) consented to participate. Student pharmacists recommended 5.1 (SD=1.0; Range=3-11) dosing intervals per 24 hours, with 27% of students successfully reducing the regimen to four total intervals. The P3 students were more effective than the P1 students in planning the number of dosing intervals (4.9 vs 5.4 per 24 hours). Conclusion. Student pharmacists may become more effective at organizing complex medication regimens as they proceed through the pharmacy curriculum and gain experience. Student pharmacists can translate what they learned from this exercise to potentially improve patients' self-organized medication regimens.

Pharmacy Students Teaching Prescription Writing and Nonprescription Product Selection to Medical Students.

Objective. To measure the impact of an interprofessional education intervention in which pharmacy students provided education to medical students. Methods. In a required workshop, fourth-year pharmacy students taught second-year medical students the basics of prescription writing. In a subsequent selective education session, the pharmacy students led a case-based discussion on nonprescription drug use for third-year medical students on their family medicine rotation. The pharmacy students were surveyed in regards to confidence in teaching abilities before and after the prescription writing workshop and the medical students were surveyed in regards to confidence with activity and teaching effectivess prior to and after the completion of the workshop or selective. Results. At the end of the workshop, second-year medical students were more confident in their abilities to write prescriptions and fourth-year pharmacy students were more confident in their ability to teach prescription writing. Based on survey responses, the second-year medical students and fourth-year pharmacy students were confident in the learning environment effectiveness throughout the activity. After participating in the selective education session, third-year medical students were more confident in their ability to access resources on nonprescription drugs and in making recommendations to and counseling patients regarding nonprescription drug use. Conclusion. The perception is that pharmacy students can be effective interprofessional educators for medical students on key aspects of the medical curriculum.

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.

Pharmacist-initiated hepatitis C virus screening in a community pharmacy to increase awareness and link to care at the medical center.

OBJECTIVE: To describe the design and implementation of a pharmacist-led hepatitis C virus (HCV) screening and education program in a community pharmacy with a protocol for linkage to care at the affiliated hepatology clinic for patients born between 1945 and 1965. SETTING: Outpatient pharmacy affiliated with the University of Illinois Hospital and Health Sciences System. PRACTICE DESCRIPTION: The community pharmacist resident conducted the HCV screening at the health system-based community pharmacy. PRACTICE INNOVATION: Community pharmacists provided patients with HCV screening and education while patients waited for their prescriptions to be ready or upon appointment. Patients were given a questionnaire before and after HCV education to assess the impact of pharmacist-provided education on patient knowledge. A protocol was developed to link patients with a positive HCV antibody test result to care with a hepatologist for confirmatory testing at a follow-up appointment at the medical center. EVALUATION: Investigators assessed the feasibility of providing the screening and education, recorded the number of patients screened, and recorded the differences in the questionnaire responses before and after education. RESULTS: Pharmacist-led HCV screening services were implemented successfully at the community pharmacy. All patients had a negative antibody result; therefore, linkage to care at the medical center, although available, was not necessary. The self-reported posttest HCV knowledge scores were significantly higher than pretest scores. CONCLUSION: This article outlines the methodology for providing a multidisciplinary HCV screening, education, and referral program in a community pharmacy affiliated with a medical center. Pharmacist-initiated HCV screening in a community pharmacy can assist with identifying patients at risk for HCV infection and provide patients with linkage to care in the health system. This report may encourage community pharmacists to conduct future prospective trials to evaluate clinical and economic outcomes of community-based HCV screenings.

Changing oral contraceptives from prescription to over-the-counter status: an opinion statement of the Women's Health Practice and Research Network of the American College of Clinical Pharmacy.

Addressing the issue of unintended pregnancy is a national priority. One proposed strategy to reduce unintended pregnancy is to improve access to oral contraceptives by changing them to over-the-counter (OTC) status. Existing data indicate that oral contraceptives meet safety criteria required of OTC products. Available literature demonstrates that women can self-screen for contraindications to oral contraceptives and can do this as well as clinicians, and experience with OTC emergency contraception suggests that OTC oral contraceptives would not increase sexual risk-taking behavior. Women support OTC access to oral contraceptives, but express an interest in accessing pharmacist counseling. On the basis of these data, the Women's Health Practice and Research Network of the American College of Clinical Pharmacy supports changing oral contraceptives to OTC status under two conditions: that they are sold where a pharmacist is on duty and that there are mechanisms in place to cover OTC contraceptives through Medicaid. Future research should address the issues of out-of-pocket costs to individuals, label-comprehension studies, and models for pharmacist reimbursement for time spent counseling on contraception.