Comparison of Traditional Lecture-Based Learning versus Interactive Electronic Book Learning in Veterinary Student Comprehension of Inhalant Anesthetic Administration, Uptake, and Elimination.

The administration, uptake, and elimination of inhalant anesthetics is a challenging topic in the veterinary curriculum, and lecture-based learning is often insufficient to ensure that students understand these concepts. We hypothesized that the use of an interactive electronic book (e-book) would enhance student comprehension of the material. Two sequential Doctorate of Veterinary Medicine student cohorts participated in a prospective controlled study. The first cohort received traditional lecture-based learning while the second cohort was taught the topic using an interactive e-book. Student comprehension of the material was assessed twice during the course via multiple-choice questions: five questions in a midcourse quiz and seven within the final exam. At the end of the course, students also completed a Likert survey assessing their confidence regarding the topic. Averaged across assessment types, students taught using the interactive e-book scored higher than those taught via the traditional method (p < .001). Final exam scores were significantly higher in the e-book cohort compared with the lecture-based cohort (p < .001). However, there was no difference in quiz scores between groups (p = .109). No significant difference was found between groups in responses to the Likert survey. In conclusion, students using the interactive e-book had better comprehension of the material than students in the traditional lecture group as measured by their scores on multiple-choice question assessments. Future studies are needed to determine whether this advantage persists later in the curriculum when students apply these concepts in the clinical year.

Assessment Structure, Culture, and Resources at US AAVMC-Accredited Colleges of Veterinary Medicine.

While outcomes assessment is commonplace in colleges of veterinary medicine, no information is published on how veterinary colleges resource, administer, and view assessment. Consequently, this article has the following objectives: (a) to determine the current level of resources (personnel, committees, software) allocated toward education assessment and program evaluation in colleges of veterinary medicine, (b) to characterize any common organizational structures within colleges of veterinary medicine for assessment, (c) to determine assessment personnel (faculty and staff) perceptions regarding whether existing assessment resources and structures are sufficient, and (d) to examine the perceived strength of the culture of assessment. Our survey found that most assessment professionals had been in their position for 4 years or less and over 50% did not have formal assessment training. A majority of respondents agreed that assessment was encouraged and supported at their institution, but there was much less agreement on items related to formal plans and structures. For example, only one quarter of respondents reported that assessment was connected to planning and budgeting, and only one third reported having a formal assessment plan. We hope that our survey will be a resource tracking the development of assessment resources and climate at American colleges of veterinary medicine.

Comparison of pharmacists' scoring of fall risk to other fall risk assessments.

OBJECTIVES: Given their professional education and participation within the health care system, pharmacists are ideal candidates to assess drug-associated fall risk for patients. The purpose of this investigation was to determine whether pharmacists can quantitatively differentiate individuals who reported falling within the previous year (fallers) from those who do not (nonfallers), and to compare the pharmacists' evaluation with 2 recently published fall risk assessments. DESIGN: Cross-sectional design of pharmacists' assessments of fall risk. SETTING AND PARTICIPANTS: This is a cross-sectional study where 6 licensed pharmacists evaluated patient records from Wave 1 of the National Social Life, Health and Aging Project dataset using generic drug list (drug counts), age, and body mass index to generate a Pharmacist Risk Score (PRS) based on these variables. Pharmacists were allowed to use drug information resources and were provided with a simple 5-point scale to assist them in scoring patients. OUTCOME MEASURES: The main outcome measure of this study was a comparison of the following fall risk assessments (PRS, drug counts, Medication-Based Index of Physical Function, Quantitative Drug Index, and Timed Up and Go [TUG]) capacity to differentiate fallers from nonfallers. RESULTS: Each fall risk assessment was highly correlated (P < 0.001) with the number of reported falls. Drug-associated fall risk assessments were highly correlated (P < 0.001) with each other, but not with TUG. Each fall risk assessment differentiated fallers from nonfallers based on logistic regression (P ≤ 0.001). Receiver operating characteristic (ROC) curve analysis was significant (P ≤ 0.002) for each assessment. The comparison of ROC area under the curve for the fall risk assessments found no significant difference between the PRS and other assessments. CONCLUSION: Fall risk assessment by pharmacists was comparable with other fall risk assessments in distinguishing fallers from nonfallers.

Surveying the current landscape of assessment structures and resources in US schools and colleges of pharmacy.

INTRODUCTION: Expectations for assessment in higher education have increased in recent decades, prompting institutions to invest additional resources in this area. This study aimed to determine the resources, structure, and perception of assessment resources in United States schools and colleges of pharmacy (S/COPs). METHODS: Assessment personnel in S/COPs were surveyed electronically. Information collected included S/COP demographics, composition of assessment positions, experience and training of assessment personnel, and structure and responsibilities of committees engaged in assessment. Respondents' perception of their S/COPs having sufficient assessment personnel, recent changes in assessment, and the factors that prompted assessment changes were also surveyed. RESULTS: Respondents included individuals from 113 S/COPs (84% response rate). Most S/COPs had 1-2 assessment positions and 1-2 assessment-related committees. The most common assessment position titles were assistant/associate dean, director, coordinator/specialist, and administrative assistant. Dean-level administrators typically had worked in assessment the longest, whereas directors were more likely to have formal assessment training. Most respondents (75%) agreed they had sufficient assessment personnel to meet the 2007 Accreditation Council for Pharmacy Education Standards. Nearly two-thirds of respondents agreed they had sufficient personnel to meet the 2016 Standards and support their current assessment plan/process. Most S/COPs had a formal assessment committee (93%) and an average of two committees overseeing assessment. CONCLUSION: Most S/COPs reported having sufficient resources to support assessment activities. Although there were some consistent themes, there does not appear to be a single model for structuring assessment resources or committees. Effectiveness of various assessment structures represents an area for future research.

Factors associated with cultures of assessment at US schools and colleges of pharmacy.

INTRODUCTION: Pharmacy education has standards for assessment that must be met, prompting many programs to develop cultures of assessment. This study assesses the extent to which assessment personnel perceive that a culture of assessment has been established within their schools/colleges of pharmacy (S/COPs) and determines whether a relationship exists between assessment structure and the perceived strength of the culture of assessment. METHODS: An electronic survey was administered to assessment personnel at 134 S/COPs. Respondents were asked about changes within the past five years pertaining to assessment personnel/committees and factors prompting these changes. They were also asked to rate items related to support for institutional assessment (SIA scale) and faculty engagement with assessment (FEA scale). The reliability of each scale was estimated using Cronbach alpha and bivariate correlations were conducted to estimate the relationships among the two scales and other survey items. RESULTS: The S/COP response rate was 84% (113/134). Most (58%) noted the formation or re-structuring of the assessment office, with 26% creating one or more new assessment positions. The most common source of change was new accreditation standards (55%) followed by a new leadership position created in assessment (40%). Cronbach alpha for the SIA scale was 0.79 and 0.84 for the FEA scale. Program size was strongly negatively correlated with school age (rs = -0.58) and the FEA scale (r = -0.21). CONCLUSIONS: There was a strong relationship between SIA and FEA. Future studies are warranted to determine the interdependency of support for assessment and faculty engagement with assessment.

The Application of Classification Trees to Pharmacy School Admissions.

In recent years, the American Association of Colleges of Pharmacy (AACP) has encouraged the application of big data analytic techniques to pharmaceutical education. Indeed, the 2013-2014 Academic Affairs Committee Report included a "Learning Analytics in Pharmacy Education" section that reviewed the potential benefits of adopting big data techniques.1 Likewise, the 2014-2015 Argus Commission Report discussed uses for big data analytics in the classroom, practice, and admissions.2 While both of these reports were thorough, neither discussed specific analytic techniques. Consequently, this commentary will introduce classification trees, with a particular emphasis on their use in admission. With electronic applications, pharmacy schools and colleges now have access to detailed applicant records containing thousands of observations. With declining applications nationwide, admissions analytics may be more important than ever.3.

Visual biofeedback training reduces quantitative drugs index scores associated with fall risk.

OBJECTIVE: Drugs increase fall risk and decrease performance on balance and mobility tests. Conversely, whether biofeedback training to reduce fall risk also decreases scores on a published drug-based fall risk index has not been documented. Forty-eight community-dwelling older adults underwent either treadmill gait training plus visual feedback (+VFB), or walked on a treadmill without feedback. The Quantitative Drug Index (QDI) was derived from each participant's drug list and is based upon all cause drug-associated fall risk. Analysis of covariance assessed changes in the QDI during the study, and data is presented as mean ± standard error of the mean. RESULTS: The QDI scores decreased significantly (p = 0.031) for participants receiving treadmill gait training +VFB (- 0.259 ± 0.207), compared to participants who walked on the treadmill without VFB (0.463 ± 0.246). Changes in participants QDI scores were dependent in part upon their age, which was a significant covariate (p = 0.007). These preliminary results demonstrate that rehabilitation to reduce fall risk may also decrease use of drugs associated with falls. Determination of which drugs or drug classes that contribute to the reduction in QDI scores for participants receiving treadmill gait training +VFB, compared to treadmill walking only, will require a larger participant investigation. Trial Registration ISRNCT01690611, ClinicalTrials.gov #366151-1, initial 9/24/2012, completed 4/21/2016.

The Social Psychology of Biased Self-Assessment.

Objective: To describe the psychological mechanisms that underlie biased self-assessment and suggest pedagogical techniques to counter them. Findings: Since the psychological mechanisms that underlie bias self-assessment occur below awareness, strategies that attempt to address bias directly are unlikely to succeed. A more effective approach may be to structure students' learning experiences in ways that prevent the unconscious biasing mechanisms from operating efficiently. Summary: Given the importance of accurate self-knowledge for professional students and clinicians, as well as its difficulty to attain, an understanding of the psychological mechanisms that contribute the most common forms of biased self-assessment is essential for creating and implementing effective mitigation strategies.

Comparing Student Performance on the Old vs New Versions of the NAPLEX.

Objective. To determine if the new 2016 version of the North American Pharmacy Licensure Examination (NAPLEX) affected scores when controlling for student performance on other measures using data from one institution. Methods. There were 201 records from the classes of 2014-2016. Doubly robust estimation using weighted propensity scores was used to compare NAPLEX scaled scores and pass rates while considering student performance on other measures. Of the potential controllers of student performance: Pharmacy Curricular Outcomes Assessment (PCOA), scaled composite scores from the Pharmacy College Admission Test (PCAT), and P3 Grade Point Average (GPA). Only PCOA and P3 GPA were found to be appropriate for propensity scoring. Results. The weighted NAPLEX scaled scores did not significantly drop from the old (2014-2015) to the new (2016) version of NAPLEX. The change in pass rates between the new and old versions of NAPLEX were also non-significant. Conclusion. Using data from one institution, the new version itself of the NAPLEX did not have a significant effect on NAPLEX scores or first-time pass rates when controlling for student performance on other measures. Colleges are encouraged to repeat this analysis with pooled data and larger sample sizes.

Assessing Faculty and Student Interpretations of AACP Survey Items with Cognitive Interviewing.

Objective. To use cognitive interviewing techniques to determine faculty and student interpretation of a subset of items from the AACP faculty and graduating student surveys. Methods. Students and faculty were interviewed individually in a private room. The interviewer asked each respondent for his/her interpretation of 15 randomly selected items from the graduating student survey or 20 items from the faculty survey. Results. While many items were interpreted consistently by respondents, the researchers identified several items that were either difficult to interpret or produced differing interpretations. Conclusion. Several interpretational inconsistencies and ambiguities were discovered that could compromise the usefulness of certain survey items.

Development and evaluation of the medication-based index of physical function (MedIP).

Background: the development of an objective and comprehensive drug-based index of physical function for older adults has the potential to more accurately predict fall risk. Design: the index was developed using 862 adults (ages 57-85) from the National Social Life, Health, and Aging Project (NSHAP) Wave 1 study. The index was evaluated in 70 adults (ages 51-88) from a rehabilitation study of dizziness and balance. Methods: the prevalence among 601 drugs for 1,694 side effects was used with fall history to determine the magnitude of each side effect's contribution towards physical function. This information was used to calculate a Medication-based Index of Physical function (MedIP) score for each individual based on his or her medication profile. The MedIP was compared to the timed up and go (TUG) test as well as drug counts using receiver operating characteristic (ROC) analysis. The associations between various indices of physical function and MedIP were calculated. Results: within the NSHAP data set, the MedIP was better than drug counts or TUG at predicting falls based on ROC analysis. Using scores above and below the cutpoint, the MedIP was a significant predictor of falls (OR = 2.61 [95% CI 1.83, 3.64]; P < 0.001). Using an external data set, it was shown that the MedIP was significantly correlated with fall number (P = 0.044), composite physical function (P = 0.026) and preferred gait speed (P = 0.043). Conclusion: the MedIP has the potential to become a useful tool in the healthcare and fall prevention of older individuals.

Beyond anti-Muslim sentiment: opposing the Ground Zero mosque as a means to pursuing a stronger America.

Americans' opposition toward building an Islamic community center at Ground Zero has been attributed solely to a general anti-Muslim sentiment. We hypothesized that some Americans' negative reaction was also due to their motivation to symbolically pursue a positive U.S. group identity, which had suffered from a concurrent economic and political downturn. Indeed, when participants perceived that the United States was suffering from lowered international status, those who identified strongly with the country, as evidenced especially by a high respect or deference for group symbols, reported a stronger opposition to the "Ground Zero mosque" than participants who identified weakly with the country did. Furthermore, participants who identified strongly with the country also showed a greater preference for buildings that were symbolically congruent than for buildings that were symbolically incongruent with the significance of Ground Zero, and they represented Ground Zero with a larger symbolic size. These findings suggest that identifying group members' underlying motivations provides unusual insights for understanding intergroup conflict.