The veteran-centered care conferences: interprofessional education and community involvement facilitated by the health sciences librarian.

Background: Veterans have a variety of unique healthcare needs and receive care from both the US Department of Veterans Affairs (VA) and private healthcare systems. Because healthcare students will likely treat veterans at some time during their career, it is important they gain exposure to working with veterans during their professional degree programs. Case Presentation: This case report presents the development of an annual Veteran-Centered Care Conference (VCCC) at the Massachusetts College of Pharmacy and Health Sciences. The VCCC included a faculty librarian who led a multi-disciplinary team that planned and coordinated each event. Speakers and participants included university students and faculty from multiple healthcare disciplines, as well as representatives from the VA, veterans' advocacy groups, and community members (including many veterans). The purpose of the VCCC was to raise awareness of the healthcare needs of contemporary veterans. The goal of the VCCC was to improve healthcare provided to veterans by enhancing civilian health professions students' knowledge of the potential effects of military service on a person's health. Conclusion: After four successful events covering such topics as PTSD, specific health concerns of women veterans, substance use disorder, and homelessness, the VCCC was canceled, primarily due to low pre-registration. Examples of lessons learned and future possibilities for the VCCC and the patient-centered care conference format are discussed. This report is of particular importance given the many years the United States has been at war in the Middle East and the recent withdrawal of troops from Afghanistan.

Comparison of a Prototype for Indications-Based Prescribing With 2 Commercial Prescribing Systems.

Importance: The indication (reason for use) for a medication is rarely included on prescriptions despite repeated recommendations to do so. One barrier has been the way existing electronic prescribing systems have been designed. Objective: To evaluate, in comparison with the prescribing modules of 2 leading electronic health record prescribing systems, the efficiency, error rate, and satisfaction with a new computerized provider order entry prototype for the outpatient setting that allows clinicians to initiate prescribing using the indication. Design, Setting, and Participants: This quality improvement study used usability tests requiring internal medicine physicians, residents, and physician assistants to enter prescriptions electronically, including indication, for 8 clinical scenarios. The tool order assignments were randomized and prescribers were asked to use the prototype for 4 of the scenarios and their usual system for the other 4. Time on task, number of clicks, and order details were captured. User satisfaction was measured using posttask ratings and a validated system usability scale. The study participants practiced in 2 health systems' outpatient practices. Usability tests were conducted between April and October of 2017. Main Outcomes and Measures: Usability (efficiency, error rate, and satisfaction) of indications-based computerized provider order entry prototype vs the electronic prescribing interface of 2 electronic health record vendors. Results: Thirty-two participants (17 attending physicians, 13 residents, and 2 physician assistants) used the prototype to complete 256 usability test scenarios. The mean (SD) time on task was 1.78 (1.17) minutes. For the 20 participants who used vendor 1's system, it took a mean (SD) of 3.37 (1.90) minutes to complete a prescription, and for the 12 participants using vendor 2's system, it took a mean (SD) of 2.93 (1.52) minutes. Across all scenarios, when comparing number of clicks, for those participants using the prototype and vendor 1, there was a statistically significant difference from the mean (SD) number of clicks needed (18.39 [12.62] vs 46.50 [27.29]; difference, 28.11; 95% CI, 21.47-34.75; P < .001). For those using the prototype and vendor 2, there was also a statistically significant difference in number of clicks (20.10 [11.52] vs 38.25 [19.77]; difference, 18.14; 95% CI, 11.59-24.70; P < .001). A blinded review of the order details revealed medication errors (eg, drug-allergy interactions) in 38 of 128 prescribing sessions using a vendor system vs 7 of 128 with the prototype. Conclusions and Relevance: Reengineering prescribing to start with the drug indication allowed indications to be captured in an easy and useful way, which may be associated with saved time and effort, reduced medication errors, and increased clinician satisfaction.

Combined use of online tutorials and hands-on group exercises in bibliographic instruction for pharmacy students.

This study describes the new blended learning methodology implemented in a Drug Literature Evaluation course for pharmacy students that involves combined use of online tutorials and in-class group exercises. Assignment grades earned by 909 students enrolled in the course before and after the new methods were implemented (2008-2010) were studied to measure student performance. Course evaluations were analyzed in order to ascertain students' perceptions. The hybrid approach used to deliver the course content allowed students to perform at the same level as traditional didactic teaching. Students' evaluations reported a positive educational experience and favorable perceptions of the new course design.