Preceptors' perceptions of an entrustable professional activities-based community introductory pharmacy practice experience curriculum.

INTRODUCTION: In 2021, the Southeastern Pharmacy Experiential Education Consortium implemented Entrustable Professional Activities (EPAs) into the community introductory pharmacy practice experience (IPPE) curriculum at five colleges/schools of pharmacy. The objective of this study was to evaluate community IPPE preceptors' perceptions regarding the newly implemented EPA-based community IPPE curriculum and corresponding preceptor training. METHODS: Community IPPE preceptors who precepted first-year student pharmacists in the EPA-based curriculum during the 2021 and 2022 community IPPE cycles were invited to complete a voluntary electronic survey. The survey collected preceptor feedback regarding the required EPA tasks, assessment tool, and preceptor development module. RESULTS: Eighty-eight preceptors began the survey, and approximately half completed the entire survey. Greater than 92% of preceptors surveyed agreed or strongly agreed EPA domain tasks were developed at an appropriate level for a student to complete by the end of the community IPPE, and ≥ 94% agreed or strongly agreed tasks prepared a community IPPE student for the community advanced pharmacy practice experience (APPE). Overall, most preceptors agreed or strongly agreed that the assessment tool was easy to navigate and effective at evaluating students' performance. All preceptors who viewed the recorded preceptor development module found it helpful to their understanding of the new assessment tool. CONCLUSIONS: Preceptors' feedback supports the use of an EPA-based community IPPE curriculum to assess student performance and prepare students for community APPEs. Preceptor involvement is valuable in the evaluation of a revised experiential curricula to assure IPPE expectations are appropriate and align with contemporary pharmacy practice.

Engaging early experiential learners to improve quality at a VA medical center - a cross-sectional analysis.

PURPOSE: An innovative population health-based introductory pharmacy practice experience (IPPE) leveraging a Veterans Affairs (VA) and college of pharmacy collaboration was implemented in fall 2019. All second-year pharmacy students from the college actively engage in the evaluation of the medical records of veterans identified using population health management tools as needing additional care or experiencing a gap in care. This study examines the clinical impact of the experience on the care of patients at the partnering VA medical center. METHODS: Course and patient records were reviewed to enumerate the number and types of interventions performed as part of the IPPE from fall 2019 to spring 2021. Descriptive statistics were used to report clinical impact. Where relevant, t test analysis was used to compare pre- and postintervention clinical values. RESULTS: A total of 1,794 medical records were reviewed. An average of 2.67 interventions were completed for each of the 615 veterans receiving an intervention. A total of 155 patients were identified as needing routine laboratory tests (eg, glycated hemoglobin), with 48.4% of patients receiving recommended laboratory tests within 3 months. Thirty-three veterans were eligible for prescription renewals, resulting in 43 medication orders. Thirty-six veterans were recommended to take a statin medication, and statin therapy was initiated in 11, resulting in a significant decrease in the mean (SD) low-density lipoprotein cholesterol concentration (-42.4 [30.3] mg/dL, P < 0.05). Eight hundred immunizations were recommended for 632 veterans, and 286 recommendations were verbally accepted. CONCLUSION: This study demonstrates that a population health-based IPPE can provide significant clinical support to the care of patients within the VA health system.

Pharmacists' perceptions regarding feasibility, acceptability, and usefulness of student-delivered naloxone education services in community pharmacy: A mixed methods study in Alabama.

BACKGROUND: Given that Alabama has the highest opioid prescribing rate in the nation, efforts to promote safe opioid use and reduce overdose mortality are critical. To address this, the Auburn University Harrison College of Pharmacy developed and piloted a didactic-experiential naloxone learning model in the first-year PharmD curriculum in 2020-2021 consisting of lectures, skills laboratory, and 120-hour community pharmacy introductory pharmacy practice experience (IPPE). Student-delivered naloxone education services (SDNES), including naloxone counseling and dispensing, were incorporated into the IPPE. OBJECTIVES: The objective of this study was to evaluate the feasibility, acceptability, and usefulness of SDNES frovm the perspective of community pharmacy IPPE preceptors. METHODS: This study used a mixed methods design including cross-sectional online surveys and follow-up semistructured telephone interviews. Survey measures were informed by validated scales and included feasibility (11 items), acceptability (13 items), and usefulness (6 items) of SDNES. Survey outcomes were assessed via 5-point Likert-type scales (1 = strongly disagree, 5 = strongly agree) and analyzed using descriptive statistics. Follow-up semistructured telephone interview questions were guided by the Consolidated Framework for Implementation Research domains of inner and outer setting and focused on SDNES barriers and facilitators, recommended strategies for service enhancement, and resource needs. Interview transcripts were analyzed using deductive and inductive rapid content analysis to determine themes and subthemes. RESULTS: Twenty-five preceptor surveys were completed (22.52% response rate). Overall, SDNES was rated as feasible (mean [SD] scale score 4.04 [0.77]), acceptable (3.95 [0.83]), and useful (3.87 [0.98]). Interviewees (N = 8) discussed 13 barrier subthemes, 12 facilitator subthemes, 7 recommended strategies, and 8 resource needs across 3 overarching themes, most of which were related to the inner setting. CONCLUSION: Community pharmacy IPPE preceptors found SDNES feasible, acceptable, and useful in their practices. The SDNES model may be used to build capacity for naloxone services delivery in community pharmacies, potentially increasing patient access to naloxone education and distribution.

Impact of a health and wellness IPPE focused on immunizations and health assessments.

BACKGROUND AND PURPOSE: Health and wellness principles are included in pharmacy education outcomes and standards, supporting the importance of integrating these concepts within pharmacy curricula. The objective of this study was to describe the development, implementation, and assessment of an intensive community pharmacy-based health and wellness introductory pharmacy practice experience (IPPE) focused on immunizations and health assessments. EDUCATIONAL ACTIVITY AND SETTING: The health and wellness IPPE was a required, one-week rotation developed to provide second-year student pharmacists with direct patient care opportunities to reinforce knowledge, skills, and abilities related to health and wellness principles. Students administered immunizations, performed hypertension and diabetes assessments, and provided education to patients at community pharmacy training sites. Students completed pre- and post-rotation self-assessments. Preceptors completed individual summative student performance evaluations and were surveyed to obtain IPPE feedback. FINDINGS: One hundred forty-seven students completed the IPPE across 89 sites. The pre-post analysis of student self-assessment results found statistically significant improvement in student confidence across all survey items. The largest improvements were found within the immunization items, specifically for preparing and administering immunizations. Ninety-nine percent of students agreed or strongly agreed participation in IPPE activities improved their ability to contribute to patient care. Qualitative analysis revealed students gained confidence and skills after practicing in a real-world setting. SUMMARY: The integration of the health and wellness IPPE within the curriculum resulted in increased student confidence in providing preventative care services. This study provides a solution to integrating health and wellness principles into pharmacy curricula to meet accreditation standards.

Impact of a Didactic-Experiential Naloxone Learning Model to Improve Student Pharmacist Skills and Patient Care.

OBJECTIVE: To assess the impact of an integrated didactic-experiential learning model on student pharmacists' knowledge, confidence, comfort, and intention regarding provision of naloxone for patients receiving opioid therapy. METHODS: An integrated didactic-experiential learning model was developed to bridge learning in the classroom and laboratory with application in the experiential setting. Student knowledge, confidence, comfort, and intentions regarding provision of naloxone services were measured via online survey at predidactic, postdidactic, and postexperiential time points, and analyzed using Friedman's analysis of variance. RESULTS: A total of 280 first-year student pharmacists completed the baseline survey. The learning model increased student knowledge, confidence, comfort, and intention regarding naloxone services implementation. Specifically, students reported an increase in mean (SD) knowledge score from 60.85% (17.40%) in the predidactic to 81.47% (13.57%) in the postdidactic period. Similarly, mean (SD) confidence (2.49 [0.75] to 3.56 [0.45]), comfort (2.06 [0.74] to 3.57 [0.45]), and intention (3.46 [0.70] to 3.66 [0.44]) increased from pre- to postdidactic period, and these changes were maintained from postdidactic to postexperiential period. CONCLUSION: The didactic-experiential learning model increased student knowledge, confidence, comfort, and intentions regarding naloxone services implementation. We believe that the model fills gaps in student pharmacist education and is the first step in enhancing and sustaining community pharmacy-based naloxone services. Although this study was limited to a single college, it shows the effectiveness of linking didactic and experiential training in improving students' knowledge and skills.

A consortium's approach to developing an EPA-based community IPPE curriculum.

INTRODUCTION: Currently, there are limited data on the use of entrustable professional activities (EPAs) within introductory pharmacy practice experiences (IPPEs). The objective of this study was to identify supporting EPA tasks community IPPE students should perform at the "Competent with Support" level to prepare them for advanced pharmacy practice experiences (APPEs). METHODS: The Southeastern Pharmacy Experiential Education Consortium utilized a modified Delphi process to incorporate EPAs into community IPPE curricula to mirror the consortium's community APPE curricula. Community IPPE and APPE preceptors (N = 140) were invited to participate in focus groups and two surveys to identify and build consensus on EPA-based activities community IPPE students should perform to prepare them for APPEs. The primary outcome was development of an EPA-based community IPPE curriculum. RESULTS: Nine preceptors (6.43%) participated in a focus group, 34 preceptors completed survey one (24.29%), and 20 preceptors completed survey two (14.29%). The initial list of 62 tasks for 14 EPAs was tailored to reflect an IPPE student skill set. Survey consensus led to a community IPPE curricula with 12 required EPAs and 54 tasks (40 required and 14 suggested). CONCLUSIONS: The modified Delphi process provided a mechanism for preceptor collaboration with experiential programs to build consensus on community IPPE curricula redesigned around EPAs and supporting tasks. A unified IPPE curriculum adds value to colleges and schools of pharmacy with shared preceptors by improving continuity of experience, expectations, and evaluation of student learners and allows for targeted regional preceptor development.

Assessing student pharmacists' ability to recognize and categorize interventions during an introductory pharmacy practice experience.

INTRODUCTION: Introductory pharmacy practice experiences (IPPEs) prepare students for advanced pharmacy practice experiences (APPEs) by reinforcing patient care skills learned in the didactic curriculum. Current literature does not assess pharmacy students' abilities to accurately recognize and categorize interventions in IPPEs or APPEs. This study evaluated the impact of incorporating paper-based simulated encounters and video answer keys to train students to accurately recognize and categorize interventions during an IPPE. METHODS: During longitudinal IPPEs, first-, second-, and third-year students reviewed four patient case scenarios that mimicked authentic patient encounters. Students were tasked with recognizing and categorizing interventions and were provided answer key videos after each assignment. Total scores for the proportion of correct and incorrect intervention options selected were calculated and compared over time. Students and faculty mentors completed post-study questionnaires designed to assess perceived improvement in students' capability to recognize and categorize interventions. RESULTS: A series of repeated measures analyses of variance were statistically significant (P < .05) for total scores and proportion of correctly selected and incorrectly selected intervention options. Students' accuracy to correctly recognize and categorize interventions improved by 8% over four case scenarios. The proportion of correctly selected interventions increased by 65%, and the proportion of incorrectly selected intervention options decreased by 49% based on mean percent scores. CONCLUSIONS: Patient case scenario assignments and video recorded answer keys were useful tools to teach students how to document interventions. Exposure to documenting interventions during IPPEs helps prepare students for documenting interventions during APPEs.

Clinical impact of a community pharmacy-based health and wellness introductory pharmacy practice experience.

OBJECTIVE: To assess the clinical impact of an intensive community pharmacy-based Health and Wellness Introductory Pharmacy Practice Experience (IPPE) completed by second-year (P2) student pharmacists. DESIGN: The Health and Wellness IPPE was a 1-week rotation developed to provide P2 student pharmacists with opportunities to provide clinical services to patients within the community pharmacy setting. Student pharmacists administered immunizations, performed blood pressure screenings and blood glucose measurements, and provided education to patients under the guidance of licensed pharmacist preceptors. SETTING AND PARTICIPANTS: Second-year student pharmacists completing a required Health and Wellness IPPE rotation in the community pharmacy setting. OUTCOMES MEASURED: Student pharmacist interventions were assessed to determine the course's clinical impact, and preceptors were surveyed regarding the feasibility of student pharmacists performing clinical services at their training sites. RESULTS: A total of 147 student pharmacists completed the IPPE at 89 community pharmacy training sites and administered 9392 injections, 90% of which were influenza vaccinations. Student pharmacists performed 3458 patient health assessments, including measuring patients' blood pressure and blood glucose and reviewing patient education materials. Most preceptors indicated that core activities were feasible during the experience. CONCLUSION: This study found that implementing a concentrated IPPE focused on immunizations and health screenings allowed student pharmacists to enhance their clinical skills and fulfill a large public health need, improving patient outcomes. Future studies should explore utilizing student pharmacists in community pharmacy settings to expand clinical services offered beyond these 2 services, such as diabetes risk tests, influenza point-of-care testing, and smoking cessation counseling.

Crisaborole: A Novel Nonsteroidal Topical Treatment for Atopic Dermatitis.

Objective: To review the efficacy and safety of crisaborole and its place in therapy for the management of mild to moderate atopic dermatitis (AD). Data Sources: A literature search of PubMed (data inception to February 2019) was performed using the search terms crisaborole and atopic dermatitis. Supplementary sources included the Journal of the American Academy of Dermatology Guidelines of Care for the Management of Atopic Dermatitis, clinicaltrials.gov data, manufacturer prescribing information, and article bibliographies. Study Selection and Data Extraction: Relevant English-language studies and those conducted in humans were considered and reviewed. Abstracts from clinical trials and drug reviews were reviewed. Phases I, II, III, and long-term safety studies were included. Data Synthesis: Data from multiple clinical trials have demonstrated the effectiveness and safety of crisaborole topical ointment. Patients treated with crisaborole experienced improvement in AD symptoms based on improvement in the Investigator's Static Global Assessment and the AD Severity Index scores. Crisaborole has a limited adverse event profile and low systemic absorption. Relevance to Patient Care and Clinical Practice: Crisaborole is the first topical phosphodiesterase 4 inhibitor indicated for the treatment of mild to moderate AD. Its place in therapy is along with topical calcineurin inhibitors as a second-line option for patients who are recalcitrant to or unable to use topical corticosteroids. Conclusions: Crisaborole is a safe and efficacious second-line option for the treatment of mild to moderate AD in patients 2 years of age and older.