Pharmacy Leaders' Reflections on Leadership and Legacy.

OBJECTIVE: To explore the experiences, contributions, and perceived legacy of individuals recognized as leaders in the pharmacy profession and compare these by gender and generational category. METHODS: A total of 54 leaders were interviewed about their journey to leadership and the legacy they leave to the profession. Interviews were transcribed, de-identified, and qualitatively analyzed using an inductive, modified constant comparison approach for open and axial coding. Qualitative responses were quantified to allow for the comparison of themes by gender and generational category. RESULTS: Common leadership themes included: humility, not expecting to be in a leadership role, taking initiative, being passionate about their work, having mentors to guide them, having a network of people around them, being a part of change, serving during a challenging time, seizing opportunities when they presented themselves, and being involved in professional organizations. The individual's clinical work (38.9%), helping to develop pharmacy as a clinical profession (33.3%), publications (29.6%), impact on students (29.6%), building programs (22.2%), involvement in organizations (20.4%), and impactful research (16.7%) were common themes noted in the legacy responses. CONCLUSION: Although there are many advancements still to be made, upcoming leaders would benefit from the journey and perceived legacy of these leaders as they carry the torch to advance the practice of pharmacy.

Perceptions and Practices for Evaluating Faculty Workload by Pharmacy Education Administration/Leadership.

OBJECTIVE: To assess how department chairs/administrators define, measure, and evaluate faculty workload to better understand practices within the Academy. METHODS: An 18-item survey was distributed to department chairs/administrators via American Association of Colleges of Pharmacy Connect. Participants identified if they are a primary decision maker for faculty workload, whether their program has a workload policy, how workload is calculated, and how faculty satisfaction with workload equity is measured. RESULTS: Of 71 participants initiating the survey, data from 64 participants from 52 colleges/schools were eligible for analysis. Leaders of practice departments reported that their faculty spend an average of 38% of their time on teaching (compared to 46% for non-practice departments), 13% on research (vs 37%), 12% on service (vs 16%), and 36% on clinical practice (vs 0%). Most survey participants (n = 57, 89%) are at schools/colleges with a tenure system, and about 24 participants reported that faculty workload metrics differ across departments/divisions. Teaching assignments and service are reportedly negotiable between faculty and supervisors, and workload expectations are widely variable. The majority indicated they do not analyze faculty satisfaction with workload fairness (n = 35) and faculty do not provide evaluative feedback on how supervisors assign faculty workload (n = 34). Of 6 priorities considered when determining workload, 'support college/school strategies and priorities' ranked highest (1.92) and 'trust between the chair and faculty' ranked lowest (4.87). CONCLUSION: Overall, only half of the participants reported having a clear, written process of quantifying faculty workload. The use of workload metrics may be needed for evidence-based decision-making for personnel management and resource allocation.

"Put me in Coach!" Engaging Faculty to Form a Winning Assessment Team.

This commentary uses the metaphor of an athletic team model to provide guidance when managing a successful assessment committee and assessment processes. To become a winning team, a joint effort must be exerted by players, coaches, and the athletic director. The topics of developing a team of productive members, creating, and implementing an assessment plan, forming a positive culture, and establishing leadership are discussed. Examples and advice are provided to assist with promoting an engaged faculty to form a well-rounded and productive assessment committee with clearly defined roles and responsibilities.

Lessons From Using Design Thinking to Develop the 2021 AACP Teachers' Seminar.

Objective. To describe and evaluate how a design thinking approach aided the creation of the 2021 American Association of Colleges of Pharmacy (AACP) Teachers' Seminar.Methods. The design thinking framework (ie, inspiration, ideation, and implementation) was used to structure the seminar development process from July 2020 to July 2021. Nine committee members engaged in a persona activity (ie, inspiration), a brainstorming activity (ie, ideation), and a prototyping activity (ie, implementation) to create a user-centered learning experience. Twenty-five small group facilitators were then recruited to create and deliver breakout session content. After the seminar, the team was invited to debrief their experience in a focus group and an electronic survey to evaluate the perceived impact of using design thinking in the planning process.Results. Twenty-one (62%) of the 34 committee members and small group facilitators attended the focus group, and 28 (82%) completed the electronic survey. Most agreed that design thinking was a useful approach to support the Teachers' Seminar, and they were generally positive about the experience. There was a significant increase in self-reported creative self-efficacy for coming up with novel ideas, ability to solve problems, and helping expand others' ideas. Team members identified positive attributes about the seminar and planning process as well as areas for improvement. Team members also acknowledged challenges and potential solutions for professional organizations and program developers to consider when creating user-centered experiences.Conclusion. Design thinking can be a useful framework for seminar planning and implementation to create engaging, meaningful, and valuable educator development experiences.

Pharmacy Leaders' Advice to Students Pursuing Leadership: A Qualitative Study.

INTRODUCTION: Leadership development is important both from a curricular standpoint and for continued advancement of the profession. Advice from current leaders in the profession may serve as a powerful motivator to students desiring to be leaders. The purpose of this qualitative study was to provide advice from experienced pharmacy leaders. METHODS: Fifty-four pharmacy leaders were identified based on pre-determined, specific criteria and by using a snowball sampling method. Interviews with leaders were conducted via Zoom to learn about their leadership journey, their legacy, and advice they would give students. The interviews were transcribed, de-identified and analyzed using the inductive, modified constant comparison approach for open and axial coding. Advice themes were compared by gender and generational category. RESULTS: The majority of the interviewees were male (69%), belonged to the Baby Boomer Generation (1946-1964, 59.3%), and held leadership positions in education (78%) and health systems (48%). Thirty-seven leadership advice themes were present. The topmost advice to students was to keep an open mind (35%) and to get involved in organizations (32%). Pieces of advice shared by both men and women leaders included: being open minded, getting involved in organizations, taking initiative, trying new or difficult things, and finding your passion. Keeping an open mind, and taking initiative were common across the three generations. CONCLUSION: Pharmacy leaders have insightful information for students aspiring to be future leaders. Leadership advice was similar by gender and generational category. Students would benefit in developing their leadership based on advice from the lived experience of pharmacy leaders. Future studies could examine students' perspectives on leadership advice.

A pilot study on the use of the nominal group technique to refine core pharmacy roles and to determine what competencies may be missing from pharmacy education.

INTRODUCTION: To describe the use of the nominal group technique (NGT) to refine pharmacy core roles and to compare these roles with current pharmacy outcomes and other literature to highlight potential deficiencies. METHODS: The NGT process was used for this proposal review. The process was conducted in four key stages: silent generation, round-robin, clarification, and voting. A convenience sampling of five pharmacy faculty and administrators that have researched the areas of practice-readiness and pharmacy competencies formed the panel of participants for the NGT process. RESULTS: Study findings offer seven core roles that define pharmacists' scope of practice: knowledge, patient care skills, professional, scholar, system-based practice/manager, collaborator, and advocate/health promoter. Development of these core roles revealed several missing pharmacy competencies or ones only covered in optional learning objectives: conflict management, professional advocacy, scholarship, empathy, personal health, transitions of care, health outcomes, quality improvement, and health insurance. CONCLUSIONS: The development of pharmacy roles is one way to ensure students are adequately prepared for pharmacy practice following graduation. Mapping of competencies to core professional roles would allow schools/colleges of pharmacy to have one cohesive document to guide pedagogical and assessment practice. More research and consensus building will be needed before these core roles could be disseminated more broadly.

Strategies for Measuring Advances in Pharmacy Student Learning.

Objective. To provide guidance to authors and reviewers on how to design and evaluate educational research studies to better capture evidence of pharmacy student learning.Findings. A wide variety of assessment tools are available to measure student learning associated with educational innovations. Each assessment tool is associated with different advantages and disadvantages that must be weighed to determine the appropriateness of the tool for each situation. Additionally, the educational research design must be aligned with the intent of the study to strengthen its impact.Summary. By selecting research methods aligned with Kirkpatrick's levels of training evaluation, researchers can create stronger evidence of student learning when evaluating the effectiveness of teaching innovations.

Evaluating Pharmacy Faculty's Awareness of Teaching and Learning Myths and Misconceptions.

Objective. To assess pharmacy faculty's knowledge of prominent and prevalent teaching and learning myths and misconceptions and evidence-based strategies prior to training.Methods. Participants completed a baseline assessment containing 16 true-false knowledge questions about teaching and learning misconceptions (10) and myths (six), one open-ended application question, and four participant demographic questions including years of experience in pharmacy academia, the focus of their institution (teaching or research), the number of education meetings attended, and whether they had formal training in education. After completing the baseline assessment of the top 16 misconceptions and myths, faculty were trained on the top 10 evidence-based teaching and learning strategies. At session completion, faculty were provided the assessment answers and scored their original responses.Results. Results from the survey revealed that most responders (56%) had been in academics between one and 10 years and attended two to 10 education meetings (62%). The majority of participants worked at teaching-intensive universities (56%), and most had no formal training in teaching (65%). The average score on the assessment was 43% for the myths section versus 70% for the misconceptions section. Faculty participants were overconfident in their predictions (predicted=74%, actual=60%). Faculty demographics did not influence the assessment scores.Conclusion. Pharmacy faculty may not know which teaching and learning strategies are evidence based and which are myths or misconceptions. In addition, they are likely to be overconfident in their knowledge of this evidence. This provides opportunity for faculty development in these areas.

Developing Critical Thinking Skills in Pharmacy Students.

Objective. To review the importance of and barriers to critical thinking and provide evidence-based recommendations to encourage development of these skills in pharmacy students. Findings. Critical thinking (CT) is one of the most desired skills of a pharmacy graduate but there are many challenges to students thinking critically including their own perceptions, poor metacognitive skills, a fixed mindset, a non-automated skillset, heuristics, biases and the fact that thinking is effortful. Though difficult, developing CT skills is not impossible. Research and practice suggest several factors that can improve one's thinking ability: a thoughtful learning environment, seeing or hearing what is done to executive cognitive operations that students can emulate, and guidance and support of their efforts until they can perform on their own. Summary. Teaching CT requires coordination at the curricular level and further to the more discrete level of a lesson and a course. Instructor training is imperative to this process since this intervention has been found to be the most effective in developing CT skills.

Pharmacists opinions of the value of specific applicant attributes in hiring decisions for entry-level pharmacists.

OBJECTIVE: The Hiring Intent Reasoning Examination (HIRE) was designed to (1) explore the relative value of applicant-specific attributes evaluated during the hiring of entry-level pharmacists; (2) examine how each of these attributes influences hiring decisions; and (3) identify which attributes practicing pharmacists perceive as most and least valuable. METHODS: An electronic questionnaire was developed and sent to 36,817 pharmacists; 3723 (11%) responded representing a broad cross-section of practice settings and job roles. Forty-eight attributes were analyzed, 24 character traits and 24 markers of academic success. Respondents identified: 1) the relative importance the possession of each attribute would play in the decision to hire an applicant; 2) the relative importance the lack of possession of the attribute would play on the decision to hire an applicant; 3) the 10 most important attributes used when considering an applicant, and; 4) the 10 least important attributes used when considering an applicant. After investigating the relative importance of the 48 traits, a factor analysis to further group the traits was undertaken. RESULTS: Character traits were consistently ranked higher than academic traits, both in importance and as more likely to effect the hiring decision. Additionally, "the top ten most important attributes" were dominated by character traits and "the top ten least important attributes" used in the hiring of an entry-level pharmacist were dominated by the academic traits. A factor analysis provided further evidence of the distinction of the character traits from the academic success markers. CONCLUSION: When selecting employees from a pool of qualified applicants, the most important attributes used in hiring decision relate to the character of the pharmacist. The results are similar across all practice settings and types of respondents completing the survey.

An evaluation of an interprofessional practice-based learning environment using student reflections.

The 12th Street Health and Wellness Center is an interprofessional, student-led, community-based clinic. Students from all University of Arkansas for Medical Sciences colleges work together to provide healthcare services for residents of an underserved community. Interprofessional student teams assess patients and present to an interprofessional preceptor team. At the conclusion of clinic, teams reflect on their experience. The objective of this study is to generate key themes from the end of clinic reflections to describe learning outcomes in an interprofessional practice environment. Student teams were asked to reflect on what they learned about patient care and interprofessional practice while volunteering at the clinic. Three hundred eighty reflection statements were assessed using the constant comparative approach with open coding by three researchers who identified and categorised themes by selecting key phrases from reflections. Eight themes emerged from this process which illuminated students' self-perceived development during practice-based learning and interprofessional collaboration. Key phrases were also coded to the four core Interprofessional Education Collaborative competency domains. These results suggest learners' perception that the Center is a practice-based environment that provides an opportunity to learn, integrate, and apply interprofessional curricular content.

Strategies for Improving Learner Metacognition in Health Professional Education.

Metacognition is an essential skill in critical thinking and self-regulated, lifelong learning. It is important for learners to have skills in metacognition because they are used to monitor and regulate reasoning, comprehension, and problem-solving, which are fundamental components/outcomes of pharmacy curricula. Instructors can help learners develop metacognitive skills within the classroom and experiential setting by carefully designing learning activities within courses and the curriculum. These skills are developed through intentional questioning, modeling techniques, and reflection. This article discusses key background literature on metacognition and identifies specific methods and strategies to develop learners' metacognitive skills in both the classroom and experiential settings.

Pharmacists' Opinions of the Value of CAPE Outcomes in Hiring Decisions.

Objective. The Hiring Intent Reasoning Examination (HIRE) was designed to explore the utility of the CAPE 2013 outcomes attributes from the perspective of practicing pharmacists, examine how each attribute influences hiring decisions, and identify which of the attributes are perceived as most and least valuable by practicing pharmacists. Methods. An electronic questionnaire was developed and distributed to licensed pharmacists in four states to collect their opinions about 15 CAPE subdomains plus five additional business related attributes. The attributes that respondents identified were: necessary to be a good pharmacist, would impact hiring decisions, most important to them, and in short supply in the applicant pool. Data were analyzed using statistical analysis software to determine the relative importance of each to practicing pharmacists and various subsets of pharmacists. Results. The CAPE subdomains were considered necessary for most jobs by 51% or more of the 3723 respondents (range, 51% to 99%). The necessity for business-related attributes ranged from 21% to 92%. The percentage who would not hire an applicant who did not possess the attribute ranged from 2% to 71.5%; the percentage who considered the attribute most valuable ranged from 0.3% to 35%; and the percentage who felt the attribute was in short supply ranged from 5% to 36%. Opinions varied depending upon gender, practice setting and whether the pharmacist was an employee or employer. Conclusion. The results of this study can be used by faculty and administrators to inform curricular design and emphasis on CAPE domains and business-related education in pharmacy programs.

Development of a Summative Examination with Subject Matter Expert Validation.

Objective. To describe the development, implementation and impact of a summative examination on student learning and programmatic curricular outcomes. Methods. The summative examination was developed using a systematic approach. Item reliability was evaluated using standard psychometric analyses. Content validity was assessed using necessity scoring as determined by subject matter experts. Results. Almost 700 items written by 37 faculty members were evaluated. Passing standards increased annually (45% in 2009 to 67% in 2014) as the result of targeting item difficulty and necessity scores. The percentage of items exhibiting discrimination above 0.1 increased to 100% over the four years. Necessity scores above 2.75 out of 4 increased from 65% to 100% of items over six years of examination administration. Conclusion. This examination successfully assessed student and curricular outcomes. Faculty member engagement observed in this process supports a culture of assessment. This type of examination could be beneficial to other programs.

Qualitative Analysis of Written Reflections during a Teaching Certificate Program.

OBJECTIVE: To evaluate the success of a teaching certificate program by qualitatively evaluating the content and extent of participants' reflections. METHODS: Two investigators independently identified themes within midpoint and final reflection essays across six program years. Each essay was evaluated to determine the extent of reflection in prompted teaching-related topic areas (strengths, weaknesses, assessment, feedback). RESULTS: Twenty-eight themes were identified within 132 essays. Common themes encompassed content delivery, student assessment, personal successes, and challenges encountered. Deep reflection was exhibited, with 48% of essays achieving the highest level of critical reflection. Extent of reflection trended higher from midpoint to final essays, with significant increases in the strengths and feedback areas. CONCLUSION: The teaching certificate program fostered critical reflection and self-reported positive behavior change in teaching, thus providing a high-quality professional development opportunity. Such programs should strongly consider emphasizing critical reflection through required reflective exercises at multiple points within program curricula.

Family Commitment and Work Characteristics among Pharmacists.

Factors associated with family commitment among pharmacists in the south central U.S. are explored. In 2010, a cross-sectional mailed self-administered 70 item survey of 363 active licensed pharmacists was conducted. This analysis includes only 269 (74%) participants who reported being married. Outcome measures were family commitment (need for family commitment, spouse's family commitment), work-related characteristics (work challenge, stress, workload, flexibility of work schedule), and job and career satisfaction. Married participants' mean age was 48 (SD = 18) years; the male to female ratio was 1:1; 73% worked in retail settings and 199 (74%) completed the family commitment questions. Females reported a higher need for family commitment than males (p = 0.02) but there was no significant difference in satisfaction with the commitment. Work challenge and work load were significantly associated with higher need for family commitment (p < 0.01), when controlled for age, gender, number of dependents, work status, and practice setting. Higher work challenge was associated with higher career satisfaction. Higher job related stress was associated with lower job satisfaction. High work challenge and work load may negatively impact family function since married pharmacists would need higher family commitment from their counterparts. The impact of work-family interactions on pharmacy career satisfaction should be further investigated.

Pharmacy students' ability to think about thinking.

OBJECTIVE: To investigate students' metacognitive skills to distinguish what they know from what they do not know, to assess students' prediction of performance on a summative examination, and to compare student-identified incorrect questions with actual examination performance in order to improve exam quality. METHODS: Students completed a test-taking questionnaire identifying items perceived to be incorrect and rating their test-taking ability. RESULTS: Higher performing students evidenced better metacognitive skills by more accurately identifying incorrect items on the exam. Most students (86%) underpredicted their performance on the summative examination (actual = 73.6 ± 7.1 versus predicted = 63.7 ± 10.5, p < 0.05). Student responses helped refine items and resulted in examination changes. CONCLUSION: Metacognition is important to the development of life-long learning in pharmacy students. Students able to monitor what they know and what they do not know can improve their performance.