Finalizing the Work Related to the Curriculum Outcomes and Example Objectives and Entrustable Professional Activities (COEPA) Document: The Report of the 2022-2023 Academic Affairs Standing Committee.

The 2022-2023 Academic Affairs Committee (AAC) was charged to (1) complete the Center for the Advancement of Pharmacy Education Outcomes and Entrustable Professional Activities (EPAs) revisions (now renamed as COEPA - Curriculum Outcomes and Entrustable Professional Activities) after receiving feedback at the 2022 American Association of Colleges of Pharmacy (AACP) Annual Meeting; (2) offer guidance on how the revised COEPA education outcomes and EPA statements should be used by member institutions, faculty, preceptor, and students; (3) guide input into the ongoing revision of the Accreditation Council for Pharmacy Education (ACPE) standards for the Doctor of Pharmacy program. The published report of the 2021-2022 AAC outlines the work of the Committee through the spring of 2022.1 This 2022-2023 AAC report focuses on the work related to finalizing the COEPA educational outcomes, EPAs, preamble, and glossary and formally receiving approval from the AACP Board of Directors.2 This report also describes the creation of a COEPA guidance document, including educational outcomes example learning objectives, and EPA example tasks for the Academy, however, the actual guidance document will be published separately. Finally, this current report outlines the feedback the AAC sought, received, synthesized, summarized, and prioritized from key interested and affected parties about the ACPE 2016 standards revisions for the ACPE 2025 draft standards.3 The Committee offers revisions for 1 AACP policy statement pertaining to diversity, equity, inclusion, accessibility, justice, and anti-racism. One new policy statement is also offered that urges ACPE to create accreditation standards for pharmacy education that support diversity, equity, inclusion, accessibility, justice, and anti-racism, despite presence of laws, executive orders, and policies that oppose these concepts.

The AACP Academic Affairs Committee's Final 2022 Curricular Outcomes and Entrustable Professional Activities (COEPA) for Pharmacy Graduates to Replace 2013 CAPE and 2016 EPAs.

The American Association of Colleges of Pharmacy (AACP) Academic Affairs Committee was charged with revising both the 2013 Center for the Advancement of Pharmacy Education (CAPE) Educational Outcomes (EOs) and the 2016 Entrustable Professional Activities (EPAs). The Committee changed the document name from the CAPE outcomes to COEPA, (Curricular Outcomes and Entrustable Professional Activities) since the EOs and EPAs would now be housed together. A draft of the COEPA EOs and EPAs was released at the AACP July 2022 Annual meeting. After receiving additional stakeholder feedback during and after the meeting, the Committee made additional revisions. The final COEPA document was submitted to and approved by the AACP Board of Directors in November 2022. This COEPA document contains the final version of the 2022 EOs and EPAs. The revised EOs have been reduced to 3 domains and 12 subdomains (from 4 domains and 15 subdomains previously in CAPE 2013) and the revised EPAs have been reduced from 15 to 13 activities.

The AACP Academic Affairs Committee's Guidance for Use of the Curricular Outcomes and Entrustable Professional Activities (COEPA) for Pharmacy Graduates.

The 2021-2023 American Association of Colleges of Pharmacy Academic Affairs Committee (AAC) was charged with and completed the revision of the 2013 Center for the Advancement of Pharmacy Education Outcomes and the 2016 Entrustable Professional Activity (EPA) statements for new pharmacy graduates. This work resulted in a new combined document, the Curricular Outcomes and Entrustable Professional Activities (COEPA) that was unanimously approved by the American Association of Colleges of Pharmacy Board of Directors and was published in the Journal. The AAC was also charged with providing stakeholders with guidance about how to use the new COEPA document. To achieve this charge, the AAC created example objectives for all 12 Educational Outcomes (EOs) and example tasks for all 13 EPAs. Although programs are asked to retain the EO domains, subdomains, one-word descriptors, and descriptions, unless they are adding more EOs or increasing the taxonomy level of a description, colleges and schools of pharmacy can expand or edit the example objectives and example tasks to meet local needs, as these are not designed to be prescriptive. This guidance document is published separately from the COEPA EOs and EPAs to reinforce the message that the example objectives and tasks are modifiable.

Revising the Center for the Advancement of Pharmacy Education (CAPE) Educational Outcomes and Entrustable Professional Activities (EPAs): The Report of the 2021-2022 Academic Affairs Standing Committee.

EXECUTIVE SUMMARY. The 2021-22 Academic Affairs Committee was charged to 1) Update the Center for the Advancement of Pharmacy Education (CAPE) Outcomes and Entrustable Professional Activity (EPA) statements for new pharmacy graduates; 2) Nominate at least one person for an elected AACP or Council Office; and 3) Consider ways that AACP can improve its financial health. This report primarily focuses on the process undertaken by the committee to revise the CAPE Educational Outcomes and EPAs. Proposed changes to the current outcomes are discussed and the reasoning behind these revisions are described. AACP members will have the opportunity to provide feedback prior to the final document being approved and published later this year.

Evaluation of anxiety in doctor of pharmacy students in their first through fourth professional years.

INTRODUCTION: Doctor of pharmacy (PharmD) student anxiety is not well accounted for in the literature. Anxiety carries the potential to cause impairment in functioning, worsen mental health outcomes, and adversely impact cognition, academic performance, and professionalism. The purpose of this study was to characterize anxiety among PharmD students in their first through fourth professional years. Secondary aims were to compare the prevalence of clinically significant anxiety and severity of anxiety among classes. METHODS: A cross-sectional, observational analysis was performed surveying 198 pharmacy students completing professional coursework. A survey shared via social media containing the Zung Self-Anxiety Scale and general demographic questions was distributed to pharmacy students to assess the prevalence and severity of anxiety in first through fourth professional year students. Clinically significant anxiety was defined as a raw score ≥ 36. A one-way analysis of variance was performed to compare the means of all classes and Tukey's honestly significant differences test was performed to evaluate for statistical differences between individual classes. RESULTS: Clinically significant anxiety was evident in 65% of respondents. The second professional year class reported the highest rate of anxiety with 84% meeting the threshold for clinically significant anxiety. The fourth professional year class reported the lowest rates with 51% reporting clinically significant anxiety. CONCLUSIONS: Anxiety is prevalent in pharmacy students with higher levels of anxiety observed in earlier years. This work highlights opportunities to expand student mental health resources. Further studies are warranted to identify factors contributing to pharmacy student anxiety.

Outcomes of a college-led community-based influenza vaccine program for underserved New York City communities.

BACKGROUND: Vaccine-preventable diseases are a major public health issue. Underserved communities are at heightened risk in New York City, where influenza morbidity and mortality remain elevated. Pharmacists and student pharmacists can play important roles in these communities through vaccine-based initiatives. OBJECTIVES: Enhance student experiences in encounters with underserved individuals; determine patient satisfaction with pharmacist-administered vaccines; assess for gaps in immunization care among the underserved. PRACTICE DESCRIPTION: St. John's University, College of Pharmacy and Health Sciences (CPHS) prioritizes public health outreach to underserved neighborhoods through various initiatives organized by its Urban Institute. The CPHS's annual Pam Shea-Byrnes community outreach immunization initiative was developed to increase access to influenza vaccinations for the indigent population through the establishment of new community partnerships. PRACTICE INNOVATION: The partnership between CPHS and community-based organizations resulted in influenza vaccines administered at no cost to beneficiaries, while offering students experiences in immunization initiatives and care for the underserved. EVALUATION METHODS: Participating students completed a pre- and postexperience survey. After vaccine administration, patients completed an immunization history survey from the Centers for Disease Control and Prevention (CDC), in addition to a satisfaction survey. RESULTS: A total of 105 patients received the influenza vaccine. Of these, 53 (50.5%) patients completed both the CDC assessment and satisfaction surveys. Of the survey respondents, 81% agreed that the pharmacists and student pharmacists were friendly and professional. Most of the patients (92.5%) were satisfied with the service. Fourteen student pharmacists participated in the initiative and completed both pre-and postsurveys. Student pharmacists indicated in postsurveys a stronger personal responsibility for caring for those in need. They also agreed that there is a clear responsibility for pharmacists to personally care for those in need. CONCLUSION: Student experiences during interactions with the underserved were enriched, and patients were satisfied with the pharmacist-run initiative. Further expansion of the initiative will be considered.

The role of academic pharmacy in tobacco cessation and control.

Despite decades of public health initiatives, tobacco use remains the leading known preventable cause of death in the United States. Clinicians have a proven, positive effect on patients' ability to quit, and pharmacists are strategically positioned to assist patients with quitting. The American Association of Colleges of Pharmacy recognizes health promotion and disease prevention as a key educational outcome; as such, tobacco cessation education should be a required component of pharmacy curricula to ensure that all pharmacy graduates possess the requisite evidence-based knowledge and skills to intervene with patients who use tobacco. Faculty members teaching tobacco cessation-related content must be knowledgeable and proficient in providing comprehensive cessation counseling, and all preceptors and practicing pharmacists providing direct patient care should screen for tobacco use and provide at least minimal counseling as a routine component of care. Pharmacy organizations should establish policies and resolutions addressing the profession's role in tobacco cessation and control, and the profession should work together to eliminate tobacco sales in all practice settings where pharmacy services are rendered.

Curriculum recommendations of the AACP-PSSC task force on caring for the underserved.

A task force was convened by the American Association of Colleges of Pharmacy (AACP) and the Pharmaceutical Services Support Center (PSSC) and charged with the development of a curriculum framework to guide pharmacy programs in educating students on caring for the underserved. Utilizing a literature-based model, the task force constructed a framework that delineated evidence-based practice, clinical prevention and health promotion, health systems and policy, and community aspects of practice. Specific learning outcomes tailored to underserved populations were crafted and linked to resources readily available to the academy. The AACP-PSSC curriculum framework was shared with the academy in 2007. Schools and Colleges are urged to share experiences with implementation so that the impact of the tool can be evaluated. The task force recommends that the AACP Institutional Research Advisory Committee be involved in gathering assessment data. Implementation of the curriculum framework can help the academy fulfill the professional mandate to proactively provide the highest quality care to all, including underserved populations.

Linezolid for the treatment of Nocardia spp. infections.

OBJECTIVE: To review the available evidence regarding the use of linezolid for the treatment of Nocardia spp. infections. DATA SOURCES: Data were identified through a search of MEDLINE (1966-May 2007), American Search Premier (1975-May 2007), International Pharmaceutical Abstracts (1960-2007), Science Citation Index Expanded (1996-2007), and Cochrane Databases (publications archived until May 2007) using the terms linezolid and Nocardia. STUDY SELECTION AND DATA EXTRACTION: Prospective and retrospective studies, case reports, case series, and in vitro studies were eligible for inclusion if they used linezolid for nocardiosis regardless of site of infection and outcome. DATA SYNTHESIS: We identified 11 published cases of linezolid use for Nocardia spp. infections. The predominant species isolated were N. asteroides (n = 4; 36%) and N. farcinica (n = 3; 27%). Nocardiosis with central nervous system involvement (n = 7; 64%) or disseminated disease (n = 4; 36%) were most common. The main reason for discontinuation of previous antimicrobials was most often related to adverse effects (n = 5; 45%), followed by clinical failure (n = 3; 27%). Linezolid was associated with cure or improvement in all cases (n = 11; 100%). However, the majority of patients developed serious complications that may have led to premature discontinuation of therapy with linezolid, including myelosuppression (n = 5; 45%) or possible/confirmed peripheral neuropathy (n = 2; 18%). CONCLUSIONS: The limited published data suggest that linezolid appears to be an effective alternative to trimethoprim/sulfamethoxazole for the treatment of nocardiosis. Unfortunately, the high cost and potentially serious long-term toxicities of linezolid appear to limit its use and relegate it to salvage therapy alone or in combination with other antimicrobials.

Role of buprenorphine in the management of heroin addiction.

OBJECTIVE: To review buprenorphine and explore its role in the treatment of heroin dependence. DATA SOURCES: Articles were identified through a search of MEDLINE (1966-February 2005) using the key terms buprenorphine, heroin, opioid, addiction, and methadone. DATA SYNTHESIS: Buprenorphine appears to provide potential advantages over methadone. Two Cochrane meta-analyses were evaluated on the use of buprenorphine in opioid dependence-one in the management of opioid dependence and the other in the management of opioid withdrawal. CONCLUSIONS: Buprenorphine offers several advantages for the treatment of heroin addiction. As maintenance treatment, buprenorphine is effective, but not more effective than methadone. In the management of opioid withdrawal, buprenorphine may be better tolerated than clonidine or methadone.

Comparison of three topical fluorides using computer imaging.

The purpose of this in vitro study was to evaluate the short and long-term effectiveness of fluoride varnish and compare it with the two most commonly used topical fluorides, i.e., fluoride gel and foam. A second purpose of the study was to compare the effectiveness of these preparations on primary and permanent teeth. Enamel slabs with a thickness of 500 microns were obtained from caries free primary molars and premolars. They were divided into four groups: control, foam (F), gel (G) and varnish (V). Fluorides were applied to the enamel slabs according to the manufacturer's instructions and were placed in a 5.1 pH acidic gel for one week. The amount of demineralization from the enamel was measured by calculating the amount of light reflected from these surfaces. This was done by using a Charged Couple Device attached to a high resolution microscope with image processing software, Optima 5.22. The enamel slabs were placed in a freshly prepared acidic gel for a second week without application of fluorides. This was done to mimic a situation where fluoride is eventually brushed away from teeth. Reflective images were recorded under the previously described conditions. A two-way analysis of covariance was used to compare the treatments. The results showed no statistically significant difference (with Bonferroni correction) in the effectiveness of different fluoride preparations over the short-term (Week I comparison; p-values: F vs. G 0.079, F vs. V 0.030, G vs. V 0.44). However, the long-term protection provided by fluoride varnish was far more than fluoride gel and foam (Week II comparison; p-values: F vs. G 9X10-5, F vs. V 7X10-8, G vs. V 1X10-4). Fluorides were equally effective for both primary and permanent enamels (p-value 0.24). The results of this study suggest that fluoride varnish is beneficial for use with white spot lesions, newly erupted permanent teeth and early decalcification in primary dentition.

La restauración de resina preventiva. Revisión de la literatura y técnica / The preventive resin restoration. Review of the literature and technique

El propósito de este artículo es actualizar al clínico con esta alternativa de tratamiento para lesiones mínimas de caries en fosas y fisuras. En contraste con las restauraciones de amalgama de clase I, existe una preservación máxima de estructura dental. Esta técnica es de valor particular en odontopediatría donde el clínico encuentra pequeñas lesiones cariosas en fosas y fisuras de los dientes permanentes recién erupcionados. Las restauraciones preventivas con resinas ofrecen una solución que es terapéutica y minimiza la invasión al diente