Falling NAPLEX pass rates are cause for concern.

INTRODUCTION: First-time pass rates of the North American Pharmacist Licensure Examination (NAPLEX) have declined 7% from 2019 to 2022 with more than a third of schools experiencing a decline of ≥10%. COMMENTARY: The cause of the decline is likely multifactorial and extends beyond the impact of the COVID-19 pandemic. Changes to the NAPLEX blueprint in 2021, curricular revisions in response to the implementation of Accreditation Council for Pharmacy Education Standards 2016, and changes to prerequisite course requirements in response to declining enrollment must also be evaluated as potential causes. IMPLICATIONS: The academy must respond to this decline by scrutinizing admissions, curriculum, and assessment processes. We urge the National Association of Boards of Pharmacy to provide access to student-level data on NAPLEX performance and increase transparency in passing standard practices to inform this process.

Interprofessional Active Learning for Chronic Pain: Transforming Student Learning From Recall to Application.

Chronic pain (CP) affects over 50 million Americans daily and represents a unique challenge for healthcare professionals due to its complexity. Across all health professions, only a small percentage of the curriculum is devoted to treating patients with CP. Unfortunately, much of the content is delivered passively via lecture without giving students an opportunity to practice the communication skills to effectively treat patients in the clinic. An interprofessional team of health educators identified 5 essential messages that students frequently struggle to convey to patients with CP. Those messages were based on interprofessional and profession-specific competencies to treat patients with CP from the International Association for the Study of Pain. The 5 messages highlighted the importance of (1) therapeutic alliance, (2) consistent interdisciplinary language, (3) patient prognosis, (4) evidence for pain medicine, surgery, and imaging, and (5) early referral to the interprofessional team. For each message, the team summarized relevant research supporting the importance of each individual message that could serve as a foundation for didactic content. The team then developed active learning educational activities that educators could use to have students practice the skills tied to each message. Each learning activity was designed to be delivered in an interprofessional manner.

A Four-day Pharmacy Course Schedule.

OBJECTIVE: To discuss the results of implementing a 4-day student didactic course schedule. METHODS: The change from a 5-day to a 4-day course schedule was implemented in spring 2021. Students in the classes of 2023 and 2024 and faculty course coordinators were surveyed in fall 2021 regarding their experience with the new schedule format. Baseline data from fall 2020 were also collected for comparison. Quantitative data was described using frequencies, percentages, odds ratios, and 95% confidence intervals. Open-ended questions were evaluated using qualitative thematic analysis. RESULTS: Almost all students (n = 193, 97%) who responded to the course planning survey in fall 2021 wanted to continue the 4-day course schedule. Students perceived the benefits of the 4-day schedule, to include more time for studying/preparing for classes (69%), and for self-care and wellness activities (20%). Student survey responses showed increased odds of engagement outside of the class. Qualitative analysis found that students reported increased engagement and liked the improved course structure. Students disliked the longer time spent in class. Academic performance was reported as somewhat or significantly improved by 85% of respondents. Faculty (n = 31; response rate 80%) reported that the 4-day course schedule positively impacted (48%) or had no impact (42%) on their job responsibilities. Work-life balance (87%) was noted as the most positive effect from faculty respondents. CONCLUSION: A 4-day course schedule was well received by both students and faculty. Institutions may consider a similar approach to allow students the flexibility of this novel schedule so as to have more time to prepare for class and wellness activities.

A Scoping Review of the Hidden Curriculum in Pharmacy Education.

Objective. The hidden curriculum has been defined as teaching and learning that occur outside the formal curriculum and includes the knowledge, skills, attitudes, behaviors, values, and beliefs that students consciously or subconsciously acquire and accept. It has been identified as an inherent part of learning in health professions education and may affect students' formation of professional identity. This scoping review investigated the definition and evidence of the hidden curriculum for pharmacy education.Findings. A comprehensive literature search was conducted for primary articles investigating the hidden curriculum in pharmacy education through August 2021. A total of five papers were included in the review: four papers from the United Kingdom and one from Sweden. The focus of each paper and the elements of the hidden curriculum, along with the study quality as assessed by the quality assessment tool, varied. Three papers focused on professionalism or professional socialization, and the other two focused on patient safety. All five studies used qualitative methods including focus groups and semistructured interviews of the students and faculty. Studies also identified approaches to addressing the hidden curriculum, such as integrating formal and informal learning activities, integrating work experiences, providing sustained exposure to pharmacy practice, and development of professionalism.Summary. The definition of the hidden curriculum varied across the five studies of varying quality. The evidence of the hidden curriculum was measured qualitatively in experiential and academic settings. Recognition of the impact of the hidden curriculum and strategies for addressing its negative effects are critical to the success of not only the students but also the pharmacy profession at large.

A multicenter study of gender bias in student evaluations of teaching in pharmacy programs.

INTRODUCTION: Student evaluations of teaching (SET) are widely used to assess effectiveness of teaching. Studies conducted to assess the presence of gender bias in SET have produced mixed results. The purpose of this study was to evaluate the presence and degree of gender bias in SET of didactic courses in United States pharmacy programs. METHODS: A three-year, retrospective, multi-institutional analysis of anonymous SET data were analyzed from required didactic courses. Analysis included gender, SET questions, mean scale score, and number of students responding to each question. A hierarchical linear model was used to compare the gender difference with the normalized SET scores as the outcome. RESULTS: A total of 2114 SET scores were included from seven pharmacy schools across eight campuses. Analysis of the results revealed that the combined data were skewed secondary to one institution whose results fell significantly outside the mean. When this school was excluded, the difference between SET scores did not differ by gender, b = 0.021, t(1,702) = 0.69, P = .49, with similar SET scores for female faculty (mean = 4.41, SD = 0.35, range = 2.54-5) and male faculty (mean = 4.44, SD = 0.32, range = 2.67-5). CONCLUSIONS: After secondary analysis, the aggregated data showed no significant difference between ratings of male and female instructors. However, there were differences within individual programs. This illustrates the importance of applying assessment principles to SET to determine the presence of bias so that continuous quality improvement strategies may be applied.

Retention of students' knowledge of immunizations following a one-day or a five-week course.

INTRODUCTION: The American Pharmacists Association (APhA) Pharmacy-Based Immunization Delivery Certificate Program is commonly used by schools of pharmacy to train student pharmacists in immunizations. This study compared student pharmacists' knowledge retention of immunization content when the live seminar of the APhA Program was delivered as a one-day co-curricular activity or as a five-week required course. The impact of immunization experience on students' knowledge retention was a secondary objective. METHODS: A 45-question knowledge assessment about immunizations was administered to second and third-year student pharmacists eight months after completing either a five-week course (second-year students) or a one-day seminar (third-year students). Students were also asked about their experience providing patient education, screening, and administering immunizations. RESULTS: Knowledge assessment scores declined by an average of 26.3% from the initial to the eight-month assessment, and declines were similar for second and third-year students. However, students who reported immunizing over 50 patients had significantly higher knowledge retention than those who reported never immunizing. CONCLUSIONS: A live immunization training given over one day or five weeks did not impact the retention of immunization knowledge eight months later. However, students who immunized >50 patients had greater knowledge retention. These findings indicate the importance of including the application of immunization knowledge in pharmacy curricula to enhance long-term knowledge retention.

Patterns of school and college of pharmacy engagement in addressing the opioid crisis.

INTRODUCTION: The American Association of Colleges of Pharmacy (AACP) has emphasized the need to prepare pharmacy students for practicing amidst the opioid crisis. This research aimed to identify patterns and predictors of pharmacy program participation in skills-based education, research, and service activities designed to address this crisis. METHODS: Opioid-related activities were identified from the AACP opioid-related activities database and classified by two independent reviewers. The final activities included: (1) direct participation in drug disposal and/or naloxone outreach, (2) opioid-focused research, and (3) skills-based training in the doctor of pharmacy curriculum. Latent class analysis was used to identify classes of program involvement in these activities. Differences in class membership based on program and geographic characteristics were examined using multivariable logistic regression. RESULTS: Of the 106 schools included, a minority reported opioid-focused research (38.7%), drug disposal or naloxone outreach (30.2%), or hands-on learning (22.6%). A "highly engaged" class (34.9%) and a "limited engagement" class (65.1%) were identified. "Highly engaged" programs were more likely to report opioid-related research (65.9% vs. 24.6%, P < .001), drug disposal or naloxone outreach events (86.5% vs. 0%, P < .001), and skills-based education (40.5% vs. 13%, P = .001) than "limited engagement" programs. No school or geographic factors were significantly associated with class membership. CONCLUSIONS: Nearly two-thirds of schools and colleges of pharmacy reported limited involvement in skills-based education, research, and outreach efforts. Future research should explore other predictors of school-level opioid-related activities, including faculty expertise and institutional priorities.

Applying Entrustable professional activities to prescription verification activities in two skills-based laboratory courses.

BACKGROUND AND PURPOSE: Prescription verification is a practice-ready expectation for pharmacy graduates. Entrustable professional activities (EPAs) should be applied to practice-ready skills-based assessments. This manuscript describes the technique of two different institutions in assessing prescription verification aligned to the Practice Manager domain of the Core EPAs as defined by the Academic Affairs Standing Committee 2015-2016 report. EDUCATIONAL ACTIVITY AND SETTING: Virginia Commonwealth University School of Pharmacy (VCU) and University of Maryland Eastern Shore (UMES) School of Pharmacy and Health Professions describe their two methods of evaluating prescription verification with the EPA Practice Manager domain. Each program performed the activities in first-year skills-based laboratory courses. FINDINGS: Fulfillment of a medication order was framed into law, medication label, and dispensing accuracy. Both institutions' assessments were high-stakes assessments that included errors. Overall, the majority of both programs' students passed with the institution-specified level of entrustment on their first attempt, with 75.9% to 77.5% of VCU students per each assessment and 74.5% for UMES. The lowest performance, Level 1, assessment scores for the first attempt were 10% for VCU and 2% for UMES, requiring repetition of the assessment for those students. All students achieved a minimum of Level 3 during the reassessments. SUMMARY: Different assessment techniques may arise from program design and institutional resources. However, it is important to ensure EPAs are met for all students in prescription verification. Faculty should consider their own verification activities and level of trust expected for students to meet prior to pharmacy practice experiences.

A classroom-based patient case activity as a potential formative indicator of pre-advanced pharmacy practice experience readiness.

BACKGROUND AND PURPOSE: Pharmacy programs must assess student readiness for advanced pharmacy practice experiences (APPEs). This study evaluated: (1) if a relationship exists between student performance on a classroom-based patient case activity (Rx Review) and (2) performance on direct patient care and perceptions of the transferability of Rx Reviews to the APPE setting. EDUCATIONAL ACTIVITY AND SETTING: Rx Reviews are timed, independent, prospective reviews of a patient's medical record intended to simulate pre-rounding activities common in acute and ambulatory care settings. Students complete 12 Rx Reviews across a skills laboratory course sequence. Rx Review scores were compared to performance on acute care and ambulatory care APPEs for students in the Class of 2019 using descriptive statistics for student scores and bivariate logistic regression for the association between Rx Review scores and performance outcomes on patient care APPEs. Student perceptions of the Rx Reviews were assessed through a survey. Descriptive statistics and qualitative responses were used to analyze responses to the multiple-choice survey questions and open-ended question, respectively. FINDINGS: One hundred twenty-two students participated in the study. A relationship was found between students' Rx Review scores and performance in certain direct patient care APPEs, with students performing in the bottom 50% on Rx Reviews being more likely to perform poorly on those APPEs. Over 93% of students identified Rx Reviews as at least somewhat helpful in preparing them for APPEs. SUMMARY: This study indicated that a classroom-based patient case activity could be used as a formative measure of APPE readiness.

Lessons learned: Assessing team creation by personality inventories in pharmacy students.

BACKGROUND: Proper team formation is critical for team performance and dynamics in the setting of team-based learning (TBL). Faculty should stratify students to ensure an even allocation of learner resources; however, the ideal method of team creation for TBL in pharmacy education has yet to be determined. A study aimed to assess team formation stratified by personality strengths on student performance for graded team activities, peer evaluations, and student perceptions of team dynamics compared to randomization of teams the previous semester with the same cohort. This Live and Learn piece will describe lessons learned throughout this project and research considerations for future studies on TBL team creation. IMPACT: The study design compared team stratification by strengths vs. randomization, which resulted in similar distribution of CliftonStrengths domains with a variation of two teams between the semesters. Due to homogeneity in student strengths and negligible difference in purposeful team creation by strengths vs. randomization, the study was limited in its methodology and findings. RECOMMENDATIONS: Through the description of this experience, the authors have outlined suggestions for designing studies to explore team creation methods, specifically capturing preliminary data, including a control group, and recognizing the influence of randomization. DISCUSSION: Future studies to identify the optimal method for team formation may include alternate stratification approaches and should be performed over multiple cohorts from varying institutions. It is equally plausible that randomization consistently generates teams with equitable resource distribution and team formation has no overall impact on TBL effectiveness.

A key performance indicators redefinition initiative at a school of pharmacy using a modified Delphi consensus technique.

OBJECTIVE: The Outcomes and Assessment Committee at the Virginia Commonwealth University School of Pharmacy was tasked with refining the school's key performance indicators (KPIs) to improve programmatic assessment by focusing on the most important measures. METHODS: Initially, 56 KPIs were tracked, nine of which were university mandated, divided into 10 modules: admissions, community outreach, continuing education, diversity, faculty experience and success, fundraising, graduate program, research and scholarship, staff experience and success, and student experience and success. Using a three-round Delphi consensus technique, KPIs were reviewed by faculty and staff. Each participant responded whether they considered each KPI to be essential or not essential for school quality assessment and improvement. Consensus for the first, second, and third rounds was defined as ≥90%, ≥80%, and ≥75% agreement, respectively. RESULTS: Of 109 faculty and staff invited, 49 participated in the first round, 51 in the second, and 42 in the third. At the end of the third round, accumulated consensus was achieved for 35 out of 88 (39.8%) KPIs that were considered essential and 3 out of 88 (3.4%) that were considered non-essential. Consensus percentage per module was: 15.4% (2/13) admissions, 28.6% (2/7) community outreach, 33.3% (3/9) continuing education, 27.3% (3/11) diversity, 62.5% (5/8) faculty experience and success, 55.6% (5/9) fundraising, 40% (4/10) graduate program, 33.3% (3/9) research and scholarship, 57.1% (4/7) staff experience and success, and 66.7% (4/6) student experience and success. CONCLUSIONS: Ultimately, 35 KPIs achieved consensus as essential to measure achievement of benchmarks for the school, which totals 44 KPIs, including nine university mandated KPIs. The process facilitated faculty and staff involvement in KPI selection and achieved improved focus for programmatic assessment.

A key performance indicators redefinition initiative at a school of pharmacy using a modified Delphi consensus technique

OBJECTIVE: The Outcomes and Assessment Committee at the Virginia Commonwealth University School of Pharmacy was tasked with refining the school's key performance indicators (KPIs) to improve programmatic assessment by focusing on the most important measures. METHODS: Initially, 56 KPIs were tracked, nine of which were university mandated, divided into 10 modules: admissions, community outreach, continuing education, diversity, faculty experience and success, fundraising, graduate program, research and scholarship, staff experience and success, and student experience and success. Using a three-round Delphi consensus technique, KPIs were reviewed by faculty and staff. Each participant responded whether they considered each KPI to be essential or not essential for school quality assessment and improvement. Consensus for the first, second, and third rounds was defined as ≥90%, ≥80%, and ≥75% agreement, respectively. RESULTS: Of 109 faculty and staff invited, 49 participated in the first round, 51 in the second, and 42 in the third. At the end of the third round, accumulated consensus was achieved for 35 out of 88 (39.8%) KPIs that were considered essential and 3 out of 88 (3.4%) that were considered non-essential. Consensus percentage per module was: 15.4% (2/13) admissions, 28.6% (2/7) community outreach, 33.3% (3/9) continuing education, 27.3% (3/11) diversity, 62.5% (5/8) faculty experience and success, 55.6% (5/9) fundraising, 40% (4/10) graduate program, 33.3% (3/9) research and scholarship, 57.1% (4/7) staff experience and success, and 66.7% (4/6) student experience and success. CONCLUSIONS: Ultimately, 35 KPIs achieved consensus as essential to measure achievement of benchmarks for the school, which totals 44 KPIs, including nine university mandated KPIs. The process facilitated faculty and staff involvement in KPI selection and achieved improved focus for programmatic assessment

No disponible

Utilizing widely available podcasts to create a reflection activity for pharmacy students.

BACKGROUND AND PURPOSE: Creative strategies can be employed to encourage development of affective domain skills. The purpose of this article is to describe and assess the creation of a written self-reflection assignment utilizing podcasts. Educational activity and setting: Second year pharmacy students (N = 122) in a skills laboratory course completed two written reflections that asked them to: (1) examine and reflect on personal beliefs, biases, motivations and emotions that were challenged while listening to a podcast; and (2) identify knowledge, skills, and abilities of a pharmacist that may impact the situation presented in the podcast. Students chose from a list of podcasts curated by faculty and completed two 450 to 600-word reflections. Students completed a pre-post modified Questionnaire for Reflective Thinking (mQRT). A one-tailed, paired t-test was used to assess the mQRT. The post-questionnaire survey also included questions related to student perceptions of the reflections. Descriptive statistics were used to summarize student perceptions. FINDINGS: Out of 122 students, 116 (95.1%) completed both the pre- and post-mQRT and survey. The majority of students responded affirmatively that the reflections made them think about healthcare in a different way (91.4%) and challenged their beliefs/biases (81.9%). Students reported applying information from previous course material to the podcast concepts (75%) and vice versa (77.6%). SUMMARY: Assignments using podcasts are a unique way of engaging student learners. These assignments may help to assess affective educational outcomes and be a way to increase self-reflection, self-awareness, and metacognition in pharmacy students.

Using a Mixed Methods Approach to Explore Perceptions of Early Learners in Classroom-Based Interprofessional Education Experiences.

Objective. To explore attitudes and learning outcomes among early-level health professions students who completed foundational interprofessional education (IPE) courses. Methods. This study used a mixed methods approach to examine assessment and evaluation data from two student cohorts enrolled in two one-credit, semester-long interprofessional courses taught in fall and spring 2017. Attitudinal changes following the fall course were measured and compared in a retrospective pretest-posttest manner across student disciplines using the Student Perceptions of Interprofessional Clinical Education-Revised Instrument, version 2 (SPICE-R2). Course evaluation comments and narrative reflection assignments for both courses were analyzed qualitatively via data reduction and compilation to identify evidence of learning. Results. Significant increases in positive student perceptions regarding IPE were found, with variation in the increase seen between professions following the first course. Core themes identified in the narrative reflections demonstrated student learning in interprofessional attitudes, communication, professional identity, collaborative behaviors, and systems of care. Conclusion. Student attitudes toward interprofessional learning were more positive following completion of a foundational IPE course. In addition, learning in the course shaped students' professional identities, collaborative behaviors, and understanding of systems of care. These findings suggest value in early IPE and directions for better structuring curriculum and timing of IPE.

A Laboratory Session to Prepare Pharmacy Students to Manage the Opioid Crisis Situation.

Objective. To educate third-year pharmacy students about the role of pharmacists in the opioid crisis and measure their knowledge, confidence, and attitudes towards opioids and opioid overdose. Methods. All third-year students (n=130) enrolled in a Doctor of Pharmacy (PharmD) degree program participated in opioid overdose and naloxone education and training followed by a three-part laboratory session that included mock naloxone counseling, case-based discussion of the Prescription Drug Monitoring Program (PDMP), and equianalgesic opioid dose conversion scenarios. A pre- and post-assessment focused on the individual's clinical knowledge, confidence, and attitudes about opioid overdose management and naloxone use was administered before and after the laboratory session to evaluate the student's baseline understanding and experience compared to learning gains from the session. An evaluation of the laboratory session was also conducted. Results. Upon completion, 99% percent of students rated the opioid laboratory as excellent (59%) or good (40%). Students believed the laboratory was stimulating (93%), relevant to pharmacy practice (96%), and contributed to their professional development (97%), and that the information provided was at an appropriate level (98%). Knowledge-based assessments improved in the areas of PDMP timely reporting, differentiating between naloxone devices, and naloxone administration technique. Student attitudes toward managing opioid overdoses improved on a majority of items. The majority of students agreed they had enough information to help them manage an opioid overdose (88.5%) and denied the need for additional training (61.5%). Conclusion. An active-learning laboratory helped to improve pharmacy students' knowledge, confidence, and attitudes with regard to opioids and the use of naloxone to treat a patient who has overdosed.