Teamwork baseline assessment tool: Sparking teamwork dialogues in health professions training.

WHAT WAS THE EDUCATIONAL CHALLENGE?: A major challenge in health professions education is to equip graduates with essential teamwork skills, addressing cognitive, motivational, and emotional barriers that hinder effective collaboration among students from diverse backgrounds. WHAT WAS THE SOLUTION AND HOW WAS THIS IMPLEMENTED?: The Teamwork Baseline Assessment Tool (TBAT) was developed as an innovative solution to teach collaboration and teamwork, focusing on growth mindsets, reactions to challenging scenarios, and ideal team player attributes. Implemented during the orientation for new first-year students, TBAT facilitated early engagement in teamwork discussions, with students receiving personalised reports to aid in self-reflection and development. WHAT LESSONS WERE LEARNED?: Key lessons included the importance of initiating teamwork conversations early, the value of personalised feedback in promoting self-awareness and peer understanding, and the effectiveness of TBAT in providing instructors with insights into students' teamwork aptitudes. WHAT ARE THE NEXT STEPS?: Expanding TBAT across various student populations and integrating it into the curriculum aims to provide continuous opportunities for applying and reinforcing teamwork and collaboration skills. This strategy will support the development of targeted instructional approaches, fostering a collaborative learning environment and preparing students for the teamwork challenges in healthcare settings.

Designing an Interprofessional Online Course to Foster Learning Health Systems.

The Learning Health Systems (LHS) framework demonstrates the potential for iterative interrogation of health data in real time and implementation of insights into practice. Yet, the lack of appropriately skilled workforce results in an inability to leverage existing data to design innovative solutions. We developed a tailored professional development program to foster a skilled workforce. The short course is wholly online, for interdisciplinary professionals working in the digital health arena. To transform healthcare systems, the workforce needs an understanding of LHS principles, data driven approaches, and the need for diversly skilled learning communities that can tackle these complex problems together.

Effect of a curriculum transformation on pharmacy student self-efficacy, self-reported activities, and satisfaction in degree and career choice.

BACKGROUND: Curriculum revision in healthcare programs occurs frequently, but to undergo a whole degree transformation is less common. Also, the outcomes of curriculum redesign interventions on the selfreported clinical decision making, experiences, and perceptions of graduates of health education programs is unclear. This study evaluated these factors as an outcome of a pharmacy degree whole-curriculum transformation. METHODS: A 25-item cross-sectional end-of-course survey was developed to evaluate pharmacy student decisions, experiences, and perceptions upon completion of degree, pre- and post- curriculum transformation. A two-way analysis of variance (ANOVA) was used to determine whether the responses to the items classed within the main factors differed across the two cohorts. Independent t-tests were used to examine the student responses to the individual questions between the two cohorts. RESULTS: Graduates from the transformed degree had greater self-efficacy in clinical activities, were more satisfied with their education, found course activities more useful, and were more confident in their career choice. Transformed pharmacy degree students also reported spending more time on weekdays and weekends on activities such as attending lectures and working. Student satisfaction with their choice to attend pharmacy school was also significantly higher in transformed degree students. CONCLUSIONS: Responses to the end of degree survey indicate that students who completed the transformed pharmacy curriculum have had positive experiences throughout their degree and felt more prepared for practice as pharmacists in comparison to students who completed the established degree. These results add value to those collected from other sources (e.g., student evaluations, assessment scores, preceptors focus groups, and other stakeholder inputs) consistent with a comprehensive quality improvement model.

A scoping review of therapeutic reasoning process research.

Therapeutic reasoning is when the purpose, task, or goal for engaging in reasoning is to determine the patient's management plan. As the field's understanding of the process of therapeutic reasoning is less well understood, we focused on studies that collected data on the process of therapeutic reasoning. To synthesize previous studies of therapeutic reasoning characteristics, methodological approaches, theoretical underpinnings, and results. We conducted a scoping review with systematic searching for English language articles with no date limits. Databases included MEDLINE, CINAHL Plus, Scopus, Embase, Proquest Dissertations and Theses Global, and ERIC. Search terms captured therapeutic reasoning in health professions education research. Initial search yielded 5450 articles. The title and abstract screening yielded 180 articles. After full-text review, 87 studies were included in this review. Articles were excluded if they were outside health professions education, did not collect data on the process of therapeutic reasoning, were not empirical studies, or not focused on therapeutic reasoning. We analyzed the included articles according to scoping questions using qualitative content analysis. 87 articles dated from 1987 to 2019 were included. Several study designs were employed including think-aloud protocol, interview and written documentation. More than half of the articles analyzed the data using qualitative coding. Authors often utilized several middle-range theories to explain therapeutic reasoning processes. The hypothetico-deductive model was most frequently mentioned. The included articles rarely built off the results from previous studies. Six key result categories were found: identifying themes, characterizing and testing previous local theory, exploring factors, developing new local theory, testing tools, and testing hypothesis. Despite the cast body of therapeutic reasoning research, individual study results remain isolated from previous studies. Our future recommendations include synthesizing pre-existing models, developing novel methodologies, and investigating other aspects of therapeutic reasoning.

Preceptor Perceptions of Pharmacy Student Performance Before and After a Curriculum Transformation.

Objective. To explore preceptors' perceptions about the performance of undergraduate pharmacy students during experiential placements in Australia, before and after curricular transformation.Methods. Using a semi-structured approach, we interviewed 26 preceptors who had recently supervised students who took part in the transformed curriculum and students from the previous curriculum. A directed content analysis approach was used to analyze the transcripts.Results. Preceptors described students from the transformed curriculum as having improved professional skills, behaviors, and attitudes and as having an increased ability to perform clinical activities compared to students of the previous curriculum. Preceptors also perceived that students in the transformed curriculum had improved clinical knowledge and knowledge application. They less frequently expressed that students in the transformed curriculum had lower-than-expected knowledge levels.Conclusion. The results of this study suggest that curricular transformation with a focus on skill-based and active learning can improve the performance of pharmacy students in terms of their professional behaviors and attitudes, skills, knowledge, and clinical abilities, as perceived by preceptors.

Cognitive and Metacognitive Processes Demonstrated by Pharmacy Students When Making Therapeutic Decisions.

Objective. To characterize the types of cognitive and metacognitive processes demonstrated by third-year pharmacy students during a therapeutic reasoning activity.Methods. A qualitative, descriptive study following a think-aloud protocol was used to analyze the cognitive (analytical) and metacognitive processes observed by third-year pharmacy students as they completed a 25-minute therapeutic reasoning activity. Using a deductive codebook developed from literature about reasoning, two independent coders characterized processes from students' audio-recorded, transcribed think-aloud episodes while making therapeutic decisions about simulated clinical cases.Results. A total of 40 think-aloud episodes were transcribed among the cohort. Categorization of the think-aloud transcriptions revealed a series of cognitive analytical and metacognitive processes demonstrated by students during the therapeutic decision-making activity. A total of 1792 codes were categorized as analytical processes, falling into six major themes: 69% gathering information (1232/1792), 13% processing information (227/1792), 7% making assessments (133/1792), 1% synthesizing information (19/1792), 7% articulating evidence (117/1792), and 4% making a recommendation (64/1792). In comparison to gathering information, a much lower frequency of processing and assessment was observed for students, particularly for those that were unable to resolve the case. Students' movement between major analytical processes co-occurred commonly with metacognitive processes. Of the 918 codes categorized as metacognitive processes, two major themes arose: 28% monitoring for knowledge or emotions (257/918) and 72% controlling the planning of next steps or verification of correct information (661/918). Sequencing the codes and co-occurrences of processes allowed us to propose an integrated cognitive/metacognitive model of therapeutic reasoning for students.Conclusion. This study categorizes the cognitive (analytical) and metacognitive processes engaged during pharmacy students' therapeutic reasoning process. The findings can inform current instructional practices and further research into educational activities that can strengthen pharmacy students' therapeutic reasoning skills.

Fostering the use of Learning Health Systems through a fellowship program for interprofessional clinicians.

Introduction: To address Australian workforce needs, we developed a Learning Healthcare System (LHS) Academy fellowship program for clinicians. In the Academy, fellows complete foundational coursework, an LHS project, and other professional development deliverables to foster their future as digital health champions within their organizations. In this paper, we describe the 11-month-long program, as well as our evaluation results from the first 2 months of the program. Methods: In the first week of the program, we sent all fellows an open-ended survey asking fellows to describe their digital health professional identities and what they expected to achieve from the fellowship program. At 2 months, we sent a follow-up open-ended survey that captured identical measures, their perceived barriers to participation in the program, perceived use of topics in the workplace and to their projects, and recommendations for program improvement. We analyzed the open text responses using qualitative content analysis, to identify categories of responses. Results: Overall, 2 months into the program, it was evident that participants were finding the teaching model engaging, useful, valuable, and applicable to their work and projects. Fellows perceived barriers to engagement in the program as balancing other commitments, lacking technical expertise, and having difficulty seeing themselves as leaders. Fellows expected that the program will allow them to implement new models of care, provide them with enough expertise to become leaders and champions in digital health, and become mentors for future generations. As far as changes in their professional identity, there was a notable increase in the number of fellows perceiving themselves as leaders. Conclusion: Fellowship programs are one promising means of developing the healthcare workforce in LHS capabilities. Future studies should describe and evaluate LHS programs, to provide insights and recommendations for other educators interested in implementing similar programs of work within their own institutions.

An introduction to text analytics for educators.

OUR SITUATION: Educators often find themselves in possession of large amounts of text-based materials, such as student reflections, narrative feedback, and assignments. While these materials can provide critical insight into topics of interest, they also require a substantial amount of time to read, interpret, and use. The purpose of this article is to describe and provide recommendations for text analytics. METHODOLOGICAL LITERATURE REVIEW: An overview of text analytics is provided, including a brief history, common types of contemporary techniques, and the basic phases of text analytics. Several examples of common text analytics techniques are used to illustrate this approach. OUR RECOMMENDATIONS AND THEIR APPLICATIONS: Practical recommendations are provided to support the use of text analytics in pharmacy education. These recommendations include: (1) clarify the purpose of the text analytics; (2) ensure the research questions are relevant and grounded in the literature; (3) develop a processing strategy and create a dictionary; (4) explore various tools for analysis and visualization; (5) establish tolerance for error; (6) train, calibrate, and validate the analytic strategy; and (7) collaborate and equip yourself. POTENTIAL IMPACT: Text analytics provide a systematic approach to generating information from text-based materials. Several benefits to this approach are apparent, such as improving the efficiency of analyzing text and elucidating new knowledge. Despite recent developments in text analytics techniques, limitations to this approach remain. Efforts to improve usability and accessibility of text analytics remain ongoing, and pharmacy educators should position their work within the context of these limitations.

Understanding Health Care Graduates' Conceptualizations of Transitions: A Longitudinal Qualitative Research Study.

PURPOSE: Although transitions have been defined in various ways in the higher education literature (e.g., inculcation, development, becoming), little research exists exploring health care learners' conceptualizations of transitions across their transition from final year to new graduate. How they understand transitions is important because such conceptualizations will shape how they navigate their transitions and vice versa. METHOD: The authors conducted a 3-month longitudinal qualitative research study with 35 health care learners from 4 disciplines (medicine, dietetics, nursing, and pharmacy) across their final year to new graduate transition to explore how they conceptualized transitions. Data collection occurred between July 2019 and April 2020 at Monash University in Victoria, Australia. The authors employed framework analysis to interrogate the interview and longitudinal audio diary data cross-sectionally and longitudinally. RESULTS: The authors found 10 different conceptualizations of transitions broadly categorized as time bound and linear (one-off events, systems, linear, adaptation, linked to identities), ongoing and complex (ongoing processes, multifaceted, complex), or related to transition shock (labor, linked to emotions). The adaptation conceptualization increased in dominance over time, the linear conceptualization was more apparent in the interviews (time points 1 and 3), and the multifaceted and emotion-linked conceptualizations were more dominant in the longitudinal audio diaries (time point 2). CONCLUSIONS: This novel study illustrates conceptualizations of transitions as broadly consistent with existing higher education literature but extends this research considerably by identifying differences in conceptualizations across time. The authors encourage health care learners, educators, and policy makers to develop expanded and more sophisticated understandings of transitions to ensure that health care learners can better navigate often challenging graduate transitions. Further research should explore stakeholders' transition conceptualizations over lengthier durations beyond the new graduate transition.

Pharmacy Student Challenges and Strategies towards Initial COVID-19 Curriculum Changes.

Due to COVID-19, tertiary institutions were forced to deliver knowledge virtually, which proposed challenges for both institutions and students. In this study, we aimed to characterize pharmacy students' challenges and strategies during COVID-19 curriculum changes, therefore developing a comprehensive understanding of students' learning, wellbeing, and resilience in the ever-changing situation. Data were collected from student written reflections across four year levels at one school of pharmacy from March-May 2020. In addition, data were collected from written responses of second-year pharmacy students responding to prompted questions. The data were qualitatively analyzed inductively by five coders using NVivo 12. For each piece of data, two coders independently coded the data, calculated the inter-rater agreement, and resolved discrepancies. The most coded challenges were 'negative emotional response' and 'communication barrier during virtual learning'. The most coded strategies were 'using new technology' and 'time management'. This study allows researchers and education institutions to gain an overview of pharmacy students' experiences during COVID-19, therefore helping universities to provide students with necessary support and techniques on how to self-cope with COVID-19 as well as stressful events in the future.

Exploring health care graduates' conceptualisations of preparedness for practice: A longitudinal qualitative research study.

INTRODUCTION: Although preparedness for practice (P4P) has been variously described, little shared understanding exists about what P4P is across the health professions. How P4P is conceptualised matters, because this shapes how stakeholders think, talk about and act towards it. Further, multiple understandings can result in diverse expectations for graduate performance. This study therefore explores health care learners' solicited and unsolicited conceptualisations of P4P over their early graduate transition. METHODS: We conducted longitudinal qualitative research including individual and group entrance interviews (phase 1: n = 35), longitudinal audio-diaries (phase 2: n = 30), and individual and group exit interviews (phase 3: n = 22) with learners from four disciplines (dietetics, medicine, nursing and pharmacy). We employed framework analysis to interrogate data cross-sectionally and longitudinally. RESULTS: We found 13 conceptualisations of P4P (eg knowledge, confidence), broadly similar across the disciplines. We found some conceptualisations dominant in both solicited and unsolicited talk (eg skills), some dominant only in solicited talk (eg competence) and others dominant only in unsolicited talk (eg experience). Although most conceptualisations appeared relatively stable across time, some appeared to dominate at certain time points only (eg employability and skills in phases 1 and 2, and competence in phase 3). DISCUSSION: This novel study extends previous uniprofessional work by illustrating a broader array of conceptualisations, differences between professions, solicited versus unsolicited talk and longitudinal cohort patterns. We encourage health care educators to discuss these different P4P understandings in graduate transition interventions. Further research is needed to explore other stakeholders' conceptualisations, and over a duration beyond the early graduate transition.

The clinical educator's guide to fostering learner motivation: AMEE Guide No. 137.

Motivation theory and research remain underused by health professions educators. Some educators say it can seem too abstract. To address this, we applied health care language to learner motivation theories. Using a familiar metaphor, we examined the indications, mechanism of action, administration, and monitoring of learner motivation interventions. Similar to the treatment monographs in medicine compendia, we summarized each motivation intervention in the form of a monograph. The purpose of this guide is for health professions educators to develop an understanding of when (i.e. indication) and how (i.e. mechanism of action) learner motivation interventions work. With this information, they can then access ready-to-implement strategies (i.e. administration) to increase their learner interest and assess the effects of these interventions (i.e. monitoring).

Sustainable Pharmacy Education in the Time of COVID-19.

Pharmacy schools and colleges worldwide are facing unprecedented challenges to ensuring sustainable education during the novel coronavirus (COVID-19) pandemic. The experiences of pharmacy educators in the Asia-Pacific region in delivering emergency remote teaching, ensuring purposeful experiential placements, supporting displaced or isolated students, and communicating with faculty members, staff members, and students are discussed. The role of this pandemic in accelerating opportunities for new models of pharmacy education across the world is also discussed.

Predictors of Pharmacy Student Performance on Written and Clinical Examinations in a Flipped Classroom Curriculum.

Objective. To examine the effects of student demographics, prior academic performance, course engagement, and time management on pharmacy students' performance on course examinations and objective structured clinical examinations (OSCEs).Methods. Study participants were one cohort of pharmacy students enrolled in a five-year combined Bachelor and Master of Pharmacy degree program at one institution. Variables included student demographics, baseline factors (language assessment and situational judgement test scores), prior academic performance (high school admission rank), course engagement, and student time management of pre-class online activities. Data were collected from course, learning management system, and institutional databases. Data were analyzed for univariate, bivariate, and multivariate associations (four linear regression models) between explanatory factors and outcome variables.Results. Three years of data on 159 pharmacy students were obtained and entered in the dataset. Significant positive predictors of OSCE communication performance included domestic (ie, Australian) student designation, higher baseline written English proficiency, and pre-class online activity completion. Positive predictors of OSCE problem-solving included workshop attendance and low empathy as measured by a baseline situational judgment test (SJT). Positive predictors of performance on year 2 end-of-course examinations included the Australian Tertiary Academic Rank, completing pre-class online activities prior to lectures, and high integrity as measured by an SJT.Conclusion. Several explanatory factors predicted pharmacy students' examination and OSCE performance in the regression models. Future research should continue to study additional contexts, explanatory factors, and outcome variables.

How Pharmacist Preceptors Foster Students' Therapeutic Reasoning Using the One-Minute Preceptor Method.

Objective. To compare whether preceptors trained in the One-Minute Preceptor (OMP) method versus preceptors not trained in the OMP method use OMP methods, and whether their students demonstrate more frequent expression of therapeutic reasoning processes during case presentations. Methods. A pilot quasi-experimental study was conducted. In 2015, four preceptors attended an OMP training session. The OMP preceptors and three preceptors not trained in OMP were asked to collect audio recordings of their students presenting patient cases. The audio recordings were coded for preceptors' use of OMP methods and students' expression of therapeutic reasoning processes. Results. In total, we collected 42 audio recordings from 27 students presenting a patient case to one of seven preceptors. Preceptors trained in OMP more frequently asked students to commit to a therapeutic assessment and plan, probed for their supporting reasoning, and reinforced what was done well. However, non-OMP preceptors' students more frequently articulated assessments and treatment plans in their case presentations. The non-OMP students also more frequently initiated discussion about the reasoning behind their assessments and plans without prompting from their preceptor. Conclusion. Implementing OMP workshops for preceptors to elicit students' therapeutic reasoning processes requires further consideration. Future research is needed on pragmatic and effective precepting methods.

Design-based research: Connecting theory and practice in pharmacy educational intervention research.

OUR SITUATION: Interventional research in pharmacy education includes the study of complex challenges that can be difficult to navigate. Design-based research (DBR), is a systematic and iterative approach to interventional research that is attentive to the practical and theoretical contributions to education. Practical contributions include the creation of novel solutions to complex problems that improve learning while theoretical contributions include refining our understanding of context-specific learning. In this paper, we describe how we addressed challenges associated with student collaboration in pharmacy education by applying DBR to bridge theory and practice. METHODOLOGICAL LITERATURE REVIEW: DBR is characterized as authentic, contextually aware, collaborative, theoretically focused, methodologically diverse, practical, iterative, and operation-oriented. DBR includes three iterative phases: (1) analysis and exploration, (2) design and construction, and (3) evaluation and reflection. OUR RECOMMENDATIONS AND THEIR APPLICATIONS: To integrate DBR into interventional research, scholars should work collaboratively with diverse teams of experts. DBR also requires extensive planning, a toolkit of expansive research methodologies, and attention to practical and theoretical considerations. Finally, scholars should share their work as often as possible and engage in creative exercises to promote innovative solutions to challenges in education. POTENTIAL IMPACT: DBR offers an approach to generate practical, theoretical, and scholarly contributions to pharmacy education research. In summary, DBR can aid pharmacy educational scholars by using a flexible, iterative, and systematic process to generate novel and creative solutions to complex problems.

Student and School-level Predictors of Pharmacy Residency Attainment.

Objective. To identify student and school level predictors of pharmacy residency attainment. Methods. Data were collected from the American Association of Colleges of Pharmacy (AACP) and the Carnegie Classification of Institutions of Higher Education. Logistic multilevel modeling was used to examine the effects of select student and school level characteristics on pharmacy residency attainment, as indicated by students on the AACP Graduating Student Survey (GSS) from 2013 to 2015. Results. The dataset included 24,351 graduating pharmacy students from 101 schools and colleges of pharmacy. Predictors of residency attainment included working in an institutional pharmacy, female gender, student age, school age, and Research I classification. Nonsignificant variables included curriculum type, class size, and institutional control. Conclusion. Student and pharmacy school characteristics impact the likelihood of pharmacy residency attainment. Further research is needed to understand the mechanisms associated with these effects.

The University of North Carolina Medical Center pharmacy resident leadership certificate program.

PURPOSE: The development and implementation of a certificate program for pharmacy residents are described. SUMMARY: University of North Carolina (UNC) Medical Center met the call for increased efforts in the area of pharmacy residency leadership training through the design, implementation, and evaluation of a leadership certificate program. The purpose of the UNC certificate program is to develop leaders who will serve others, improve their communities, and advance the profession. The program is designed to (1) foster self-awareness, social awareness, and altruism, (2) provide transferable and individualized leadership experiences, (3) enrich other residency components through integration of leadership development opportunities, and (4) create role models for departmental leadership. A team of preceptors and residents implemented the certificate program by integrating program components into the existing pharmacy residency infrastructure. The certificate program includes required and flexible components to allow residents to set and achieve their determined leadership development goals. Overall, residents are satisfied with the program and perceive it as worthwhile. During the first 3 years since implementation of the certification initiative, program facilitators improved the feasibility of, participant engagement in, and sustainability of the program. Future directions include an effectiveness evaluation and a "scale-up" to other institutions. CONCLUSION: The need for a pharmacy residency leadership certificate was met by designing, implementing, and evaluating such a program at UNC. Through its first 3 years, the program was feasible, sustainable, and valued by program participants.