A transitions of care (TOC) PharmD elective and its impact on students' perceptions on their TOC knowledge, skills, and attitudes.

INTRODUCTION: Transitions of care (TOC) continue to evolve as a problem within our health care system and is a direct driver to worsened patient outcomes. Currently information of in-depth instruction and application of TOC content within health care education, especially pharmacy, is limited. In 2012, a small team of faculty members created a specialized TOC pharmacy elective for third year doctor of pharmacy students. The purpose of this paper is to describe the impact of this TOC course on students' perceptions on their TOC knowledge, skills, and attitudes over the four years course span. METHODS: A pre-/post-paper anonymous survey was distributed to the students. Descriptive statistics captured the analyzed survey questions into four main themes. Within each respective theme, quantitative data were provided for pre- and post-survey responses to illustrate the difference in the scores with corresponding P values to showcase if significance was present. RESULTS: The response rate of the survey was 100%. Within all of the respective themes, all of the survey questions, pre- to post-responses, had a significant shift toward a higher degree of agreement. CONCLUSIONS: This study illustrates the impact a course dedicated to TOC has on student's learning.

Case report: Medical cannabis-warfarin drug-drug interaction.

AIM: A case of an 85-year-old patient with concurrent use of warfarin and medical cannabis containing delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) is described. Warfarin continues to be a cornerstone of anticoagulation treatment despite the recent addition of FDA-approved anticoagulant agents. It is well known that warfarin has numerous drug interactions; however, much remains unknown about its interaction with THC and CBD. A literature review was conducted to identify documented cases of possible interactions between cannabis and warfarin. The case reports we identified noted that cannabis may potentially increase warfarin's effect. Therefore, we aimed to determine why an effect was not seen on our patient's warfarin dose despite daily use of medical cannabis. CASE: This case report describes an 85-year-old patient who despite starting an oromucosal medical cannabis regimen of THC and CBD (which provided 0.3 mg of THC and 5.3 mg CBD once daily and an additional 0.625 mg of THC and 0.625 mg CBD once daily as needed) had minimal INR fluctuations from October 2018 to September 2019. CONCLUSION: Despite the introduction and use of medical cannabis therapy, with both THC and CBD components, an elderly patient with concurrent warfarin use did not see major INR fluctuations, in contrast to published literature. The potential for warfarin and THC/CBD interactions may be dependent on route of administration and dose of the cannabis product.

Revised Bloom's taxonomy as a mentoring framework for successful promotion.

INTRODUCTION: Promotion is both a rewarding and challenging milestone in an academic career, and the process is enriched by intentional mentorship. Junior faculty often seek a stepwise mentorship approach that allows them to accurately self-reflect on their progress toward promotion, while more seasoned faculty may benefit from guidance on how to effectively mentor their colleagues through the process. PERSPECTIVE: Fortunately, the revised Bloom's taxonomy, the same tool commonly utilized to guide curricular development and assessment, serves both of these purposes very effectively. IMPLICATIONS: This tale of four pharmacy academicians uses the construct of the revised Bloom's taxonomy knowledge dimension to define various stages of an academic career while drawing parallels with aspects of the cognitive process dimension in each stage and describes a mentoring framework that successfully leads faculty toward the next step of their careers.