Generational awareness education as a strategy to prepare IPPE and APPE students for the modern workplace.

INTRODUCTION: There is limited literature on generational awareness improving the student-preceptor relationship and student experiences. The primary objectives of this study were to determine the level of generational awareness of pharmacy students and to examine whether didactic instruction on generational diversity leads to student-perceived improvements in learning and student-preceptor relationships. METHODS: This was a longitudinal, quasi-experimental design study, including pharmacy students at two different institutions from May 2019 to May 2020. A generational lecture was delivered to students in pharmacy years 1, 2 and 3 (P1, P2, and P3). Pre-, post-, and follow-up surveys were created and collected from each student cohort. RESULTS: A total of 388 respondents were included in the pre- and post-survey analysis. Overall scores for each question were significantly improved in the post- compared to the pre-period (P < .001). A total of 124 responses were received for the follow-up survey. Seventy-one percent of respondents agreed or strongly agreed that understanding generational differences improved their learning, communication, and professional relationships during their experiential rotations. Majority of respondents (82.3%) agreed or strongly agreed that further education on generational differences should be provided. CONCLUSIONS: This study indicates that providing education on generational differences to students is beneficial and positively impacts student experiential rotations.

A longitudinal quality improvement program to optimize experiential education's ability to develop trusted independent pharmacist practitioners.

PROBLEM DESCRIPTION: To meet the evolving role of today's pharmacist, student pharmacists need to be given independent responsibilities that increase in rigor as they advance through the curriculum and be able to practice both autonomously and as part of an interprofessional team. Quality improvement methods: The University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences (SSPPS) experiential programs office undertook a 20-year process of developing independence for students. Students faced increasing challenges and responsibilities as they moved through experiential practice settings, with constant, cyclic adjustments made in response to feedback. RESULTS OF CQI INQUIRY: The continuous focus on developing independence in students has established a culture of trust in the Colorado pharmacy practice community. Students are allowed autonomy, and are challenged with increasing rigor as they advance. Graduates are well-prepared to perform both independently and as part of a team. INTERPRETATION AND DISCUSSION: The curricular framework based on trust and independent learning has helped the SSPPS train student pharmacists to meet the demands of current pharmacy practice, as well as expected roles in the future. Requiring increasing responsibilities from students as they move through the curriculum allows them to move along the spectrum set up through the entrustable professional activity (EPA) assessments to achieve high ratings for an individual skill. Continuous feedback and adjustments are necessary to identify what can be accomplished in pharmacy practice settings. CONCLUSIONS: This 20-year approach to curricular design and modifications within experiential education has produced independent pharmacy practitioners upon graduation.

A multimethod evaluation of an interprofessional IPPE in an underserved clinic.

INTRODUCTION: To evaluate the design of an interprofessional introductory pharmacy practice experience (IP-IPPE) designed to integrate third-year pharmacy students in patient care workflow under the direct supervision of non-pharmacist practitioners in a federally qualified health center. METHODS: Data was gathered to evaluate the success of the IP-IPPE from the students', providers', and clinic's perspectives. Preceptors completed a mixed-methods survey to determine satisfaction and value of the IP-IPPE. Students completed the Interprofessional Collaborative Competencies Attainment Survey (ICCAS) post-IP-IPPE to assess change in interprofessional outcomes. Student performance and competency demonstration was assessed using a modified interprofessional professional assessment scoring tool. Finally, a retrospective patient chart review was conducted to determine student value to the clinic. RESULTS: During a 12-week period at the studied clinic, 32 students were supervised by eight primary care providers (PCPs) and cared for 516 patients. Six providers (75%) endorsed students' ability to provide value-added interventions during clinical care. A chart review of 200 patient records indicated students provided medication education to 12% of patients engaged with, in addition to other contributions. Students' ICCAS self-assessments indicated significant improvement across all outcomes following the IP-IPPE. Qualitative provider responses indicated meaningful investment into the IP-IPPE and appreciation for pharmacy student's collaboration during patient care. CONCLUSION: All 32 students in this study were able to earn the trust of their assigned PCP preceptors. The IP-IPPE design created value for learners, patients, and providers.

Cultivating a Culture of Reflection Among Pharmacy Students Through Storytelling.

Objective. To hold a storytelling event and assess its effect on Doctor of Pharmacy (PharmD) students' perspectives on and attitudes toward reflection. Methods. Story Slam, a four-hour storytelling competition, was incorporated into the spring semester of the first professional year of a PharmD program. The event featured short first-person stories told by faculty members as well as students. Students were invited to participate in a pre- and post-intervention survey and focus group. An inductive qualitative analysis of the resulting data was conducted using textual and audio artifacts. Results. All 136 first professional year (P1) students participated in the 2019 Story Slam. Eleven students submitted qualitative pre- and post-intervention survey instruments and participated in a semi-structured recorded focus group. Thematic analysis revealed nine themes. Students' perspectives regarding the importance of self-reflection changed after participating in Story Slam, with students expressing a greater willingness to engage in self-reflection in the context of professional practice following the event. Students believed Story Slam created an environment conducive to reflection and engagement, resulting in strengthened relationships with peers and faculty members. Students expressed feeling a wide range of emotions as they shared their story and listened to the stories of others. Conclusion. Story Slam is an effective strategy for introducing P1 students to reflection, while also strengthening the school's reflective culture. Additionally, sharing stories may foster positive relationships and cultivate trust and respect between students and faculty members.

Design and Content Validation of Three Setting-Specific Assessment Tools for Advanced Pharmacy Practice Experiences.

Objective. To develop and validate three assessment tools to measure student performance in clinical settings during required advanced pharmacy practice experiences (APPEs). Methods. Each assessment tool was developed by subject-matter experts and validated using three sources of evidence. Proposed content underwent a job-task analysis by external APPE preceptors, evaluating each outcome in terms of importance and frequency of opportunity for student demonstration. After implementation, tool performance was evaluated using a measure of item applicability and student achievement. Finally, a two-step grade verification process was developed and grade acceptance by preceptor was determined. A priori benchmarks for acceptable tool performance were established for each strategy. Results. The job-task analysis was completed by 131 preceptors (52% response), with items achieving a composite score from 1.08 to11.83 (possible range: 1=most valuable, 25=least valuable). The mean item applicability ranged from 91.3% to 94.1% (n=849 student assessments) during the first year. Preceptors accepted the tool-generated grade in 798 (94%) assessments. Conclusion. Data from three evaluation strategies provide evidence of effective design and use of three unique APPE setting-specific student assessment tools. Pharmacy programs can adopt similar methodologies to develop and validate their assessment tools.

Assessing a Longitudinal Reflection Curriculum: A Case Study Of Student Self-Awareness Expressed Through Rotation Goal Achievement.

The Center for the Advancement of Pharmacy Education 2013 Affective Domain mandates students develop self-awareness of personal attributes affecting professional growth. Students should self-identify needs, create and implement goals, and evaluate success. This case study describes the qualitative and quantitative findings of an intentional reflection assignment prompting students to engage in a cycle of goal writing - monitoring - reflection - new goal writing, during an immersive clinical practice experience. A blinded review of 144 student assignments is presented in the context of a curricular review of the Reflective Practitioner Program (RPP), a longitudinal reflective thread spanning four years of professional pharmacy training. Evidence gathered in the assignment review indicates that students are sufficiently capable of establishing meaningful goals and describing why the goal is important to their professional development. In contrast, students struggle with articulating strategies for goal achievement and emotions experienced during goal monitoring. In consideration of these findings, RPP faculty identified three major themes when discussing key aspects of the RPP curricular design: 1) students need to articulate strategies for goal achievement in addition to stated aims, 2) students hesitate to identify emotions when reflecting, and 3) reflection needs to be both retrospective and prospective in nature. This case study has resulted in meaningful changes to RPP curricular design and illustrates how programs may approach assessment of the Affective Domain via common curricular elements.

Coral feeding on microalgae assessed with molecular trophic markers.

Herbivory in corals, especially for symbiotic species, remains controversial. To investigate the capacity of scleractinian and soft corals to capture microalgae, we conducted controlled laboratory experiments offering five algal species: the cryptophyte Rhodomonas marina, the haptophytes Isochrysis galbana and Phaeocystis globosa, and the diatoms Conticribra weissflogii and Thalassiosira pseudonana. Coral species included the symbiotic soft corals Heteroxenia fuscescens and Sinularia flexibilis, the asymbiotic scleractinian coral Tubastrea coccinea, and the symbiotic scleractinian corals Stylophora pistillata, Pavona cactus and Oculina arbuscula. Herbivory was assessed by end-point PCR amplification of algae-specific 18S rRNA gene fragments purified from coral tissue genomic DNA extracts. The ability to capture microalgae varied with coral and algal species and could not be explained by prey size or taxonomy. Herbivory was not detected in S. flexibilis and S. pistillata. P. globosa was the only algal prey that was never captured by any coral. Although predation defence mechanisms have been shown for Phaeocystis spp. against many potential predators, this study is the first to suggest this for corals. This study provides new insights into herbivory in symbiotic corals and suggests that corals may be selective herbivorous feeders.

Preceptor perceptions of the importance of experiential guidelines.

OBJECTIVES: To assess preceptors' perceptions of the importance of experiential guidelines and identify and compare differences in perceptions. METHODS: Active advanced and introductory pharmacy practice experience preceptors for the University of New Mexico were invited to participate in an anonymous electronic survey regarding the importance of specific tasks and abilities expected in new pharmacist practitioners as outlined in Appendix C of the Accreditation Council for Pharmacy Education (ACPE) Standards and Guidelines. RESULTS: While the majority of preceptors rated most tasks (eg, communication, patient counseling) as very important or important, emerging tasks (eg, health literacy, public health, physical assessment) were not rated as highly by a majority of preceptors. CONCLUSION: The deficiencies identified in the study suggest potential reductions in the transfer of learning from preceptors to experiential students. Preceptor training programs should be structured to raise the perceived level of importance of these tasks.