Student-led podcasts to enhance literature evaluation skills.

BACKGROUND AND PURPOSE: Critical evaluation and understanding of primary literature is essential to pharmacy practice. This project evaluated student confidence and learning outcomes in a critical care elective course where podcasts were used as an active learning assignment for literature evaluation. EDUCATIONAL ACTIVITY AND SETTING: Third-year pharmacy students created a 15- to 20-min podcast episode that reviewed a landmark critical care trial. A pre/post survey was used to assess student perceptions of confidence in evaluating primary literature. A standardized rubric was used to assess literature evaluation skills in several domains. FINDINGS: Ninety-two third-year pharmacy students were enrolled in the critical care elective course, and 93% (86 of 92) completed the survey. Student perceptions of their ability to evaluate literature improved for all seven questions, including comfort in interpreting study methodology and applying findings of literature to patient care. Students scored proficient on most components of the standardized rubric, with ability to discuss results and conclusions being the lowest performing domain (78.2% fully proficient). After completing the activity, students felt more confident in interpreting results, applying findings, and orally presenting a journal article to peers. Most students felt the podcast activity helped them strengthen their literature evaluation skills and recommended this activity to a peer. SUMMARY: Third-year pharmacy students reported an improvement in confidence in the interpretation and application of primary literature after creating a podcast episode reviewing a critical care trial. Additional research with creation of podcasts or other audio/visual methods should be studied in the future.

Academic Pharmacy Fellowship Programs are an Innovative Solution to Improve the Faculty Pipeline.

Academic pharmacy fellowship programs can offer an innovative training solution to help prepare pharmacists for successful careers as clinical faculty members. However, there is no well-defined program blueprint or recommendations for what a successful program should include. This commentary describes the program overview for the academic pharmacy fellowship at the University of Houston College of Pharmacy and discusses the implications of incorporating a similar program at a college of pharmacy. The purpose of the fellowship program is to prepare pharmacists for a career in pharmacy education through training in teaching, curriculum development, college service, mentoring, scholarship, and clinical practice. A structured program with monthly rotations in key academic areas, teaching experience and mentorship (didactics and skills labs), committee service, and leading a research project make up the core structure of the program. These experiences, coupled with significant student interaction, can prepare fellowship graduates to transition effectively into clinical faculty roles.

Evaluation of student emotional intelligence at various points in a pharmacy curriculum.

INTRODUCTION: The purpose of this study is to evaluate emotional intelligence in doctor of pharmacy (PharmD) students at various points in the curriculum. METHODS: This was a cross-sectional, single site, observational study that included first- through fourth-year PharmD students, conducted from December 2021 to April 2022. The study used the Emotional Quotient Inventory, version 2.0 (EQ-i 2.0) to obtain student emotional intelligence scores. A survey in QualtricsSM (SAP) was used to obtain baseline characteristics. The primary endpoint was the mean total EQ-i 2.0 scores comparing professional years. Secondary endpoints included mean EQ-i 2.0 scores in the composite scales of self-perception, self-expression, interpersonal, decision-making and stress-management. Change in EQ-i 2.0 scores was evaluated using descriptive statistics and analysis of variance. Multivariable regression analysis identified associations between baseline characteristics and EQ-i 2.0 scores. RESULTS: A total of 137 (137/485, 28.2%) students completed the EQ-i 2.0 assessment. The mean (SD) total EQ-i 2.0 scores were 98.1 (15.5), 92.2 (15.9), 92.4 (12.9), and 103.5 (13.1), for first-, second- (P2), third- (P3), and fourth-year (P4) students, respectively. A statistically significant increase in total EQ-i 2.0 scores was noted in P4 students compared to P2 and P3 students. Work experience and leadership roles within student organizations may be associated with an increase in total EQ-i 2.0 scores. CONCLUSIONS: Emotional intelligence varied among students in different years of the pharmacy curriculum. P4 students were found to have the highest average emotional intelligence. The effect of curricular and co-curricular components on emotional intelligence development warrants further exploration.

Identifying predictors of generalized anxiety among student pharmacists in response to the COVID-19 pandemic.

INTRODUCTION: To explore the prevalence of generalized anxiety (GA) among doctor of pharmacy (PharmD) students at an academic institution during the COVID-19 pandemic and use Alderfer's existence, relatedness, and growth (ERG) theory to elucidate which unsatisfied needs are predictive of higher levels of GA symptoms. METHODS: This was a cross-sectional, single-site survey administered to first- through fourth-year PharmD students from October 2020 to January 2021. The survey tool included demographic information, the validated Counseling Center Assessment of Psychological Symptoms-62 tool, and nine additional questions developed to assess Alderfer's ERG theory of needs. Predictors of GA symptoms were evaluated using descriptive statistics, multiple linear regression, correlation analysis, and multivariable analysis. RESULTS: A total of 214 of 513 students completed the survey (42%) . Among students, 49.01% had no-clinical, 31.31% had low-clinical, and 19.63% had high-clinical GA symptoms. The relatedness needs, which included feeling disliked, socially disconnected, and misunderstood had the strongest correlation (65%) to GA symptoms and was most associated with GA symptoms (ß = 0.56, P < .001). Students who did not exercise experienced more symptoms of GA (P = .008). CONCLUSIONS: Over 50% of PharmD students met clinical cut-offs for GA symptoms and the relatedness need was most predictive of GA symptoms among students. Future student-centered interventions should aim to create opportunities that increase social connections, build resilience, and provide psychosocial support.

Systemization of a pharmacy technician career ladder in a multi-hospital system.

Purpose: Hospital consolidation into larger, systemized health systems has enabled system-wide standardization of promotion processes, including pharmacy technician career ladders. However, whether system standardization affects the job satisfaction or outcomes of pharmacy technicians is unknown. The purpose of this project was to assess pharmacy technician perceptions and outcomes after systemization of a pharmacy technician career ladder. Methods: Pharmacy technician satisfaction scores and outcomes (promotion and turnover rates) were assessed in an eight-hospital health system before and after systemization of a pharmacy technician career ladder. Results: Two hundred and forty-nine pharmacy technicians were employed during the pre-intervention (n = 104) and post-intervention (n = 145) time periods. One hundred and twenty-three of 145 (84.83%) pharmacy technicians completed a job satisfaction survey after implementation of the system-wide technician career ladder. Overall satisfaction for the career ladder averaged 3.8 ± 0.61 or between neutral to positive satisfaction. There was no difference in total satisfaction regardless of teaching (3.8 ± 0.59) or community hospital (3.8 ± 0.63) location (p = 0.53) or stratifying by Pharmacy Technician status. A total of 50 pharmacy technicians were hired during the study period, either during the pre-implementation (n = 36) or post-implementation (n = 14) time periods. Time to the first promotion averaged 1.73 ± 1.00 years in the pre-implementation period and 1.36 ± 0.55 years in the post-implementation period (p = 0.20). Technician voluntary turnover was similar between the time periods. Conclusion: In conclusion, the standardization of a systems-level pharmacy technician promotion ladder from a single hospital to a systems-level was associated with positive job satisfaction and similar promotions and turnover rates as the historic, single hospital-based promotion ladder.

Correction: Herring supports Northeast Pacific predators and fisheries: Insights from ecosystem modelling and management strategy evaluation.

[This corrects the article DOI: 10.1371/journal.pone.0196307.].

Does Social Desirability Influence Preceptors' Completion of Student Experiential Evaluations?

Many variables influence a preceptor's experiential evaluation of a pharmacy learner. However, the impact of social desirability bias, or the measure of an individual's need for social approval, and its impact on the truthfulness of an evaluation is not well understood. Social desirability may present a barrier to students receiving accurate and truthful evaluations. Differences in the effect of social desirability may be seen between full-time faculty and non-faculty preceptors. Colleges of pharmacy should work to support preceptors by providing professional development, standardizing evaluation processes, and ensuring two-way communication. Additionally, a social desirability measure could be used for each preceptor and used by the experiential team to identify preceptors potentially in need of additional development. Future studies should evaluate the effect of social desirability on how preceptors complete evaluations, and propose methods to mitigate this form of bias in the evaluation process.

Program development of a preceptor bootcamp for operational pharmacy preceptors.

PURPOSE: To describe the development, design, and implementation of a pilot preceptor development bootcamp and feedback related to its feasibility and impact on operational pharmacy preceptors. SUMMARY: The University of Texas MD Anderson Cancer Center designed and implemented a pilot preceptor development bootcamp for operational staff pharmacists serving as residency preceptors for longitudinal weekend staffing experiences. A systematic, multipronged approach was taken to identify preceptor development gaps and design a full-day bootcamp curriculum. The resultant curriculum was comprised of content in major functional areas including using the 4 preceptor roles, documenting performance, giving and receiving feedback, and dealing with difficult situations or learners. The impact of the pilot preceptor development bootcamp was assessed using survey methodology and qualitative feedback from debrief discussions. CONCLUSION: Implementation of a pilot preceptor bootcamp program addressing major areas of precepting skill was well received, resulted in positive feedback from operational pharmacy preceptors, and was feasible to implement at a large academic medical center.

A systematic approach to optimize electronic health record medication alerts in a health system.

PURPOSE: The effectiveness of a systematic, streamlined approach to optimize drug-drug interaction alerts in an electronic health record for a health system was studied. METHODS: An 81-week quasi-experimental study was conducted to evaluate interventions made to medication-related clinical decision-support (CDS) alerts. Medication-related CDS alerts were systematically reduced using a multi disciplinary healthcare committee. The primary endpoint was weekly overall, modification, and acknowledgement rates of medication alerts after drug-drug interaction reclassification. Secondary endpoints included sub analysis of types of medication alerts (drug-drug interaction and duplicate therapy alerts) and alert use by providers (pharmacist and prescribers). Data was analyzed using interrupted time series regression analysis. RESULTS: After implementation of the new alert system, total number of weekly inpatient alerts decreased from 68,900 (66,300-70,900) and 50,300 (48,600-53,600) in the postintervention period (p < 0.001). The perentage of alerts acknowledged weekly increased from 11.8% (IQR, 11.4-12.1%) in the preintervention period to 13.7% (IQR, 13.3-14.0%) in the postintervention period (p < 0.001). The percentage of alerts that were modified also increased from 5.0% (IQR, 4.9-5.3%) in the preintervention period to 7.3% (IQR, 7.0-7.6%) in the postintervention period (p < 0.001). Both increases were primarily seen with pharmacists versus other healthcare professionals (p < 0.001). CONCLUSION: A committee-led systematic approach to optimizing drug-drug interactions facilitated a significant decrease in the overall number of alerts and an increase in both medication alert acknowledgement and modification rates.

Correction: Herring supports Northeast Pacific predators and fisheries: Insights from ecosystem modelling and management strategy evaluation.

[This corrects the article DOI: 10.1371/journal.pone.0196307.].

Herring supports Northeast Pacific predators and fisheries: Insights from ecosystem modelling and management strategy evaluation.

This paper analyzes the trophic role of Pacific herring, the potential consequences of its depletion, and the impacts of alternative herring fishing strategies on a Northeast Pacific food web in relation to precautionary, ecosystem-based management. We used an Ecopath with Ecosim ecosystem model parameterized for northern British Columbia (Canada), employing Ecosim to simulate ecosystem effects of herring stock collapse. The ecological impacts of various herring fishing strategies were investigated with a Management Strategy Evaluation algorithm within Ecosim, accounting for variability in climatic drivers and stock assessment errors. Ecosim results suggest that herring stock collapse would have cascading impacts on much of the pelagic food web. Management Strategy Evaluation results indicate that herring and their predators suffer moderate impacts from the existing British Columbia harvest control rule, although more precautionary management strategies could substantially reduce these impacts. The non-capture spawn-on-kelp fishery, traditionally practiced by many British Columbia and Alaska indigenous peoples, apparently has extremely limited ecological impacts. Our simulations also suggest that adopting a maximum sustainable yield management strategy in Northeast Pacific herring fisheries could generate strong, cascading food web effects. Furthermore, climate shifts, especially when combined with herring stock assessment errors, could strongly reduce the biomasses and resilience of herring and its predators. By clarifying the trophic role of Pacific herring, this study aims to facilitate precautionary fisheries management via evaluation of alternative fishing strategies, and thereby to inform policy tradeoffs among multiple ecological and socioeconomic factors.

Ecosystem approach to fisheries: Exploring environmental and trophic effects on Maximum Sustainable Yield (MSY) reference point estimates.

We present a comprehensive analysis of estimation of fisheries Maximum Sustainable Yield (MSY) reference points using an ecosystem model built for Mille Lacs Lake, the second largest lake within Minnesota, USA. Data from single-species modelling output, extensive annual sampling for species abundances, annual catch-survey, stomach-content analysis for predatory-prey interactions, and expert opinions were brought together within the framework of an Ecopath with Ecosim (EwE) ecosystem model. An increase in the lake water temperature was observed in the last few decades; therefore, we also incorporated a temperature forcing function in the EwE model to capture the influences of changing temperature on the species composition and food web. The EwE model was fitted to abundance and catch time-series for the period 1985 to 2006. Using the ecosystem model, we estimated reference points for most of the fished species in the lake at single-species as well as ecosystem levels with and without considering the influence of temperature change; therefore, our analysis investigated the trophic and temperature effects on the reference points. The paper concludes that reference points such as MSY are not stationary, but change when (1) environmental conditions alter species productivity and (2) fishing on predators alters the compensatory response of their prey. Thus, it is necessary for the management to re-estimate or re-evaluate the reference points when changes in environmental conditions and/or major shifts in species abundance or community structure are observed.

Supply-demand equilibria and the size-number trade-off in spatially structured recreational fisheries.

Recreational fishing effort varies across complex inland landscapes (e.g., lake-districts) and appears influenced by both angler preferences and qualities of the fishery resource, like fish size and abundance. However, fish size and abundance have an ecological trade-off within a population, thereby structuring equal-quality isopleths expressing this trade-off across the fishing landscape. Since expressed preferences of recreational anglers (i.e., site-selection of high-quality fishing opportunities among many lakes) can be analogous to optimal foraging strategies of natural predators, adopting such concepts can aid in understanding scale-dependence in fish-angler interactions and impacts of fishing across broad landscapes. Here, we assumed a fish supply-angler demand equilibria and adapted a novel bivariate measure of fishing quality based on fish size and catch rates to assess how recreational anglers influence fishing quality among a complex inland landscape. We then applied this metric to evaluate (1) angler preferences for caught and released fish compared to harvested fish, (2) the nonlinear size-numbers trade-off with uncertainty in both traits, and (3) the spatial-scale of the equilibria across 62 lakes and four independent management regions in British Columbia's (BC) rainbow trout Oncorhynchus mykiss fishery. We found anglers had low preference for caught and released fish (~10% of the value compared to harvested fish), which modified anglers' perception of fishing quality. Hence, fishing quality and angler effort was not influenced simply by total fish caught, but largely by harvested fish catch rates. Fishing quality varied from BC's northern regions (larger fish and more abundant) compared to southern regions (smaller fish and less abundant) directly associated with a 2.5 times increase in annual fishing effort in southern regions, suggesting that latent fishing pressure can structure the size-numbers trade-off in rainbow trout populations. The presence of two different equal-quality isopleths suggests at least two effective landscapes support co-occurring ideal free distributions of recreational fishing effort in BC's rainbow fishery. Anglers' expressed preferences among lakes interacted with density dependent growth and survival within lakes to structure a size-numbers trade-off influencing how anglers perceive fishing quality and, ultimately, distribute across complex inland landscapes.

Bayesian decision-network modeling of multiple stakeholders for reef ecosystem restoration in the coral triangle.

Proposals for marine conservation measures have proliferated in the last 2 decades due to increased reports of fishery declines and interest in conservation. Fishers and fisheries managers have often disagreed strongly when discussing controls on fisheries. In such situations, ecosystem-based models and fisheries-stock assessment models can help resolve disagreements by highlighting the trade-offs that would be made under alternative management scenarios. We extended the analytical framework for modeling such trade-offs by including additional stakeholders whose livelihoods and the value they place on conservation depend on the condition of the marine ecosystem. To do so, we used Bayesian decision-network models (BDNs) in a case study of an Indonesian coral reef fishery. Our model included interests of the fishers and fishery managers; individuals in the tourism industry; conservation interests of the state, nongovernmental organizations, and the local public; and uncertainties in ecosystem status, projections of fisheries revenues, tourism growth, and levels of interest in conservation. We calculated the total utility (i.e., value) of a range of restoration scenarios. Restricting net fisheries and live-fish fisheries appeared to be the best compromise solutions under several combinations of settings of modeled variables. Results of our case study highlight the implications of alternate formulations for coral reef stakeholder utility functions and discount rates for the calculation of the net benefits of alternative fisheries management options. This case study may also serve as a useful example for other decision analyses with multiple stakeholders.