The Intersection of Growth Mindset and Accreditation in Pharmacy Education.

OBJECTIVES: To describe existing growth mindset literature within pharmacy and health care education, describe how a growth mindset can be beneficial in the accreditation process, and propose potential ways to promote a growth mindset in faculty, preceptors, students, and staff within pharmacy education. FINDINGS: To help pharmacy learners develop a growth mindset, existing literature emphasizes the need for a shift toward and aligning assessment with a growth mindset, helping to create self-directed adaptive learners, leading to health care providers who can adjust their practice to tackle expected and unexpected challenges throughout their careers. Strategies to create a culture of growth mindset identified include training faculty and learners on growth mindset and developing new assessments that track a learner's growth. Recommendations for pharmacy educators include encouraging educators to assess their own growth mindset and use a variety of teaching methods and provide feedback on learner effort that encourages the process of learning rather than focusing on individual attributes, traits, and results. SUMMARY: Growth mindset intersects with accreditation standards for both professional degree programs and providers of continuing pharmacy education. Continuing professional development process is one way to encourage faculty, staff, and students to develop a growth mindset. While a growth mindset can have many positive impacts on pharmacy accreditation, it is essential to recognize that achieving and maintaining accreditation is a multifaceted process involving numerous factors. A growth mindset can positively influence pharmacy education accreditation by fostering a culture of continuous improvement, innovation, resilience, student-centeredness, data-driven decision-making, collaboration, and effective leadership.

The Need for Competency-Based Education.

OBJECTIVES: While pharmacy education updates learning as new information arises, changes to learning experiences can trail behind current practices and technology. There have been multiple calls for radical changes in how health professions education is delivered to ensure patients are receiving high-quality care. Competency-based education has been one way discussed in the literature for how to handle this need to develop students who have a willingness to learn and can problem-solve. The goal of this review is to examine whether competency-based education is needed to drive the profession of pharmacy forward. FINDINGS: To address, we collaboratively identified stakeholder perspectives to evaluate the need. The following stakeholders achieved consensus among the committee members: patients/society, learners, workplace/profession, and academic institutions. SUMMARY: Based on those perspectives, needs, and gaps to address those needs were identified and are presented in this review.

Development of the entrustable professional activity 'medication reconciliation' for clinical pharmacy.

BACKGROUND: Entrustable professional activities (EPAs) are observable process descriptions of clinical work units. EPAs support learners and tutors in assessment within healthcare settings. For use amongst our pharmacy students as well as pre-registration pharmacists we wanted to develop and validate an EPA for use in a clinical pharmacy setting at LMU University Hospital. METHODS: The development of the clinical pharmacy EPA followed a set pathway. A rapid literature review informed the first draft, an interprofessional consensus group consisting of pharmacists, nurses, and medical doctors refined this draft. The refined version was then validated via online survey utilising clinical pharmacists from Germany. RESULTS: We designed, refined and validated an EPA regarding medication reconciliation for assessment of pharmacy students and trainees within the pharmacy department at LMU University Hospital in Munich. Along with the EPA description an associated checklist to support the entrustment decision was created. For validation an online survey with 27 clinical pharmacists from all over Germany was conducted. Quality testing with the EQual rubric showed a good EPA quality. CONCLUSIONS: We developed the first clinical pharmacy EPA for use in a German context. Medication reconciliation is a suitable EPA candidate as it describes a clinical activity performed by pharmacists in many clinical settings. The newly developed and validated EPA 'Medication Reconciliation' will be used to assess pharmacy students and trainees.

For the rural curious: mixed methods evaluation of a rural pharmacy practice elective.

BACKGROUND: As of 2020, 20% of people residing in the United States of America (U.S.) lived in rural communities. Despite rural residents tending to be older, poorer, and having greater disease burden than their urban counterparts, the number of rural primary care providers continues to decline. Nearly 66% of U.S. Primary Care Health Professional Shortage Areas are designated as rural. Pharmacists can help address this shortage of rural primary care providers, often serving as providers of first-contact care; however, only 12% of U.S. pharmacists practice in rural communities. To help address this gap, in 2022 an elective Rural Pharmacy course was created at the University of Minnesota College of Pharmacy by a faculty member who has rural practice experience. METHODS: The course combines formal lectures, guest presentations by rural pharmacists and student interviews with additional rural pharmacists. For the 42 students enrolled in the course in 2022 and 2023, non-parametric statistics were used to compare the percentage of students who were raised in rural communities or who otherwise had extensive exposure to rural, and compare student interest ratings (1 to 7) about practicing/living rural at the beginning and end of the course. Students also wrote end-of-course reflection papers, commenting on the course and their interviews with rural pharmacists. RESULTS: Across both years, 45% of the enrolled students had previous experience in rural communities. The net change in Rural Interest scores among students completing both questionnaires was + 5 in 2022 and + 2 in 2023, both non-significant differences. The largest shifts in student interest were from "Not Sure" at the start of the course to "Interested" or "Not Interested" at the end of the course, and from "Interested" to "Very Interested." In their reflection papers nearly 60% of students reported being most impressed by their interviews with rural pharmacists. CONCLUSIONS: A course addressing the benefits and challenges of practicing pharmacy in rural communities was well-received by pharmacy students. Even students who have little interest in living in a rural community can benefit from being introduced to rural culture, enabling them to provide more culturally-responsive care for patients from rural communities.

Joint interprofessional education of pharmacy and dietetics undergraduates - a scoping review.

INTRODUCTION: Interprofessional education (IPE) is an integrative approach that enables collaboration of students of two or more different health professions in aim to acquire skills and competencies related not only to their field of study but also to ensure the standard of care based on collaborative practice. IPE has not yet been explored in relation to collaboration between dietetics-nutrition and pharmacy students, while there is evidence that in many cases nutrition is complementary to pharmacotherapy in the treatment process. AIM: The aim of this scoping review was to gather, describe and discuss all relevant literature regarding joint interprofessional training of pharmacy and dietetics-nutrition undergraduates. METHODS: We performed a literature search for studies where IPE between dietetics-nutrition and pharmacy students was described. 2204 articles on this topic were identified. After eligibility assessment, 8 articles were included in the review. RESULTS: Eight studies were included in the review. Two of these described IPE activities between dietetics and pharmacy students only. The included studies varied in setting, methodology and outcome measures and covered a wide range of topics relevant to clinical practice, such as management of inflammatory bowel diseases, care of the older adults or counselling skills. The most common teaching method was the use of case studies. Some of the included studies did not identify specific learning objectives. The most common way of gathering feedback from participants was through questionnaires and interviews. CONCLUSIONS: IPE of pharmacy and dietetics-nutrition students is feasible and may be beneficial in many aspects related to learning. However, there is no well-established model or standard that would facilitate the implementation of such activities in individual educational institutions.

Evaluating the Impact of an Innovative Integrative Health-Focused Elective in a Doctor of Pharmacy Program.

OBJECTIVE: To assess knowledge and perceptions of integrative health principles. METHODS: This was a retrospective, pre-post observational cohort study evaluating Doctor of Pharmacy students following completion of an innovative elective course that was offered between 2020-2022. This Integrated Health in Pharmacy elective was created at the University at Buffalo School of Pharmacy and Pharmaceutical Sciences in the Spring of 2020. The primary objective was to assess student knowledge of integrative health principles. The secondary objective was to assess student confidence and perceptions of integrative health principles. RESULTS: Students completed a pre-course assessment (n = 80/81) and a post-course assessment (n = 73/81). Overall, the mean (SD) performance on the assessment questions increased between the pre-post assessment groups (57.59 [12.98]% vs 65.46 [14.43]%). Survey results indicated that students' perceptions and confidence pertaining to integrative health increased after completing this elective course offering. CONCLUSION: Participation in this innovative elective course was associated with improved knowledge and perceptions of integrative health principles.

Why Should Pharmacy Students Take Biochemistry?

The role of biochemistry in the pharmacy curriculum has recently been questioned based on its relevance to the career of a working pharmacist. This commentary explores the historical background of pharmacy education and the central role of chemistry since the 19th century. Reasons for the importance of biochemistry and other sciences are introduced to demonstrate their role in the practice of pharmacy.

The Role of Consumerism in Pharmacy Education.

The notion of consumerism and that students are customers of pharmacy colleges was explored by proponents and opponents of the idea. First, a working definition of a "customer" in pharmacy education is pondered with respect to the roles and responsibilities of students and schools/colleges of pharmacy. Second, the pros and cons of "student-centered" education are considered in the light of students and their families being consumers of the educational experience. Third, the duality of student-centered education is discussed including student engagement/disengagement in their learning, professional/unprofessional behaviors, and shared/individual responsibilities. Lastly, learning and teaching environment dynamics are discerned when higher education becomes more student-centric and how that may affect the overall outcome of the student and the goals of pharmacy educational programs.

Old Habits Die Hard: Regression in Learning and Study Strategies Inventory Scores in PharmD Students.

OBJECTIVE: Prior studies have demonstrated that "learning to learn" (L2L) courses can lead to significant improvements in students' Learning and Study Strategies Inventory (LASSI) scores immediately following the course. This study aimed to analyze whether improvements in LASSI scores are sustained 1 year following an L2L elective course. METHODS: First-year pharmacy students in the classes of 2024 and 2025 completed the LASSI at the start of the fall semester and again immediately following an L2L course. One year later, during the second professional year, students completed the LASSI a third time. Repeated-measures multivariate analysis of variance was used to analyze within-participant differences in LASSI scores across each of the 10 LASSI scales. Univariate analysis of variance with Bonferroni correction was used for pairwise comparison. RESULTS: A total of 119 students completed all 3 LASSI assessments. LASSI scores improved in all 10 scales following completion of the L2L course. However, 1 year after the completion of the course, there was a statistically significant regression in all 10 scale scores (Wilks' Λ [20,98] = 8.7). Among the 10 scales, scores for the Attitude and Concentration scales were statistically significantly lower during the second professional year relative to baseline at the start of the first professional year. Selecting Main Ideas was the only scale with a higher score during the second professional year relative to baseline. CONCLUSION: Despite marked improvements in LASSI scores following the implementation of a "learning to learn" course for first-year pharmacy students, the improvements were not sustained after 1 year.

Current state of education, training and practices in antimicrobial stewardship among pharmacy students: A cross-sectional survey from Kerala, India.

PURPOSE: Pharmacists are recognised in guidelines from across the globe as key stakeholders in antimicrobial stewardship (AMS) initiatives. The current study aims to assess the current practices and level of training and education in relation to AMS among pharmacy students from Kerala, India. METHODS: A cross-sectional web-based survey was developed and disseminated among doctor of pharmacy 5th year students and interns from selected pharmacy colleges across Kerala through key informants. Descriptive statistics were used to analyse the responses. RESULTS: The response rate was 34.8% (157/450). Whilst the majority of respondents (89.8%, 141/157) recalled being taught about antimicrobial resistance (AMR) as part of the pharmacy curricula, 84.7% (133/157) believed they didn't have sufficient knowledge about AMR. Most of the respondents (64.9%, 102/157) had not received any AMS training. Clinical posting in AMS was the preferred mode of training suggested by most respondents. Respondents who audited antimicrobials as part of their clinical postings (77.9%, 88/113) reported their main responsibility was review of patient records for assessing the appropriateness of antimicrobials (68.2%, 60/88). Inappropriate selection of antimicrobials was the most common error identified by respondents (38.1%, 43/113) and the key method of communicating their recommendation was informing the prescriber in person (46%, 52/113). CONCLUSION: Whilst pharmacy students are reviewing antimicrobial prescriptions as part of their clinical postings, their education and training in AMR and AMS remain low. The inclusion of practical clinical training for pharmacy students as part of their curricula can be a cost-effective way to promote AMS initiatives.

Paper-based versus digital-based learning among undergraduate medical, nursing and pharmaceutical students in Japan: a cross-sectional study.

OBJECTIVE: Since the emergence of COVID-19, university education has drastically transformed into digital-based learning (DBL). Online education has been well recognised as a promising mode of teaching; however, only a limited number of studies have reported the students' preferred format for academic learning. DESIGN: Cross-sectional. SETTING: The study was conducted in a university setting in Japan. A Google Forms online questionnaire was distributed to the participants between April and May 2022. PARTICIPANTS: A total of 939 undergraduate medical, nursing and pharmaceutical students in the pre-clinical grade were recruited, and 344 were included in the final analysis. PRIMARY AND SECONDARY OUTCOME: The questionnaire assessed students' format preferences between paper-based learning (PBL) and DBL as it pertained to academic performance and eyestrain. In terms of academic performance, comprehension, memory retention and absorption (concentration) were assessed. We also explored the association between students' daily time spent using DBL and their digital preference by the Cochran-Armitage trend test and logistic regression analysis. RESULTS: A total of 344 (191 medical, 73 nursing and 80 pharmaceutical) university students completed the questionnaire (response rate 36.6%). An even distribution was observed in the preferred learning format for comprehension: PBL (32.0%), both formats equivalent (32.8%) and DBL (35.2%; digital preference). Only few students preferred DBL for memory retention (6.1%), absorption (6.7%) and eyestrain (1.2%). Although a positive association was observed between daily time spent using DBL and digital preference for comprehension, there was no association for memory retention, absorption and eyestrain. CONCLUSION: Among university students, DBL was just as preferred as PBL for comprehension; however, only a few students reported that DBL was better in terms of memory retention, absorption and eyestrain. A learning environment where students can study using PBL should be continued.

Evaluating Curriculum Differences in US PharmD Programs: A Peer Evaluation.

OBJECTIVE: To evaluate the differences in curriculum structure and content and observe commonalities across various Doctor of Pharmacy (PharmD) programs in the United States. METHODS: This research involves the collection of course content and credit hour data from the curricula and course descriptions, course catalogs, and student handbooks of all the PharmD programs available on their websites and categorization based on the content areas outlined in the Accreditation Council of Pharmacy Education. The core courses, elective offerings, and experiential education (eg, Introductory and Advanced Pharmacy Practice Experience) were evaluated using Excel® for credit hours, integration, non-integration, program duration (3-year vs 4-year), and online offerings. RESULTS: Of 142 accredited schools/colleges, 135 were included in the study, which met the inclusion criteria. In total, 85 of these schools have an integrated curriculum, 19 have a 3-year curriculum, and 15 offer a distance learning pathway for a PharmD degree. Fourteen of the 37 required content areas from the Accreditation Council of Pharmacy Education Appendix 1 were identified, with more than 50% of schools listing no credit hours allocated. Only 9 areas had 90% or more of pharmacy schools allocating credit hours. On average, biomedical, pharmaceutical, social/administrative/behavioral, clinical sciences, experiential education, and electives allocate 10.6, 25.3, 17.1, 40.5, 45.5, and 7.0 credit hours, respectively. CONCLUSION: Each school's curriculum has a significant variation in credit hours, and there is an opportunity to simplify the curricular structure and content by reducing redundancy and increasing flexibility based on health care needs.

A Systematic Review of Immunization Administration Training for African Pharmacists and Student Pharmacists.

OBJECTIVES: Recent calls to action have encouraged African pharmacists to become trained to administer immunizations with the goals of developing a strong pharmacy vaccination workforce, addressing a shortage of vaccinators, and improving vaccination access. However limited availability of training programs for pharmacists and student pharmacists to learn to administer immunizations may restrict the ability of African pharmacists and student pharmacists to meet these goals. This work sought to systematically identify literature published regarding immunization administration training for pharmacists and student pharmacists in Africa. FINDINGS: In total, 940 articles were identified from 6 databases and gray literature. After eligibility criteria were applied, a total of 8 studies from 7 African countries were included, representing Democratic Republic of Congo, Ethiopia, Nigeria, Senegal, South Africa, Uganda, and Zimbabwe. Three studies described immunization administration training programs for pharmacists and 1 described training for student pharmacists. SUMMARY: This literature review identified that there are limited publications describing immunization training for pharmacists and student pharmacists in Africa. Training pharmacists to immunize could make a meaningful impact in increasing immunization access and reducing the spread of vaccine-preventable diseases in Africa. Expansion of available immunization administration training is needed for African pharmacists and student pharmacists if calls to action are to be met.

A Cycle of Reinforcing Challenges and Ideas for Action in Experiential Settings.

Evidence suggests that both pharmacy students and preceptors are struggling in the experiential setting. Underlying this phenomenon is a potential interconnected and cyclic set of behaviors being reinforced between students and preceptors. These behaviors can contribute to or are the result of higher levels of burnout and a decrease in the development of student clinical skills and subsequent performance on rotation. In this review, the authors investigate various challenges commonly encountered in the experiential environment. These challenges can range from an observed decrease in student engagement, motivation, and critical thinking skills to an increase in preceptor burnout and culture shifts in the clinical practice environments. These factors all ultimately impact patient care and overall student performance. For each challenge identified, strategies will be presented that can be implemented by students, preceptors, and pharmacy programs to break the cyclic pattern identified.

Use of a clinical reasoning scaffolding document improves student performance.

OBJECTIVE: Clinical reasoning is an essential skill set for practicing pharmacists to possess. Given its complex nature, optimal pedagogies for teaching clinical reasoning are largely unknown. The use of scaffolding to expand a student's zone of proximal development and improve clinical reasoning performance was assessed in this study. METHODS: This prospective, observational cohort study of second professional year (P2) students compared performance of those who were exposed to a clinical reasoning scaffolding tool (CRST) to historic control P2 students (No CRST) on FARMR notes in alignment with the Pharmacists' Patient Care Process. Student performance was assessed using an entrustment-like scale for each of 5 sections (Findings, Assessment and goals, Recommendations, Monitoring, and Rationale) of the FARMR to link classroom and experiential education settings. RESULTS: In total, 141 CRST students from 28 groups were compared to 77 No CRST students from 13 groups. CRST students performed significantly higher in Assessment and goals of therapy, Recommendations, Monitoring, Rationale sections but no difference in Findings. CONCLUSIONS: Scaffolding has been utilized successfully in other health professions education. This study provides evidence of it successfully improving student pharmacist clinical reasoning skills, an essential ability for successful pharmacy practitioners.

Revealing rural motivations in pharmacy students pursuing a graduate certificate program.

INTRODUCTION: To assist recruitment and retention efforts and influence the need for an increased supply of future rural pharmacists, this study examines perceptions and key motivators of pharmacy students who chose to participate in the Rural Pharmacy Health Certificate (RPHC) program and pursue pathways to rural practice. METHODS: We interviewed six RPHC students prior to or shortly after beginning their first semester in the RPHC program. Interview questions assessed applicants' reasons for pursuing the RPHC, perceptions of living in and providing healthcare in rural and small communities, awareness of barriers and health disparities in rural areas, and qualities needed to be a successful rural pharmacist. We analyzed data with the Sort and Sift, Think and Shift method, a common approach to qualitative data analysis. RESULTS: Interest in pursuing rural pharmacy grew out of growing up in a rural area, as well as a desire to serve and help others. Students expected that completing the RPHC would strengthen their skillsets to provide the best care by addressing barriers such as difficulty accessing care and health literacy. Being a learner of one's community was the primary quality identified as necessary to be a successful rural pharmacist. CONCLUSION: This study identified primary motivators and perceptions that led students to pursue a rural health program at one US pharmacy school. The results can be used to identify and train good candidates for rural pharmacy practice, strengthening the rural pharmacy workforce to better meet communities' needs.

Pharmacy students' knowledge, perceptions, and satisfaction in a nutrition course.

BACKGROUND AND PURPOSE: Little is known about nutrition education in pharmacy programs. This study reports on the outcomes assessment of pharmacy students' knowledge, perceptions, and satisfaction in a clinical nutrition course. EDUCATIONAL ACTIVITY AND SETTING: A 2-credit required course in clinical nutrition and diet therapy provides third-year professional pharmacy students with knowledge on various diet and nutrition topics. These relate to nutrition concepts in health and disease, the prevention and treatment of diet- and nutrition-related health conditions, and enteral and parenteral nutrition. FINDINGS: Between the academic years 2012 and 2021, 720 students were enrolled in the course. Direct assessment data were collected from 227 students, and indirect assessment data from 173 students. On average, 85.7% of students acquired the necessary knowledge on all 23 course learning objectives. Average course evaluation ratings by students on a 5-point Likert scale (strongly disagree = 1; disagree = 2; somewhat agree = 3; agree = 4; strongly agree = 5) were high (4.43). High ratings were also recorded for students' satisfaction with the course structure (4.46) and teaching effectiveness (4.39). Students appreciated the clear presentation of the course learning objectives, requirements, and teaching effectiveness. They also acknowledged the quality of the learning experience and the course's relevance to pharmacy. DISCUSSION: Students highly rated the course in achieving its learning objectives in addition to their satisfaction with its content, structure, delivery, and relevance to pharmacy education and practice. Furthermore, the course content addressed the accreditation requirements for nutrition education and covered the topics listed in the American College of Clinical Pharmacy (ACCP) Pharmacotherapy Didactic Curriculum Toolkits. SUMMARY: The clinical nutrition and diet therapy course was well received. Educating pharmacy students on diet and nutrition prepares graduates for expanding their role in these domains in the community, hospital and clinical practice settings.

Utilizing a podcast to supplement common medication learning.

INTRODUCTION: Podcasts are a popular way to learn and engage at the convenience of the listener. Education is incorporating podcasts to supplement and reinforce students learning inside and outside the classroom. METHODS: The authors created a podcast covering the Top 200 commonly prescribed medications. This was to help students recall and reinforce medication knowledge they typically must learn on their own. RESULTS: Student performance on post-tests improved (p = 0.0011) compared to pre-tests with an effect size r of 0.39 (0.37, 0.32, and 0.42 for P1, P2 and P3 respectively). Students reported the content was easy to follow, and they enjoyed learning from other students. The total number of plays for the podcast as of 19 July 2023 were 882. Each episode had a range of one to 89 number of plays. DISCUSSION: The podcast was well received by students, and drug knowledge increased. While the podcasts were shorter in time, they still provided the foundational information for a first-year pharmacy student to know. Overall, podcasts provide another way to help students retain and reinforce material learned inside and outside the classroom.

Peer mentoring in pharmacy programs: Recommendations for implementation based on a review of available literature.

BACKGROUND: Stress experienced by pharmacy students is on the rise and is negatively impacting student success. Pharmacy accreditation standards encourage schools to promote student success and well-being. Peer to peer student support is a largely under-investigated strategy to address this. The objective of this manuscript is to conduct a literature review on the development of peer mentoring programs for pharmacy students and describe best practices for successful implementation into pharmacy programs. METHODS: This literature review identified studies using major databases, including PubMed, Embase, International Pharmaceutical Abstracts, and Education Resources Information Center. Search terms included [(peer mentor*) AND pharmacy]. Any study that involved peer assessment, peer tutoring, or peer learning within a course, faculty mentors only, non-pharmacy students, and/or did not implement a mentor-mentee relationship, was excluded. RESULTS: Three studies met the criteria for inclusion. Mentorship programs varied with regard to duration, mentor recruitment, participant incentives, and overall structure. Various methods of analyses were employed. Despite major differences between the included studies, three themes were identified regarding development of peer mentoring programs: participation, support, and pairing. Active engagement led to higher perceived benefit and both mentors and mentees found the programs beneficial, agreed to recommend the programs to others, and provided positive feedback. IMPLICATIONS: Successful mentoring programs should aim to incorporate the following characteristics to some degree: mandatory participation by mentor and mentee as well as support for mentors with training and faculty oversight. Peer mentoring programs have a positive impact on participants. More studies are needed to assess the effects of peer mentoring in pharmacy programs. This is the first known review of peer mentoring within pharmacy programs and identifies a gap in knowledge in this area. There is a paucity of data surrounding peer mentoring in pharmacy and its potential value as a tool to improve student well-being.