Advanced Pharmacy Practice Experience Students Research Articles

Implementation and evaluation of a learner-driven leadership initiative for pharmacy students and pharmacy residents.

Introduction: Leadership training is a crucial component of the pharmacy education curriculum. The Accreditation Council for Pharmacy Education (ACPE) emphasizes and encourages the use of different leadership initiatives, and universities employ tactics with varying levels of success to implement these initiatives. "Leadership theory" debates if leadership can be learned or if it is a natural-born skill. This article explores learned leadership and describes a small study deployed to different levels of pharmacy learners to foster leadership confidence and self-awareness. Educational Context and Methods: Second- and third-year didactic students in a leadership elective, voluntary fourth-year Advanced Pharmacy Practice Experience (APPE) students on an ambulatory care rotation, and first postgraduate year (PGY1) pharmacy residents were included in this initiative. Each cohort facilitated a leadership book club discussion and completed professional development activities over the course of their experience. Learners' perspectives on leadership were surveyed utilizing a pre-post survey study, administered prior to beginning the initiative and after completing the initiative. Findings and Discussion: Results demonstrated learners' perceived confidence and self-awareness in their leadership skills increased from pre-survey to post-survey. Evaluation of qualitative responses exhibited that participants found value in adding more leadership development to their pharmacy training. Most participants noted leadership book discussion facilitation as the most valuable part of the initiative and posited they would utilize skills gained through these discussions nearly every day in their careers. Results suggest PGY1 pharmacy residents showed the most significant increase in their scores from pre- to post-study, while didactic students showed the least significant increase. Implications: Our findings suggest learner-driven leadership initiatives, specifically learner-facilitated book club discussions, are beneficial to incorporate into both didactic and experiential coursework. Implementation of these discussions could be applied in many aspects of the curriculum with minimal resources and a reasonable expectation of perceived benefit to student leadership development.

Assessment of an education tool to improve knowledge and reduce stigma of a syringe service program (SSP) at a VA Medical Center

BackgroundDrug overdose deaths are a growing epidemic in the United States owing in part to inadequate support from health care systems. In response, the Veterans Health Administration (VHA) plans to implement syringe service programs (SSPs) across VHA medical centers. This SSP education project aims to positively affect health care staff perceptions regarding SSPs and reduce the stigma surrounding substance use. ObjectivesThe purpose of this research was to allow Advanced Pharmacy Practice Experience (APPE) students to implement and assess an educational program regarding SSP enactment at this institution. Furthermore, the objectives of the educational program were to address the stigma associated with substance use and provide knowledge to staff about SSPs. Practice descriptionEleven complete and one abbreviated (no questionnaire) presentations were delivered by APPE students throughout the main facility and outpatient clinics, with presentations being delivered to physicians, nurses, and a range of other professions. Practice innovationAPPE students developed educational content and pre- and postsurveys that were used to assess for changes in knowledge and perception surrounding substance use and SSPs. Evaluation methodsThe primary outcome was to assess individual pre- and postprogram survey responses using mean, SD, and mean change to measure the impact that the presentation had on individualized stigma. ResultsA total of 104 completed surveys were analyzed in Microsoft Excel and subcategorized by profession; 10 of the 15 questions asked in the questionnaire yielded statistical significance when comparing pre- and postpresentation results (P < 0.05). ConclusionsA presentation method developed and delivered by APPE students resulted in a statistically significant change in perception and knowledge, proving to be an effective method for educating health care staff on SSPs.

Strengths and limitations of a novel “Flip the Pharmacy” practice transformation coach advanced pharmacy practice experience

Background and purposeFlip the Pharmacy (FtP) helps community pharmacies “flip” from dispensing- to patient-centered care models with assistance from practice transformation coaches (“coaches”). Purdue University College of Pharmacy created a novel advanced pharmacy practice experience (APPE) positioning students to serve as FtP coaches with oversight from four faculty coaches. This communication describes the APPE's design, characterizes preliminary student coaching outcomes, and identifies the APPE's strengths and limitations. Educational activity and settingTwelve pharmacies were coached by APPE students. The APPE was designed to enhance student knowledge and skills in the scaled implementation of advanced patient care services through structured weekly activities: Week 1, student orientation and training; Week 2, preparing for pharmacy visits; and Weeks 3 and 4, conducting pharmacy visits. Students also performed recurring tasks each week, including managing social media accounts. FindingsTwenty-eight students completed the APPE. Students conducted 81 in-person and 105 virtual visits. Faculty coaches were estimated to need 40 to 50 hours each month for coaching-related activities; involving student coaches reduced faculty coach time by approximately 50%, with faculty spending 20 hours on average per month vs. students spending 50.84 hours. APPE strengths included intentional weekly structuring and oversight and careful student transitions; limitations included minimal pharmacy vendor knowledge and limited rapport-building with pharmacies. SummaryEarly experiences demonstrated several benefits, including optimized faculty coach time and student exposure to practice transformation. Future endeavors to implement similar APPEs should incorporate strategies to enhance pharmacy vendor knowledge and strengthen relationship-building with participating pharmacies.

Evaluation of a Well-being Promotion (WelPro) Program on Advanced Pharmacy Practice Experience (APPE) Student Burnout

ObjectiveThe objective of this study is to evaluate the Well-being Promotion (WelPro) program and its effect on burnout in Advanced Pharmacy Practice Experience (APPE) students at the University of California, San Francisco. MethodsA longitudinal cohort study evaluating the WelPro program was conducted in the class of 2021 (Transformation, a 3-year all-year-round curriculum, and Pathway (P), a 4-year traditional curriculum) APPE students. The primary and secondary aims were to evaluate changes in emotional exhaustion (EE) scores from the beginning of year (BOY) to end of year (EOY) for the class of 2021 students and compare EOY EE scores between the classes of 2021 (P) and 2020 (P) students using the Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS [MP]) survey. Independent and paired t tests were used to evaluate EE scores; Wilcoxon signed-rank test and Wilcoxon Mann–Whitney rank sum test were used to evaluate ordinal data. ResultsEvaluable survey response rates were 69.6% BOY and 57.7% EOY for the class of 2021 students and 78.7% EOY for the class of 2020 (P) students. No differences in EE scores were observed for the matched class of 2021 from BOY to EOY and between classes of 2021 (P) and 2020 (P) students. ConclusionWelPro did not change EE scores for class of 2021 APPE students. Given multiple confounding factors in the study, additional studies are warranted to determine the effectiveness of such a program on APPE student burnout.

Pharmacy student involvement in population health management of statin quality measures

AbstractBackgroundPharmacists have demonstrated their value in population health management (PHM). With appropriate training, advanced pharmacy practice experience (APPE) students are also well positioned to participate in PHM.MethodsAt Providence Medical Foundation, a PHM workflow was remodeled to be more standardized and incorporate APPE students into the statin quality measure improvement process. This was driven by institutional goals for quality improvement in patient care and creating a better experiential teaching opportunity. APPE students underwent three training sessions and completed clinical review of patient charts, determined statin eligibility, and completed patient outreach. Rates of statin initiation and student feedback were collected. The rates of statins initiated or declined with this new workflow were retrospectively compared to a previous year's workflow, which was pharmacist‐led.InterventionReview pharmacy student involvement with PHM, including statin initiation rates for quality measure improvement as well as student feedback and learning.ResultsAmong the 543 patients included in the remodeled workflow, students started statins for 75 (13.8%) patients while 114 (21%) patients declined statins. Among the 829 patients included in the previous year's traditional workflow, pharmacists started statins for 102 (12.3%) patients while 167 (20.1%) patients declined statins. There was no statistically significant difference in rates of statins started (odds ratio [OR] 0.88; 95% confidence interval [CI] 0.63–1.22; p = 0.41) and statins declined (OR 0.95; CI 0.72–1.25; p = 0.73) between the two groups. Student feedback on this activity was positive with self‐reported improvement in confidence, clinical knowledge, and communication skills.ConclusionsIncorporating pharmacy students into PHM was a valuable learning experience for students and effective for initiating statins to assist with quality measures. Students can be an asset to the team in PHM and help ease resource shortages.

Implementing Oncology Pharmacy Boot Camp for Advanced Pharmacy Practice Experience Students at a Regional Conference in Saudi Arabia.

Background Upon graduation, pharmacy students are expected to possess a diverse array of knowledge, skills, and attitudes. A subject-specific boot camp may support bridging the gap between the information and skills gained during clerkships, courses required for pharmacy school after graduation, and skills needed for the job market, as well as the gap between pharmacy school and residency. This research aimed to determine whether an integrated boot camp increased Advanced Pharmacy Practice Experience (APPE) student self-confidence and enhanced students' knowledge in oncology pharmacy. Method APPE students who attended the annual meeting of the Saudi Oncology Pharmacy Assembly (SOPA)/International Societyof OncologyPharmacy Practitioners(ISOPP) Regional Conference 2021 were voluntarily enrolled in a three-hour oncology-focused boot camp consisting of interactive lectures. Pre- and post-intervention examinations were used to evaluate student learning outcomes and their experience feedback. Result Of 118 students who attended the boot camp, 80 students who met the criteria were included in the study. The pre- and post-intervention examinations were completed by the 80 APPE students. The pre-intervention test results (mean: 66%, standard deviation (SD): 16%) increased by 21.5% after the boot camp (mean: 87.5%, SD: 12%, p = 0.001). Students scored better on each of the 10 test questions, with nine questions demonstrating a statistically significant result. Conclusion The results of this research showed that interns who participated in an oncology boot camp had a higher level of knowledge and confidence in applying key oncology concepts. Interns were satisfied with the chance to engage in the activity, and they agreed to adding boot camps to future conferences would be valuable. This research shows that it is possible to hold a transitional boot camp during conferences to better prepare students for their fields of study and increase their participation in oncology conferences.

An Online, Multi-institutional Debate on Diabetes Medications by Advanced Pharmacy Practice Experience Students

Objective. The purpose of this study was to evaluate changes in advanced pharmacy practice experience (APPE) students' knowledge and to measure student perceptions of an online, multi-institutional debate curriculum as an alternative to a journal club to improve critical thinking skills related to diabetes medications.Methods. All APPE students assigned to four faculty (n=37) at three different colleges during the 2020-2021 academic year received instruction on diabetes medication classes and their cardiovascular outcome trials. Students debated via the Lincoln-Douglas format whether the preferred second-line therapies for patients with type 2 diabetes mellitus are either glucagon-like peptide-1 receptor agonists or sodium-glucose cotransporter-2 inhibitors. Matched pre- and post-APPE knowledge scores were measured using a seven-item assessment tool. A 22-item post-debate survey measured student perceptions of the activity.Results. Pre- and post-APPE knowledge scores were compared in 32 students, yielding an 86% response rate. Knowledge scores improved 32% (59% pre vs 87% post). Thirty-three students completed the perceptions survey, yielding an 89% response rate. Students reported that the debate activity was beneficial (100%) and rated it more effective than a journal club at improving critical thinking skills and knowledge retention.Conclusion. Preliminary results suggest that incorporating an online, multi-institutional debate as an alternative to journal clubs during APPE rotations was well received. Further research is warranted on the impact of the multi-institutional debate and how to best deliver it during the APPEs of a pharmacy curriculum.

Pharmacy Students' and Pharmacist Preceptors' Perceptions of the Hospital Rotation Experience during the COVID-19 Pandemic.

The COVID-19 pandemic brought significant disruptions to pharmacy experiential education. To ensure the safety of students and staff, university and rotation site educators needed to make changes rapidly to adapt to the dynamic environment. To explore the impact of the COVID-19 pandemic on pharmacy students and their preceptors during experiential rotations and to identify any barriers to learning that arose and opportunities for improvement. Two online questionnaires were developed to explore the perceptions of pharmacy students and preceptors during experiential rotations. The following topics were examined: support for rotations by the hospital and the university, perceived safety, accessibility of resources, interpersonal interactions, professional development, assessment and evaluation, and overall impressions. All Advanced Pharmacy Practice Experience students from the University of Toronto who completed 1 or more rotations at North York General Hospital during the 2020/21 academic year and their preceptors were invited to participate. Sixteen and 25 questionnaires were completed by students and preceptors, respectively. Both groups agreed that they were adequately prepared for the rotations and felt safe. There was a decrease in interpersonal interactions, while the use of virtual communication tools increased. Lessons learned included the need for timely communications and access to resources for learners and preceptors, contingency plans for staff shortages and outbreaks, and workspace assessments. During the COVID-19 pandemic, implementation of experiential rotations was associated with many challenges, but pharmacy learners and preceptors believed the overall experience was not significantly affected.

Design and Assessment of a Pharmacy Student–Delivered Preceptor Development Program

Objective. To design and assess the use of a pharmacy student-delivered preceptor development program.Methods. A student-delivered preceptor development program was developed to ensure all preceptors received documented preceptor development. A menu of discussion topics and associated teaching sheets were created by the school's office of experiential education. On each rotation, advanced pharmacy practice experience (APPE) students led discussions with their preceptors on a topic chosen by the preceptor and submitted documentation of the education. Preceptors answered a survey related to the amount of information and time required for the program, their preference for different formats of preceptor development, one important thing they learned through the program, and future development topics of interest. Students were interviewed regarding their perceptions and use of the program.Results. A novel student-delivered preceptor development program resulted in documentation of preceptor development for all APPE rotations. Seventy-nine preceptors (31% response rate) participated in the survey. In their responses, preceptors generally agreed that they were able to customize their development and incorporate what they learned into practice, and that the program had a convenient format and was valuable for preparing students to be future preceptors. Students reported that the program improved their confidence in communicating with a supervisor and prepared them for precepting.Conclusion. A student-delivered preceptor development program improved documented preceptor development. The program allowed preceptors to customize development opportunities in a convenient format. It was perceived positively by preceptors who would recommend the program to other schools of pharmacy.

Implementation of a Global Health Equity fellowship established in partnership between an academic institution and governmental agency

AbstractHealth disparities exist globally in high‐income and low‐ and middle‐income countries. They are driven by social determinants of health (SDOH). While a role for pharmacists in addressing SDOH exists, a lack of structured postgraduate training limits pharmacists from being equipped to build innovative programs and contribute to health policy on SDOH in an impactful way. Postgraduate training, specifically, fellowships provides opportunities for pharmacists to develop the needed skills for working with SDOH. The Purdue University College of Pharmacy (PUCOP)‐United States Agency for International Development (USAID) Global Health Equity Fellowship was developed to meet this training need. This 2‐y fellowship represents a partnership between USAID and PUCOP. During the fellowship, time is split between USAID in Washington DC, PUCOP in Indianapolis, Indiana, and the Purdue Kenya Partnership (PKP) in Eldoret, Kenya. The fellowship was developed with a foundation of core values, the creation of a logic model, strategic partnerships, maintaining an adaptable structure, and intentional partner communication. Fellow outcomes were evaluated in three categories: engagement, education, and scholarship. Fellows completed 10 experiential opportunities between three sites and participated in the development of new and supported ongoing care programs and policy implementation in both local and international settings. Fellows completed the following educational outcomes: completed an online Master of Public Health (MPH) through Purdue Global, provided 13 educational presentations and lectures at various sites, and precepted a total of 12 PUCOP advanced pharmacy practice experience (APPE) students and 16 Kenyan pharmacy interns and Master of Pharmacy (MPharm) students. Fellows completed three publications and two abstracts at international conferences. This established training model provides pharmacists with a structured path to gain the knowledge, skills, and attitudes to be leaders in addressing Global Health Equity.

Burnout Among Pharmacy Preceptors in Northern California

Objective. The objectives of this study were to investigate the incidence of burnout syndrome among pharmacy preceptors and to identify predictors for the development of burnout in this population.Methods. This cross-sectional survey study examined burnout syndrome among pharmacy preceptors in Northern California. Preceptors were included if they self-identified as a preceptor to advanced pharmacy practice experience (APPE) students or to postgraduate pharmacy residents in their first year of residency. Burnout was assessed using the Maslach Burnout Inventory Human Services Survey, and preceptors were classified as having burnout syndrome if they scored high on emotional exhaustion and also either scored high on depersonalization or scored low on personal accomplishment. Additionally, respondents' demographics, workplace environment, workload, and day-to-day workflow were queried to help determine predictors of burnout syndrome among this population.Result. The study included 113 pharmacy preceptors. Of the preceptors, 22% reported scores consistent with burnout, with 57% of preceptors scoring positive for burnout in one of the three burnout criteria. On multivariate regression analysis, two independent risk factors for burnout syndrome were identified: preceptors who precepted many difficult or unmotivated learners per year and preceptors who did not feel their contributions as preceptors were appreciated by their institution.Conclusion. The rate of burnout among pharmacy preceptors is high, with preceptors exhibiting high emotional exhaustion and low levels of personal accomplishment. Predictors of burnout syndrome for this population appear to be precepting many difficult or unmotivated learners and not feeling that one's contributions as a preceptor are appreciated.

The Role of an Infectious Diseases Faculty Pharmacist and Pharmacy Students on an Antimicrobial Stewardship Team at a Community Non-teaching Hospital

Background: Antimicrobial stewardship program implementation at non-teaching community hospitals differs due to staffing and resource disparities. Objective: Demonstrate that an infectious disease (ID) pharmacist faculty with advanced pharmacy practice experience (APPE) students can expand antimicrobial stewardship services at non-teaching community hospitals. Methods: A single-center, retrospective chart review was conducted comparing prospective audit and feedback antimicrobial stewardship interventions by an ID pharmacist faculty with and without APPE students between January 16, 2020 to January 16, 2021. The primary endpoints were intervention rate and the intervention acceptance rate. Secondary endpoints included: the difference in the time from antimicrobial order to intervention and length of stay, as well as comparison of acceptance rates stratified by intervention type or the antimicrobial intervened upon. Results: A total of 739 antimicrobial stewardship interventions were made with an overall acceptance rate of 55.2%. The ID pharmacist faculty with APPE students had a higher number of interventions and intervention rate per working day compared to without students (428 vs 311 and 4.46 vs 2.99, respectively). Conversely, the intervention acceptance rate was lower for the ID pharmacist faculty with APPE students vs without (48.8% vs 64%, P < .001). Both the median time from antimicrobial order to the intervention and length of stay was lower for the ID pharmacist faculty with students vs without (2.50 days [interquartile range (IQR) 1.24 - 4.01] vs 2.99 days [IQR 1.64 - 4.95], P = .003, and 9.20 days [IQR 5.57 - 14.93] vs 11.69 days [IQR 6.89 - 22.31], P < .001, respectively). The acceptance rates by intervention type and the antimicrobial intervened upon were similar between groups. Conclusion: An ID pharmacist faculty with APPE students at a non-teaching community hospital increased the number of stewardship interventions, and was associated with decreased time from antimicrobial order to intervention and length of stay.

“Death Over Dessert” – A conversation with pharmacy students about what really matters in the end

Background and purposePharmacists will encounter the death of patients and loved ones throughout their career. Though this is a part of our profession as health care providers, many pharmacy students express discomfort and even fear of discussing death and dying with their patients. “Death Over Dessert” has been developed as a loosely structured discussion held during a required geriatrics advanced pharmacy practice experience (APPE). Educational activity and setting“Death Over Dessert: uses principles of “Death Over Dinner,” a free online program, “Where I Stand” scales from The Conversation Project, and a series of written reflection questions for after the activity. The discussion is led by two faculty members and ranges from two to six APPE students per offering. A mixed-methods approach was used to assess participant responses to reflection questions. FindingsOf the 19 participants, all (n = 19, 100%) found the activity to be beneficial despite many mentioning the topic can be uncomfortable. There were five overall themes identified that broached personal and professional views: significance of end-of-life discussion with family, important aspects of personal wishes at end-of-life, the definition of living, approaches to end-of-life discussion, and the role of end-of-life in the pharmacy curriculum. Summary“Death Over Dessert” is a new teaching modality for faculty and preceptors to consider using in their classrooms or rotation activities.

Creation of a Pharmacy Student Longitudinal Rotation to Expand the Scope of an Antimicrobial Stewardship Program.

Allergy assessments and penicillin skin testing have emerged as a vital intervention for Antimicrobial Stewardship Programs (ASPs). Investment and involvement in such programs by ASPs, however, are often limited due to resources, time, and personnel constraints. Harnessing an underutilized resource, 4th-year advanced pharmacy practice experience (APPE) students, allows for expanded ASP involvement and scope of practice. We aim to outline and provide insight on how 4th-year APPE students serve as an asset to an ASP. Through our novel longitudinal rotation experience, APPE students complete penicillin allergy assessments, patient education, and work alongside a clinical pharmacist to refer patients for penicillin skin testing if appropriate. Students also achieve many of the education standards required by the Accreditation Counsel for Pharmacy Education (ACPE) for graduation within the Doctor of Pharmacy degree while developing a strong foundation in antimicrobial stewardship and gaining invaluable knowledge for their future. The addition of APPE pharmacy students to our ASP has also enabled our program to achieve its goals and expand involvement and reach within our facility.

Oncology boot camp: A preparatory curriculum for advanced pharmacy practice experience students.

The primary objective of this study was to evaluate the effectiveness of an autonomous oncology boot camp on Advanced Pharmacy Practice Experience (APPE) student knowledge. Secondary objectives included assessing student perception of the virtual learning experience and overall comfort level with the material. APPE students rotating through our institution between November 2019 and March 2020 were voluntarily enrolled in a 4-hour oncology-focused boot camp, which included five PlayPosit (Denver, CO, USA) interactive video lectures embedded with case-based application questions followed by one comprehensive web-based Quandary (Victoria, BC, Canada) action-maze case. Student learning was measured by a pre- and post-intervention exam. A web survey tool (Qualtrics, Provo, UT, USA) collected student perceptions evaluating their comfort with oncology-specific drug knowledge and APPE rotations tasks. Fifty students enrolled in the oncology boot camp, with 100% completing the pre- and post-intervention assessments. Overall, pre-intervention exam scores (mean: 55.4%, SD: 21.8%) improved by 23.2% following the boot camp (mean: 78.6%, SD: 19.2%; p < 0.001). Students performed better on all 10 exam questions, with 6 questions showing a statistically significant improvement (p < 0.05). Forty-five students (90%) completed the perception surveys. Of those, 93% agreed that it effectively reinforced important oncology knowledge, 91% supported the autonomous design, and 82% would recommend the oncology boot camp for future students. The boot camp proved to be a beneficial educational tool that enhanced student knowledge and confidence in navigating common oncology concepts. Students valued the ability to independently complete the activities and supported its continuation.

Student and educator perspectives on virtual institutional introductory pharmacy practice experience (IPPE)

BackgroundThe COVID-19 pandemic has required governments around the world to suspend face-to-face learning for school and university students. Colleges of pharmacy are faced with the challenge of training students in hospitals that are under considerable pressure at this time. The government of Saudi Arabia has moved all classes and training online to limit the spread of the virus. This study describes the experience of the Introductory and Advanced Pharmacy Practice Experience (IPPE and APPE) students and preceptors engaged in the virtual IPPE training.MethodsA cross-sectional study was conducted to describe and appraise the implemented virtual IPPE training from the experiences of IPPE and APPE students, and their preceptor. The IPPE students described their experiences in close-ended questionnaires, while APPE students in open-ended questionnaires, and the preceptor described the experiences in narrative. The study focused on highlighting the advantages, opportunities, challenges, and shortcomings of the virtual training.ResultsTwo preceptors and seven APPE students participated in the preparation and administration of the virtual training. The IPPE students’ experiences, based on 87 respondents, were mostly positive. Although IPPE students enjoyed the time flexibility that allowed the learning of new skills and reflection on previous experiences, 15% experienced difficulty finding quiet places with a reliable internet connection or had difficulty working on team-based activities. Moreover, some were anxious about the lack of adequate patient-care experience. On the other hand, the APPE students found the experience enriching as they gained experience and understanding of academic workflow, gained skills, and overcame the challenges they faced during this virtual training experience.ConclusionsFuture training programs should be organized to overcome the challenges and to maximize the benefits of training experiences. Schools of pharmacy may benefit from the training materials constructed, prepared, and administered by APPE students to improve IPPE students’ learning experiences and outcomes.

Teaching advanced pharmacy practice experience students to be effective teachers of second-year pharmacotherapy students

IntroductionAcademic advanced pharmacy practice experiences (APPEs) are unique elective opportunities for student pharmacists to engage with and learn about academia. The purpose of this research was to determine the impact of second-year (PY2) student participation in fourth-year (PY4) academic APPE student-delivered review sessions on individual pharmacotherapy examination scores. MethodsThe PY2 cohort was evaluated by comparing their performance against the class average when they did and did not attend a review session. Utilizing a t-test, we sought to determine if there was a significant change in student performance. Qualitative evaluations were also performed on the PY4 students experience during their rotation. ResultsA total of 28 PY2 student pharmacists took a total of 140 exams during the study period. Of the 140 exams taken, 54 individual exams were taken after attending a review session created and led by PY4 student pharmacists and 86 exams were taken in the absence of attending a review session. Analysis showed that student performance on exams after attending a review session was 0.4 SD above the class average, while performance was very close to the class average at 0.05 SD above the class average when review sessions were not attended. ConclusionsPY4 student pharmacists trained on an academic APPE can improve PY2 student pharmacists' pharmacotherapy exam scores. APPE students also self-reported positive learning experiences while participating in this teaching.

Faculty preceptors' strategies for teaching clinical reasoning skills in the advanced pharmacy practice experience setting

IntroductionClinical reasoning is essential to providing quality patient care. However, advanced pharmacy practice experience (APPE) students may struggle with the real-life aspects of patient care, and it may be difficult to quickly identify these students in order to make meaningful interventions. The purpose of this study was to explore pharmacy faculty preceptors' strategies for identifying gaps and teaching clinical reasoning in the APPE setting. MethodsA qualitative study utilizing 30-min, one-on-one phone interviews was conducted with faculty members from two schools of pharmacy. Faculty participants were invited based on their APPE preceptor role and expertise in adult general medicine. Interview questions collected faculty demographics and reflections on evaluation and instruction of clinical reasoning skills. Demographics were analyzed using descriptive statistics. Thematic analysis was completed to identify themes from qualitative interview data. ResultsFifteen faculty preceptors participated. The cohort had an average of 17.1 pharmacy practice years and an average of 11.9 faculty member years. Interviews yielded a 7735-word document for data analysis, which resulted in 11 themes. ConclusionsThis study explored pharmacy faculty preceptors' strategies for identifying gaps in clinical reasoning and their instructional methods to improve those skills, which resulted in 11 themes. Future directions include implementation of a standardized clinical reasoning assessment tool in the APPE setting and exploration of targeted educational interventions.

Multisite Study Assessing the Effect of Cognitive Test Anxiety on Academic and Standardized Test Performance

Objective. To evaluate the degree of cognitive test anxiety (CTA) present in student pharmacists at multiple pharmacy programs in the United States and to determine if there are associations between self-reported CTA and relevant academic outcomes.Methods. All 2018-2019 advanced pharmacy practice experience (APPE) students from three US Doctor of Pharmacy (PharmD) programs (N=260) were invited to participate in the study. Participants completed a validated 37-question survey that included the Cognitive Test Anxiety Scale-2 (CTAS-2) along with demographics-related questions. Responses were analyzed using analysis of variance (ANOVA), Kruskal Wallace, and multiple linear regression where appropriate.Results. One hundred twenty-four students (48%) from the three programs participated in the study, and the individual data of 119 (46%) were included in the final analysis. Twenty-two students (18.5%) were classified as having high CTA, 41 (34.5%) as having moderate CTA, and 56 (47.1%) as having low CTA. High CTA predicted a 8.9 point lower NAPLEX total scaled score after accounting for other variables and was also correlated with lower cumulative didactic GPA, performance on the Pharmacy Curriculum Outcomes Assessment (PCOA), and increased likelihood of requiring course remediation.Conclusion. High cognitive test anxiety affects 18% of pharmacy students and may significantly impact their performance on a variety of traditional student success measures, including the NAPLEX. Pharmacy educators should consider further use and adoption of test anxiety measurements to identify and assist potentially struggling students.

Comparing perceptions of student abilities in diabetes self-management education and support among students, faculty and patients

Background and purposeDiabetes self-management education and support (DSMES) equips patients with diabetes with the knowledge needed for appropriate management. The purpose of this study was to compare perceptions of student confidence/aptitude held by students, pharmacy faculty preceptors, and patients regarding student teaching of a DSMES class. Educational activity and settingThe study was a prospective assessment of fourth-year ambulatory care advanced pharmacy practice experience students. Students taught a single DSMES class and evaluated their confidence using a 14-item survey before and after the class. Patients who participated in the class and a pharmacy faculty observer completed the same instrument. Responses were compared using Friedman and Wilcoxon signed-rank tests, as appropriate. FindingsTwenty-six students completed the survey. Overall, students’ self-perceived confidence scores significantly increased for all questions after teaching the DSMES class (P < .001 for all questions). Confidence scores among students and faculty preceptors were similar with no significant differences in perceived confidence. There were some significant differences found among student and patient scores, with patients assessing student’s perceived self-confidence higher than the students on three items (P < .05). SummaryStudent pharmacists’ perceptions of their own confidence and abilities improved from before to after teaching a DSMES class. Student and faculty preceptor confidence scores were similar. There were few differences between student and patient confidence scores, with patients rating students highly on their perceived confidence in teaching a DSMES class. Patient feedback is important to consider when evaluating student confidence and abilities.