Pharmacy Education Research Articles

Learner and supervisor perspectives on factors that influence the effectiveness of educational supervision in postgraduate pharmacy education

Abstract Introduction Educational supervision underpins the Centre for Pharmacy Postgraduate Education’s (CPPE) publicly funded national training pathways for pharmacy professionals working in primary care in England, mirroring arrangements for postgraduate medical specialty training. The educational supervision provided by CPPE comprises both one-to-one support and group learning to enable pharmacy professionals transitioning into primary care roles to progress with their education, manage workplace challenges and practise safely.1 However, little is known about its effectiveness. Aim The aim of this study was to explore learner and supervisor perceptions of factors that influence the effectiveness of educational supervision. Methods The study used a concurrent embedded mixed methods design. Following institutional ethical approval, data were collected using a validated online survey comprising items adapted from the Manchester Clinical Supervision Scale (MSCC-26®)2 and the Academy of Medical Educators’ (AOME) framework. The survey, comprising a 25-item questionnaire, together with open-ended questions inviting respondents to explain their ratings, was sent to all 902 learners enrolled on a CPPE primary care training pathway and 52 CPPE education supervisors in July 2020. Statistical data were analysed with SPSS®, using non-parametric tests due to negative data skewing. Responses to open-ended questions were analysed with NVivo® using framework analysis and then compared with the statistical data. Results 187 learners (20.7%) and 51 supervisors (98%) responded to the survey. Overall, 82.5% learners and 100% of supervisors rated the educational supervision provided by CPPE as effective. Framework analysis of responses to open-ended survey questions identified three main factors perceived by learners and supervisors to influence the effectiveness of educational supervision: supervisor-learner relationships; a safe learning environment; and peer support. Within the theme of supervisor-learner relationships, trust and rapport was awarded the highest mean score of any survey item. Trust and rapport and the ability of supervisors to establish a safe learning environment showed significant positive correlations (ρ(8) = .48, p < .001 and ρ(8) = .74, p < .001 respectively) with overall scores for the effectiveness of educational supervision. Peer support did not form part of the survey yet was mentioned spontaneously in many learner and supervisor responses. Learners described the benefits of educational supervision in providing opportunities to learn from peers, to receive peer feedback and to obtain peer and supervisor support for personal issues such as workplace challenges. Discussion/Conclusion Consistent with the literature on factors that influence the effectiveness of clinical supervision in other healthcare professions3, the results indicate that educational supervision provided by CPPE was more effective when levels of trust and rapport between learners and supervisors were high and when supervisors were able to create a safe learning environment. However, peer support has not previously been identified as an influencing factor. This is an important finding, reflecting that unlike other disciplines, the educational supervision provided by CPPE encompasses both one-to-one and group learning sessions. Limitations of the study include the relatively low learner response rate, the effect of the COVID-19 pandemic which required provision of online supervision and the potential bias from insider research.

Design and Usability Testing of an Augmented Reality (AR) Environment in Pharmacy Education—Presenting a Pilot Study on Comparison between AR Smart Glasses and a Mobile Device in a Laboratory Course

An essential feature of pharmacy education is the teaching of theoretical knowledge with the support of practical work in the laboratory. When properly utilized, laboratory activities have the potential to enhance students’ achievement, conceptual understanding, and positive attitudes towards learning. In this pilot study, an augmented reality (AR) environment was designed and introduced for teaching laboratory skills in pharmacy education at the university level. The AR environment was used by pharmacy students (n = 36), featuring gate questions, information screens, Quick Response codes, think-aloud questions, and instant feedback. The environment was utilized with smart glasses and mobile devices with the aim of comparing the support to students’ performance. User experience was evaluated through self-efficacy beliefs and anxiety towards the technology. As a result, students found the environment a useful supplement to traditional laboratory teaching. Smart glasses and mobile devices were both accepted with great positivity but neither being clearly preferred over the other. Smart glasses were noted to provide sufficient feedback in the right stages of work. In contrast, mobile devices promoted the learning process more than the smart glasses. The self-efficacy results for mobile device use were higher, especially related to device handling and operating the AR environment. The pilot study gives educators valuable insights on the usability of AR technology in guiding laboratory tasks, although future work should involve larger and more diverse samples, as well as different learning tasks.

Adapting the layered learning model to a virtual international exchange program

IntroductionThe layered learning model (LLM) is a well-established teaching approach designed for attending preceptors to train post-graduate learners and to precept students. The adaptation of a LLM to a virtual exchange program has not been previously described. The purpose of this study was to evaluate the effectiveness of the longitudinal virtual international exchange program in applying principles of the LLM to multiple levels of learners and instructors at West Virginia University (WVU) School of Pharmacy and Kitasato University (KU) School of Pharmacy. MethodsThe online survey piloted the impact of applying the LLM to virtual international exchange sessions on improving participant knowledge in pharmacy practice, pharmacy education, cultural practices, and cultural awareness. The survey questions assessed the program's structure and effectiveness in achieving learning outcomes related to pharmacy residency topics and cultural competency using a five-point Likert scale. ResultsMedian scores of the effectiveness of the virtual international exchange program structure were high (≥ 4.0). Two questions evaluating the use of the LLM had median scores of 4.0. All nine residency-related questions were rated ≥3.0. The median scores for three questions evaluating small group discussions and the use of the LLM were rated significantly higher by WVU participants than KU participants. There were no significant differences in program structure and learning outcome ratings between participant groups (student vs. resident/fellow vs. preceptor/faculty). ConclusionsApplication of the LLM to the virtual international exchange program was positively received by participants, particularly by United States participants.

Information and Communication Technologies Combined with Mixed Reality as Supporting Tools in Medical Education

The dynamic COVID-19 pandemic has destabilized education and forced academic centers to explore non-traditional teaching modalities. A key challenge this creates is in reconciling the fact that hands-on time in lab settings has been shown to increase student understanding and peak their interests. Traditional visualization methods are already limited and topics such as 3D molecular structures remain difficult to understand. This is where advances in Information and Communication Technologies (ICT), including remote meetings, Virtual Reality (VR), Augmented Reality (AR), Mixed Reality (MR), and Extended Reality (XR, so-called Metaverse) offer vast potential to revolutionize the education landscape. Specifically, how MR merges real and virtual life in a uniquely promising way and offers opportunities for entirely new educational applications. In this paper, we briefly overview and report our initial experience using MR to teach medical and pharmacy students. We also explore the future usefulness of MR in pharmacy education. MR mimics real-world experiences both in distance education and traditional laboratory classes. We also propose ICT-based systems designed to run on the Microsoft HoloLens2 MR goggles and can be successfully applied in medical and pharmacy coursework. The models were developed and implemented in Autodesk Maya and exported to Unity. Our findings demonstrate that MR-based solutions can be an excellent alternative to traditional classes, notably in medicine, anatomy, organic chemistry, and biochemistry (especially 3D molecular structures), in both remote and traditional in-person teaching modalities. MR therefore has the potential to become an integral part of medical education in both remote learning and in-person study.

Assessing student reflections of significant professional identity experiences

IntroductionProfessional identity formation (PIF) is an essential component of pharmacy education. A student-focused holistic approach can be introduced through exposure to a variety of curricular and co-curricular activities. It is essential for students to not only participate in these activities but also to reflect on their actions and thoughts about those activities. The objective of this study was to better understand the experiences students identify as significant in their PIF. MethodsA mixed methods approach with qualitative thematic analysis was conducted for first-year (P1) and second-year (P2) student pharmacist end-of-year reflections to understand the types and impact of various experiences on PIF. Students identified which experience was most impactful; additional analysis based on this identification was conducted. ResultsA review of 151 student reflections led to coding and analysis of 453 experiences. Co-curricular experiences were identified most frequently in both P1 and P2 groups (59.8% and 56.4%, respectively). Curricular experiences were more likely to be mentioned by P1 students than P2 students (28.8% vs. 9.8%, P < .001). P2 students were more likely to identify experiential rotations (17.9% vs. 6.4%, P < .001) or work (13.7% vs. 9.1, P < .001). Other experiences were cited less frequently but were ranked as most impactful by students. Students often identified experiences that allowed them to apply skills and knowledge and opportunities to attend seminars and lectures. ConclusionsWhen reflecting on experiences and their impact on PIF, student pharmacists discussed a variety of experiences but identified co-curricular opportunities most frequently as impactful.

Can we do it all? Reflections on the development of a collaborative, three day a week internal medicine rounding experience

PurposeInterdisciplinary training is a critical part of pharmacy education, and often much of the interdisciplinary participation occurs during the advanced practice experiences of the final professional year of pharmacy education. Creation and maintenance of these experiences can be difficult for faculty members, especially faculty at community hospitals or those with multiple roles and responsibilities at their practice site. The purpose of this article is to reflect on the development process and student acceptance of a collaborative, three-day a week internal medicine rounding student experience. DescriptionInstead of a traditional five-day a week rounding schedule with a single, primary faculty preceptor, students participated in a three-day a week internal medicine rounding experience where their primary faculty preceptor had a faculty partner who functioned as a substitute. The student activities on the other days were adapted by each faculty preceptor based on their internal medicine subspecialty duties and needs of the practice site. Analysis/InterpretationResults from a seven-question, anonymous survey to students who participated in the three-day a week internal medicine rounds found high impact on their reported confidence and knowledge. Those responding “positive impact” or “extreme positive impact” ranged from 67% to 100%. In addition, 78% indicated comfort with the substitute faculty preceptor. ConclusionsThis collaborative, three-day a week rounding experience was well received by pharmacy students. ImplicationsNon-traditional rounding may be an option that could help decrease pharmacy student and faculty burnout, while still providing a positive learning experience for students.

Preparing pharmacy faculty through a postgraduate year one pharmacy residency program that includes a master of science in education degree

AbstractAn effective pharmacist workforce requires highly qualified and effective pharmacy educators. Qualifications required of pharmacy practice faculty may vary by academic institution but the American College of Clinical Pharmacy recommends completion of a residency or fellowship that includes structured teaching experiences and scholarly activities. Although teaching and learning certificate programs may offer a way for residents to gain this experience, program quality may vary and there is evidence that department chairs and other administrators may value additional advanced degrees over these certificate programs. However, less than 20% of the faculty surveyed obtained an additional degree beyond the Doctor of Pharmacy. Advanced degree programs are also a relatively uncommon component of pharmacy residency programs, with a Master of Science in Health‐System Pharmacy Administration being the most common. The first year of an innovative postgraduate 24‐month pharmacy practice residency program that includes completion of a Master of Science in Education degree offers the breadth and depth of ambulatory care practice, teaching, service, and research/scholarship that is beneficial for pharmacists seeking pharmacy practice faculty appointments. Eight key residency elements critical for success are detailed. A description of core coursework highlighted the intentional design of the Master of Science in Education degree program. Previous resident graduates reflected on the value of the Master of Science in Education degree program and the overall pharmacy residency program. This unique post‐graduate training program may serve as a model for preparing pharmacy practice faculty.

Optimising database searching in pharmacy education.

To determine the effectiveness of databases in a pharmacy education literature search. Six databases (CINAHL, ERIC, Google Scholar, Ovid MEDLINE, Science Direct and Scopus) were compared for effectiveness in identifying pharmacy education literature. Articles were coded for database of retrieval and results cross-referenced. Sensitivity, precision and number of unique retrievals were calculated. Scopus yielded the highest sensitivity (65%) and precision (47%). The combination of three databases (Scopus, Science Direct and Google Scholar) identified 97% (n = 64) of 66 relevant articles. Pharmacy education literature searches require more than one database, ideally Scopus, Science Direct and Google Scholar.

Pharmacy Education Conference 2022

We are pleased to confirm the publication of the oral and poster presentations of the Pharmacy Education Conference Abstract 2022: Initial education and training of pharmacists in a post-pandemic world.

ASHP Distinguished Leadership Award.

Marie A. Chisholm-Burns, PharmD, PhD, MPH, MBA, FCCP, FASHP, FAST, executive vice president and provost at Oregon Health and Science University in Portland, and Miriam A. Mobley Smith, PharmD, FASHP, interim dean of the University of Hawaii at Hilo Daniel K. Inouye College of Pharmacy, are the 2022 recipients of the ASHP Board of Directors Distinguished Leadership Award. The award recognizes contributions to excellence in pharmacy practice leadership in acute and ambulatory care settings. For nearly 30 years, Chisholm-Burns has embraced transformational learning opportunities that foster diverse and equitable academic and healthcare environments and encourage dialogue and innovation among students, patients, and providers. She seeks and supports opportunities to advance the success of students, faculty, staff, alumni, and other academic stakeholders. Her scholarly accomplishments include more than 380 publications and over $17 million in external funding as principal investigator or coinvestigator on research projects. She has served on governing boards of the Accreditation Council for Pharmacy Education, the American Society of Transplantation, the Georgia College Foundation, and the University of Tennessee Foundation.

Development of workplace‐based assessment tools to support postgraduate training of provisionally registered pharmacists in Australia

AbstractThe Australian Pharmacy Council (APC) is the national accreditation authority for pharmacy education and training in Australia. In 2020, APC published revised Accreditation Standards and a new Performance Outcomes Framework (POF). The POF details expected performance for pharmacy students at the point of graduation and for pharmacy graduates on completion of postgraduate training. The APC and the pharmacist regulator, the Pharmacy Board of Australia collaborated on a project to develop workplace‐based assessment (WBA) tools for use in assessing performance of pharmacy graduates in the postgraduate training period. The objectives of the project were to; identify and develop an initial suite of WBA tools; develop accompanying guidance and supporting documentation; seek feedback from stakeholders; and pilot the WBA tools in community and hospital settings. The WBA tools were developed through consultative process overseen by a group of education experts (a Technical Working Group) and a governance group. The latter comprising members from the Pharmacy Board and APC. The Technical Working Group agreed on the tools to develop based on an available Intern Year Assessment Blueprint and the tools were then drafted by a consultant. APC held consultative forums and a pilot study to gather feedback from intern pharmacists and preceptors. The project resulted in development of a suite of three types of WBA tools; Entrustable Professional Activities (EPAs), Case Based Discussions (CbD), and In Training Assessment (ITA) activities covering six areas of focus. All types of tools that were initially agreed upon were made available for use. The WBA tools address 15 performance outcomes in the POF. Future direction will involve further evaluation of the tools in diverse practice settings and expansion of the current suite of tools to cover additional performance outcomes.

Comparison of the University Pharmacy Education Programs in Germany and Vietnam.

During the global COVID pandemic, the importance of professionals in the health care sector has been put in a new light, including pharmacists. In this context, the focus is also on how pharmacists are trained in different countries. Through an exchange of pharmacy teaching staff from a German to a Vietnamese university, the pharmacy education programs in both countries were compared. Aspects such as access to studies, structure of studies, and further training opportunities were considered. Differences and similarities emerged. In both countries, students first acquire basic knowledge and then delve deeper into pharmaceutical content in main studies. There is, expectedly, a great overlap in the content of the courses. Overall, the education at Vietnamese universities seems to be more practice-oriented due to a large number of placements. This also allows a specialization, which can be pursued in Germany with self-interest after graduation. There, the preparation for everyday work in the community pharmacy is separated from the university by a mandatory practical year. For the future, efforts are being made in both countries to strengthen the importance of clinical pharmacy in the curriculum. To this end, the Vietnamese are taking their inspiration from abroad in many cases, including Germany.

A Call for Simplification and Integration of Doctor of Pharmacy Curricular Outcomes and Frameworks

Pharmacy education faces an upcoming revision of accreditation standards designed to outline degree program requirements for training the next generation of pharmacists. At the same time, pharmacy educators are increasingly expected to integrate multiple other educational frameworks and recommendations from distinct groups into their curricula. With this list of expectations constantly expanding and changing, education leaders are forced to spend valuable time and resources trying to satisfy "checklists" instead of enhancing their programs. The following commentary discusses concerns about the growing complexity of the standards and frameworks used in the accreditation process, overlap and redundancy in these various requirements, and relevant comparisons between pharmacy and medical education. We outline recommendations regarding purposeful integration of frameworks with the goal of simplifying accreditation requirements and enhancing program flexibility to deliver innovative, high-quality curricula.

Using Online Cancer Genomics Databases to Provide Teaching Resources for Pharmacy Education

Connecting scientific concepts with clinical applications is an important objective of pharmacy education. As the field of precision oncology expands, it is critical for pharmacy students to understand how genetic information informs cancer treatment decisions. However, to effectively teach students about pharmacogenomics and pharmacogenetics, faculty require relevant educational resources, including those that support higher-order learning. In this Commentary, we demonstrate the potential utility of publicly accessible cancer genomics databases as teaching resources for pharmacogenomics and pharmacogenetics in oncology pharmacy education. Using clinical data retrieved from a genomics database, we illustrate how case studies can be developed to target core competencies, including understanding tumor genomics profiling, somatic mutations and pharmacotherapy selection, and clinical pharmacogenetics testing. Cancer genomics databases provide readily available, cost-effective, clinical data resources that support active learning related to pharmacogenomics and pharmacogenetics education in oncology pharmacy curricula.

Student Performance on Graded Versus Ungraded Readiness Assurance Tests in a Team-Based Learning Elective

Objective. Team-based learning is widely used in pharmacy education. In this context, students need to be incentivized to do preclass preparation, thus ensuring they are ready for team-based learning, via graded readiness assurance tests (RATs). The purpose of this study was to determine the effect of graded versus ungraded RATs on examination performance in an ambulatory care elective course for third-year student pharmacists.Methods. For the course offered in spring 2020 and 2021, a standard team-based learning framework was employed. In 2020 the RATs were graded and contributed to the overall course grade (graded RAT cohort), but in 2021 RAT grades did not contribute to the course grade (ungraded RAT cohort). For the ungraded RAT cohort, at the end of the course students completed an online anonymous survey regarding class preparation and perceived team accountability.Results. No significant difference was found between the graded RAT (n=47) and ungraded RAT cohorts (n=36) in the overall mean percentage score on individual RATs (76% vs 74%) and individual examinations (82% vs 80%). Most students (69%-91%) in the ungraded RAT cohort reported completing preclass preparation assignments. In the postcourse survey, 94% of students agreed or strongly agreed that RATs contributed to team members' learning, and 86% agreed or strongly agreed that they were proud of their ability to assist in the team's learning.Conclusion. Ungraded RATs did not significantly impact students' examination performance in an elective course. Removing the grading of this test, whereby grading promotes the performance approach to learning, may have shifted the students' motivation to the mastery approach in the context of preclass preparation. This challenges a widely held belief that grades are necessary incentives for preclass preparation within team-based learning.

The Role of Pharmacy Education in Mitigating Weight Bias

Two-thirds of American adults are labeled as overweight or obese by current body mass index weight status categories. Individuals categorized as overweight or obese are at risk of weight bias and, subsequently, poorer health care experiences and outcomes. However, schools and colleges of pharmacy may not be providing robust education or training to student pharmacists on weight bias, assessment of their own bias, or how to address and mitigate weight bias against patients. This commentary explores the impact of weight bias on patient care and how efforts can be advanced to recognize and address weight bias in pharmacy education and pharmacy practice to provide optimal care to patients of all sizes.

Five Essential Steps for Faculty to Mitigate Racial Bias and Microaggressions in the Classroom

Educators must recognize the pharmacy curriculum itself is an instrument that can propagate or discourage systemic racism. The role of pharmacy education in disseminating racial bias through didactics deserves further consideration. While microaggressions have begun to be acknowledged in the pharmacy learning environment, specific guidance on mitigating racial microaggressions in the classroom has not been provided. This paper aims to suggest actionable strategies pharmacy educators may use to mitigate or prevent these negative classroom experiences. As such, it combines five experiences of racial biases and microaggressions in the classroom with suggested action items in a practical guide for pharmacy faculty members. It is our hope that this commentary will challenge faculty to self-assess their teaching, with the aim of preventing racial biases from propagating and creating better learning environments for future pharmacists.

Clinical and Research Applications of the Electronic Medical Record in Multiple Sclerosis: A Narrative Review of Current Uses and Future Applications.

The electronic medical record (EMR) has revolutionized health care workflow and delivery. It has evolved from a clinical adjunct to a multifaceted tool, with uses relevant to patient care and research. A MEDLINE literature review was conducted to identify data regarding the use of EMR for multiple sclerosis (MS) clinical care and research. Of 282 relevant articles identified, 29 were included. A variety of EMR integrated platforms with features specific to MS have been designed, with options for documenting disease course, disability status, and treatment. Research efforts have focused on early diagnosis identification, relapse prediction, and surrogates for disability status. The available platforms and associated research support the utility of harnessing EMR for MS care. The adoption of a core set of discrete EMR elements should be considered to support future research efforts and the ability to harmonize data across institutions.

The ASHP Section of Pharmacy Educators Crystal Ball project: Insight into the future of pharmacy education.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Current State of and Opportunities for Enhancing Peer Evaluation Practices Across the Pharmacy Academy

Objective. To examine and summarize policies and procedures for peer evaluation of teaching/instructional coaching (PET/IC) programs within departments, schools, and colleges of pharmacy and to identify opportunities for improving these based on best practices.Methods. A survey was sent to all Accreditation Council for Pharmacy Education (ACPE)-accredited pharmacy programs to collect information regarding procedures to support and evaluate PET/IC programs across institutions. Descriptive statistics were used to summarize the general features of PET/IC programs, and inferential statistics were used to make group comparisons based on institutional control (public, private) and institution age (0-10 years, older than 10 years).Results. Surveys for 91 institutions were completed (response rate=64.5%). Most institutions (78.4%) reported having a PET/IC program. Most institutions with PET/IC programs reported using a combination of formative and summative evaluations (57.4%). The top purposes for PET/IC programs were faculty development (35.8%) and improving teaching (35.8%). Almost half of the PET/IC programs (46.3%) were mandatory for all faculty at the institutions. Most institutions (66.7%) had one standardized instrument used in their PET/IC program. Few institutions (11.9%) reported evaluating or being in the process of evaluating the effectiveness or success of their PET/IC program. Private institutions were more likely to incentivize observers than public institutions (17.1% vs 0).Conclusion. Overall, PET/IC programs are needed to assess and provide feedback to instructors about their teaching practices. While most institutions report having a PET/IC program, wide variability exists in how the programs are implemented. Opportunities exist for institutions to evaluate the effectiveness of their program and identify best practices.