Pharmacists' Patient Care Process Research Articles

Impact of a Mock OSCE on Student Confidence in Applying the Pharmacists' Patient Care Process.

The Medical and Pharmacy Student Collaboration (MAPSC) student organization at the University of Southern California, Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, created an extracurricular, peer-led, virtual group mock objective structured clinical examination (MOSCE) to expose first-year pharmacy students (P1s) to the Pharmacists' Patient Care Process (PPCP). The purpose of this study is to evaluate the impact of a MAPSC MOSCE on P1s self-reported confidence in applying the PPCP and on patient communication, medication knowledge, and clinical skills. An anonymous, optional, self-reported survey was administered to P1s before and after the event, where they rated their confidence on a scale of 0-100 (0 = not confident, 100 = certainly confident). The statistical analysis was a paired two-tailed t-test with a significance level of p < 0.05. A total of 152 P1s and 30 facilitators attended the MOSCE. One hundred thirty-nine students met the inclusion criteria and were included in the data analysis. There was a statistically significant difference in the change in self-reported confidence for all PPCP components and learning outcomes. The results of our study strongly indicate that introducing P1 students to the PPCP through a MAPSC MOSCE format is a valuable experience.

Collaborative inpatient and ambulatory care topic discussions in experiential education: An approach to assessing the Pharmacists' patient care process and transitions of care

IntroductionThe Pharmacists' Patient Care Process (PPCP) is woven throughout the doctor of pharmacy program; however, advanced pharmacy practice experiences (APPEs) are not structured in a specific order allowing students to apply the PPCP across the care continuum. Two faculty preceptors from two practice sites, inpatient family medicine and ambulatory care, joined to provide twice weekly, preceptor-led collaborative topic discussions to bridge this gap. This paper describes an approach to improve students' knowledge by incorporating progressive cases and assessments highlighting care across the continuum aligned with the PPCP. MethodsPreceptors developed topic discussions, progressive cases, and assessments to emphasize the PPCP and transitions of care (TOC) during month-long APPEs. Students' perceptions were assessed through an anonymous Likert-type item survey. To assess learning, students completed anonymous, preceptor-developed, multiple-choice pre- and post-assessments aligned with the different components of the PPCP and TOC. ResultsIn two academic years (2021−2023), 24 perception surveys were distributed and 21 were received from 19 unique students (87.5%). Compared to pre-implementation surveys, a significant increase was seen in the students strongly agreeing the incorporation of progressive cases improved their ability to apply the PPCP to patient care (48% vs. 76%, P value = .06). Twenty-four pre- and post-assessments (100%) were completed by 22 unique students, showing a statistically significant difference in students' understanding of content (71.8% vs. 81.6%, P value = .02). ConclusionsThe incorporation of collaborative topic discussions for APPE students between inpatient and ambulatory care preceptors increased students' knowledge to apply the PPCP during TOC.

Determining preceptor perceptions of APPE readiness through the use of entrustable professional activities

IntroductionPharmacy programs are required to demonstrate that students are advanced pharmacy practice experience (APPE) ready, but neither a professionally recognized definition of nor a consistent approach to assess APPE readiness exists. MethodsAPPE preceptors were surveyed about the relationship of EPAs to APPE readiness in three domains, including: (1) each EPA's relative importance, (2) indicators that a student is not ready to begin APPEs, and (3) each EPA's expected level of entrustment on the first day of the first APPE. We determined consensus of EPA importance and expected level of entrustment by adapting previously published thresholds. We analyzed the association between preceptor or practice setting characteristics with ranking of EPA importance. ResultsOf the 431 preceptors queried, 31% responded. Ten EPAs, primarily those reflecting the first three steps of the Pharmacists' Patient Care Process (PPCP), were identified as important with strong consensus. Ambulatory care preceptors placed higher importance on EPAs, primarily in the final steps of the PPCP and within the public health domain. Professionalism issues were most often cited as reasons for a lack of APPE readiness. There was considerable variability (weak or moderate consensus) in preceptors' expected level of entrustment per EPA. ConclusionsPharmacy programs can consider prioritizing EPAs in the domains of patient care and information master when developing APPE readiness plans; professionalism should also be emphasized. Further work is needed to better understand what level of entrustment preceptors expect of an APPE ready student.

Medication histories to identify medication-related problems through the pharmacists' patient care process in a simulated ambulatory care laboratory

Background and purposeAssessment of the Pharmacists' Patient Care Process (PPCP) in pharmacy curricula has been reported in a variety of contexts, but results have not described individual student performance in a controlled ambulatory care skills laboratory to purposefully identify medication-related problems (MRP) and develop plans for resolution. Educational activity and settingOne of five MRPs was embedded within standardized medication profiles to facilitate student completion of three graded ambulatory care medication history encounters in a third-year skills laboratory. Data analysis included student performance in aggregate and according to MRP type from the first to the third medication history encounter. FindingsOne hundred thirty-six students completed three medication histories for 408 encounters. Regardless of MRP, the total and subscale scores for adjusted marginal means were significantly higher in Sessions 2 and 3. Performance on MRP scenarios for drug interactions and adverse effects were significantly lower and higher, respectively. Successful collection of patient history significantly influenced marginal mean scores for respective MRPs. SummaryImprovement in student application of PPCP Steps 1 through 3 may be evident using three simulated ambulatory care medication history patient encounters toward the end of the third professional year, with potential influences by MRP type, MRP repetition, and adequate collection of patient history. Repetition with individualized grading and formative feedback are essential for skill development to identify MRPs in this setting. Confirmation of findings and extension into experiential education with higher complexity are needed to develop consistent and effective application of the PPCP to patient care.

Students' self-efficacy completing the pharmacist patient care process: Integrating authentic assessment into a pharmacy elective

Background: Authentic assessments can be used to accurately measure students’ ability to perform tasks reflective of practising pharmacist responsibilities. Objective: To evaluate the impact of an authentic assessment on student self-efficacy in completing the Pharmacists Patient Care Process (PPCP) in an elective course. Methods: An authentic assessment simulated a direct patient care visit in an ambulatory care setting. For the assessment, students completed four steps of the PPCP, followed by a survey to evaluate their perceived self-efficacy in completing the activity. Results: After the activity, 90% or more students felt more confident in knowing what information to collect, conducting a patient interview, and counselling a patient. General themes from free response questions confirmed student confidence and knowledge. Conclusion: Creating and implementing an authentic assessment allowed for students to demonstrate improved self-efficacy while conducting the PPCP in a setting that closely resembled a real-life practice environment.

Analysis of Expert Feedback to Determine Intellectual Standards for Student Pharmacist Clinical Reasoning Development

Objectives. Clinical reasoning (CR) is one of the most important skills for pharmacy learners. Feedback has been proposed as a pedagogy to improve CR skills; however, essential components of CR have yet to be determined within pharmacy education. This study sought to streamline feedback to align with the Pharmacists' Patient Care Process (PPCP).Methods. The investigators used deidentified clinical reasoning "Keep," "Start," or "Stop" (KSS) feedback comments from student-written CR "think-aloud" sessions with pharmacy students in their third professional year. Sections were mapped to the PPCP and were coded by 2 independent investigators according to proposed essential components of CR, using an adapted grounded-theory approach. Investigators could inductively add codes after conferring with the other. Coded feedback was analyzed using a summative content approach. Intercoder reliability was calculated via Holsti index.Results. Five essential components of CR were identified after analysis of 635 KSS comments. The 5 essential components of CR were coded 1178 times. "Accurate," "Concise," "Specific," and "Thorough" were identified a priori, while "Connected" was discovered during feedback comment review. Literature analysis added supporting data to these results through the Paul-Elder Critical Thinking Framework. To maintain consistency in language, these essential components will be referred to as "intellectual standards" moving forward.Conclusion. This novel study successfully identified 5 key intellectual standards of CR. These intellectual standards provide a framework for pharmacy educators to focus feedback to improve student CR. Future research of other intellectual standards pertinent to experiential education is imperative.

Teaching Spanish using the pharmacists' patient care process

Background and purposeThe Hispanic population of the United States now comprises the largest minority and is expected to increase. Student pharmacists must be prepared to care for this segment of the population. Efforts to learn medical Spanish will assist in these endeavors. Educational activity and settingThis paper describes the design and implementation of a novel course teaching Spanish for student pharmacists using the framework of the Pharmacists' Patient Care Process (PPCP). A two-credit hour elective course was developed to provide a focused course on practical Spanish used in the pharmaceutical care space. Lessons were framed with the various steps in the PPCP of collect, assess, plan, implement, and follow-up. FindingsInterest in the course was high, with first through third professional year cohorts and varying Spanish experience represented. Student feedback from self-reflections and course evaluations revealed the course was helpful in increasing ability to work with patients of differing cultural backgrounds and in medical Spanish skill in pharmaceutical care. SummaryPharmacy programs can utilize the PPCP as an instructional method to increase offerings of medical Spanish in their curriculum with modest resource utilization.

Ethical Decision-Making in the Pharmacists’ Patient Care Process

The intent of the Pharmacists' Patient Care Process (PPCP) is to provide a comprehensive approach to team-based, comprehensive patient-centered care. Consideration of potential ethical issues is a necessary component of comprehensive care provision and is a requirement of accreditation standards, but there is no specific mention of ethics in any of the phases of the PPCP. A more explicit incorporation of ethical decision-making into the PPCP should help faculty involved in teaching ethics and students who need to incorporate ethical considerations into the PPCP to provide optimal patient care. The aims of this commentary are to provide faculty with a foundational introduction to ethics and an explicit approach for incorporating ethical decision-making into the PPCP.

Using the Pharmacists’ Patient Care Process to address social determinants of health in patients with diabetes

Owing to the accessibility of pharmacists and frequency of their patient encounters, pharmacists may be in the unique position to help recognize the impact that social determinants of health (SDOH) have on a patient’s health. The American Pharmacists Association wants to provide practical tools and resources for pharmacists to assess and mitigate SDOH with their patients. Through the use of a diabetes patient case and the Pharmacists’ Patient Care Process (PPCP), this article will highlight a few of the numerous items available to provide culturally and linguistically tailored disease management and health literate and numerate communication and to improve food security. Using tools and resources to address SDOH in the context of the PPCP allows pharmacists to develop an even more patient- and person-centered care plan with the goal of achieving optimal patient outcomes and reducing health disparities. As pharmacists gain comfort with using these tools and resources to address SDOH in their practices, they should continue to seek opportunities to learn about other SDOH and their impact on patients’ chronic medical conditions, including diabetes.

Preparing students for pharmacy practice using critical thinking and reflection

Background: Social, behavioural, and administrative sciences are among the Accreditation Council of Pharmacy Education (ACPE) mandated foundational knowledge requirements for pharmacy school curricula. However, they are often taught in isolation, whereby students lose sight of their meaning and significance in the Pharmacists’ Patient Care Process (PPCP). Objective: The objective was to assess performance and critical thinking skills and explore student perceptions of a Longitudinal Patient Case assignment that integrates knowledge from multiple domains into a learning experience exploring how patients and pharmacists navigate the complexities of the US healthcare system. Methods: Student pharmacists developed their case throughout the term by incorporating course concepts, then submitted a narrated PowerPoint presentation. Quantitative data sources included overall scores, scores for each domain, midterm and final examination scores, and final course grades, analysed using descriptive statistics and Pearson’s correlation. Student reflections encouraged self-discovery and professional identity development and served as the qualitative data source. Thematic analysis occurred through a multi-phase approach. Results: All first-year student pharmacists (n = 153) participated. Scores on the narrated PowerPoint were significantly correlated with midterm and final exams and were moderately correlated with overall course grades. Themes that evolved from students’ self-reflections focused on project execution and learning/knowledge. Conclusions: Synthesising and applying content across a course in this manner enables students to make connections, think critically, and be creative.

Predictors of student pharmacist success on an advanced pharmacy practice experience-readiness performance-based assessment

IntroductionThe study objective was determining the relationship of certain predictor variables with student performance on an advanced pharmacy practice experience (APPE)-readiness performance-based assessment (PBA) in the third professional year (P3). MethodsThis retrospective study aimed to identify if student predictors and/or curricular-related predictor variables correlate with student performance on a patient interview and documentation activity (PIDA), an APPE-readiness assessment. Student predictors included Pharmacy College Admission Test score, pre-pharmacy cumulative grade point average (GPA), end of first professional year (P1) GPA, end of second professional year GPA, end of fall P3 GPA, and elective Pharmacists' Patient Care Process (PPCP) score. Curricular-related predictor variables comprised specific activities with emphasis on patient care skill development in P1 through P3 years. Adjusted and unadjusted linear regression models assessed correlations between PIDA score and student predictors as well as curricular variables. ResultsStudents from the Classes of 2018 through 2020 at Southern Illinois University Edwardsville School of Pharmacy (N = 231) were included. Two student predictors, P3 GPA and PPCP elective score, showed statistically significant correlations with PIDA performance. One curriculum-related variable, P3 activity with an emphasis on medication reconciliation, demonstrated a statistically significant correlation with student performance on the PIDA. ConclusionsStudent performance on a cumulative PBA may be predictive from prior curricular learning experiences that assess similar patient care skills. The predictive impact of the elective PPCP score on a PBA needs additional research. Recent implementation of a new curriculum may lead to identification of other predictors of student success on PBAs.

Evaluation of pharmacy students' self-efficacy and performance in applying components of the Pharmacists' Patient Care Process within a capstone course and during advanced pharmacy practice experiences

IntroductionCapstone courses are ideal for reinforcing and assessing the Pharmacists' Patient Care Process (PPCP). The purpose of this study was to assess pharmacy students' (1) self-efficacy in applying PPCP components before and after a capstone course, (2) performance in applying PPCP components in several assignments, and (3) self-efficacy in applying the PPCP during advanced pharmacy practice experiences (APPEs). MethodsStudent evaluation included: (1) electronic surveys to assess students' self-efficacy in applying three components of the PPCP (Collect, Assess, and Plan) via a pre−/retrospective pre−/post-survey design, (2) course evaluations, and (3) an electronic survey to assess students' self-efficacy in applying the PPCP after completing five APPEs. Faculty evaluation included rubrics assessing performance in applying the PPCP model given patient cases. Descriptive statistics, paired t-tests, and mixed-effects linear modeling were conducted. ResultsSixty-four students participated in the course during spring 2018. The sum mean self-efficacy scores for the PPCP components significantly improved between the beginning and end of the course (P < .05). There was a significant increase in evaluators' ratings of students' ability to apply the PPCP (P < .05). The sum mean self-efficacy scores for the PPCP components did not change significantly between the end of the course and after completion of five APPEs, except for a few specific items. ConclusionsA capstone course integrating the PPCP in patient case assignments resulted in improved student performance and self-efficacy in applying three PPCP components (Collect, Assess, and Plan). Students' self-efficacy remained consistent after the course concluded and during APPEs.

An interprofessional activity involving pharmacy and physician assistant students aimed at reinforcing the patient care process

BackgroundPharmacy students should have the opportunity to practice applying the Pharmacists' Patient Care Process (PPCP) in an interprofessional environment. The purpose of this study was to compare the change in students' confidence in their ability to complete the five steps of the PPCP before and after participation in an interprofessional activity involving physician assistant (PA) students. Interprofessional education activitySecond-year pharmacy students and second-year PA students completed an activity in teams of six (four pharmacy and two PA students per team) in which they applied the PPCP to a patient case to create a plan of care. Students completed a pre- and a post-survey regarding their confidence in completing the PPCP and their attitudes toward interprofessional collaboration, as well as a program evaluation after completion of the activity. DiscussionThere were 117 pharmacy and 58 PA students divided into 29 interprofessional teams. Of those, 99 (85%) pharmacy and 52 (90%) PA students completed both surveys. There was a statistically significant increase in confidence to perform the PPCP for all students, with a large effect size. There were no changes in attitudes toward interprofessional collaboration. Overall, the program evaluation reflected the activity was rated highly by students. ImplicationsThe interprofessional activity demonstrated a positive effect on students' self-reported confidence in their ability to complete steps of the PPCP. While the interprofessional activity did not affect student attitudes toward interprofessional collaborative practice, the activity was rated highly and most found it to be an important part of their professional development.

Implementation strategy for teaching the pharmacists' patient care process to first year student pharmacists

AbstractObjectivesThis study aimed to (1) name, define, and operationalize an implementation strategy utilized to teach the Pharmacists' Patient Care Process (PPCP) within a first‐year pharmacy practice course series and (2) evaluate the strategy's impact on students' self‐reported competence in providing the PPCP and subjective, objective, assessment, and plan (SOAP) note performance.MethodsThe implementation strategy was described using the Expert Recommendations for Implementation Change (ERIC) terminology and the reporting recommendations developed by Proctor and colleagues. The implementation strategy consisted of developing educational material and conducting training via 7 in‐class workshops and auditing and providing feedback via a 6‐part longitudinal assignment. The validated Comprehensive Medication Management Patient Care Process Fidelity Assessment (CMM PCPFA) was adapted to the educational context and administered to students in March 2020 after completion of the course series to retrospectively assess their self‐perceived change in competence in providing the PPCP. Items were aggregated at the essential function (EF) level. Mean retrospective pre and post EF scores were compared using paired sample t‐tests. Students' performance on SOAP note submissions were analyzed using descriptive statistics.ResultsOne hundred seven students (98%) completed the adapted CMM PCPFA and were included in this analysis. The paired t tests showed a statistically significant change in students' self‐reported competence for each essential function. The mean individual student score on their SOAP note was 87.6% ± 11%.ConclusionsFindings suggest the implementation strategy was successful in increasing students' perceived competence in providing the PPCP. Employing an effective implementation strategy across pharmacy curricula is key to developing competent pharmacists and consistency in patient care delivery in practice.

Inclusion of the Pharmacist Patient Care Process in Doctor of Pharmacy Curricula

Objective. With the inclusion of the Pharmacists' Patient Care Process (PPCP) in the most recent Accreditation Council for Pharmacy Education standards, institutions must determine how best to vertically and horizontally integrate and assess the PPCP in the curriculum. The objective of this study was to identify the breadth and depth of PPCP implementation as well as faculty involvement in teaching the PPCP at ACPE-accredited institutions.Methods. A survey to address the study objectives was developed, piloted, and distributed electronically to all US pharmacy institutions in candidate or accredited status. Electronic reminders were implemented to improve response rates. The data were analyzed descriptively.Results. Approximately 70% of institutions responded to the survey. Integration of the PPCP was most often championed by an individual faculty member and/or a committee. Practice faculty taught PPCP at nearly all institutions, while only a third of survey respondents reported that foundational and social administrative faculty taught the PPCP. Development related to PPCP curricular integration mainly focused on preceptors. Most institutions integrated the PPCP through the didactic and experiential curriculum in an approach that allowed for reinforcement or mastery of concepts. There were limited integration efforts into interprofessional education. Institutions had a plan for assessing the effectiveness of the integration, but were varied in their approach.Conclusion. Institutions have embraced integrating the PPCP into their curricula, didactically and experientially. Progress still needs to be made regarding inclusion of all faculty in teaching the PPCP as well as integrating the PPCP into other key curricular areas, such as interprofessional learning. Faculty development efforts may be beneficial to address these aspects.

A mixed-methods study of pharmacy instructors' early experiences with a teaching electronic medical record

IntroductionAs use of electronic medical records (EMRs) increases in healthcare, multiple accreditation organizations recommend training future clinicians on EMRs as part of the academic curriculum. Therefore, some pharmacy programs now utilize an academic EMR. Our objective was to examine pharmacy instructors' early experiences with a commercially available teaching EMR (tEMR) in order to identify current and future priorities along with benefits and barriers to academic EMR use in pharmacy education. MethodsWe conducted semi-structured interviews and a web-based survey with pharmacy instructors. Interview and survey data analyses consisted of hybrid inductive/deductive approaches to coding data and descriptive statistics, respectively. We mapped themes to the Pharmacists' Patient Care Process (PPCP). ResultsSeven instructors participated in interviews, and 10 completed the survey. We identified 25 interview themes that were generally congruent with survey responses. A noted benefit of the tEMR was providing a large repository of real-life patient data. Instructors' current priorities for tEMR activities primarily aligned with “collect,” “assess,” and “plan” steps of the PPCP. One reported barrier was insufficient training regarding the tEMR capabilities. Instructors offered innovative ideas for future academic EMR use, including pharmacokinetics, incident reporting, and longitudinal cases. ConclusionsStudy findings are most applicable to pharmacy programs in the early stages of academic EMR adoption. We identified opportunities for pharmacy programs to facilitate innovative, future use of academic EMRs, including curriculum planning, so pharmacy students gain experience using EMR functions for each PPCP step and develop more advanced EMR skills.

Curricular integration of the pharmacists' patient care process

IntroductionThe Accreditation Council for Pharmacy Education Standard 10 specifies the need to prepare students to provide patient-centered collaborative care. The aim of this study is to assess the impact of a newly introduced Pharmacists' Patient Care Process (PPCP) based laboratory course on students' perception of their preparedness to apply PPCP steps in introductory pharmacy practice experiences (IPPEs). MethodsThe PPCP was introduced into the Pharmaceutical Care and Dispensing Laboratory course during the second professional year. Students' self-perception of preparedness to apply the PPCP was assessed via a survey composed of questions related to PPCP skillsets. The pre-PPCP laboratory cohort (control group) took the survey after the completion of their IPPEs. The PPCP laboratory cohort (intervention group) took the same survey prior to taking the course, at the end of the course, and following the completion of their IPPEs. Pearson's and McNemar chi-square tests were used for statistical analyses. ResultsThe findings indicate that the PPCP-based laboratory significantly improved students' perception of their preparedness to apply a standardized pharmacist care process to verify prescriptions, to collect relevant patient information, and to develop an individual patient-centered care plan. This significant impact of the PPCP-based laboratory course on students' perception was maintained through the following year when assessed after IPPEs. ConclusionsIntroduction of the PPCP model within a dispensing laboratory course, prior to students' IPPEs, develops students' perception of preparedness. Incorporating the PPCP via active learning and simulation narrows the gap between the didactic and experiential curriculum.

Implementation and assessment patient cases using the SBAR method to teach patient quality of life issues

Background and purposeQuality of life (QoL) preferences are an important consideration with respect to the Pharmacists' Patient Care Process (PPCP) and should be assessed prior to implementing a patient-centered plan. The objectives of this intervention were to determine if the design of a QoL activity impacts student performance, and to discern student perceptions of an innovative, case-based activity. Educational activity and settingTwo cohorts of students in their second professional year were asked to present an article that included a QoL consideration. The two student cohorts were asked to complete the activity using a case report and modified SBAR (Situation, Background, Assessment, Recommendation) format. Presentations were graded using a rubric, and scores were assessed retrospectively. An unpaired t-test was used to examine differences. The final cohort of students was also asked to complete a survey to gather their perspectives. Results were described using descriptive statistics; thematic analyses were also performed. FindingsStudents who completed the SBAR activity (N = 71) performed significantly better than those who completed the article (N = 98) presentation (95.62 ± 5.47 vs. 86.30 ± 16.54, P < .001). Those who completed the survey (N = 22) felt they made moderate to excellent progress explaining QoL (86%) and that the activity was helpful (68%). Overall, students reported an improved understanding of the patient's perspective. SummaryThe PPCP requires that students must consider the patient's QoL in order to develop an optimal patient-centered plan. Activities such as this may improve student understanding of QoL implications.

Pharmacy Regulatory Innovation Index: Benchmarking the regulatory environment in 10 western states

BackgroundPharmacy is among the most regulated of health professions on the basis of both word count and restrictions. State-level restrictions limit the ability of pharmacists to be fully engaged as members of the health care team. ObjectiveThis paper aimed to create a simple benchmark—the Pharmacy Regulatory Innovation Index (PRII)—that takes into account the scope-of-practice allowances that a state provides to pharmacists and the overall regulatory burden for the pharmacy profession using 10 western states as a sample. MethodsA scorecard was developed on the basis of the activities reported as necessary for pharmacists to fully engage in the Pharmacists’ Patient Care Process (PPCP). The laws and regulations of 10 western states were analyzed using plain-text interpretation. ResultsThe 10 western states fall into 3 of 4 distinct quadrants. Three states appear in the highly regulated, low-innovation quadrant (Oregon, California, and Nevada), and 2 states appear in the low-regulated, high-innovation quadrant (Idaho and Washington). The remaining 5 states fall in the low-regulated, low-innovation quadrant (Alaska, Hawaii, Montana, Utah, and Wyoming). ConclusionThe PRII has been created to assess a state’s regulatory burden and its scope-of-practice allowances, using the PPCP as a guide for innovation. States can use the PRII tool to benchmark their regulations in comparison with those of peer states and identify opportunities for improvement.

Development of a scale to determine student self-efficacy in performing key pharmacists' patient care skills.

The Pharmacists' Patient Care Process (PPCP) was developed to describe a consistent process in which pharmacists in any setting provide patient care. Faculty at a midwestern university developed and refined an assessment tool which provides an indirect approach to measure student confidence in performing skills essential to the PPCP. The objective of this paper is to conduct a stepwise factor analysis to refine the PPCP survey. Assessing appropriateness of survey response data led to an exploratory factor analysis (EFA) on student confidence data to refine the survey instrument and examine the underlying constructs that influence student responses. Post EFA, the results were presented to the research team that collaboratively reached consensus on inclusion or exclusion of items. EFA factor loadings identified a 4-factor solution suggesting elimination of 30 items from the original 53 item survey. Team discussions led to eliminating 29 items, combining two items and generation of 5 new items in order to retain important concepts. The outcome was a well-conceptualized and refined 29 item-survey model assessing 4 constructs. To potentially improve patient outcomes, it is imperative to utilize comprehensive yet concise survey instruments, like the PPCP Skills Self-Efficacy Survey, to prepare students to translate PPCP skills to practice.