Pharmacists' Patient Care Process Research Articles

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.

Moving out of disciplinary silos - Integration of the Pharmacists' Patient Care Process

IntroductionIn order to better delineate the specific roles of the pharmacist in generating positive health outcomes, pharmacy programs have incorporated the Pharmacists' Patient Care Process (PPCP). However, there has been limited integration in disciplines outside of pharmacy practice. PerspectiveThis article makes the case that schools need to commit to fully integrating the PPCP that is inclusive of all disciplines. By fostering such integration, all faculty can recognize their role in creating practice-ready, team-ready pharmacists that are consistent, collaborative, and drive positive patient health outcomes. There also is likely innovative integrative efforts being done related to the PPCP in non-practice disciplines, and this article provides some ideas for future scholarly efforts. ImplicationsIf the academy embraces the PPCP fully, we can unite and demonstrate how pharmacists contribute value to the healthcare team.

Validity Evidence for a Pharmacists’ Patient Care Process Self-Efficacy Scale Among Pharmacy Students

Objective. To further refine and examine the validity of an instrument for assessing pharmacy students' self-efficacy in implementing the Pharmacists' Patient Care Process (PPCP) components.Methods. An instrument was developed and pilot tested in spring 2018 at one college of pharmacy. In spring 2019, a modified version of the instrument, the PPCP Self-Efficacy Scale (PPCP-SES), was administered to third professional year (P3) pharmacy students at seven institutions. Self-efficacy items were based on Bandura's theory of self-efficacy, and students were asked to rate each item on a continuous scale (0-100). Data analyses included descriptive statistics, reliability analysis, and confirmatory factor analysis (CFA).Results. Three hundred P3 students completed the PPCP-SES. The domain-specific Cronbach alpha coefficients were: collect, α=.89; assess, α=.92; plan, α=.95; implement, α=.96; and follow-up, α=.95. Based on the factor analysis results, three items were removed. Model fit statistics indicated the overall instrument had moderate goodness of fit.Conclusion. Results indicate the PPCP-SES demonstrated initial evidence of validity for use by pharmacy faculty members to identify students' self-efficacy related to implementing components of the PPCP. Future research is needed to examine validity evidence in other student populations and among practicing pharmacists.

Use of Adaptive Learning Technology to Promote Self-Directed Learning in a Pharmacists’ Patient Care Process Course

Objective. To evaluate student changes in self-directed learning (SDL) in a Pharmacists' Patient Care Process (PPCP) course using adaptive learning technology (ALT).Methods. The Pharmacists' Patient Care Process was delivered using traditional teaching methods in fall 2018 and ALT in spring 2019. First-year student pharmacists were surveyed three times throughout the academic year on SDL factors. Focus groups were conducted at the end of the spring semester to identify perceptions of course delivery. Multilevel linear modeling and qualitative content analysis were used to evaluate survey responses and focus group feedback, respectively.Results. Ninety-two of 106 students completed all three surveys. Scores on stress management and examination management increased from the beginning to the end of the academic year. Scores on seminar (lecture) learning proficiency, procrastination management, and time management decreased from the beginning to the end of the year. Assignment management and comprehension competence trends varied from the end of the first semesters to the end of the second semester. Themes identified from the focus groups were student learning preferences, semester comparisons, value, and technology.Conclusion. Student pharmacists struggled with the integration of ALT into their previously established study routines. Focus groups helped add context to students' SDL scores. Although significant differences were found between some SDL factors, it was not possible to conclude that implementation of ALT improved SDL.

Designing an Escape Room to Increase Pharmacy Preceptor Knowledge of the Pharmacists’ Patient Care Process

Objective. To design and assess the use of an escape room for pharmacy preceptor development.Methods. An escape room for preceptor development that focused on the Pharmacists' Patient Care Process (PPCP), preceptor resources, and the school of pharmacy's mission and vision was created. Teams had to solve digital and practical puzzles to escape a pharmacy. The team to correctly solve all the puzzles the fastest was considered to have escaped the pharmacy. Escape room puzzles included digital locks, cipher wheels, a rebus puzzle, riddle, hidden object, and other puzzles. Preceptor's knowledge of the PPCP and perceptions of the game were evaluated using a pre- and post-activity test and survey.Results. Fifteen preceptors with a variety of practice sites and precepting experience participated in a matched pre-and post-activity survey. Preceptor knowledge of the order of the PPCP improved, with nine (60%) preceptors answering correctly before participating in the activity vs 13 (87%) after. However, the preceptors were less likely to correctly answer the type of approach the PPCP uses after completing the escape room activity, with 14 (93%) answering correctly before vs 10 (67%) after. Participants' perceptions of the game were positive and all preceptors agreed or strongly agreed that they would recommend participating in this activity to another preceptor.Conclusion. A preceptor development escape room was viewed positively by preceptors. Future research should focus on digital-only escape rooms for preceptors to increase availability and participation.

Impact of remote delivery on a pharmacists' patient care process capstone course on the development of patient work‐up skills

AbstractIntroductionThe coronavirus disease 2019 (COVID‐19) pandemic caused colleges of pharmacy to abruptly change teaching strategies mid‐semester in Spring 2020 due to campus closure and transition to remote learning. The objective of this study was to evaluate the effects of pandemic‐induced remote learning on student skill acquisition in a third year pharmacy student (P3) Pharmacists' Patient Care Process (PPCP) capstone course.MethodsStudent performance on weekly quizzes and mid‐term and final practical examinations were evaluated before and after implementation of remote learning in 2020 and were compared with a previous class in 2019. Paired and anonymous student perceptions of their skill development were also compared within the same semester and between years. Independent sample and paired Student's t tests were used to compare means, the Pearson correlation was used to identify associations between continuous variables, and nonparametric tests were used to compare ordinal data.ResultsIn 2020, student performance was significantly higher on quizzes at the end of the semester after implementation of remote learning compared with pre‐remote learning (8.2 ± 1.6 vs 7.7 ± 1.8 points, P &lt; .05). Students performed significantly worse on the final examination compared with the mid‐term examination (21.2 ± 5.4 vs 23.4 ± 5.3 points, P &lt; .05) in 2020. Students also performed significantly worse on the final examination in 2020 compared with 2019 (21.3 ± 5.4 vs 23.1 ± 5.4, P &lt; .01). In both 2019 and 2020, students rated their ability to meet course objectives higher at the end of the semester compared with the beginning of the semester (P &lt; .05).ConclusionThe COVID‐19 pandemic‐related changes in course delivery, participation, and assessment had a mixed effect on development of a systematic process for patient work‐up skills using the PPCP. Students progressed throughout the semester on early PPCP patient work‐up skills, but performance decreased when higher level skills or later PPCP steps were assessed and was lower compared with a previous offering of the course.

Scholarship Does Not Have to Be Hard

Scholarship is an important part of the academic environment. It’s one of three main areas used to evaluate faculty for promotion and tenure, but the idea of a scholarly mindset touches multiple elements of academic pharmacy for both faculty and students. American Council for Pharmacy Education (ACPE) Accreditation Standards 2016 include an expectation of faculty scholarship, saying “The college or school creates an environment that both requires and promotes scholarship and also develops mechanisms to assess both the quantity and quality of faculty scholarly productivity.” 1 The 2011-12 American Association of Colleges of Pharmacy Academic Affairs Standing Committee report advocated a scholarly approach to teaching, defined as “...[going] beyond content knowledge and preparing and delivering lecture content to include evidencebased practice and pedagogical knowledge of teaching and motivation best practices.” 2 ACPE’s Standards 2016 also support the importance of a scholarly mindset for students, saying they should be prepared for “Evaluation of research methods and protocol design required to conduct valid and reliable studies to test hypotheses or answer research questions, and to appropriately evaluate the validity and reliability of the conclusions of published research studies.” 1 The Pharmacists Patient Care Process, widely endorsed and supported by professional pharmacy organizations, can be described as a scholarly approach to patient care, with data collection and assessment steps familiar to anyone experienced with experimental design.3

Effect of a Simulated Activity on Student Ability, Preparedness, and Confidence in Applying the Pharmacists’ Patient Care Process to Contraceptive Prescribing

Several states now permit pharmacists to prescribe hormonal contraception. Consequently, some schools of pharmacy now incorporate activities intending to prepare students to offer this service. This study aimed to assess the impact of a simulated activity on student pharmacists’ readiness for, ability to use, and confidence in applying the Pharmacists Patient Care Process along with the United States Medical Eligibility Criteria to a patient seeking contraception. Students completed a contraceptive-prescribing simulation with standardized patients. Scores were analyzed for safe and appropriate prescribing practices. Pre- and post-workshop surveys measured confidence and perceived preparedness. Chi-square and Mann–Whitney U tests were used to analyze categorical variables and Likert-scale data, respectively.The mean activity score was 86% (median 90%), with significant change in student confidence of ability to complete the process (p < 0.0001). The majority of students at baseline (52.2%) and follow up (53.2%) reported needing more practice during advanced pharmacy practice experiences (APPEs) to feel prepared. There was a significant change pre/post in students who agreed that their curriculum prepared them (15% to 28.7%, p = 0.0014). This study suggests that students are able to safely and appropriately prescribe contraception in a simulated activity. The activity increased student reported confidence and moved some students towards readiness for contraceptive prescribing.

Unpacking student learning from an early experience with the Pharmacists' Patient Care Process

BackgroundTo illuminate learning, a case study approach was used to examine early, authentic experiences within Pharmacists' Patient Care Process (PPCP)-focused practices. Educational activitySix students were matched with five practitioners and spent five half-days in a primary care clinic in a PPCP-committed health system. Students practiced interviewing, determining the patient's medication experience, and formulating the beginnings of the assessment, as well as observing and debriefing on the completion of the process by a practitioner mentor. The Five R Model was used to prompt student learning reflection. In addition, instructors examined students' work for evidence of transformative learning and observations were captured using forms of reflective practice and collaborative debriefing. Critical analysis of the educational activityReflection performance ratings varied; however, there was strong evidence of transformative learning for all students. Specifically, most student reflections demonstrated a focus on elaborating on existing frames of reference. The most prevalent indicator of transformative learning was exploration of options for new roles, relationships, and actions. The codes from instructors' observations revealed five categories of learning evidence, with the strongest in the patient centeredness category. The process of reviewing student work products, documenting instructor observations, and collaborative debriefing resulted in insights for curricular improvement and explanations for learning difficulties. Further work is needed in understanding student experiential learning intentions and their influence on learning and reflection. Additionally, further research should explore the value of longitudinal assessment of reflection and the value of assessing student work products using criteria beyond traditional reflection criteria.

Virtual Versus Paper-based Cases in Reinforcing the Collect and Assess Elements of the Pharmacists’ Patient Care Process

Objective. To compare pharmacy students' perceptions about and performance when using paper-based versus virtual patient cases to reinforce knowledge of the collect and assess elements of the Pharmacists' Patient Care Process (PPCP). Methods. Twenty-seven pharmacy students enrolled in an ambulatory care elective course were randomized to receive either paper-based cases or virtual patient cases for three weeks. They then crossed over to receive the alternative case format for the next three weeks. Each student received a score for their performance on questions related to the collect and assess elements of the PPCP. Students completed a survey and participated in a focus group to evaluate their perceptions of each learning method. Statistical analyses were performed on all data collected. Results. Students' performance (n=27) was better on the assess questions of the PPCP when they used paper-based patient cases than when they used virtual patient cases. The only difference in students' perceptions was related to the collect element, as students favored using paper-based patient cases over virtual patient cases when collecting subjective and objective information. Students who participated in the focus groups believed that the virtual patient cases provided a more realistic and engaging experience in addition to promoting critical thinking. Conclusion. While paper-based patient cases allowed pharmacy students to quickly identify and "collect" relevant information, increased use of virtual patient cases may enhance students' comfort level with and ability to "assess" actual patients.

A learning pharmacy practice enabled by the pharmacists’ patient care process

To address the Quintuple Aim of health care improvement, the profession of pharmacy is on the verge of a practice transformation that incorporates continuous learning from medication-related data into existing clinical and dispensing roles. The pharmacists’ patient care process (PPCP) enables a learning pharmacy practice through the systematic and standardized collection of real-world medication-related data from pharmacists’ patient care activities. A learning pharmacy practice continually generates data-powered discoveries as a byproduct of PPCP interactions. In turn, these discoveries improve our medication knowledge while upgrading our predictive powers, thus helping all people achieve optimal health outcomes. Establishing a practice management system connected to the PPCP means that data are generated from every PPCP interaction, combined with existing data, and analyzed by teams of pharmacists and data scientists. The resulting new knowledge is then incorporated into all future PPCP interactions in the form of predictions coupled to actionable advice. The primary purpose of a learning pharmacy practice is to combine the power of predictive modeling with evidence-based best practices to achieve and sustain population-level health improvements. This purpose is achieved by systematically optimizing individual medication use in an equitable manner on a global scale.

Pharmacists’ perceptions of the pharmacists’ patient care process and performance in a simulated patient interaction

ObjectivesTo (1) evaluate the use of the pharmacists’ patient care process (PPCP) by licensed pharmacists through a simulated patient activity and (2) describe pharmacists’ awareness and perceptions of the PPCP in the state of Arizona. DesignInterviews were conducted to elicit pharmacists’ perceptions and awareness of the PPCP. A simulated patient activity involved a role-play pharmacist-patient interaction in a community pharmacy setting. The PPCP was employed as the evaluative framework to assess pharmacist behavior. Setting and participantsPharmacists licensed in the state of Arizona practicing in various pharmacy settings were recruited through e-mail list serves and snowball recruitment. Data were collected in person, by telephone, and via video chat. Outcome measuresEmergent qualitative themes from interviews were used to describe pharmacists’ awareness and perceptions of the PPCP. The presence or absence of PPCP elements were assessed during the simulations. ResultsA total of 17 pharmacists were interviewed; 16 participated in the simulated activity. Of these, 7 (41.2%) participants recalled specific details regarding the PPCP process. Participants felt that the PPCP accurately reflected their daily workflow. Accordingly, a mean of 15.8 of the 19 PPCP elements was observed in simulated pharmacist-patient interactions, still allowing room for improvement in pharmacist-led care planning. Participants indicated perceived value in a shared patient care process that facilitates collaboration with myriad health professionals and as an aid to leverage pharmacists’ role on health care teams. ConclusionIn this study, pharmacists practicing in Arizona in various settings expressed an awareness of the PPCP, felt it accurately reflected the work they do, and expressed that the tool potentially added value to their work.

Pharmacy Students’ Ability to Identify the Steps of the Pharmacists’ Patient Care Process During IPPE

Objective. To determine the ability of first-year Doctor of Pharmacy (PharmD) students to describe patient care activities performed by pharmacists and accurately associate those activities with the five core steps of the Pharmacists' Patient Care Process (PPCP). Methods. First-year student pharmacists completed introductory practice experiences at ambulatory and institutional pharmacies. Students' ability to describe activities that occurred in these settings and align them with the five core steps (collect, assess, plan, implement, and follow-up) of the PPCP were assessed. Results. The students were more adept in describing patient care activities and aligning them to the appropriate PPCP steps in an ambulatory pharmacy setting than in an institutional pharmacy setting. Students achieved higher scores when describing and aligning patient care activities associated with the collect and implement steps in an ambulatory pharmacy setting and for the assess step in an institutional pharmacy setting. Conclusion. As institutions strive to adopt the PPCP in all areas of the curriculum, this application serves as an example of successful PPCP integration early in the introductory experiential curriculum. Our results challenge faculty to provide early opportunities for students to apply the PPCP in a variety of practice settings, including settings focused on the medication distribution system.

Implementation of the Pharmacists’ Patient Care Process in a Medicinal Chemistry Course

Objective. To implement the Pharmacists' Patient Care Process (PPCP) in a medicinal chemistry course. Methods. Doctor of Pharmacy students in a medicinal chemistry course were challenged to apply the PPCP in a lesson on cholinesterase inhibitors and NMDA receptor antagonist in the treatment of Alzheimer's disease. A clinical faculty member with expertise in the topic reviewed the clinical information provided to ensure applicability to patient care. A pre- and post-course survey was administered to assess students' understanding of the PPCP and the effectiveness of the strategies used. Students' pre- and post-course responses were analyzed, and qualitative themes were identified. Results. Of the 141 students enrolled in the course, 96% and 97% completed the pre- and post-course surveys, respectively. Students' post-course responses were higher than pre-course answers to the question that they knew all the steps of the PPCP (96% vs 66%, respectively). Ninety one percent in the post-course survey compared to 62% in the pre-course survey listed the PPCP steps correctly. In addition, more than 90% of the students indicated that the strategies used in the class helped them understand and relate to the PPCP. Qualitative responses revealed themes with positive responses related to the course, course activities, PPCP goals and curriculum design based on the implementation of the PPCP. Conclusion. The introduction of the PPCP as a framework for all pharmacy practitioners is a worthy endeavor. Purposeful strategies to introduce the PPCP in a medicinal course were positively received by students. Formalized efforts to implement the PPCP in clinical, social and administrative, and science courses are critical to introduce the PPCP as a framework for all future pharmacy practitioners.

Evaluating Pharmacist's Patient Care Process in Shiraz, using a newly-validated questionnaire: The First Report from Iran.

Background:The Pharmacists’ Patient Care Process (PPCP) as one of many inter-related foundations for the delivery of evidence-based and outcomes-focused patient care has a positive trend in academic literatures in the world. Unfortunately, PPCP has not been establish well in community pharmacies in Iran, yet. This study was performed to explore the current status of the provision and perception toward patient care services and finally evaluate professional competency of pharmacists about PPCP implementation, in both patients and pharmacist’s perspectives.Methods:A cross-sectional study was conducted using two self-administrated Likert-based questionnaires_ one for pharmacists and another one for patients. In total, 121 pharmacists and 479 patients participated to the study. Questionnaires were distributed and collected in the Shiraz during the Oct 2017 till Jun 2018. Obtained data were analyzed through the statistical package for social sciences (SPSS) version 25. In addition, the competency to PPCP implementation was classified to three groups _good, moderate, and weak _ based on achieving ≥75%, 50%-75%, and <50% of the dimensions’ total score, respectively.Results:The pharmacist’s age range was 23-76 years (mean age: 40.61±12.85 years). Their Competency to PPCP implementation was good (43.8%), moderate (52%), and just 4% weak. Patient’s response to PPCP was 11.2% good, 50.7% moderate and 35.6% weak.Conclusion:Besides promotion of public awareness about PPCP, improvement of pharmacists’ motivation toward these services seems necessary. In addition, the introduced instrument may be useful for practice of pharmacists, but it should be used cautiously until it is tested among clients of pharmacies known to provide all levels of pharmacy care within pharmacy stores. (www.actabiomedica.com)

Incorporating the Pharmacists' Patient Care Process Into An Interprofessional Second Year Capstone

ObjectiveTo describe elements of an interprofessional second year capstone experience designed to incorporate each step of the Pharmacists' Patient Care Process (PPCP) and to evaluate changes in attitudes towards interprofessional collaboration. MethodsSecond year pharmacy students collaborated with dental students to collect information from a standardized patient (SP), assess dental and pharmacy-related problems, and develop a plan resolving the problems identified. Students documented via a SOAP note (subjective, objective, assessment, and plan) and followed up with the SP after an emergency room visit, developing a new plan for implementation. Pharmacy students followed up in the inpatient setting when the SP was preparing for discharge, collecting information from the electronic health record (EHR), assessing the patient's medical conditions, and planning for treatment. Multiple assessment methods were used including extended multiple-choice questions (eMCQs) to assess clinical reasoning skills and a rubric for SOAP note grading. ResultsStudents performed well on the assessments especially communicating with the SP during medication history and discharge counseling and documenting their care in a SOAP note. Students stated value was added to their education through this experience. ConclusionsThis capstone allowed students the opportunity to practice each step of the PPCP and to collaborate as a member of an interprofessional team As the PPCP is integrated into pharmacy curricula, assessments such as this will be essential for determining practice-readiness and team-readiness of graduates.

Aiding Transformation from Student to Practitioner by Defining Threshold Concepts for the Pharmacists’ Patient Care Process

Objective. To explore critical milestones in the transition from student to practitioner by identifying the threshold concepts associated with learning the Pharmacists' Patient Care Process (PPCP). Methods. A threshold concept represents a transformed way of thinking about a topic or discipline. This study convened five focus groups to identify possible threshold concepts related to learning the PPCP. The data were analyzed by deductive content analysis and confirmed by an expert consensus panel using a modified nominal group technique. Results. Moving beyond the process outlined by the PPCP, the five focus groups identified additional elements of learning required in becoming a patient care practitioner. These elements were focused on the more intangible aspects of patient-centered care, such as practitioner priorities, attitude, and approach. As such, the data help to describe how practitioner's think, feel, and act (ie, their identity). Deductive content analysis resulted in five Patient Care Threshold Concepts (PCTC), which were confirmed by the expert consensus panel. Conclusion. The five PCTCs provide pharmacy educators with an additional tool to use in teaching the PPCP. The PCTCs can aid in the student-practitioner transformation by helping to make implicit aspects of patient care more explicit. They are supplements to patient care competencies that help explain the practitioner's priorities, attitude, and approach. They can also serve as guidance to pharmacy educators in evaluating curricular activities and assessments, as well as identity formation. This approach can be applied to the identification of threshold concepts in other areas of pharmacy education, such as leadership.

This is how I think: Evaluation of a preceptor development webinar on incorporating the Pharmacists' Patient Care Process into experiential teaching

IntroductionThere is a critical need to establish and teach a uniform pharmacists' patient care process (PPCP) to create consistency in the profession. Little is known about preceptor incorporation of the PPCP into experiential teaching. MethodsUsing a pre-/post-program survey, this study aimed to characterize preceptors' perception of PPCP incorporation in teaching, confidence in PPCP articulation to team members and students, and ability to identify precepting strategies before and after completing a continuing education (CE) webinar. Results103 of the 158 preceptors enrolled in the CE program completed pre-/post-program surveys. Preceptors' perception of PPCP incorporation with introductory pharmacy practice experience (IPPE) students did not change significantly after the program (1.98 vs. 1.88, p = 0.317). However, advanced pharmacy practice experience (APPE) preceptors were less likely to strongly agree to PPCP incorporation after completing the program (1.91 vs. 1.72, p = 0.016). Preceptors felt increased confidence in their ability to articulate the PPCP to both team members (2.07 vs. 1.60, p = 0.000) and students (2.01 vs. 1.63, p = 0.000). Preceptors strongly agreed they had new strategies to use in precepting. ConclusionIn order to prepare student pharmacists, preceptors must be prepared to explicitly incorporate the PPCP into their teaching. A webinar with case examples and a preceptor tool can help equip preceptors to articulate the PPCP to colleagues and students, and to identify strategies to incorporate the PPCP into their precepting.