Competent Pharmacy Research Articles

The current status of transgender health education in doctor of pharmacy curricula in North America.

Doctor of pharmacy programs across the country strive to prepare culturally competent pharmacy professionals who are trained to provide compassionate and evidence-based care to a variety of patients. Within the Accreditation Council for Pharmacy Education 2016 Standards and Key Elements for the Doctor of Pharmacy Degree, pharmacy schools are charged with the task of developing professionals who can identify and diminish health care disparities. Transgender persons represent one of the most underrepresented and underserved communities within the modern health care system, yet very little information is available for training future pharmacists to care for the transgender community. A literature search using the MeSH terms transgender persons or trans-sexualism and pharmacy education was conducted, and it revealed 1 article published by Parkhill and colleagues in the American Journal of Pharmacy Education. A Google® search of the phrase “transgender education in pharmacy school” was conducted and produced 1 additional published article as well as an online transgender education program launched in November 2016. The following commentary outlines the current literature and practices that involve integration of transgender health education into pharmacy schools in North America and a discussion on areas for future study.

Emerging roles and competencies of district and sub-district pharmacists: a case study from Cape Town

BackgroundDistrict and sub-district pharmacist positions were created during health sector reform in South Africa. High prevalence of HIV/AIDS, tuberculosis and increasing chronic non-communicable diseases have drawn attention to their pivotal roles in improving accessibility and appropriate use of medicines at the primary level. This research describes new roles and related competencies of district and sub-district pharmacists in Cape Town.MethodsBetween 2008 and 2011, the author (HB) conducted participatory action research in Cape Town Metro District, an urban district in the Western Cape Province of South Africa, partnering with pharmacists and managers of the two government primary health care (PHC) providers. The two providers function independently delivering complementary PHC services across the entire geographic area, with one provider employing district pharmacists and the other sub-district pharmacists. After an initiation phase, the research evolved into a series of iterative cycles of action and reflection, each providing increasing understanding of district and sub-district pharmacists’ roles and competencies. Data was generated through workshops, semi-structured interviews and focus groups with pharmacists and managers which were recorded and transcribed. Thematic analysis was carried out iteratively during the 4-year engagement and triangulated with document reviews and published literature.ResultsFive main roles for district and sub-district pharmacists were identified: district/sub-district management; planning, co-ordination and monitoring of pharmaceuticals; information and advice; quality assurance and clinical governance; and research (district pharmacists)/dispensing at clinics (sub-district pharmacists). Although the roles looked similar, there were important differences, reflecting the differing governance and leadership models and services of each provider. Five competency clusters were identified: professional pharmacy practice; health system and public health; management; leadership; and personal, interpersonal and cognitive competencies. Whilst professional pharmacy competencies were important, generic management and leadership competencies were considered critical for pharmacists working in these positions.ConclusionsSimilar roles and competencies for district and sub-district pharmacists were identified in the two PHC providers in Cape Town, although contextual factors influenced precise specifications. These insights are important for pharmacists and managers from other districts and sub-districts in South Africa and inform health workforce planning and capacity development initiatives in countries with similar health systems.

Does a transition in education equate to a transition in practice? Thai stakeholder's perceptions of the introduction of the Doctor of Pharmacy programme.

BackgroundPharmacy education and pharmacy practice are facing remarkable changes following new scientific discoveries, evolving patient needs and the requirements of advanced pharmacy competency for practices. Many countries are introducing or undertaking major transformations in pharmacy education. The Thai pharmacy curriculum has been changed from a 5-year BPharm and a 6-year PharmD to only a 6-year PharmD programme. Curriculum change processes usually involve stakeholders, including both internal and external educational institutions, at all levels. This study aims to understand the experiences and perceptions of stakeholders regarding the transition to an all-PharmD programme in Thailand.MethodsSemi-structured interviews were conducted in Thailand with 130 stakeholders (e.g., policy makers, pharmacy experts, educators, health care providers, patients, students and parents) from August-October 2013. The interviews were audio recorded, transcribed verbatim and analysed using an inductive thematic analysis.ResultsThree main themes were derived from the findings: 1. influences on curriculum change (e.g., the needs of pharmacists to provide better patient care, the US-Thai consortium for the development of pharmacy education); 2. perceived benefits (e.g., improve pharmacy competencies from generalists to specialists, ready to work after graduation, providing a high quality of patient care); and 3. concerns (e.g., the higher costs of study for a longer period of time, the mismatch between the pharmacy graduates’ competency and the job market’s needs, insufficient preceptors and training sites, lack of practical experience of the faculty members and issues related to the separate licenses that are necessary due to the difference in the graduates’ specialties).ConclusionsThis is the first study to highlight the issues surrounding the transition to the 6-year PharmD programme in Thailand, which was initiated due to the need for higher levels of competency among the nation’s pharmacists. The transition was influenced by many factors. Many participants perceived benefits from the new pharmacy curriculum. However, some participants were concerned about this transition. Although most of the respondents accepted the need to go forward to the 6-year PharmD programme, designing an effective curriculum, providing a sufficient number of qualified PharmD preceptors, determining certain competencies of pharmacists in different practices and monitoring the quality of pharmacy education still need to be addressed during this transitional stage of pharmacy education in Thailand.

Development and Assessment of a Horizontally Integrated Biological Sciences Course Sequence for Pharmacy Education

To design and assess a horizontally integrated biological sciences course sequence and to determine its effectiveness in imparting the foundational science knowledge necessary to successfully progress through the pharmacy school curriculum and produce competent pharmacy school graduates. A 2-semester course sequence integrated principles from several basic science disciplines: biochemistry, molecular biology, cellular biology, anatomy, physiology, and pathophysiology. Each is a 5-credit course taught 5 days per week, with 50-minute class periods. Achievement of outcomes was determined with course examinations, student lecture, and an annual skills mastery assessment. The North American Pharmacist Licensure Examination (NAPLEX) results were used as an indicator of competency to practice pharmacy. Students achieved course objectives and program level outcomes. The biological sciences integrated course sequence was successful in providing students with foundational basic science knowledge required to progress through the pharmacy program and to pass the NAPLEX. The percentage of the school's students who passed the NAPLEX was not statistically different from the national percentage.

High-Fidelity Simulation Training in Advanced Resuscitation for Pharmacy Residents

To assess the impact of high-fidelity patient simulation on pharmacy resident knowledge, confidence, and competency with advanced resuscitation algorithms and interventions. An overview of the institutional cardiopulmonary arrest algorithm and a review of pertinent medications and calculations were presented to postgraduate year 1 (PGY1) pharmacy residents, followed by participation in 3 simulated clinical scenarios using a high-fidelity mannequin. An improvement of pharmacy resident knowledge, confidence, and competency with advanced resuscitation skills was observed. In addition, pharmacy residents demonstrated high performance levels with skills requiring advanced competency and proactive interactions with the cardiac arrest team. Incorporating high-fidelity patient simulation into an advanced resuscitation training program can help pharmacy residents achieve competency through the active learning of practical skills.

Drug Information—The Systematic Approach

Proper drug information (DI) skills are essential for being a competent pharmacy practitioner. To effectively manage DI queries and clinical dilemmas, the practitioner should follow a systematic approach that includes identifying the requester, determining the “true” DI need and obtaining background information, categorizing the question, performing the search and analyzing the information, disseminating the information, and following up when appropriate. The practitioner must be mindful to couple the published literature with clinical experience, knowledge, and logic in order to achieve optimal clinical outcomes.

Validated Competency Framework for Delivery of Pharmacy Services in Pacific‐Island Countries

ABSTRACTBackgroundScarcity of health personnel with relevant competence is an impediment to achieving the UN health‐related Millennium Development Goals in many Pacific‐Island Countries (PICs). A systematic approach to improving essential medicines supply management and workforce competence has begun in the region. The development of a pharmacy competency framework has been identified as a priority.AimTo develop a validated pharmacy competency framework for PICs.MethodAcademics, Ministry of Health officials and health personnel collaborated to articulate a competency framework using participatory action research. The draft framework was revised via a process of workplace interviews and focus groups in Vanuatu and Papua New Guinea with wider regional validation undertaken using an online survey tool.ResultsA validated pharmacy competency framework was developed for PICs. 113 competencies required for delivery of pharmacy services, organised into four clusters: organisation and management (n = 24), professional/personal (n = 24), pharmaceutical public health (n = 24) and pharmaceutical care (n = 24) were identified.ConclusionThe pharmacy competency framework for PICs is service‐based and not cadre‐specific, allowing wide application to the Pacific region where a myriad of personnel provide pharmacy services. Pharmacy service personnel in PICs are encouraged to use this tool when training staff and monitoring their effectiveness in local environments.

Implementation of a journal surveillance program

The scope of pharmacy practice continues to evolve toward high-level medication therapy management and disease prevention services.1 The expansion of pharmacists’ clinical responsibilities has created new opportunities for pharmacists to play integral roles in patient care. In order to succeed in these evolving roles, pharmacists need to continuously improve as clinicians and as leaders and educators in the field of drug therapy management. In 2008 the American College of Clinical Pharmacy published a white paper on clinical pharmacy competencies that addressed the importance of keeping abreast of the current biomedical literature and incorporating this information into clinical decision-making.2 Staying current with new research and reviewing existing drug therapies allow pharmacists to improve their knowledge of drug therapy and patient care. The recent Pharmacy Practice Model Initiative Summit outlined the importance of competencies and education programs to optimal pharmacy practice models.3 With over 30,000 new articles added to the MEDLINE database each month, clinicians need help to remain up-to-date in their knowledge of new and innovative interventions described in the literature.4,5 Scanning the contents of the numerous publications related to clinical pharmacy practice is a daunting task for the individual clinician. There are commercially available journal surveillance publications; however, they may not cover the journals and information desired by representatives of the many subspecialties of clinical pharmacy practice. A journal surveillance program whereby pharmacists share the work of keeping abreast of new additions to the primary literature can make that task more manageable, increase staff exposure to the contents of a variety of journals, and promote continuous professional development.

Improvement in Pharmacist's Performance Facilitated by an Adapted Competency‐Based General Level Framework

ABSTRACTBackgroundThe General Level Framework (GLF) is a tool for evaluating pharmacists' performance, providing tailored feedback and training, and guiding professional development.AimTo ascertain the changes in pharmacists' workplace performance over time using the GLF and to describe pharmacists' views on the baseline evaluation process.MethodThe UK GLF was mapped against Australian pharmacy competency standards and practice guidelines. 61 of the 92 competencies from the Queensland Health version of the GLF representing core professional activities of Australian pharmacists were analysed. Trained evaluators used the adapted GLF to observe pharmacists from 18 Queensland public hospitals in their workplace (baseline and repeat) and rate the frequency with which competencies were completed to a defined standard. The evaluators then provided pharmacists with tailored feedback, encouraged self‐problem solving, and identified and addressed their training needs. Pharmacists' views of the baseline evaluation process was assessed using a 7‐point rating scale.Results66 pharmacists from 18 Queensland hospitals underwent the evaluation. At baseline, pharmacists had a median of 3 (1 to 10) years hospital experience. A median of 14 (5 to 22) months lapsed between baseline and repeat observations. Of the 61 competencies analysed, 35 (57%) competencies showed a significant improvement from baseline to repeat observations (p = 0.05). Competencies that improved significantly from baseline included: aspects of medication history taking; medication management; identification, documentation and resolution of drug‐related problems; appraisal of therapeutic options; and communication with doctors and nurses. For 9 (15%) competencies, pharmacists were already performing at the maximum level (median score 4) at baseline and no change was recorded between observations. No competency demonstrated a decrease in performance between observations. When the mean scores with 95% confidence intervals for the clusters of competencies were compared over time all the mean scores except for discharge facilitation and medicines information/patient education/liaison showed a significant improvement. 52 pharmacists provided feedback on the baseline evaluation process and the majority found it a useful professional development tool. They considered the evaluation process fair and constructive but taxing.ConclusionThe GLF tool assisted with the identification of pharmacists' training needs, which are integral to their professional development.

CCP Pharmacy Technician Credentialing Framework: Commentary

The Council on Credentialing in Pharmacy (CCP) has formulated and published a Pharmacy Technician Credentialing Framework that offers a clear and detailed plan for a uniform national system of regulating pharmacy technician registration, training, and competency assessment in the US. Based on standardizing currently available instruments, including a task analysis, model curriculum, training program accreditation, and adoption of a psychometrically sound competency examination, the framework is a proposal endorsed by a broad range of pharmacy groups and practice areas and represents a consensus model on which progressive future measures can be based if it is widely accepted and adopted.

Web-based Portfolios for Pharmaceutical Care Plans During Advanced Pharmacy Practice Experiences

To implement and assess a Web-based patient care portfolio system for development of pharmaceutical care plans by students completing advanced pharmacy practice experiences (APPEs) throughout a statewide preceptor network. Using a Web database, students in APPEs documented 6 patient cases within 5 disease state categories. Through discussion of the disease states and inclusion of patient information such as problems, desired outcomes, and interventions, a complete pharmaceutical care plan was developed for each patient. Student interventions were compared by geographical regions to assess continuity of patient care activities by students. Additionally, students completed an evaluation of the portfolio course to provide feedback on the portfolio process. Students documented an average of 1.8 therapeutic interventions per patient case and documented interventions in all geographical regions. The majority of students indicated that the portfolio process improved their ability to develop a pharmaceutical care plan. The Web-based patient care portfolio process assisted with documentation of compliance with Accreditation Council of Pharmacy Education (ACPE) standards and College of Pharmacy Competency Statements. Students indicated the portfolio process was beneficial in developing skills needed for creating pharmaceutical care plans.

PharmD or Needs Based Education: Which Comes First?

PharmD or Needs Based Education: Which Comes First?

Certification of pharmacy technicians

Medications continue to be a significant and vital component of medical care. And while the complexity and scope of medication use continues to grow, the role of pharmacists in caring for patients is expanding to help meet patient needs for safe and effective care. In addition to this important role for pharmacists, it is clear that safe medication-use systems also require the support of well-qualified and competent pharmacy technicians. Recent reports in the media of tragic errors serve to reinforce this point. This letter is intended to reinforce the position of both the American Pharmacists Association (APhA) and the American Society of Health-System Pharmacists (ASHP) regarding the role of pharmacy technician certification in ensuring that individuals have demonstrated a professionally recognized level of competence in the handling and preparation of medications. Both APhA and ASHP have established professional policy on the importance of pharmacy technicians supporting the professional imperative of pharmacists in helping people make the best use of medicines. Pharmacists and the public require assurance that pharmacy technicians are qualified to handle the tasks delegated to them. We believe it will be difficult for pharmacy to achieve its vision for pharmacist practice unless the profession adopts uniform national standards for pharmacy technician education, training, certification, and registration. The pharmacy technician is accountable to the supervising pharmacist, who is legally responsible through state licensure for the care and safety of patients served by the pharmacy.

Pharmacist perceptions of new competency standards

To suggest revisions to the Thai pharmacy competency standards and determine the perceptions of Thai pharmacy practitioners and faculty about the proposed pharmacy competency standards. The current competency standards were revised by brainstorming session with nine Thai pharmacy experts according to their perceptions of society's pharmacy needs. The revised standards were proposed and validated by 574 pharmacy practitioners and faculty members by using a written questionnaire. The respondents were classified based on their practice setting. The revision of pharmacy competency standard proposed the integration and addition to current competencies. Of 830 distributed questionnaires, 574 completed questionnaires were received (69.2% response rate). The proposed new competency standards contained 7 domains and 46 competencies. The majority of the respondents were supportive of all 46 proposed competencies. The highest ranked domain was Domain 1 (Practice Pharmacy within Laws, Professional Standards, and Ethics). The second and third highest expectations of pharmacy graduates were Domain 4 (Provide pharmaceutical care) and Domain 3 (Communicate and disseminate knowledge effectively). The expectation for pharmacy graduates' competencies were high and respondents encouraged additional growth in multidisciplinary efforts to improve patient care.

The WHO UNESCO FIP Pharmacy Education Taskforce: Enabling Concerted and Collective Global Action

Pharmacy Education is a priority area for the International Pharmaceutical Federation (FIP), the global federation representing pharmacists and pharmaceutical scientists worldwide that is spearheading the Global Pharmacy Education Taskforce. This paper describes the work of the Taskforce that was established in March 2008, explores key issues in pharmacy education development, and describes the Global Pharmacy Action Plan 2008-2010. Given the significance of pharmacy education to the diverse practice of contemporary pharmacists and pharmacy support personnel, there is a need for pharmacy education to attain greater visibility on the global human resources for health agenda. From this perspective, FIP is steering the development of holistic and comprehensive pharmacy education and pharmacy workforce action to support and strengthen regional, national, and local efforts. The role of a global organization such as FIP is to facilitate, catalyze, and share efforts to maximize pharmacy education development and stimulate international research to develop guidance, tools, and better understanding of key issues. To achieve this goal, FIP has (1) established a formal collaborative partnership with the 2 United Nations agencies representing the education and health sectors, United Nations Educational, Scientific and Cultural Organization (UNESCO) and the World Health Organization (WHO); and (2) established the Global Pharmacy Education Taskforce to serve as the coordinating body of these efforts. The initial effort will serve to leverage strategic leadership and maximize the impact of collective actions at global, regional, and national levels. Three project teams have been convened to conduct research, consultations and develop guidance in the domains of vision for pharmacy education, competency, quality assurance, academic workforce, and institutional capacity.

Evaluation of Curricula Content Based on Thai Pharmacy Competency Standards

To evaluate the curricula content of Thai pharmacy schools based on the Thai pharmacy competency standards. Course syllabi were collected from 11 pharmacy schools. A questionnaire was developed based on the Thai pharmacy competency standards. Course coordinators completed the questionnaire assessing the curricula content. The curricula for both the bachelor of science in pharmacy degree (BS Pharm) and doctor of pharmacy (PharmD) degree programs included the minimum content required by the 8 competency domains. The dominant content area in BS Pharm degree programs was product-oriented material. The content ratio of patient to product to social and administrative pharmacy in the BS Pharm degree programs was 2:3:1, respectively. However, the content ratio suggested by the Thai Pharmacy Council was 3:2:1, respectively. For the PharmD programs, the largest content area was patient-oriented material, which was in agreement with the framework suggested by the Thai Pharmacy Council. The curricula of all Thai pharmacy schools met the competency standards; however, some patient-oriented material should be expanded and some product-oriented content deleted in order to meet the recommended content ratio.

The NAPLEX: Evolution, Purpose, Scope, and Educational Implications

Since 2004, passing the North American Pharmacist Licensure Examination (NAPLEX) has been a requirement for earning initial pharmacy licensure in all 50 United States. The creation and evolution from 1952-2005 of the particular pharmacy competency testing areas and quantities of questions are described for the former paper-and-pencil National Association of Boards of Pharmacy Licensure Examination (NABPLEX) and the current candidate-specific computer adaptive NAPLEX pharmacy licensure examinations. A 40% increase in the weighting of NAPLEX Blueprint Area 2 in May 2005, compared to that in the preceding 1997-2005 Blueprint, has implications for candidates' NAPLEX performance and associated curricular content and instruction. New pharmacy graduates' scores on the NAPLEX are neither intended nor validated to serve as a criterion for assessing or judging the quality or effectiveness of pharmacy curricula and instruction. The newest cycle of NAPLEX Blueprint revision, a continual process to ensure representation of nationwide contemporary practice, began in early 2008. It may take up to 2 years, including surveying several thousand national pharmacists, to complete.

Developing Key Competencies for a Clinical Pharmacy Education and Peer Review Program

Objectives: To describe a model for the development of a competency‐based clinical pharmacy training program using educational principles and practice change strategies.Method: The program development was guided by educational literature and advice from an educationalist and a staff development consultant. Clinical pharmacy competencies were identified in a series of consultant‐led staff forums. Performance indicators and evidence guides were established to measure attainment of each competency. Staff values were also identified and a practice change strategy devised. Instructional methods were devised which optimised progression to competent practice: reading, lectures, interactive tutorials, guided discussion, case presentations, case‐based training, simulation/role play and practice‐based learning. These were supported by interactive training through mentoring, individualised practice‐based learning using direct instruction, modelling (problem clarification), coaching (practice in problem solving), and facilitating (self evaluation).Conclusion: This model provides a sound approach to clinical pharmacy education as it is based on an accepted definition of competency and uses values established by staff combined with recognised educational principles and practice change strategies.