Pharmacy Residency Training Research Articles

Impact of a social media post on improving an existing residency program.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. A social media post prompted reflection and changes to a longstanding pharmacy residency program. Pharmacy leadership utilized consultants with expertise in pharmacy residency training to help facilitate change and introduce new ideas to tenured staff. Other health systems working to continuously improve their residency programs may benefit from our example. The guiding principles of the changes were to align with the new harmonized residency program standards and reduce preceptor burden and potential burnout. Changes were made to the entire program's design, including new leadership, changes to committee structure, reduced requirements for preceptors that were not required in the standards, and resident recruitment and onboarding. We encourage residency programs to regularly evaluate program structure, design, and conduct to ensure alignment with the organization's evolving priorities as well as its mission and vision.

Psychiatric learning experiences in PGY1 pharmacy residency training: A 5-year analysis.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. A growing shortage of mental health providers and the increasing prevalence and severity of mental illness necessitate a qualified pharmacist workforce to increase access and care. Psychiatric learning experiences (PLEs) completed during pharmacy residency training are one way to address this need. The purpose of this study was to characterize PLEs offered by postgraduate year 1 (PGY1) programs and completed by PGY1 residents over a 5-year period. A retrospective review of data from PharmAcademic was conducted. All ASHP-accredited PGY1 programs from the 2016-2017 through 2020-2021 residency years were included in the descriptive analysis. PLE presence was identified using a keyword search of learning experience titles and descriptions. A post hoc analysis was conducted to compare yearly PLE completion rates during the study period and annual completion rates relative to presence or absence of a postgraduate year 2 psychiatric pharmacy residency. Of 1,461 PGY1 programs, 511 programs (34.9%) offered a PLE. Most PLEs were elective (82%). During the study period, 20.8% of PGY1 residents completed a PLE despite 77% having access. PGY1 residents complete PLEs at low rates. The reasons for this are unclear and need to be further explored. The growing need for qualified pharmacists to care for patients with mental illness calls for strategies to increase mental health training, including greater completion of PLEs by PGY1 residents and an understanding of how PLEs are promoted to PGY1 residents.

Correction to “Educational outcomes necessary to enter pharmacy residency training: 2023 update”

Correction to “Educational outcomes necessary to enter pharmacy residency training: 2023 update”

Educational outcomes necessary to enter pharmacy residency training: 2023 update

AbstractThe 2023 Educational Affairs Committee reviewed relevant position statements and publications to update the 2014 ACCP position statement on the educational outcomes (EOs) necessary for pharmacy students to enter postgraduate year 1 (PGY1) residency training. The committee initially aligned entry‐level graduate outcomes with current PGY1 residency competencies achieved after postgraduate training. The committee then used these alignments to identify consistencies, insufficiencies, and gaps in preparation. This process revealed that the EOs and entrustable professional activities from curricular outcomes and entrustable professional activities and the North American Pharmacist Licensure Examination blueprint could serve as a partial list of outcomes necessary to enter postgraduate training; however, some of the outcomes necessary to enter residency were not consistently addressed. To improve residency readiness, the committee recommends that both academic programs and the individual learner evaluate and seek opportunities to address any curricular gaps in alignment. The findings also underscore the need for a single set of well‐defined and mutually agreed‐on educational competencies that evolve over time and embrace the knowledge, skills, and attitudes that demonstrate residency readiness.

Pharmacy residency training program increases residents' confidence in inpatient medical emergency response.

The benefits of pharmacists' involvement in medical emergencies are well established, but optimal methods of training pharmacists for emergency response are unknown. The primary objective of this report is to describe the design and evaluation of a pharmacy resident medical emergency response training (PR-MERT) program for preparing trainees to respond to hospital medical emergencies, including cardiac arrest and rapid sequence intubation (RSI). The PR-MERT program was a year-long longitudinal experience designed to prepare postgraduate year 1 pharmacy residents for medical emergency response. During the first month, the residents completed an orientation session that encompassed several lectures, certification by the American Heart Association in basic life support and advanced cardiovascular life support, standardized simulation scenarios, and mock medical emergencies. The trainees continued to utilize these skills and clinical knowledge through a longitudinal didactic lecture series, resident case conferences, and practice-based application by responding to real-life medical emergencies. Residents were assessed and coached throughout the program by clinical pharmacy preceptors and a "code coach" with extensive medical emergency response experience. After the year-long training, residents completed an anonymous survey assessing self-confidence and the structure of the program. The results showed improved confidence in medication selection and dosing, as well as anticipating the needs of the team and speaking up in cardiac arrest and RSI situations. Residents were satisfied with the training offered and structure of the program. The development of a PR-MERT program at an academic medical center was successful in achieving longitudinal learning objectives and improving residents' confidence in responding to medical emergencies. The implementation of a similar medical emergency training curriculum in inpatient pharmacy residency programs may be beneficial.

Research barriers in Saudi pharmacy residency training programs

BackgroundThe aim of this study is to identify potential barriers to conducting and publishing pharmacy residency research. MethodsA cross-sectional study surveyed pharmacy residents in Saudi Arabia from August to September 2020. The online survey assesses residents’ characteristics, residency research experience, barriers to completion, and challenges in publishing. A Likert scale assessed factors and barriers to conducting and publishing research during residency. Descriptive statistics were performed for binary variables, with Likert scale responses visualized using Gannt charts. ResultsA total of 69 residents completed the survey, of whom 63.5 percent were female, and the median age was 28 years. More than half of the residents were in R2 (56.5 %), followed by R1 (24.6 %) and R3 (4.4 %). Half of residents had prior research experience, while 84.1 % had prior research training in workshops or courses. Cohort study design was the most common type of residency research project conducted. According to residents, the main barriers to conducting research were a lack of allocated time for research during rotations (81.7 %) and a lack of a realistic timeline determined by the SCFHS to finish the research project (66.2 %). Regarding barriers to publishing research, the majority of residents reported lack of time to work on the publication process (78.6 %), lack of previous publication experience (60 %), and lack of guidance from mentors (55.7 %) as the most important barriers. ConclusionPharmacy residents face barriers to conducting research during their residency program, including limited allocated time during rotations, a lack of realistic timelines, and data collection limitations. Additionally, they face challenges in publishing their research due to a lack of experience, mentorship, and guidance. Future research should consider seeking the perspective of residency program directors and preceptors on research barriers and evaluating the publication rate of residents’ projects.

Comment on “Evaluation of pharmacy residency recruitment and interview processes during the COVID‐19 pandemic”

JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACYVolume 6, Issue 6 p. 654-654 LETTER TO THE EDITOR Comment on “Evaluation of pharmacy residency recruitment and interview processes during the COVID-19 pandemic” Jessica Kulawiak Pharm.D., Corresponding Author Jessica Kulawiak Pharm.D. [email protected] Rush University Medical Center, Chicago, Illinois, USA Correspondence Jessica Kulawiak, Rush University Medical Center, Chicago, IL 60612-3801, USA. Email: jessicakul[email protected]Search for more papers by this authorSara Hovey Pharm.D., Sara Hovey Pharm.D. orcid.org/0000-0002-1438-3247 University of Illinois at Chicago, Chicago, Illinois, USASearch for more papers by this authorKirsten Ohler Pharm.D., FCCP, Kirsten Ohler Pharm.D., FCCP orcid.org/0000-0002-9984-9754 University of Illinois at Chicago, Chicago, Illinois, USASearch for more papers by this author Jessica Kulawiak Pharm.D., Corresponding Author Jessica Kulawiak Pharm.D. [email protected] Rush University Medical Center, Chicago, Illinois, USA Correspondence Jessica Kulawiak, Rush University Medical Center, Chicago, IL 60612-3801, USA. Email: [email protected]Search for more papers by this authorSara Hovey Pharm.D., Sara Hovey Pharm.D. orcid.org/0000-0002-1438-3247 University of Illinois at Chicago, Chicago, Illinois, USASearch for more papers by this authorKirsten Ohler Pharm.D., FCCP, Kirsten Ohler Pharm.D., FCCP orcid.org/0000-0002-9984-9754 University of Illinois at Chicago, Chicago, Illinois, USASearch for more papers by this author First published: 07 June 2023 https://doi.org/10.1002/jac5.1825Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. REFERENCES 1Wingler MJB, Cretella DA, Wagner JL, Barber KE, Bookstaver PB, Freeman L, et al. Evaluation of pharmacy residency recruitment and interview processes during the COVID-19 pandemic (2020-2021 application cycle). J Am Coll Clin Pharm. 2023; 6(3): 241– 51. https://doi.org/10.1002/jac5.1684 2Beechinor RJ, Eche IM, Edmonds N, Mordino J, Serafin H, Roller L, et al. Perceptions of a virtual interview process for pharmacy residents during the COVID-19 pandemic: a multisite survey of residency candidates, preceptors, and residency program directors. Am J Health Syst Pharm. 2022; 79(16): 1385– 92. https://doi.org/10.1093/ajhp/zxac130 3Hovey SW, Arif SA, Khan AM, Hyderi AF, Varughese C, Peksa GD, et al. More than a buzz word: building diversity, equity, and inclusion into pharmacy residency recruitment. J Am Coll Clin Pharm. 2023; 6: 154– 64. https://doi.org/10.1002/jac.5.1716 4Fischetti BS, Ciaramella C, Kim EM, Papamanolis IC. Evaluation of the use of social media and virtual meeting platforms in the pursuit of pharmacy residency training. J Pharm Pract. 2022. [Online ahead of print]. https://doi.org/10.1177/08971900221088806 5Breitkopf D, Albold C, Barlow J, Bellamkonda V, Dorcent C, Sadosty A, et al. Virtual residency recruitment: future directions in the new era. Ann Med. 2022; 54(1): 3342– 8. https://doi.org/10.1080/07853890.2022.2148732 Volume6, Issue6June 2023Pages 654-654 ReferencesRelatedInformation

“Following your dreams, and not killing yourself to do so”: Black PharmDstudent perceptions of pharmacy residency

ObjectiveResidency training is a key element of advancing the roles of pharmacists in patient care. Diversifying the healthcare workforce is also crucial in reducing health disparities and improving health equity.1 The objective of this study was to investigate Black Doctor of Pharmacy students’ perceptions of pursuing pharmacy residency training to aid pharmacy educators in creating and improving structures to support the professional advancement of Black student pharmacists. MethodsA qualitative study employing focus groups was conducted at one of the top 20 colleges of pharmacy. Four focus groups consisting of Black students in years 2 through 4 of the Doctor of Pharmacy program were organized. A constructivist grounded theory approach2 was utilized to collect and analyze the data, which was organized into a conceptual framework. ResultsThe elements of the framework developed showcase Black students’ consistent negotiation between personal well-being and pursuit of professional advancement. This framework also highlights how the experience of navigating personal wellness is unique for Black students, rather than simply a work/life balance concern. ConclusionThe concepts in this framework may be valuable for colleges of pharmacy seeking to increase diversity in their residency pipeline. Targeted interventions to ensure adequate mentorship, mental health resources, diversity and inclusion efforts, and financial support will be necessary if the profession truly desires to expand increased diversity in clinical pharmacy.

Charting a new path forward for pharmacy residency expansion

AbstractA core component of the vision of the American College of Clinical Pharmacy (ACCP) for the profession is that most pharmacists will provide direct patient care. Residency training programs are considered a prerequisite to meet the standards and competencies required for pharmacists providing direct patient care. Barriers to residency training expansion are numerous and include, but are not limited to, lack of funding, challenges in meeting accreditation standards for residency programs, limited practice sites, and lack of qualified preceptors. The demand for postgraduate year one (PGY1) and postgraduate year two (PGY2) pharmacy residency training has exceeded position availability over the past 10 years. The American Society of Health‐System Pharmacists (ASHP) Foundation Pharmacy Forecast 2021 predicts pharmacy expansion within ambulatory care, population health, specialty pharmacy, and home care. To promote pharmacy residency expansion and maintenance of pharmacy residency quality, this commentary makes four recommendations with specific actions for consideration: develop preceptors and promote board certification, promote and foster innovation in residency training, expand residency training to address health equity with a focus on rural/underserved areas, and expand nontraditional residency training programs.

952. Implementation of Antimicrobial Stewardship Weekend Coverage within a Community Hospital with a PGY2 Infectious Diseases Pharmacy Resident

Abstract Background Antibiotic use contributes to antibiotic resistance affecting individual patients and communities. Important antimicrobial stewardship program (ASP) strategies, such as prospective audit and feedback, may be limited to peak weekday hours in many institutions. Currently, a lack of data exists to support expansion of ASP beyond peak hours in community hospitals. The goal of this study was to describe the impact of expanding inpatient ASP weekend coverage with a newly established PGY2 infectious diseases pharmacy resident program. Methods This retrospective cohort study was approved by the Institutional Review Board and conducted using the pharmacist documentation function within the electronic health record of weekend interventions taking place between July 1, 2021 and December 31, 2022. The primary objective was to describe the impact of expanding weekend AMS coverage with a PGY2 ID pharmacy resident through quantification of inpatient antimicrobial stewardship interventions. Secondary endpoints included comparing the PGY2 resident’s weekend stewardship activities based on intervention quantity, type, and impact, to weekends without PGY2 ID resident coverage. Comparator groups included: 1) A single experienced clinical pharmacist, 2) Two new PGY1 pharmacy residents (first 6 months of residency), and 3) Two experienced PGY1 pharmacy residents (final 6 months of residency). Results 8 weekends of interventions were collected for each group. Significantly more interventions, including low-, medium-, and high-impact interventions were made by an ID-PGY2 pharmacy resident compared to a clinical pharmacist and both PGY1 groups. The median number of interventions made by each group are outlined in Table 1. Additionally, significantly more interventions were made per protocol as well as interventions that required communication with providers. Conclusion Expansion of ASP services to include weekend clinical coverage with an ID PGY2 pharmacy resident significantly increased weekend ASP interventions in a community teaching hospital. Specialty pharmacy residency training programs may offer a high-value opportunity to expand ASP coverage. Disclosures All Authors: No reported disclosures.

Healthcare Equity and Leadership: Implementation of Diversity, Equity, and Inclusion Training for Pharmacy Residents.

BackgroundPharmacy training programs infrequently include formal training in the areas of diversity, equity, and inclusion (DEI). Hence, the purpose of this report is to offer perspectives gained from the delivery of a DEI curriculum within a pharmacy residency program aimed at expanding experiential learning focused on DEI and health equity. Program Implementation: Pharmacy residents at an academic medical center were invited to participate in a longitudinal DEI/equity seminar series that was thoughtfully and strategically developed by a team of residents and program leadership based on a six-step process. Residents were offered 9 individual seminars covering 4 major focus areas to facilitate enhanced awareness, learning, and vulnerability. Participants were invited to provide evaluations of each seminar and the overall series. Program Assessment: A total of 41 residents (100%) participated in at least one of the 9 seminars that were offered and approximately 50% completed the post-series survey. Resident-perceived benefit of each individual session was consistently favorable. Additionally, greater than 70% of participants responded favorably when asked about the impact of each session on their awareness, resources provided, and ability to apply the learnings to their practice. Conclusion: Our inaugural experience with the integration of a DEI seminar series into a pharmacy residency program suggests that there is a clear benefit to including DEI/health equity into pharmacy residency training. This data may suggest that adoption of DEI-focused experiential training may increase cultural awareness and the availability of resources to better equip pharmacy residents in applying concepts of DEI into their practice.

Promoting health equity in pharmacy postgraduate training programs: A call to action for clinical pharmacists

AbstractShortages of primary care providers across the United States have exacerbated health disparities, particularly for marginalized groups. As one of the most accessible healthcare professionals in the United States, pharmacists are well‐positioned to help address health disparities. Addressing health inequities is an Accreditation Council for Pharmacy Education requirement in pharmacy school curricula, however, there is currently no standardized requirement to incorporate these principles into postgraduate pharmacy residency or fellowship training. A PubMed search was conducted to explore examples of health equity inclusion within postgraduate training for pharmacy and similar healthcare disciplines, as well as identify best practices. As limited models—pertaining to pharmacy postgraduate training programs—were available, this endeavor aims to provide recommendations for the successful implementation of health equity education into didactic and experiential learning opportunities.

A university‐led initiative to expand pharmacy residency program development statewide

Given trends in pharmacy practice advancement, additional residency training positions are needed to meet future workforce development goals. Although there has been aggressive growth in the number of pharmacy residency training programs over the past decade, a shortage in the number of available residency positions persists. As such, residency expansion initiatives across the profession are ongoing. To describe a university-led initiative to expand pharmacy residency program development statewide, programmatic outcomes associated with implementation, and key elements of success. Health systems interested in residency program development were invited to participate in a university-led initiative that included an online residency resource repository, preceptor interest inventory, monthly video calls, collaboratively established goals and deadlines, and preceptor development. Health system participation rates, utilization of resources, and programmatic outcomes such as number of new residency programs and positions were tracked over time. Over a 3-year period, six health systems participated in the initiative, yielding four new postgraduate year 1 (PGY1) programs and eight new PGY1 positions. Five of six health systems utilized the online resources and participated in the monthly video calls. Four of the six health systems accessed the preceptor development materials. A University-led initiative is an effective method for developing new residency training programs. Widescale efforts to implement models such as this one, could prove beneficial in addressing the nationwide shortage of residency programs.

Affective domain predictors of PharmD student pursuit of and successful matching for postgraduate pharmacy residency training.

A study was conducted to identify significant associations between affective domain (AD) features identified using the Birkman Method assessment and students' likelihood to pursue and to successfully match for postgraduate residency training (PGRT), while controlling for demographic and academic variables known to impact PGRT match rates. A retrospective analysis of 3 graduating classes of PharmD students from 2 colleges of pharmacy was performed. Data points such as PGRT match results, PGRT pursuit, student demographics, academic performance information, and AD data from the Birkman assessment were analyzed. Regression analysis was used to identify statistically significant associations between demographic, academic performance, and AD variables with both pursuit of PGRT and successful matching for PGRT. Data from 503 students were evaluated, with 211 (42%) pursuing PGRT. A variety of AD variables were significantly associated with pursuing PGRT and matching for PGRT. Two groups of actionable variables emerged: (1) variables associated with a lesser likelihood of pursuing PGRT but a greater likelihood of successful matching, and (2) variables associated with a greater likelihood of pursuing PGRT and a lesser likelihood of successful matching. Early identification of students' AD features along with specific interventions to promote PGRT pursuit in those less likely to pursue but more likely to match, as well as interventions to promote successful matching in students most likely to pursue but less likely to match for PGRT, is a strategy for possibly optimizing PharmD student career path planning and PGRT match success that merits further evaluation.

Evaluation of the Use of Social Media and Virtual Meeting Platforms in the Pursuit of Pharmacy Residency Training.

Introduction: The American Society of Health-Systems Pharmacists (ASHP) and American College of Clinical Pharmacy (ACCP) Residency Directories are two of the more traditional resources available to pharmacy students and residents looking for post-graduate programs. More recently, social media platforms have grown as an innovative means of resident recruitment and program marketing. Objective: The objective of this study was to evaluate the use of social media by both PGY1 and PGY2 candidates in their pursuit of post-graduate training through the disbursement of a survey. Methods: A survey consisting of 14 questions ranging from multiple-choice questions to free-text options was emailed out to the Office of Experiential Education from 141 ACCP-accredited pharmacy schools and 1341 ASHP-accredited PGY1 Pharmacy Residency Program Directors, requesting them to forward the email to their students or residents. Results: There were a total of 714 respondents to the survey. A majority of surveyors were in the process of completing a PGY1 residency training program (70.6%). The most common platform used to research pharmacy residency programs was the ASHP directory (97.3%). A majority of respondents did not use social media to research residency programs (66.7%). Out of the ones who did use social media, Instagram was the most common platform used and provided the greatest insight into the residency program. About 60% of respondents preferred Zoom as the virtual meeting platform during interviews. Conclusion: Although social media may not be the main source of information candidates are using, residency program accounts can provide residency programs with a free additional tool for recruitment.

Comparison of Current Post-Graduate Pain Management and Palliative Care Pharmacy Residency Programs

Post-graduate pharmacy residency training in pain management and palliative care is continuing to increase in availability. It is expected that there will be further expansion in the need for specialty trained pain and palliative care pharmacists as the population continues to age and prevalence of pain increases; however, descriptions of current post-graduate year 2 pain management and palliative care residencies are limited. The purpose of this survey is to collect program information and compare baseline characteristics of the currently available programs. Data collected included funding source, required and elective experiences, residency program director training, jobs held by residents upon completion of the program, and preceptor availability/training. Of the 15 respondents, baseline characteristics were variable. Outpatient chronic pain management was the most commonly selected required experience. Approximately 33% of residency program directors had completed a post-graduate year two residency in pain management and palliative care, and the majority of responding programs were funded by the Department of Veterans Affairs. The characteristics of responding programs illustrates the diversity of current post-graduate pain management and palliative care residency opportunities. The results of this survey help evaluate these opportunities and will provide valuable information as this specialty continues to progress.

Implementation of a novel learning experience in scientific writing, publishing, and peer review into a first year pharmacy practice residency

BackgroundPharmacists with competency in writing, publishing, and peer review are essential to continue advancing the pharmacy profession, but structured training of these skills may vary. ObjectiveThe authors set out to implement and assess the impact of a structured learning experience into a postgraduate year 1 pharmacy residency training program that provides tangible experience in the processes of scientific writing, publishing, and peer reviewing. MethodsA quarterly pharmacy newsletter process was augmented to include an editorial board that consisted of residency trained pharmacists with varying levels of experience in scientific writing, publishing, and peer reviewing. The process was designed to provide a structured writing learning experience, to reinforce important concepts and terminology, and to simulate the process of submitting a manuscript to a peer-reviewed publication. Impact of the learning experience on quality of article submissions was assessed by comparing first quarter and last quarter writing submission scores for residents between 2017 and 2020. ResultsA statistically significant difference was observed in both raw scores (27 vs. 42.5 points out of 50 points possible, P < 0.05) and the proportion of pass or fail when comparing writing submission scores from the first quarter of the learning experience to submission scores from the last quarter (25% passing rate vs. 83% passing rate, P = 0.007). ConclusionThis novel learning experience was successfully integrated into a quarterly pharmacy newsletter and resulted in improved writing scores. This structured writing learning experience can be readily integrated into pharmacy residency training programs, and it provides hands-on training in scientific writing, publishing, and peer review for both residents and preceptors.

Characteristics Contributing to a Pharmacy Services Excellence Model in a Large Health System.

To identify characteristics that contribute to and promote a pharmacy services center of excellence model in a large health system. In 2019, a survey was conducted of 161 acute care pharmacy departments of health system-affiliated hospitals. Information captured included pharmacy practice models, pharmacist resource allocation, training of pharmacy residents, postgraduate training and pharmacist certifications. Results were combined with clinical pharmacy metric performance and centralized electronic data to identify features of top performing pharmacy departments. Survey results were received from 141 of 161 affiliated hospitals (88%). Hospitals with 100 to 299 beds comprised 54% (n = 16 of 30) of the hospitals "at goal" and 66% (n = 26 of 40) of hospitals with "opportunity". Hospitals with top performing pharmacy services had greater participation in interdisciplinary rounds, reporting "always" participating in Adult Critical Care (67% versus 43%) and Medical/Surgical (30% vs. 8%) rounds. Hospitals that trained pharmacy residents had a greater number of clinical pharmacy metrics at goal (5.89 ± 1.59 versus 4.16 ± 1.86, p < 0.001), employed more board-certified pharmacists (2.32 ± 1.49 versus 1.57 ± 1.62, p = 0.019), more postgraduate year 1 (PGY1) trained pharmacists (2.06 ± 1.33 versus 1.19 ± 1.19, p < 0.001) and more PGY2 trained pharmacists (0.58 ± 0.64 versus 0.19 ± 0.44, p = 0.002). When including several key hospital characteristics into a single model, hospitals that trained pharmacy residents were significantly associated with achieving "at goal" status (p = 0.011). Defining characteristics of a pharmacy services center of excellence model included "at goal" clinical pharmacy metrics performance, clinical pharmacist time dedicated to patient care activities, accredited pharmacy residency training programs, presence of pharmacists with advanced training or board certification and optimal operations and scheduling.

The Role of an Inpatient Hospice and Palliative Clinical Pharmacist in the Interdisciplinary Team.

Palliative care is a specialized health care service for individuals with serious illness at any stage and can be provided in any setting. Current national consensus developed by palliative care experts recommends the inclusion of pharmacists in an interdisciplinary team (IDT) to provide quality palliative care. However, national registry data report that less than 10% of inpatient palliative teams in the U.S. have a clinical pharmacist. Clinical pharmacists have an impactful role in palliative patients' quality of life by optimizing symptom management, deprescribing, and providing education to the palliative care team as well as patients and their families. In this report, we review the current literature on the role of a palliative pharmacist in an inpatient palliative care setting and compare and contrast this with our own clinical practice, providing case examples about the role of a palliative clinical pharmacist in an interdisciplinary inpatient palliative care setting. Future strategies are needed to increase post-graduate specialized pharmacy residency training in palliative care as well as education on palliative and hospice care in pharmacy schools to support the role of clinical pharmacists in palliative care.

The role of a pharmacy residency program in global health: Establishing pediatric clinical pharmacy services in a Malawian hospital

To describe the establishment of pediatric clinical pharmacy services in a Malawian hospital as part of a pharmacy residency program's engagement in global health. While pharmacy is expanding its role in global health through the introduction of international advanced pharmacy practice experience (APPE) rotations at US schools of pharmacy, international experiences for pharmacy residents are currently very limited. Such programs are advantageous for pharmacists planning for a career in public or global health, and there is also great opportunity for clinical pharmacists to work with international partners for professional development and to help advance pharmacy practice. The University of North Carolina at Chapel Hill Eshelman School of Pharmacy recently expanded its international APPE rotation in Malawi into the postgraduate training space through creation of a pediatric pharmacy residency training program, with the specific aim of working with partners in Malawi to introduce pediatric pharmacy services at Kamuzu Central Hospital. As this was the first time there was a pharmacist involved in patient care on the pediatric wards, the focus for the participating pharmacy resident was on establishing a positive relationship with the medical team through providing high-quality collaborative patient care for the pediatric population. In addition to working to establish pediatric clinical pharmacy services, the resident further contributed to sustainable improvements in pediatric patient care by identifying areas for quality improvement. We discuss several considerations for the successful implementation of international experiences and their impact on participating residents. Pharmacy has an opportunity to build on the success of international APPE rotations and expand postgraduate offerings. Through collaboration with other institutions already involved in global health and identifying international rotation sites, residency programs across the country can create similarly beneficial global health experiences for their pharmacy residents.