Pharmacy Residency Research Articles

Assessment of Postgraduate Year 1 Residency Program Director Preferences and Priorities in Evaluation of Pharmacy Residency Candidates.

Limited and conflicting evidence exists evaluating how components of pharmacy residency applications are prioritized by residency program directors (RPDs). This study aims to identify what pharmacy residency programs prioritize when selecting candidates to interview given the incorporation of new American Society of Health-System Pharmacists (ASHP) Pharmacy Residency Standards. A Qualtrics survey was distributed to postgraduate year 1 (PGY1) RPDs across the United States. Programs were identified using the American College of Clinical Pharmacy and ASHP residency directory. Data was collected from October 23, 2023, to December 4, 2023, and priorities were captured using percentage weighting and rank order lists. Of the 1389 survey links disseminated, a total of 254 programs submitted responses for a total response rate of 18.2%. According to RPDs the highest weighted section of a residency application was the curriculum vitae (CV) with an average weight of 51.7% followed by letters of recommendation, letter of intent, and supplemental application (if applicable) in descending order, respectively. Within the CV, programs valued work, leadership, and rotation experiences most. Ability to organize and manage time was reported to be the most important characteristic within letters of recommendation. Based on the results of this study, when reviewing pharmacy residency applications, PGY1 RPDs prioritize the CV, followed by letters of recommendation and letter of intent. These findings could be used by RPDs when assessing current scoring rubrics and may help to inform the efforts of students and letter of recommendation writers when preparing individual components of an application.

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.

Meeting the accreditation standard through implementation of a multiprogram residency advisory committee and ongoing quality improvement.

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. To describe the process utilized by a large multiprogram residency site to expand preceptor engagement and establish ongoing quality improvement efforts in order to meet the program's needs in response to evolving ASHP accreditation standards. A multiprogram residency advisory committee (RAC) primarily composed of residency program leadership was formed to focus on aspects of program management and accreditation compliance that were not being addressed at the monthly all-preceptor meeting. The ASHP standard and a recent residency accreditation survey guided the RAC agenda, which led to the creation of a combined manual for the institution's 5 residency programs and a preceptor manual. Preceptor engagement was improved through the establishment of local preceptor requirements, inclusion of preceptor representatives on the RAC, expansion of subcommittee opportunities, addition of a preceptor midpoint retreat, and optimization of the end-of-year preceptor retreat. Communication with residents and identification of continual improvement opportunities were improved through roundtables with residents, residency program directors, and the RAC chair; a monthly meeting with the rotating chief resident and RAC chair; and face-to-face exit interviews with the department's chief of pharmacy. The RAC chair has been a key figure in coordinating program change to meet the ASHP standard as well as leading planning for subsequent ASHP surveys. Through the establishment of a multiprogram RAC and a RAC chair, our program has been able to engage a large preceptor group that is dedicated to continual improvement and provides the ability to dynamically respond to ASHP's progressing guidance for pharmacy residency programs.

Exploring Pharmacists' Perceptions of Text-Based Artificial Intelligence in Resident and Student Education.

Introduction: As artificial intelligence (AI) becomes increasingly integrated into various professional fields, understanding its impact on pharmacy education is crucial. This study explores pharmacists' perceptions of AI's role in enhancing educational and professional practices, particularly focusing on the generation of educational content and analytical tasks. Objectives: The primary objective was to assess pharmacists' concerns and perceived benefits regarding the use of AI in pharmacy education, examining variations across different age groups and years of practice. Methods: A cross-sectional survey was completed by 446 pharmacists who actively precept pharmacy residents and students. Respondents practiced across 35 states with over half (53.4%) being in Ohio. The survey included items on concerns about AI's quality and accuracy, human interaction, plagiarism, and its potential benefits in data analysis and research literature summarization. Responses were analyzed to identify trends across demographic categories, including age and years in practice. Results: Of the respondents, 67.9% expressed concerns about the quality and accuracy of AI-generated content, while 50.9% were concerned about plagiarism. Younger pharmacists (73.8% of those aged 20-29) showed heightened concern about accuracy compared to older groups (56.8% of those aged 60+). In contrast, 57.8% of respondents recognized AI's potential benefits for data analysis, with experienced pharmacists (>20 years in practice) being more likely to see these advantages (62.2%). Conclusion: The findings indicate a need for targeted educational strategies to address AI literacy and ethical use in pharmacy education. Integrating AI tools that support educational objectives while addressing these concerns could enhance the efficacy and acceptance of AI in pharmacy practice. Further research should explore the development of training programs that align with the evolving expectations and technological competencies of different pharmacist demographics.

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

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

An interprofessional postgraduate quality improvement curriculum: results and lessons learned over a 5-year implementation

ABSTRACT Problem Quality Improvement (QI) is interprofessional by nature; however, most academic QI programs occur in silos and do not leverage the opportunity to bring interprofessional learners together. Intervention To evaluate QI competencies of physician, nursing, pharmacy, behavioral health, and social work residents after participating in a longitudinal QI curriculum. Lessons learned are shared to guide educators in developing QI curriculum for interprofessional learners. Context Cohorts of graduate students over 5 years participated in a QI curriculum that aligned with each professions’ core quality competencies. Residents engaged in didactics and experiential learning in primary care clinics. Impact All learners (N = 74) demonstrated improvement in QI knowledge measured by the QIKAT-R and applied their skills demonstrated by completion of a QI project presented at the Institute for Healthcare Improvement annual forums. Participation in QI curriculum resulted in knowledge and skill improvement. Lessons learned An experiential QI curriculum is a natural place to bring diverse post-graduate learners together to improve QI knowledge and skills. Successful QI curriculum goals are to (a) align projects with institutional and stakeholder goals, (b) include coaches to promote teamwork and project management, (c) narrow project scope, (d) develop an improvement mindset that failures are learning opportunities, and (e) address needs for data access.

A Comparison of Telesimulation Using the Virtual Resus Room and In Situ Simulation in Pediatric Emergency Medicine.

During the COVID-19 pandemic, there was a marked shift toward telesimulation in medical education. Limited studies exist comparing the effectiveness of online and offline simulation education. The goals of this study are to evaluate active learners' perceived effectiveness of telesimulation versus in situ simulation and to identify potential shortcomings of existing online teaching platforms. Through participant evaluations after a simulation, we compared telesimulation using the Virtual Resus Room (VRR) to in situ simulation in the domains of (1) self-efficacy, (2) fidelity, (3) educational value, and (4) teaching quality. Study subjects included medical and pharmacy residents and medical students completing their pediatric emergency medicine rotation at two children's hospitals as well as nurses, nurse practitioners, and physician assistants who were recently hired and orienting to their new roles in the emergency department. Learners used a modified Michigan Standard Simulation Experience Scale to evaluate either a telesimulation or in situ simulation case. Survey responses were compared using Wilcoxon rank sum tests with Bonferroni correction for multiple comparisons. In overall assessment, in situ simulation was rated higher than telesimulation. There were significant differences noted related to perceived realism, utility in training device-related skills, and utility in training team-building skills. All P values were less than 0.0036. There were no significant differences between simulation types in perception of physical examination fidelity, instructor adequacy, or self-efficacy. Telesimulation using the VRR is comparable to in situ simulation in learners' perception of improvement in self-efficacy and of teaching quality for pediatric emergency medicine topics. However, participants felt less able to practice tactile and communication skills virtually. Further innovation is needed to improve learners' experience with fidelity and educational value.

Nationwide Survey to Characterize and Compare the Research Experiences of American Society of Health-System Pharmacists-Accredited Postgraduate Year One Pharmacy Residency Programs.

Background: Many Postgraduate Year One (PGY1) Pharmacy residencies provide research training however, details of this training are not well described. Publication rates have been utilized to assess residency research learning experiences. Higher publication rates have been reported by programs that have implemented a structured research learning experience. Objective: The primary objective was to identify differences in the research learning experiences for American Society of Health-System Pharmacists (ASHP) accredited PGY1 Pharmacy residencies with reported resident publication rates of ≥20% vs <20%. Methods: This survey was distributed to PGY1 Pharmacy residency program directors (RPDs). Seven sections were analyzed to identify research learning experience differences between programs with reported publication rates of ≥20% vs <20%: (1) program characteristics/research outcomes; (2) involved individuals; (3) requirements; (4) learning experience structure; (5) educational methods; (6) formal education; (7) barriers/RPD perceptions. Variables with P < 0.05 on logistic regression were considered statistically significant. Results: The survey response rate was 31.3% (308/984). Significant positive predictors for reported publication rates of ≥20% were: involved individuals: research director/coordinator, individuals trained in statistics, non-pharmacy medical staff; requirements: Collaborative Institutional Training Initiative training, research seminars/training courses, research manuscript; learning experience structure: research committee; educational methods: didactic residency-led lectures/courses, formal workshops, self-taught online modules; and formal education: manuscript preparation. Conclusion: This study suggests there are differences in the research learning experiences at PGY1 Pharmacy residencies with reported resident publications rates of ≥20% vs <20%. We encourage PGY1 Pharmacy residency programs to consider implementing elements associated with reported resident publication rates of ≥20%.

Characterizing the Perceived Need for Advanced Clinical Pharmacy Training in British Columbia.

Currently in Canada there are limited opportunities for advanced clinical pharmacy training after a year 1 residency. Advanced training programs currently in existence are year 2 residencies, clinical Master's degrees, and Fellowships. To characterize the perceived need for advanced clinical pharmacy training in British Columbia and to determine the desired educational competencies to be gained through advanced training. Current pharmacy residents (academic year 2021/22) and residency graduates of the past 5 years (2017-2021), together referred to as early career pharmacists or ECPs, were surveyed. Provincial health authority pharmacy leaders who hire clinical pharmacists were also surveyed and invited to participate in key informant interviews. Eighty-four ECPs and 22 pharmacy leaders participated in the surveys (estimated response rates 26% and 35%, respectively). Eleven (13%) of the ECPs had already completed advanced clinical training, and an additional 24 (29%) planned to pursue such training within 5 years. Sixteen (73%) of the pharmacy leaders had experienced difficulties in filling advanced practice positions over the previous 3 years due to a lack of qualified applicants, and 21 (95%) believed that more advanced training positions should be offered. The majority of ECPs interested in advanced training (39/60, 65%) chose year 2 residency as their preferred program, and 20 (91%) of the pharmacy leaders agreed that British Columbia should offer year 2 residencies. Both ECPs and leaders rated clinical skills and knowledge as the most important educational competencies. Pharmacy leaders expressed a need for more pharmacists with advanced clinical pharmacy training, and many ECPs were interested in pursuing such advanced training. Most respondents preferred the year 2 residency, with the most common goal being to improve clinical competencies.

What competencies are needed to develop collaboration between general practitioners and pharmacists through initial interprofessional training? An analysis of training needs through a qualitative occupational didactic approach

BackgroundCollaborative practice in primary health care increases care quality and security. In France, primary health care professionals increasingly work together. The link between general practitioners (GPs) and community pharmacists (CPs) is an important element. Nevertheless, effective collaboration between GPs and CPs is difficult to develop and formalize. Interprofessional education has been identified as a necessary step to prepare “collaborative practice-ready professionals”. We aimed to identify the interprofessional training needs of last-year GP and CP students to develop interprofessional collaborations.MethodWe conducted an analysis of training needs using a method inspired by occupational didactics. We collected data through individual semidirective interviews with CPs and GPs in 2022. At each stage we aimed to identify the elements of the occupational didactics to deduce the training needs in the form of a frame of reference: apparent competencies, emblematic situations and acting characteristics. We conducted an initial deductive thematic analysis to identify the apparent competencies of the two professions, the emblematic situations in which these competencies are used, and the acting characteristics used in these situations. We made an inductive categorization to define the collaborative competence and the families of situations and to model the actions of this GP-CP collaboration.ResultsWe defined the competency “to collaborate effectively in an interprofessional setting in order to respond to care issues in one’s territory” expressed in various professional situations. We described it by three capacities based on two interacting dynamics: one-off exchanges and structured collaborations. Various communication tools facilitate the implementation of these interactions. We modeled the actions of the GP-CP collaboration in the form of a conceptual map.ConclusionThe collaboration between the CP and the GP implements a competency that could be integrated into their professional referential.This competency, entitled “collaborating effectively in interprofessional settings to respond to care issues in one’s territory”, is expressed in a variety of professional situations. It is based on two parallel and interacting dynamics: one-off exchanges and a dynamic of lasting collaboration.This study thus lays the groundwork for the development of this collaborative skill among general practice and pharmacy residents.

Cross-sectional description of hospital pharmacy services in Puerto Rico in 2022 using the Practice Advancement Initiative 2030 Self-Assessment Tool.

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. The American Society of Health-System Pharmacists (ASHP) developed the Practice Advancement Initiative 2030 (PAI 2030) to support the continuous improvement of hospital pharmacy services in the United States. Puerto Rico (PR) hospitals' level of compliance with PAI 2030 recommendations is not currently known. The primary objective of this study was to describe the hospital pharmacy scenario in PR in the 5 areas addressed in PAI 2030 recommendations. Through a collaboration between the state affiliate, a school of pharmacy, and ASHP, completion of the PAI 2030 Self-Assessment Tool was promoted among hospital pharmacy directors between August 2022 and March 2023. A total of 18 out of 66 hospitals completed the survey. The results were compared with national data provided by ASHP from 163 US hospitals. Areas where PR hospitals rated high were in PAI 2030 domain A (Pharmacy Technician Role, Education, and Training) and domain E (Pharmacist Leadership in Medication Use and Safety). PR hospitals rate their performance lower in domain A (Patient-Centered Care) and domain B (Pharmacist Role, Education, and Training). Specific focus areas for improvement by PR hospitals include pharmacist participation in medication reconciliation, 24/7 access to advanced clinical pharmacy services, expansion of the pharmacist's scope of practice, and training through the Board of Pharmacy Specialties and residency programs. This study illustrates how the PAI 2030 Self-Assessment Tool can be used to benchmark pharmacy services at the state level. We suggest that changes are needed to close the gap between hospital pharmacies working towards optimizing the role of pharmacists in healthcare systems and those still struggling with dedicating staff to well-recognized pharmacist roles and responsibilities.

Development of a Competency Assessment Framework for Pharmacy Residents Participating in High-Fidelity Simulation and Creation of the SIMPHARM Assessment Tool.

Simulations are used to improve professional practice across multiple health professions; however, the application of simulations in pharmacy curricula has been limited by a lack of evidence. To delineate the competencies of pharmacy residents needed to assess their progress while participating in a high-fidelity simulation training program and to create a reliable assessment tool based on these competencies. A literature review was conducted, followed by application of a modified Delphi method. An assessment tool based on the results of these activities was drafted (in French). A second modified Delphi process was carried out to assess the reliability of the tool, and the tool was modified accordingly. The literature search yielded a total of 2670 articles, of which 289 were included for analysis. The first modified Delphi process involved 19 experts in the first round and 10 experts in the second round. The Cronbach α was 0.866 (95% confidence interval [CI] 0.713-0.960), indicating good reliability. A total of 7 competencies were retained for inclusion in the SIMPHARM assessment tool: professionalism, leadership, teamwork, communication, critical thinking, preparation and packaging of medications, and pharmaceutical calculations. The second modified Delphi process involved 9 experts in the first round and 11 experts in the second round. The final Cronbach α was 0.877 (95% CI 0.741-0.960). To the authors' knowledge, this was one of the largest studies exploring pharmacy competencies in the context of simulations. This work yielded a reliable framework for the assessment of pharmacy residents' competencies. This assessment tool may help evaluators in assessing the competencies of pharmacy trainees after simulation training.

Comment on “Navigating obstacles: Perspectives of US pharmacy residency directors on non‐US candidates for PGY‐1 residencies: A survey‐based research”

Comment on “Navigating obstacles: Perspectives of <scp>US</scp> pharmacy residency directors on non‐<scp>US</scp> candidates for <scp>PGY</scp>‐1 residencies: A survey‐based research”

Response to Comment on “Navigating obstacles: Perspectives of US pharmacy residency directors on non‐US candidates for PGY‐1 residencies: A survey‐based research”

Response to Comment on “Navigating obstacles: Perspectives of <scp>US</scp> pharmacy residency directors on non‐<scp>US</scp> candidates for <scp>PGY</scp>‐1 residencies: A survey‐based research”

Response to Comment on “Factors associated with attaining a pharmacy residency interview: A scoping review”

Response to Comment on “Factors associated with attaining a pharmacy residency interview: A scoping review”

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.

How Preceptors Support Pharmacy Learner Professional Identity Formation

ObjectivePharmacy preceptors play a role in helping learners form professional identities during experiential education. However, it is not clear what specific roles and precepting strategies best foster professional identity formation (PIF). The objective of this study was to explore how preceptors support pharmacy learner PIF. MethodsThis qualitative study used an interpretative descriptive approach. Preceptors from 5 experiential education programs were recruited using purposive sampling for individual semistructured interviews. Interviews were recorded, transcribed, coded, and analyzed by thematic analysis. Team members used a reflective and iterative approach for data analysis and generation of themes. ResultsA total of 22 participants were interviewed from various pharmacy practice settings and precept a range of learners, including introductory pharmacy practice experiences, advanced pharmacy practice experiences, and residents. Four main themes were identified to support pharmacy leaner PIF: making learners part of the practice and team, preparing learners to assume the role of a pharmacist, helping learners navigate emotions during practice experiences, and supporting learners in finding the right fit within the profession. Specific precepting strategies associated with each theme were identified. ConclusionPreceptors play an important role in supporting learners in thinking and acting as professionals while also helping navigate emotional experiences that may impact PIF and having conversations to help define learner’s future aspirations of the pharmacist they want to become. Strategies identified can inform curricular approaches and preceptor development that intentionally supports PIF.

By the residents, for the residents: Creation of a health-system pharmacy residency committee.

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.

Creating a win-win: A novel layered learning approach for assessing first-year pharmacy students' communication skills

Background and purposeIndividualized assessment of students in skills-based courses is essential for practice readiness, however recruiting evaluators is challenging. Our school of pharmacy offers a teaching certificate program for postgraduate year one pharmacy residents (PGY1 residents; PGY1s) which requires completion of a teaching experience. The longitudinal layered learning assessment experience (LLLAE) was designed to meet instructional needs for individualized assessment of first-year pharmacy students' communication skills and provide a meaningful teaching opportunity for PGY1s. This manuscript describes the implementation and evaluates the impact of the LLLAE. Educational activity and settingPGY1s were invited to participate in the yearlong LLLAE. Faculty developed PGY1s' skills through training sessions, direct observation, and debrief sessions. PGY1s evaluated students and provided feedback using pre-defined criteria during 3 summative assessments (capstones). Capstones were common pharmacy practice scenarios in which students interact with an actor serving as a standardized patient or provider. PGY1s completed an end-of-year survey to self-rate their improvement in evaluating students, providing feedback, and confidence. FindingsTwenty-two PGY1s participated in the LLLAE over 2 years. They evaluated 73.2% of total capstone interactions. The end-of-year survey was completed by 20 PGY1s (90.9% response rate). All respondents indicated improvement in their skills to evaluate students, ability to provide feedback, and confidence. Scores were 4 or 5 (scale of 1 to 5) across all measures. Key contributors fostering improvement were the training and debrief sessions, faculty feedback, pre-defined criteria, and multiple practice opportunities. SummaryThis novel layered learning approach was a win-win for faculty and PGY1s. The approach improved feasibility for faculty to continue individualized student assessment while mentoring early career pharmacists. PGY1s gained an opportunity to contribute to student growth, learn from experienced faculty, and develop skills for practice. Additionally, students benefited from individualized feedback.