Year Doctor Of Pharmacy Students Research Articles

Evaluating accuracy and reproducibility of large language model performance on critical care assessments in pharmacy education.

Large language models (LLMs) have demonstrated impressive performance on medical licensing and diagnosis-related exams. However, comparative evaluations to optimize LLM performance and ability in the domain of comprehensive medication management (CMM) are lacking. The purpose of this evaluation was to test various LLMs performance optimization strategies and performance on critical care pharmacotherapy questions used in the assessment of Doctor of Pharmacy students. In a comparative analysis using 219 multiple-choice pharmacotherapy questions, five LLMs (GPT-3.5, GPT-4, Claude 2, Llama2-7b and 2-13b) were evaluated. Each LLM was queried five times to evaluate the primary outcome of accuracy (i.e., correctness). Secondary outcomes included variance, the impact of prompt engineering techniques (e.g., chain-of-thought, CoT) and training of a customized GPT on performance, and comparison to third year doctor of pharmacy students on knowledge recall vs. knowledge application questions. Accuracy and variance were compared with student's t-test to compare performance under different model settings. ChatGPT-4 exhibited the highest accuracy (71.6%), while Llama2-13b had the lowest variance (0.070). All LLMs performed more accurately on knowledge recall vs. knowledge application questions (e.g., ChatGPT-4: 87% vs. 67%). When applied to ChatGPT-4, few-shot CoT across five runs improved accuracy (77.4% vs. 71.5%) with no effect on variance. Self-consistency and the custom-trained GPT demonstrated similar accuracy to ChatGPT-4 with few-shot CoT. Overall pharmacy student accuracy was 81%, compared to an optimal overall LLM accuracy of 73%. Comparing question types, six of the LLMs demonstrated equivalent or higher accuracy than pharmacy students on knowledge recall questions (e.g., self-consistency vs. students: 93% vs. 84%), but pharmacy students achieved higher accuracy than all LLMs on knowledge application questions (e.g., self-consistency vs. students: 68% vs. 80%). ChatGPT-4 was the most accurate LLM on critical care pharmacy questions and few-shot CoT improved accuracy the most. Average student accuracy was similar to LLMs overall, and higher on knowledge application questions. These findings support the need for future assessment of customized training for the type of output needed. Reliance on LLMs is only supported with recall-based questions.

Implementation and Evaluation of a Residency Preparation Program for Fourth Year Doctor of Pharmacy Students

Implementation and Evaluation of a Residency Preparation Program for Fourth Year Doctor of Pharmacy Students

Rapid integration and student outcomes of virtual, case-based, patient scenarios in advanced pharmacy practice experiences

Background: Many healthcare and educational institutions have continued to utilise technology-driven learning well before 2020. However, there is limited published literature that rigorously evaluates student outcomes in virtually-delivered advanced pharmacy practice experience (APPE) rotations. This article reports student competency and comfort from eighteen 4th professional year Doctor of Pharmacy students from May 2020 to December 2020. Methods: Students completed 40 virtual, case-based, clinical reasoning cases during each 6-week APPE. A validated expert-generated anonymous survey was administered to students on two separate occasions. Student competency was assessed using expert-generated case-based clinical questions, and comfort was assessed using a 5-point Likert scale. Results: Competency scores demonstrated statistically significant improvements in 40% (N=6) of the domains and non-statistically significant improvements in the remaining 60% (N=9). Student comfort improved in 93.33% of the domains but was not statistically significant. Conclusion: Future directions include exploring the impact of virtual cases in combination with on-ground rotations and comparing student knowledge after graduation.

Exploration of wellbeing in entering first year doctor of pharmacy students

IntroductionThe purpose of this study was to assess wellbeing in entering first-year student pharmacists beginning their doctor of pharmacy degree program. MethodsThis was a mixed-methods study conducted in entering first-year student pharmacists during their pharmacy school orientation. After their wellbeing orientation session, students were asked to complete a voluntary survey that asked students to rate their current level of wellbeing according to the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). Students also wrote a reflection related to their wellbeing and perceptions. Qualitative analysis was completed for student responses to reflection questions to identify recurring themes. ResultsOne hundred thirty-one students attended the wellbeing orientation session and completed the reflection assignment. Of those, 87 (66.4%) completed the voluntary quantitative survey. On average, first-year student pharmacists indicated having a moderate level of wellbeing based on WEMWBS scores. Major themes that emerged as most influential on student pharmacist wellbeing included sense of optimism/self-care, social isolation and emotional connectedness, and uncertainty/worry/anxiety. ConclusionsEntering student pharmacists had slightly lower than average levels of wellbeing based on WEMWBS scores. Pharmacy programs should continue to consider the importance of variables that impact student wellbeing (e.g., promotion of self-care, mental health, social and emotional connectedness).

A transitions of care (TOC) PharmD elective and its impact on students' perceptions on their TOC knowledge, skills, and attitudes

IntroductionTransitions of care (TOC) continue to evolve as a problem within our health care system and is a direct driver to worsened patient outcomes. Currently information of in-depth instruction and application of TOC content within health care education, especially pharmacy, is limited. In 2012, a small team of faculty members created a specialized TOC pharmacy elective for third year doctor of pharmacy students. The purpose of this paper is to describe the impact of this TOC course on students' perceptions on their TOC knowledge, skills, and attitudes over the four years course span. MethodsA pre−/post-paper anonymous survey was distributed to the students. Descriptive statistics captured the analyzed survey questions into four main themes. Within each respective theme, quantitative data were provided for pre- and post-survey responses to illustrate the difference in the scores with corresponding P values to showcase if significance was present. ResultsThe response rate of the survey was 100%. Within all of the respective themes, all of the survey questions, pre- to post-responses, had a significant shift toward a higher degree of agreement. ConclusionsThis study illustrates the impact a course dedicated to TOC has on student's learning.

Student pharmacists' attitudes, perceptions, and knowledge regarding opioid use, misuse, and overdose: Four years of data

IntroductionThe American Association of Colleges of Pharmacy has urged pharmacy faculty to commit to actions to reduce the public health threat from opioid use and misuse. Optimizing student pharmacist training necessitates understanding changes in their attitudes and perceptions over time. This study assessed student attitudes, perceptions, and understanding of addiction, opioid use and misuse, and opioid overdose over four sequential years, from 2016 to 2019. MethodsThe participants were third-professional year doctor of pharmacy students enrolled in a required course. Participants voluntarily completed a 27-statement survey to determine student attitudes, perceptions, and understanding. ResultsA total of 452 participants completed the survey (response rate = 76.5%). Of the 27 survey items, five survey statements showed year on year positive increases in specific student attitudes towards addiction, hopefulness for its treatment, and confidence to use and train opioid overdose reversal agents. These yearly changes did not appear to be related to any changes in the academic aptitude of the students. The 22 remaining statements showed positive and stable attitudes towards self-perceived understanding of opioid use and misuse, hopefulness for its treatment, and the role of pharmacists. ConclusionTo our knowledge, this is the first large multiyear assessment of student pharmacists' attitudes, perceptions, and understanding of opioid use, misuse, and overdose. The data indicate favorable and improving attitudes. Knowledge of student attitudes, perceptions, and understanding regarding opioid use, misuse, and overdose will aid in the development of effective training programs for students in our, and other colleges of pharmacy.

Implementation and Assessment of a Heart Failure Virtual Patient Simulation in a Required Pharmacotherapy Course

Objective. To assess second year Doctor of Pharmacy students' academic performance in and perceptions of a heart failure (HF) virtual patient simulation used in a required pharmacotherapy course.Methods. A heart failure virtual patient simulation was created to augment heart failure pharmacotherapy course material at the University at Buffalo School of Pharmacy and Pharmaceutical Sciences in the fall of 2019. This was a retrospective, pre-post observational cohort study. The primary objective was to compare student performance on heart failure pharmacotherapy examination questions in a cohort of students who completed a virtual patient simulation in 2019 compared to a control cohort who completed a paper-based case activity in 2018. Student perceptions of the simulation experience were assessed via electronic survey.Results. Students completed either the virtual patient simulation (n=122) or a paper-based case activity (n=123). Overall, the proportion of correctly answered heart failure pharmacotherapy examination questions was 83.3% in the virtual simulation group compared to 79.2% in the paper-based case group. Survey results indicated that students would prefer that the virtual patient simulation be incorporated in the pharmacotherapy curriculum.Conclusion. Use of a heart failure virtual patient simulation was associated with improved examination performance and was well received by students.

A rasch analysis of three socialization and communication measures in 4th-year doctor of pharmacy students.

The impact of communication and anxiety on Doctor of Pharmacy students across three measures was examined. Data were collected (N = 120) from 4th-year Doctor of Pharmacy students at a historically black college/university using the Interprofessional Socialization and Valuing Scale, the Personal Report of Communication Apprehension, and the Social Phobia Inventory. Results of Rasch Differential Item Functioning Analysis indicated statistically significant differences between each ethnic group on subcomponents of anxiety in each measure (20% Caucasian, 43% African American, 31.7% Asian, and 4.2% others). Evidence from this study shows that racial demographics affect different subscales of anxiety across doctoral pharmacy students. While some pedagogical implications exist, issues within the measures and their items must also be addressed.

Impact of Supplemental Material Use on Student Metacognitive Monitoring and Calibration

Objective. To determine whether third year Doctor of Pharmacy students' self-reported use of optional supplemental material impacted their ability to accurately predict their performance on a low-stakes assessment.Methods. An instructor created optional supplemental material in the form of an online quiz. Students were asked to report whether they used the supplemental material and to predict and postdict their performance on an in-class assessment. The relative accuracy of the predictions and postdictions as well as the assessment grades and overall course grades were compared between students who reported using the supplemental material and those who reported not using the supplemental material.Results. More than half of the students (60%) reported using the supplemental material. Most students underpredicted their performance on the in-class assessment, but there was no difference in the accuracy of predictions based on supplemental material use or non-use (-1.2 vs -1.0) or on the postdictions (-1.3 vs. -1.0). Students who reported using the supplemental material performed better on both the low-stakes assessment (7.7 vs 7.2 out of 10) and overall in the course (87.0% vs 84.9%).Conclusion. Pharmacy students' self-reported use of optional supplemental material does not appear to impact their ability to accurately predict their performance on a low-stakes assessment.

Impact of a pilot elective course to address student pharmacist well-being

IntroductionSurvey results from 2016 and 2018 at the University of Michigan College of Pharmacy highlighted mental health concerns for the student population, including struggles with depression, anxiety, and academic distress. This led to creation of a pilot well-being elective course for first year doctor of pharmacy students. This article describes how this course was assessed and adapted for the future. MethodsThe well-being elective course used a course-specific survey and the Brief Inventory of Thriving to assess student outcomes. The course-specific survey was based upon the course objectives and the University of Michigan Common Agenda for Well-Being. Both surveys were given pre- and post-course to identify change. ResultsCourse survey results illustrated an improvement in student well-being over a single semester. Compared with pre-course responses, students who completed the course were significantly more likely to agree with statements indicating they had strong time management skills, resilience to manage the fluctuations of life, were able to make thoughtful choices to reduce harm and promote well-being, and overall rated their well-being as excellent. Additionally, nearly all students felt a sense of strengthened community with peers and faculty within the course, better able to recognize or refer a peer for help, and felt the course contributed to their overall well-being. ConclusionsImplementation of this well-being elective pilot course provided students the tools and resources to improve upon their overall well-being in an effort to address anxiety, depression, and academic distress.

Assessment of Cultural Competence in Pharmacy Students Prior to Advanced Pharmacy Practice Experiences

Objective. To assess various aspects of cultural competence in second year Doctor of Pharmacy students' and investigate the relationship between cultural competence and students' demographics, work experience, and prior education.Methods. A 63-item survey modified from the Clinical Cultural Competency Questionnaire (CCCQ) and comprising four domains (knowledge, skills, encounters or situations, and attitudes towards cultural competency) was administered to second year pharmacy students before they started their advanced pharmacy practice experiences (APPEs). Additional questions regarding their ability to identify and recognize elements of cultural competence were asked. The effects of demographics, work experience, and education on cultural competence also were assessed.Results. Ninety-seven students (86.6%) participated in the study. The majority of participants were Asian, female, and in their late 20s. Most students agreed or strongly agreed that they could identify and recognize elements of cultural competence. However, participants indicated they were only a little or somewhat comfortable when asked questions about knowledge, skills, and comfort. Students indicated they had "quite a bit" of competence regarding attitudes towards other cultures. Previous cultural diversity training in undergraduate studies and pharmacy school were associated with higher scores on the modified CCCQ.Conclusion. The findings emphasize the importance of schools providing training in the didactic and experiential portion of the pharmacy curriculum to increase pharmacy students' knowledge, skills, comfort, and attitudes towards other cultures.

Strategies first year doctor of pharmacy students use to promote well-being

IntroductionThe objective of this study is to assess strategies that first-year doctor of pharmacy (PharmD) students utilize to manage stress and promote well-being throughout the program. MethodsParticipants included students at a university in an urban Midwestern region. Students were enrolled in the second semester of their first year of a four-year PharmD program. Students were participating in a social and administrative sciences course in which they were required to write a two-page reflection before a small group discussion and lecture on their overall well-being while in pharmacy school. Open and axial coding was conducted on these reflections using a standard content analysis approach of qualitative thematic analysis. ResultsA total of 49 pharmacy students reported multiple strategies to help cope with stressors of a PharmD program and improve their well-being. Four themes emerged, including: (1) availability and accessibility of institutional resources, (2) personal time management and organizational strategies, (3) personal mental and physical health strategies, and (4) activities that maintain social relationships. ConclusionsFirst-year pharmacy (P1) students are actively thinking about and participating in activities to promote personal well-being, manage extreme stress, and proactively prevent the detrimental effects of burnout. P1 students were aware of the need to incorporate specific strategies into their daily routine to aid in their overall well-being and experience during pharmacy school. Colleges and schools of pharmacy can use the findings of this study to understand strategies students currently use to identify approaches for supporting student needs and any gaps in wellness resources.

Use of active learning and simulation to teach pharmacy students order verification and patient education best practices with oral oncolytic therapies.

The primary objective of this study was to describe the incorporation of the flipped classroom model and use of real-life oncology patients to facilitate student learning of oral oncolytic best safety practices and patient counseling. The secondary objective was to assess the impact of the flipped classroom learning activity on students' perceived confidence. This study was a prospective, single center, flipped classroom learning activity and pre/post assessment survey administered to third year doctor of pharmacy students enrolled in the Oncology Pharmacotherapy didactic elective in 2016 and 2017. A pre/post survey was used to assess student's perceived confidence with oral oncolytic best practice competencies. Ten students participated in the flipped classroom learning activity and survey. Five students completed both the pre- and postsurvey. The overall change in student's mean scores for their confidence of oral oncolytic competencies improved significantly from 3 to 4.1 on a 6-point Likert Scale (p = 0.03) following the learning activity. Students perceived confidence in performing oral oncolytic order verification increased following the implementation of a flipped classroom learning activity and use of real-life cancer oncology patients. This study describes the development and implementation of a flipped classroom learning activity and use of real-life patients with cancer that can be implemented at other institutions of higher education in a didactic or experiential learning environment. Additionally, this study demonstrated a potential benefit in student learning.

A heart failure themed escape room approach to enhance pharmacy student learning

IntroductionThe purpose of this study was to design, pilot, and evaluate the efficacy of an educational escape room to enhance second professional year doctor of pharmacy students' knowledge of heart failure medicinal chemistry, pharmacology, and therapeutics in an integrated Modular Organ Systems Therapeutics (MOST) course and to assess students' perceptions of the game. MethodsHeart failure pharmacology, medicinal chemistry, and pharmacotherapeutics were taught in MOST prior to the escape room activity. Students were randomized into groups of approximately eight. At the completion of the activity, students were asked to fill out a perceptions survey. A follow up survey of their perceptions was again administered four weeks after the activity. ResultsOne-hundred-ninety-three students participated in the escape room activity. Overall, performance indicated that the escape room satisfactorily reinforced students' learning of the course material. Students expressed satisfaction toward the escape room activity on both surveys, with response rates of 92.22% and 56.99% for the initial and follow up surveys, respectively. Findings revealed no statistically significant differences between the first and the second group of responses, confirming that positive attitudes toward the activity did not alter over time. Students' satisfaction levels were inversely related to their grade point average (r = −0.20, p = 0.05). ConclusionsPositive student perceptions reported immediately after the completion of the escape room activity and measured in the follow-up survey demonstrated that the escape room is a satisfying learning activity that can engage all students.

Student confidence with oncology pharmacy competencies

ObjectiveThe purpose of this study was to assess the change in student confidence to perform oncology pharmacy competencies before and after completing oncology didactic instruction using a flipped classroom approach. MethodsFirst year doctor of pharmacy students completed a survey prior to the Applied Science and Therapeutics (AST) oncology module (pre-survey) and the same survey following the completion of the oncology module (post-survey). The survey consisted of questions addressing prior oncology pharmacy experience related to employment (research or patient care) and education, level of interest in oncology pharmacy, and level of confidence to perform thirteen oncology pharmacy competencies. ResultsOne-hundred sixteen students completed the pre-survey and 35 completed the post-survey. Students completing both surveys reported greater confidence in all oncology pharmacy competencies (p < 0.0001) after instruction. The greatest increases in student confidence were related to chemotherapy dose calculations, patient education, and drug-drug interactions. ConclusionsThe delivery of oncology content using flipped classroom instruction in the AST course successfully increased student confidence in ability to perform oncology pharmacy competencies. Cancer screening, cancer risk factors, and the preparation and dispensing of chemotherapy were competencies identified as needing greater emphasis in classroom instruction. Future studies are needed to assess student's knowledge and application of oncology pharmacy competencies in both the experiential and classroom settings.

A novel and comprehensive design of mock residency interviews for fourth-professional year doctor of pharmacy students

Background and purposeTo describe a comprehensive design of mock residency interviews intended to closely mimic the environment and variety of interview settings commonly seen in post-graduate year 1 (PGY-1) interviews. Educational activity and settingMock interviews were held during one evening where a total of 24 fourth-professional year doctor of pharmacy students each experienced seven different interview scenarios over the course of nearly three hours. Twenty-seven faculty members and pharmacists and 11 current pharmacy residents participated as interviewers. Students received individual written feedback after the conclusion of the event. FindingsDuquesne University School of Pharmacy has successfully hosted this residency mock interview program for four consecutive years. After establishing a basic template for the interview format, we have been able to include more students, more interviewers, and a greater variety of interview scenarios. SummaryThis comprehensive approach to mock residency interviews has been successfully implemented to help prepare students at Duquesne University School of Pharmacy for PGY-1 residency interviews.

Preceptor confidence and engagement in providing leadership activities to students in advanced pharmacy practice experiences

IntroductionPreceptor perceptions about providing leadership activities during the fourth year of the doctor of pharmacy curriculum were examined. MethodsAn anonymous questionnaire was sent electronically to 610 preceptors of fourth year doctor of pharmacy students in August 2015 inquiring about confidence in leadership ability, extent of student engagement in leadership activities, and preceptor support needed. Differences based on leadership background, such as formal training, were examined using independent t-test. Continuous data are presented as mean (standard deviation). P-value < 0.05 was considered significant. ResultsSurvey response rate was 28% (n = 171). Preceptor confidence in ability to provide leadership activities was 7.38 + /−1.66 [0–10 Likert scale; 0 = cannot do at all, 10 = highly certain can do]. Preceptors were most confident teaching that leadership comes from those with and without titles (8.48 + /−1.64) and least confident engaging students in advocacy (5.41 + /−3.02). Preceptors were most likely to engage students in collaboration [3(1–4)] and least likely to involve them in advocacy [1(1–4)] (measured from 1–4 with 1 = never and 4 = very often). Preceptors with formal leadership training demonstrated higher confidence and more engagement with involving students in leadership activities than those without training (p < 0.05). Examples of common leadership activities shared by preceptors included experiential clinical activities and projects, teaching opportunities, discussions with leaders, and participation in meetings. Leadership training and development was the most requested type of support by preceptors (n = 23, 13.5%). ConclusionPreceptors were overall confident about their ability to provide leadership activities, were involving students in some leadership activities, and had the least confidence and engagement in involving students in advocacy. Preceptors may consider increasing engagement in teaching student leadership skills by utilizing examples in this study. Colleges of pharmacy and organizations may collaborate to increase preceptor access to formal leadership training programs and offer preceptor development programs designed to enhance preceptors’ abilities to facilitate student leadership experience, reflection on experience, and feedback.

Influence of pharmacy students on the attitudes of medical students following an interprofessional course.

Clinical interprofessional education (IPE) can promote mutual understanding of other health professions and respectful behaviors among health-care professionals. The aims of this study were to evaluate the effects of IPE on the attitudes of medical and pharmacy students in an inpatient hospital setting and, in particular, the influence of pharmacy students on the attitudes of medical students. The 6th year doctor of pharmacy students and medical students were enrolled in a prospective cohort study. They were paired and each pair was responsible for three beds and all the patients occupying these mentioned beds over the 2-week course. The Readiness for Interprofessional Learning Scale (RIPLS) questionnaire was used to assess the students' attitudes before and after the course. The attitudes of the medical students changed positively after the IPE course based on RIPLS teamwork and collaboration and professional identity subscales. Changes in the attitudes of the pharmacy students were not statistically significant based on the mentioned scale and subscales. IPE could improve the attitudes of the medical students regarding interprofessional teamwork, communication, and sharing learning experience. Based on the current investigation, IPE did not have an effect on pharmacy students.

A pre- and post-test assessment of concept learning in research design

ObjectiveTo assess concept learning and topic difficulty in a concept-based research methods course. MethodsA pre–post exam was given to second professional year Doctor of Pharmacy students enrolled at the University of Arizona College of Pharmacy using 25 concept-based multiple choice questions. Rasch analysis was used to determine the change in student ability and to assess question difficulty. ResultsA total of 94 students completed both pre- and post-tests (response rate = 96.9%). As a group, student ability significantly increased from the pre- to post-test (p < 0.001). Of these, 30 students showed a significant increase in ability (p < 0.05). Ten questions showed a significant change in difficulty level. ConclusionsStudents learned the material over the semester as indicated by the overall increase in student ability. Changes in question difficulty provide evidence for the importance of practice when learning concepts.

Incorporation and Assessment of Portable Tablet Technology During a Patient Counseling Exercise

Background: The marriage of cutting-edge technology to the practice of pharmacy for the purpose of promoting patient safety and enhancing pharmacy workflow is an exciting and continuous evolution. Objective: To assess whether the incorporation of portable tablet technology into a mock patient counseling exercise enhances or detracts from the overall counseling experience. Methods: Second professional year Doctor of Pharmacy students enrolled in a pharmacy practice laboratory were randomly assigned to either a portable tablet or a desktop computer group. During patient counseling, students using the portable tablet were required to incorporate the device into the counseling session in addition to written notations; the desktop computer group was allowed to utilize only written notations. Surveys were developed and distributed to students and instructors following each counseling session. Survey data and numerical grades earned for each counseling session were collected and analyzed. Results: One hundred seventy-eight students participated in the study. Survey data revealed students in the portable tablet group were more satisfied with their patient counseling sessions, as well as more confident during their interactions. Instructor grading revealed similar earned numerical grades for both study groups. Instructors noted little or no difference between the groups with regard to counseling effectiveness; however, students in the portable tablet group appeared more engaged with their mock patients. Conclusion: Incorporation of a portable tablet during a patient education session did not detract from, and may have enhanced, the experience. However, the essential components of the pharmacist–patient interaction remain vital, and technology should not become the focus of the interaction.