Andrew S. Bzowyckyj

A Consensus Definition and Core Competencies for Being an Advocate for Pharmacy

Objective. To develop a consensus definition for “advocacy for the profession of pharmacy” and core competencies for doctor of pharmacy (PharmD) graduates to be effective advocates for the profession. Methods. A 3-round modified Delphi process was conducted using a panel of 9 experts. Participants revised a definition for “advocacy for the profession” and ultimately rated their agreement using a 5-point Likert scale. Competency statements were developed and subsequently rated for importance for being an advocate and importance to address in PharmD curricula. Results. A consensus-derived definition was developed. Two competency statements achieved consensus for both measures of importance. Four competency statements achieved consensus for only 1 measure and another 4 did not reach consensus for either measure. Conclusion. A consensus-derived definition was developed describing advocacy for the profession of pharmacy and began laying the groundwork for the knowledge and skills necessary to be an effective advocate for the profession of pharmacy.

Deliberate Integration of Student Leadership Development in Doctor of Pharmacy Programs

The CAPE 2013 Outcomes answered the call for increased student leadership development (SLD) by identifying leadership as a desired curricular goal. To meet this outcome, colleges and schools of pharmacy are advised to first identify a set of SLD competencies aligned with their institution’s mission and goals and then organize these competencies into a SLD framework/model. Student leadership development should be integrated vertically and horizontally within the curriculum in a deliberate and longitudinal manner. It should include all student pharmacists, begin at the point of admission, and extend beyond extracurricular activities. The school’s assessment plan should be aligned with the identified SLD competencies so student learning related to leadership is assessed. To accomplish these recommendations, a positive environment for SLD should be cultivated within the school, including administrative backing and resources, as well as support among the broader faculty for integrating SLD into the curriculum.

A design thinking approach to evaluating interprofessional education

ABSTRACT The complex challenge of evaluating the impact of interprofessional education (IPE) on patient and community health outcomes is well documented. Recently, at the Radcliffe Institute for Advanced Study in the United States, leaders in health professions education met to help generate a direction for future IPE evaluation research. Participants followed the stages of design thinking, a process for human-centred problem solving, to reach consensus on recommendations. The group concluded that future studies should focus on measuring an intermediate step between learning activities and patient outcomes. Specifically, knowing how IPE-prepared students and preceptors influence the organisational culture of a clinical site as well as how the culture of clinical sites influences learners’ attitudes about collaborative practice will demonstrate the value of educational interventions. With a mixed methods approach and an appreciation for context, researchers will be able to identify the factors that foster effective collaborative practice and, by extension, promote patient-centred care.

Hypersensitivity reactions to human insulin analogs in insulin-naïve patients: a systematic review

Objective: The objective of this study was to raise awareness of hypersensitivity reactions to human insulin analogs (HIAs) in insulin-naïve patients and encourage consistent and detailed reporting of HIA reactions. Data sources: A search of PubMed, MEDLINE and International Pharmaceutical Abstracts using the terms ‘insulin’ and ‘hypersensitivity’ was completed with English language, humans, and publication date after 1 January 1990 as limits. Study selection and data extraction: The initial search identified 598 articles. These titles and abstracts were reviewed for relevance (e.g. mention of HIA) resulting in the exclusion of 477 articles. The full texts of the remaining titles were evaluated in addition to each article’s references to identify additional reports meeting criteria (n = 14). Upon extensive review, 118 articles were excluded for not meeting prespecified inclusion criteria, resulting in 17 articles. Data synthesis: Evidence supporting hypersensitivity reactions to HIAs was variable, potentially due to a variety of causes (e.g. difficulty identifying a true case of hypersensitivity reaction to HIAs). Inconsistencies were noted for the identification, confirmatory testing, management, and reporting of these reactions. Management strategies included use of insulin desensitization protocols, antihistamines, steroids, immunosuppressant/immunomodulator therapies, conversion to noninsulin therapies, and pancreas transplantation. Conclusions: Complete and consistent identification, evaluation, management, and reporting of these reactions is essential. Specific aspects of the patient’s history should be reported, including previous insulin exposure, the specific HIAs used, duration of use prior to the reaction, a clear timeline of the reaction, and discussion of precipitating events or confounding factors.

Embracing the Insulin Revolution in the Ambulatory Care Setting

IN BRIEF Recent additions of various new formulations of insulin to the U.S. marketplace have increased the number of treatment options available to people living with diabetes. However, it is important to take into consideration the implications of these new insulins in terms of patient safety and medication errors, integration with electronic medical records, and financial considerations. This review outlines several considerations for practitioners regarding the implications of these new insulin products for ambulatory care practice.

Editors’ Perspectives on Enhancing Manuscript Quality and Editorial Decisions Through Peer Review and Reviewer Development

Objectives. To identify peer reviewer and peer review characteristics that enhance manuscript quality and editorial decisions, and to identify valuable elements of peer reviewer training programs. Methods. A three-school, 15-year review of pharmacy practice and pharmacy administration faculty’s publications was conducted to identify high-publication volume journals for inclusion. Editors-in-chief identified all editors managing manuscripts for participation. A three-round modified Delphi process was used. Rounds advanced from open-ended questions regarding actions and attributes of good reviewers to consensus-seeking and clarifying questions related to quality, importance, value, and priority. Results. Nineteen editors representing eight pharmacy journals participated. Three characteristics of reviews were rated required or helpful in enhancing manuscript quality by all respondents: includes a critical analysis of the manuscript (88% required, 12% helpful), includes feedback that contains both strengths and areas of improvement (53% required, 47% helpful), and speaks to the manuscript’s utility in the literature (41% required, 59% helpful). Hands-on experience with review activities (88%) and exposure to good and bad reviews (88%) were identified as very valuable to peer reviewer development. Conclusion. Reviewers, individuals involved in faculty development, and journals should work to assist new reviewers in defining focused areas of expertise, building knowledge in these areas, and developing critical analysis skills.

Report of the APhA and APhA-ASP Houses of Delegates.

The sun shined bright over this year’s APhA Annual Meeting and despite the beautiful weather, your dedicated representatives were bunkered up in the windowless ballrooms of the San Diego Convention Center thoroughly discussing several pressing issues facing the profession of pharmacy. Below is a summary of the policies that were passed by the APhA House of Delegates from the perspective of the APhA Academy of Pharmacy Practice and Management. The complete wording of these policies is available at www.pharmacist.com/house-ofdelegates and in the House of Delegates report in this issue of JAPhA.

APhA House of Delegates: Ensuring the power and promise of pharmacy

This year’s American Pharmacists Association (APhA) Annual Meeting featured another exciting session of the House of Delegates (HOD). Pharmacists and student pharmacists from across the country discussed key issues affecting the future of pharmacy. This year’s topics didn’t seem to stir up as much debate as previous years but the issues discussed are nonetheless vital to the future of our profession. Below is a summary of the policies that were passed by the 2013–14 HOD from the perspective of APhA’s Academy of Pharmacy Practice and Management (APhA– APPM). The complete wording of these policies is available on the APhA website at www.pharmacist. com/house-of-delegates.