Beth A. Martin

Educational testing and validity of conclusions in the scholarship of teaching and learning.

Validity and its integral evidence of reliability are fundamentals for educational and psychological measurement, and standards of educational testing. Herein, we describe these standards of educational testing, along with their subtypes including internal consistency, inter-rater reliability, and inter-rater agreement. Next, related issues of measurement error and effect size are discussed. This article concludes with a call for future authors to improve reporting of psychometrics and practical significance with educational testing in the pharmacy education literature. By increasing the scientific rigor of educational research and reporting, the overall quality and meaningfulness of SoTL will be improved.

A Nontraditional Faculty Development Initiative Using a Social Media Platform

Objective. To assess the outcomes from an 11-year nontraditional professional development activity implemented by female faculty members at several colleges and schools of pharmacy. Design. Within the context of an online fantasy football league, faculty members practiced community-based faculty development strategies, including peer mentoring, skills development, constructive feedback and other supportive behaviors. Assessment. Data were extracted from curriculum vitae to characterize the academic progress of participants and to quantify scholarly work collaborations among league members. Analyses were limited to members who had participated in the league for 10 or more consecutive years. Seventy-one collaborative scholarly works occurred among team managers, including presentation of 20 posters and 2 oral presentations at national or international meetings, publication of 29 peer-reviewed articles and 15 book chapters, and funding of 5 research projects. Conclusion. Social media platforms can foster nontraditional faculty development and mentoring by enhancing connectivity between pharmacy educators who share similar interests.

Impact of a medication therapy management intervention targeting medications associated with falling: Results of a pilot study

BACKGROUND The use of fall risk-increasing drugs (FRIDs) by older adults is one factor associated with falling, and FRID use is common among older adults. A targeted medication therapy management intervention focused on FRID use that included prescription and over-the-counter (OTC) medications, along with follow-up telephone calls was designed. OBJECTIVE The purpose of this pilot study was to examine preliminary effects of a medication therapy management (MTM) intervention focused on FRIDs provided by a community pharmacist to older adults. DESIGN Randomized, controlled trial. SETTING One community pharmacy. PARTICIPANTS Eighty older adults who completed a fall prevention workshop. MAIN OUTCOME MEASURES The main outcome measures were the rate of discontinuing FRIDs, the proportion of older adults falling, and the number of falls. A secondary outcome was the acceptance rate of medication recommendations by patients and prescribers. RESULTS Thirty-eight older adults received the targeted MTM intervention. Of the 31 older adults using a FRID, a larger proportion in the intervention group had FRID use modified relative to controls (77% and 28%, respectively; P < 0.05). There were no significant changes between the study groups in the risk and rate of falling. Medication recommendations in the intervention group had a 75% acceptance rate by patients and prescribers. CONCLUSION A targeted MTM intervention provided by a community pharmacist and focused on FRID use among older adults was effective in modifying FRID use. This result supports the preliminary conclusion that community pharmacists can play an important role in modifying FRID use among older adults.

Impact and Application of Material Learned in a Pharmacy Residency Teaching Certificate Program

Objective. To describe the impact and application of material learned in a pharmacy resident teaching certificate program on the career experiences of alumni 1 to 11 years after completion of the program. Design. A teaching certificate program was established in 2001 that brought together residents from various training programs throughout Wisconsin to discuss essential educational skills in a dynamic learning environment. The purpose of the program was to teach participants the fundamental skills to continue to develop as a pharmacy educator throughout their career. Assessment. An electronic survey instrument was sent to alumni of the program. Greater than 70% of respondents agreed that the teaching certificate program reinforced their desire to teach in practice and that the program helped qualify them for their current or previous practice position. Alumni in academic positions more strongly agreed that the program changed their career interest to include academia and qualified them for their position in academia. Conclusions. A teaching certificate program can reinforce or stimulate interest among pharmacy residents in pursuing an academic career and prepare them for this role. Completion of the program led to a high level of confidence among the majority of alumni in their ability to precept students and residents and influenced some alumni involved in the hiring of pharmacists.

A model for partnering first-year student pharmacists with community-based older adults.

Objectives. To design, integrate, and assess the effectiveness of an introductory pharmacy practice experience intended to redefine first-year student pharmacists’ views on aging and medication use through their work with a healthy, community-based older-adult population. Design. All students (N = 273) completed live skills training in an 8-hour boot camp provided during orientation week. Teams were assigned an independently living senior partner, completed 10 visits and reflections, and documented health-related information using an electronic portfolio (e-portfolio). Assessment. As determined by pre- and post-experience survey instruments, students gained significant confidence in 7 skill areas related to communication, medication interviews, involving the partner in health care, and applying patient-care skills. Student reflections, in-class presentations, and e-portfolios documented that personal attitudes toward seniors changed over time. Senior partners enjoyed mentoring and interacting with students and many experienced health improvements as a result of the interaction. Conclusions. The model for partnering first-year student pharmacists with community-based older adults improved students’ skills and fostered their connections to pharmacist roles and growth as person-centered providers.

Longitudinal Teaching of Evidence-Based Decision Making

Objective. To determine whether longitudinal design and delivery of evidence-based decision making (EBDM) content was effective in increasing students’ knowledge, skills, and confidence as they progressed through a doctor of pharmacy (PharmD) curriculum. Design. Three student cohorts were followed from 2005 to 2009 (n=367), as they learned about EBDM through lectures, actively researching case-based questions, and researching and writing answers to therapy-based questions generated in practice settings. Assessment. Longitudinal evaluations included repeated multiple-choice examinations, confidence surveys, and written answers to practice-based questions (clinical inquiries). Students’ knowledge and perception of EBDM principles increased over each of the 3 years. Students’ self-efficacy (10-items, p<0.0001) and perceived skills (7-items, p<0.0001) in applying EBDM skills to answer practice-based questions also increased. Graded clinical inquiries verified that students performed satisfactorily in the final 2 years of the program. Conclusions. This study demonstrated a successful integration of EBDM throughout the curriculum. EBDM can effectively be taught by repetition, use of real examples, and provision of feedback.

Validation of learning assessments: A primer

The Accreditation Council for Pharmacy Educations Standards 2016 has placed greater emphasis on validating educational assessments. In this paper, we describe validity, reliability, and validation principles, drawing attention to the conceptual change that highlights one validity with multiple evidence sources; to this end, we recommend abandoning historical (confusing) terminology associated with the term validity. Further, we describe and apply Kanes framework (scoring, generalization, extrapolation, and implications) for the process of validation, with its inferences and conclusions from varied uses of assessment instruments by different colleges and schools of pharmacy. We then offer five practical recommendations that can improve reporting of validation evidence in pharmacy education literature. We describe application of these recommendations, including examples of validation evidence in the context of pharmacy education. After reading this article, the reader should be able to understand the current concept of validation, and use a framework as they validate and communicate their own institutions learning assessments.

Improving health care communication for caregivers: A pilot study

ABSTRACT With the growing older adult population, there will also be more informal caregivers assisting friends and family with their health care. With the increasing complexity of health care, improved caregiver communication skills have the potential to reduce caregiver burden and frustration and improve care recipient health. The primary goal of this project was to develop and refine the content and teaching methods of a small-group behavioral change program to improve communication between caregivers of older adults and health care professionals. The authors developed the Care Talks program for improving communication between caregivers and health care professionals. They conducted a prospective cohort feasibility study of the intervention to assess caregiver communication confidence at baseline and one month postintervention. Six participants were enrolled. Of the 15 participants who answered the question, 15 (100%) would recommend this program to a friend. There was significant improvement in a 10-question composite of communication confidence pre/post scores from 74.1 to 79.6 p = .03. This small-group behavioral change intervention significantly improved communication confidence for this sample of caregivers. Further research is needed to determine the long-term effects of this program on caregivers and care recipients.

Work System Barriers to Providing Safe Over-the-Counter (OTC) Medication Recommendations for Older Adults

Background: Unsafe medication use represents a major public health concern, especially for older adults. OTC medications, those that can be purchased without a formal prescription or advice from a health care professional, are one contributor to unsafe use because of their perceived safety and accessibility. Despite the recognition of pharmacists’ ability to help patients make safe OTC medication choices, the prevalence of older adult misuse of OTC medications is well documented. Objective: To identify barriers to pharmacists providing safe OTC medication recommendations to older adults. Methods: Twenty-one retail pharmacists in three focus groups with questions developed using the critical incident technique. Analysis was guided by the Input-Performance-Output Model for Health Care Professional Performance. Results: Thematic analysis revealed barriers within all of the input categories of the work system model, including provider, patient, work system, organizational factors, and external environment. The results provide support that any intervention to improve safe OTC medication use in older adults should take into consideration the role of individual and interacting components of the work system.

Risk for Osteoporosis in Elderly Nuns: Need for Better Recognition and Treatment

BACKGROUND The risk for osteoporosis in Catholic sisters (nuns) may be even higher than that of the general female population given their longer life expectancy (82.0 to 89.0 years vs 79.6 years for the average white woman) and the use of a traditional habit as a young adult, resulting in limited sun exposure (ie, exposure to vitamin D). OBJECTIVES The aim of this study was to determine, in a group of elderly nuns attending an annual health screening day (Health Forum), how many met National Osteoporosis Foundation (NOF) treatment criteria using peripheral bone mineral density (BMD) measurements and risk factors; what proportion received adequate vitamin D; whether BMD was related to length of time that nuns wore a habit; and whether BMD measurement led to medical interventions. In addition, we compared the usefulness of calcaneal BMD with that of BMD at central sites for identification of those at risk for osteoporosis. METHODS This cross-sectional study assessed BMD by calcaneal dual energy X-ray absorptiometry (DXA) and, for some participants, central DXA. A baseline questionnaire and follow-up mail survey also were included. RESULTS Of the 230 nuns attending the Health Forum, 146 (63%) (mean age, 70 years; range, 48-90 years) participated in the study. Of these, 14% had calcaneal osteoporosis (T-score <-2.5) and 32% met NOF treatment criteria, indicating risk comparable to that of other postmenopausal American women. Sixty-four percent were receiving less than the recommended amount of vitamin D (≥400 IU/d for those aged <71 years and ≥600 IU/d for those aged ≥71 years). Calcaneal BMD was inversely related to the length of time nuns had worn a habit. Fifty-six women subsequently underwent central DXA. Using a calcaneal T-score of -1.2 to identify those with central osteoporosis, sensitivity and specificity of 78% and 76%, respectively, were obtained. According to the mail survey, 11 of 42 respondents who had met NOF treatment criteria started new medications for osteoporosis. CONCLUSIONS Elderly nuns are at substantial risk for osteoporosis. Most receive inadequate vitamin D. For nuns and others who may have limited access to central DXA measurement, peripheral measurements may help identify those in need of further intervention. Further efforts, in addition to BMD measurements, are necessary to ensure appropriate therapy for those who meet treatment criteria.