Denise A. Soltis

A Review of Remediation Programs in Pharmacy and Other Health Professions

The Accreditation Council for Pharmacy Education (ACPE) Accreditation Standards and Guidelines 2007 states that colleges and schools of pharmacy must have a remediation policy. Few comparative studies on remediation have been published by colleges and schools of pharmacy, making it challenging to implement effective and validated approaches. Effective remediation policies should include early detection of problems in academic performance, strategies to help students develop better approaches for academic success, and facilitation of self-directed learning. While the cost of remediation can be significant, revenues generated either cover or exceed the cost of delivering the remediation service. Additional research on remediation in pharmacy education across the United States and abroad is needed to make sound decisions in developing effective policies. This paper provides a review of current practices and recommendations for remediation in pharmacy and health care education.

An Introductory Pharmacy Practice Experience to Improve Pertussis Immunization Rates in Mothers of Newborns

Objective. To implement an introductory pharmacy practice experience (IPPE) involving discharge counseling on postpartum pertussis immunization recommendations and evaluate its impact on student learning and patient immunization rates. Design. Seventeen pharmacy students provided verbal and written information based on Centers for Disease Control and Prevention (CDC) recommendations regarding pertussis immunization for mothers and caregivers of newborns. Assessment. Educational and clinical outcomes were evaluated using student documentation and pharmacy records. Students completed 615 IPPE hours and provided 1,263 consultations. Students reported that 52% of mothers requested immunization, 27% were undecided, 11% had previously been immunized, and 10% declined. Following counseling, immunization rates, as a percentage of total births, significantly increased by 18.5%. Learning objectives of enhanced counseling and documentation skills were achieved. Conclusions. IPPE students provided patient counseling in an institutional setting that contributed to healthcare team efforts to increase pertussis immunization rates in mothers of newborns. This IPPE may serve as a potential model for additional student involvement in discharge counseling.

Garnering Widespread Involvement in Preparing for Accreditation Under ACPE Standards 2007

On February 17, 2006, the Accreditation Council for Pharmacy Education (ACPE) announced the release of the revised Accreditation Standards and Guidelines for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree that became effective on July 1, 2007. (1) Although there are numerous differences between Standards 2007 and previous versions, the general core areas remain similar but are condensed into 6 groupings of the Standards and Guidelines: Mission, Planning, and Evaluation; Organization and Administration; Curriculum; Students; Faculty and Staff; and Facilities and Resources. (2) Within these core areas, significant changes have occurred, including the reorganization of standards to include institutional accreditation, student complaint policies, and more specific requirements for areas such as experiential education hours. Review procedures are more defined with an emphasis on the evaluation form/ rubric, use of standardized survey instruments, and broad participation by faculty members and other key groups. (3) Implementation of Standards 2007 presents several unknowns to schools and colleges undergoing accreditation for the first time under the new standards. Ramifications for being partially or non-compliant with the standards include a limited (2-year) time period to become compliant, potential probation, public availability of a college/schools status, and potential adverse accreditation action. (4) Clearly, colleges/schools need to have their stakeholders knowledgeable and involved in the self-study to assure success. The self-study process also changed, including the use of a self-study template supplied by ACPE. The template offers a consistent format to self-study reports, additional direction on sources of information to be used, and specific requirements for each standard and guideline. The template includes sections for both a summary of self-study process and a formal rating of the overall organization and clarity of the self-study process. The latter addition adds further evidence of the need for broad and inclusive participation during the self-study process. Within the Overall Organization and Clarity section of the template, colleges and schools of pharmacy are rated on 6 general areas, 3 of which are linked directly to the involvement of stakeholders in the self-study process and their awareness of the subsequent findings. These 3 areas are: * Participation: the self-study report was written and reviewed with broad-based input from students, faculty members, preceptors, staff members, administrators, and a range of other stakeholders, such as patients, practitioners, and employers. * Completeness and transparency: all narratives and supporting documentation are thorough, clear, and concise. The content appears thoughtful and honest. Interviews match the self-study findings. * Knowledge of the self-study: students, faculty members, preceptors, and staff members are conversant in the major themes of the report and how the program intends to address any deficiencies. Little information has been published on how schools and colleges of pharmacy approach the self-study process or the new Standards 2007. Although one program published their experiences using a project management approach, no other information is available. (5) To our knowledge, no literature focuses on garnering widespread stakeholder involvement in the accreditation process. This paper describes several practices that may aid programs in achieving such involvement in the self-study process. PARTICIPATION IN THE SELF-STUDY PROCESS When possible, colleges and schools of pharmacy should consider attending a program such as the AACP Institute that can help focus and plan the self-study process. The 2007 AACP Institute coincided with the start of our self-study, and included a topic related to accreditation. (6) Programs like this allow the faculty to begin planning and discussing their self-study, including the main ideals to promote throughout the process. …

Personal and Professional Growth Through an International Sabbatical Experience

I would like to encourage faculty members to apply for sabbaticals and consider pursuing international experiences. From January through June of 2012, I completed a sabbatical at Hillside Health Care International in Belize. While there were many objectives listed on my application, one important goal was to give back to an organization that had educated our pharmacy students over the previous 4 years. In April 2008, a delegation from Drake University and University of Wisconsin had visited Belize to explore the potential of establishing advanced pharmacy practice experiences (APPEs) there. From that first visit, I planned to return and spend an extended period of time providing care to the people in the Toledo District of Belize. At Drake University “preparing students for responsible global citizenship” is part of our mission, and therefore, it was not difficult to show how my sabbatical proposal reflected this mission. As I look back, I reflect not on the impact I had on the people but on the impact they had on me. Hillside provides free health care in a permanent clinic in Eldridgeville and mobile clinics to remote villages. Belizean staff members interpret Quetchi and Mopan Mayan dialects for patients who do not speak English. Villagers are very patient with the students providing the care and the physicians rechecking the students’ work, and are grateful for the access to care. In the villages, life is simple, with many of the modern conveniences missing, and manual labor is a way of life. Men walk to fields they have carved out of the jungle hills using machetes and fire. Crops are sold at market while they eat rice and tortillas to save money. Typically only women and children are seen in the mobile visits because the men are working. Women seek birth control many times without the permission of their husbands. While collaborating with Hillside staff members to develop goals, I realized their concerns are many of the things taken for granted here: fixing their houses to stay dry during the torrential rains and making enough money to send their kids to grade school and hopefully high school. College is just a dream. Hillside staff members are among the most amazing people I have met. Each month they welcome a new group of 11-13 healthcare students for an educational rotation in medicine, pharmacy, physical therapy, and nursing. Every 2 or 3 years they welcome a new medical director. They gladly accept various short-term volunteers who stay anywhere from 1 week to 1 year. The staff members are among the most flexible people I have ever encountered. They have been trained to provide care and skills way beyond their years of formal education. There were patients who had a huge impact on me. First, there was an elderly man we often stopped by to see, bring food, give medicine to, and bathe. He was a man who seemed forgotten by family and neighbors, living in conditions that most could not imagine. During our visits, he routinely made us laugh, even in the midst of what some would consider a desperate situation, he seemed to have found peace. I also remember a 4 year-old girl who had part of her foot cut off in a machete accident, but during her stay on an amputee ward in the hospital remarked to her mother, “At least I have my leg.” Even through their struggles to make enough money to feed and clothe their families, educate their children, and provide adequate housing, the people are fairly happy. Who are we to decide what they need? I saw mission group after mission group come to provide what they deemed Belize needs, many times forgetting to ask the community or neglecting to understand the impact of their project. As one traveler and author wrote, “One outcome of traveling should be to develop an uneasy conscience and a critical self-consciousness about our practices when we go abroad.”1 I learned to be patient and to listen to the needs of others first and foremost. In the United States, our way is just that…our way. After treating patients in Africa, a young doctor commented, “We could get so much done with so little over there it’s like we’re not doing something right over here.”2 There are other ways of life that can provide more joy and peace than our hectic consumer-driven world. Should we return to a more simple approach? So look into a sabbatical, consider international experiences, write a plan, and have an adventure that will bring personal growth and renewal. The more we learn about others the more we learn about ourselves. To teach empathy, cultural competence, and global citizenship, pharmacy faculty members must develop those areas in themselves.

Remote library access for pharmacy preceptors.

Objective. To institute and evaluate the response to a program providing access to electronic library resources for pharmacy preceptors. Design. The pharmacy experiential office and the library collaborated using existing programs and technology to provide and market secure remote access for preceptors. Assessment. Preceptor participation was tracked in the experiential office, and response to the program was assessed using an online survey instrument that included questions about use of and preference for specific library resources. Three hundred thirty-four adjunct faculty members registered, representing 34% of all preceptors with active e-mail accounts. Conclusion. Preceptor participation in the program exceeded expectations. Some minor flaws in the logistics of delivering the service were identified and remedied.

National Survey of Volunteer Pharmacy Preceptors: effects of region, practice setting, and population density on responses.

Objectives: To survey volunteer pharmacy preceptors regarding experiential education and determine whether differences in responses relate to such factors as geographic region, practice setting, and population density. Methods: An online survey was sent to 4396 volunteer experiential preceptors. The survey consisted of 41 questions asking the preceptor to comment on the experiential education environment. Experiential education administrators from 9 schools of pharmacy administered the survey to their volunteer preceptors in all regions (Northeast, Midwest, South, and West) of the United States, in various pharmacy practice settings, and areas of differing population densities. Results: A total of 1163 (26.5%) preceptors responded. Regionally, preceptors in the West disagreed more than those in the Midwest and the South that they had enough time to spend with students to provide a quality experience and also required compensation less often than their counterparts in the Northeast and South. Concerning practice settings, hospital preceptors accepted students from more schools, had greater increases in requests, turned away more students, and spent less time with the students compared to preceptors in other settings. Population density differences reflected that preceptors at urban sites took and turned away more students than those at rural sites. Preceptors from rural areas spent more time with students and felt they were spending enough time with their students to provide quality experiences when compared to other preceptors. Conclusions: The results of this national volunteer preceptor survey may assist pharmacy school leaders in understanding how location, practice type, and population density affect experiential education, preceptor time-quality issues, and site compensation so they can take necessary actions to improve quality of student practice experiences.