Diane E. Beck

Center for the Advancement of Pharmacy Education 2013 Educational Outcomes

An initiative of the Center for the Advancement of Pharmacy Education (formerly the Center for the Advancement of Pharmaceutical Education) (CAPE), the CAPE Educational Outcomes are intended to be the target toward which the evolving pharmacy curriculum should be aimed. Their development was guided by an advisory panel composed of educators and practitioners nominated for participation by practitioner organizations. CAPE 2013 represents the fourth iteration of the Educational Outcomes, preceded by CAPE 1992, CAPE 1998 and CAPE 2004 respectively. The CAPE 2013 Educational Outcomes were released at the AACP July 2013 Annual meeting and have been revised to include 4 broad domains, 15 subdomains, and example learning objectives.

Outcomes and experiential education.

Outcomes‐based assessment in education involves continuous use of assessment measures to provide feedback about the efficacy of the curricular structure, content, and teaching methods. This process is initiated by establishing educational outcome statements for the Doctor of Pharmacy curriculum, selecting assessment methods that most appropriately measure the educational outcomes, and establishing a learning environment that is congruent with both the outcomes and assessment methods. To ensure a successful continuous outcomes‐based assessment process, a systematic assessment plan should be prepared that focuses the process by identifying only the most essential hypotheses, uses a practical yet appropriate methodology, ensures efficient data collection, includes data analyses that link the educational outcomes to the learning environment, and promotes timely development and implementation of an action plan. An overview of outcomes‐based education and the use of outcomes‐based practice experiences in pharmacy education is presented.

Toxicities with Intravenous and Subcutaneous Administration of a Petroleum Distillate

Although ingestion of petroleum distillates is common, injection of these products has not been widely reported. The effects of subcutaneous administration have not been fully documented. Presented is a 27-year-old male who developed a sterile abscess and pneumonitis following concurrent intravenous and subcutaneous administration of a petroleum distillate.

Call to action: expansion of pharmacy primary care services in a reformed health system.

The AACP Argus Commission is comprised of thefive immediate past AACP presidents and is annuallycharged by the AACP President to examine one or morestrategicquestionsrelatedtopharmacyeducationofteninthe context of environmental scanning. Depending uponthe specific charge, the President may appoint additionalindividuals to the Commission.The 2009-10 Argus Commission was charged to ex-amine the topic of the pharmacist’s contribution to pri-mary healthcare delivery in the context of nationalhealthcare reform and identify the resources of the Acad-emy and the profession needed to engage in the nationalconversation. The charge further requested the ArgusCommission to scan the environment to determine theopportunitiesforexpansionofprimaryhealthcarecapacityto include pharmacists’ unique contributions to quality,cost, and access as medication use specialists on the team.President Baldwin invited representatives from edu-cation associations of various disciplines recognized asprimary healthcare providers to meet with the ArgusCommission. This included the following individuals:Sandra Carlin Andrieu, Ph.D., President-elect of theAmerican Dental Education Association and ADEA Ex-ecutiveDirectorRichardW.Valachovic,D.M.D.,M.P.H.;Carol A. Aschenbrener, M.D., Executive Vice President,Association of American Medical Colleges; Timi AgarBarwick, Executive Director, Physician Assistant Educa-tion Association and Dana Sayre-Stanhope, Ed.D., PA-C,Physicians Assistants Program Director, Emory Univer-sity School of Medicine; Jean E. Johnson, Ph.D. (repre-senting American Association of Colleges of Nursing),Senior Associate Dean for Health Sciences Programs,School of Medicine and Health Sciences, The GeorgeWashington University; and Harrison Spencer, M.D.,M.P.H., President and CEO, Association of Schools ofPublicHealth. StephenShannon,D.O., M.P.H.,Presidentand CEO, Association of American Colleges of Osteo-pathic Medicine provided input for the meeting but wasunable to attend.The Argus Commission drew upon the issue briefprepared by Manolakis and Skelton and a copy of thepaperwasalsodistributedforreviewbytheinvitedguestsprior to the meeting. Argus Commission members rec-ommend that all individuals who have interest in thepharmacist’s role in primary care should review this doc-ument.

Roles of the Pharmacy Academy in Informing Consumers about the New American Pharmacist: 2010-2011 Argus Commission Report

The AACP Argus Commission is comprised of the five immediate past AACP presidents and is annually charged by the AACP President to examine one or more strategic questions related to pharmacy education often in the context of environmental scanning. Depending upon the specific charge, the President may appoint additional individuals to the Commission. The 2010-2011 Argus Commission was charged to examine how AACP and its members can engage with appropriate consumer and payer groups to increase awareness of “the new American pharmacist” and the pharmacists role and value in patient-centered care. President Carter emphasized that although increasing public awareness will require broad action by all pharmacy organizations, the Argus Commission was to focus their discussions on the unique roles of the Pharmacy Academy in increasing public awareness about “the new American pharmacist” as compared to what other professional organizations may contribute. The following individuals were invited to participate in the discussions with the Argus Commission: Artem Gulish (Citizen Advocacy Center), Marsha Henderson, MCRP (Office of Womens Health, Food and Drug Administration), and Karen Williams (Office of Womens Health, Food and Drug Administration). In preparation of the Argus Commission meeting, these participants were informed that pharmacist roles have changed and that pharmacy educators need to identify the Academys role in increasing consumer awareness. In preparation of the meeting, Commission members read the article by Worley, et al., which reported the results of a study that investigated both patient and pharmacist views about what patients and pharmacists expect of each other in the patient-pharmacist relationship.1 This study reported that both patients and pharmacists have similar views about the pharmacists role in sharing information such as how to watch for medication side effects and whether a medication should be taken with over-the-counter products. However, patients agreed less about pharmacist behaviors such as showing interest in working with patients to meet their health needs and communicating a desire to help patients with their medication concerns. Patients also had less agreement about the pharmacists role in providing a patient-centered relationship such as being approachable when a patient wants to discuss medication concerns. There was also less agreement among patients about the pharmacists role in interpersonal communications such as greeting patients at the prescription counter and taking prescription information. Furthermore, patients had less agreement about the role of the pharmacist in general healthcare communications such as pharmacist availability when patients call the pharmacist via phone to discuss a new medication question. Argus Commission members also reviewed resources from the Patient Safety and Clinical Pharmacy Services Collaborative which included documents communicating the new roles of pharmacists and patient-focused information.2 Articles summarizing the current roles of pharmacists and the value they bring to patient care were also reviewed. Specifically, the 2009-2010 Professional Affairs Committee Report provided a summary of evidence supporting pharmacist integration in primary care practice within community settings where there were also partnerships with patients and other healthcare service providers.3 The recent study by Kassam et al. stimulated Argus Commission members to think about the role of practice experiences in helping the profession increase consumer awareness about the roles of the pharmacist.4 This study compared patients’ expectations and experiences at pharmacies offering traditional APPE learning opportunities to APPEs which provided pharmaceutical care learning activities and found significantly higher in-store satisfaction and fewer service gaps in the later. Several other publications that highlighted the value of pharmacists were also reviewed. A report by the National Association of Chain Drug Stores provided a review of how pharmacies are improving health and reducing costs.5 The recent article by Chisholm-Burns et al. which provided evidence that pharmacists positively impact patient care also provided the Argus Commission with insights.6 The Commission noted this article was published in Medical Care and provided readers such as health systems leaders, payers, health-care CEOs and CFOs with greater awareness about the role of the pharmacist. As the Argus Commission members read this article, they realized the importance of informing healthcare leaders outside the pharmacy profession and the value of having faculty write publications outside the pharmacy profession as a means for communicating to others about the role of “the new American pharmacist.”6 The Argus Commission meeting initially focused on the roles of “the new American pharmacist” and reasons why the public has a low awareness about the value of pharmacists in improving medication therapy outcomes of patients. Discussions then addressed how pharmacy educators can promote greater awareness among consumers, healthcare payer groups, and other stakeholders.

An Initial Validation Study of the Self-Rating Scale of Self-Directed Learning for Pharmacy Education

Objective. The purpose of this study was to explore and validate the factor structure of the original SRSSDL scale with pharmacy students enrolled in a four-year Doctor of Pharmacy program at a southeastern university, and to assess the differences in the self-directed learning behaviors across different class years of students. Methods. Factor analysis was used to identify the factor structure of a self-rating scale of self-directed learning (SRSSDL) among pharmacy students (n=872) and to examine students’ self-directed learning (SDL) behaviors by year in the pharmacy education curriculum. Results. Five factors – intrinsic motivation, awareness, collaboration, reflection and application – showed acceptable levels of reliability. P4 students scored significantly higher than P2 students on the total scale. P4 students scored significantly higher on awareness than P1 and P2 students, while P2 students had a significantly higher collaboration score compared to P1 students. Conclusion. The revised 55-item SRSSDL is a valid and homogenous scale of pharmacy students’ self-directed learning within one pharmacy program. However, due to differences in factor structure compared to earlier studies, further research is needed before this survey tool can be broadly implemented in pharmacy education.

Perceptions of pharmacy faculty need for development in educational research

INTRODUCTION Pharmacy educators have identified that pharmacy faculty need a better understanding of educational research to facilitate improvement of teaching, curricula, and related outcomes. However, the specific faculty development needs have not been assessed. The purpose of this study was to investigate self-reported confidence among clinical doctor of pharmacy faculty in skills essential for conducting educational research. METHODS Faculty members with primary responsibilities in teaching at the University of Florida College of Pharmacy were invited to the take the Adapted Self-Efficacy in Research Measure (ASERM). Descriptive analysis and independent samples t-tests were used to compare the self-efficacy items by faculty rank, gender, and years of experience. RESULTS Twenty-two of the 37 faculty members answered the 30-item survey that identified their self-efficacy in items and categories of skills, including writing skills, statistical skills, research design, research management and dissemination in education research. Senior faculty had significantly higher confidence than junior faculty on seven items. Participants who worked more than ten years had statistically higher confidence in preparing and submitting grant proposals to obtain funding for educational research. Skills where both junior and senior faculty had low confidence were related to using non-traditional methods such as qualitative methods and identifying funding resources for educational research. DISCUSSION AND CONCLUSIONS Findings from the ASERM provided insights among pharmacy educators regarding self-efficacy related to skills needed for educational research, options for faculty development opportunities and actions for improving educational research knowledge and skills among them.

Report of the 2004–2005 Finance Committee

INTRODUCTION According to the AACP Bylaws, the Finance Committee is charged with advising the Executive Vice President (EVP) in preparing the annual budget of the Association for review and approval by the Board of Directors. The Committee met via conference call on March 10, 2005 and again on June 9, 2005 to review the financial statements for the period ended June 30, 2004 and the audit process, the statement of revenues and expenses for the year-to-date, updated PharmCAS projections, cash flows, legislation which may affect nonprofit organizations doing business in certain states, sales tax exemption for Association purchases, electronic job board issues, managed reserves, and staffing/space issues relative to program growth. The committee also firmed up the budget proposal for 2005/2006 and reviewed general projections through 2008/2009.

An Evaluation of Dosing Regimens for Insulin in Diabetic Ketoacidosis

A review of the literature was performed to evaluate insulin dosing regimens used in the treatment of diabetic ketoacidosis. High-dose insulin therapy was demonstrated to be effective in the largest number of patients, but carries the added risks of a high incidence of hypokalemia and hypoglycemia. Low-dose insulin regimens are effective for most patients, and these regimens produce a lower incidence of hypokalemia and hypoglycemia than do the high-dose therapies. Continuous intravenous infusion appears to be preferable to intermittent intramuscular or subcutaneous administration of insulin. Low-dose insulin therapy is recommended unless the DKA patient presents with shock. Regardless of the dosing regimen or route of administration selected, careful patient monitoring and correction of electrolyte imbalances is most important in the prevention of any complications.