Elizabeth W. Blake

Enhancing Interprofessional Education: Integrating Public Health and Social Work Perspectives

National stakeholders in health system improvement and patient safety including accreditation bodies have requested health professional educational programs to include multiple interprofessional experiences through didactic and experiential opportunities. Clinical and population health faculty at the University of South Carolina redesigned and expanded an introductory interprofessional course to include more than 500 students from public health, social work, medicine, pharmacy, and nursing. Students participated in 3 live class meetings and completed required online coursework to explore concepts related to social determinants of health and health disparities, health system improvement, patient safety, cultural competency, and ethics to address interprofessional education core competencies. Course modifications and expanded student enrollment improved understanding of key health concepts and appreciation of interprofessional collaboration.

A pharmacy political advocacy elective course.

Objective. To develop and implement an elective course to increase pharmacy students’ awareness of legislation that might affect the pharmacy profession and to promote advocacy for the profession. Design. Students participated in class discussions regarding current legislative issues and methods to advocate for the pharmacy profession. Assignments included a student-led presentation of the advocacy agendas for various pharmacy organizations, a take-home examination, participation in class debates, and a legislative presentation. Assessment. Forty-eight students enrolled in the elective course over 3 years. Assignments and class participation were assessed using grading rubrics. At the end of the semester, students completed a questionnaire to assess the overall benefit of the course. Conclusions. Participation in an elective course devoted to pharmacy political advocacy increased awareness of legislation and the desire to become involved in pharmacy organizations to promote the pharmacy profession.

Incorporating Standardized Colleague Simulations in a Clinical Assessment Course and Evaluating the Impact on Interprofessional Communication

Objective. To determine the impact of incorporating standardized colleague simulations on pharmacy students’ confidence and interprofessional communication skills. Design. Four simulations using standardized colleagues portraying attending physicians in inpatient and outpatient settings were integrated into a required course. Pharmacy students interacted with the standardized colleagues using the Situation, Background, Assessment, Request/Recommendation (SBAR) communication technique and were evaluated on providing recommendations while on simulated inpatient rounds and in an outpatient clinic. Additionally, changes in student attitudes and confidence toward interprofessional communication were assessed with a survey before and after the standardized colleague simulations. Assessment. One hundred seventy-one pharmacy students participated in the simulations. Student interprofessional communication skills improved after each simulation. Student confidence with interprofessional communication in both inpatient and outpatient settings significantly improved. Conclusion. Incorporation of simulations using standardized colleagues improves interprofessional communication skills and self-confidence of pharmacy students.

Evaluation of Anticoagulation Management and Chronic Disease State Control in a Pharmacist-Run Pharmacotherapy/Anticoagulation Clinic

Background: The benefit of pharmacist-run clinics for anticoagulation, dyslipidemia, diabetes, and hypertension has been described in the literature as individual services. We describe a clinic model in which anticoagulation and other chronic disease states are managed concomitantly. Objective: To evaluate the control of anticoagulation, hypertension, dyslipidemia, and diabetes in anticoagulation patients enrolled in a pharmacotherapy/anticoagulation clinic. Methods: Patients seen in the pharmacotherapy/anticoagulation clinic for management of anticoagulation were included in a retrospective review. Demographic information, blood pressure measurements, and laboratory values were recorded. Initial and final results were compared and statistically analyzed. Benchmark goals were set for each parameter analyzed. Results: Between August 2007 and July 2008, 282 patients were enrolled in the clinic. While slightly increasing the average time in therapeutic range from 69.9% to 70.7%, the clinical pharmacists also managed hypertension, dyslipidemia, and diabetes, if present. Systolic (p = 0.0075; 95% CI 0.98 to 6.31) and diastolic (p = 0.004; 95% CI 1.26 to 4.33) blood pressures decreased during the study period such that the number of patients with controlled blood pressure increased to 81%. Low-density lipoprotein cholesterol measurements decreased by an average of 5.9 mg/dL (p < 0.0001; 95% CI 3.121 to 8.789), with an increase in number of patients at goal to 86%. Although not significant, mean hemoglobin A1c (A1C) values decreased an average of 0.12% (p = 0.1138; 95% CI 0.029 to 0.271), with an increase to 59% of those achieving a goal A1C. Conclusions: A pharmacotherapy/anticoagulation clinic can be considered a practice model for effective management of anticoagulation patients who require management of other chronic disease states.

Examining collaborative leadership through interprofessional education: findings from a mixed methods study

ABSTRACT Collaborative leadership is essential as recent trends in healthcare service delivery necessitate interprofessional collaboration and care. Interprofessional education (IPE) efforts, therefore, have to prepare students for this type of leadership. The purpose of this study was to understand how students’ perceptions of leadership change as a result of embedding a collaborative leadership model, the Social Change Model (SCM) of leadership, in an IPE course. Data were collected from 30 students participating in an interprofessional course through two interprofessional course reflections, pre/post leadership posters and poster reflections, and a pre/post survey. Results from paired sample t-tests suggested students significantly improved in their perceptions of leadership efficacy. These data also indicated improvements to the three group-level values of the SCM: collaboration, common purpose, and controversy with civility. Findings from the qualitative data suggest that students learned to view leadership as more of a team effort than the actions of a single individual and as more of a process than a role. Findings also revealed the benefits and challenges of using a visual process of poster development as a way of examining students’ changes in perceptions of leadership over the course of the semester. Implications are discussed in relationship to the utility of the SCM in promoting students’ shifts in conceptualizations of leadership that emphasizes collaboration and helps prepare students to engage in these ways within interprofessional teams in their practice.

Evaluating the perceived impact of an interprofessional childhood obesity course on competencies for collaborative practice

ABSTRACT Interprofessional education (IPE) is needed to prepare health professional students to address the complexities of childhood obesity in practice. This mixed-method study sought to evaluate the perceived impact of a childhood obesity IPE intervention on health professional students’ collaborative competency development within two domains: roles/responsibilities and teams/teamwork. Fourteen health professional students participated in this mixed-methods study. Quantitative data were collected through pre/post surveys, while qualitative data were collected through reflection assignments. Survey findings indicated that students reported significant increases in growth within both interprofessional competency domains. Qualitative data elaborated on the types of learning students experienced relative to each domain. Implications of this study for research and practice related to IPE to address complex health issues, such as childhood obesity, are shared.

Pharmacy Student Perceptions of Teaching Award Recipients and Teaching Excellence

Traditional Diabetes Education and the Pharmacist’s Role • DM self-management education (DSME) is an ongoing process of teaching patients the knowledge, skills, and abilities necessary for diabetes self-care.4,5 • Group education has been shown to improve outcomes; however, this typically consists of lecturebased presentations with some interactive group discussion.6,7 • Studies have shown improvement of patient outcomes with a pharmacist-led DM care program.8,9is to describe a co-curricular legislative experience that can be mapped to the 2016 ACPE Standards 3.2, 4.2, and 4.4. Since 2004, the URI College of Pharmacy has participated in the Annual Face of Pharmacy event held at the Rhode Island State House. This event brings student pharmacists, faculty and members of state pharmacists associations together to rally behind issues and legislation affecting pharmacy practice. Demonstration tables, staffed by APPE students, preceptors and faculty showcase services to the legislators such as: hypertension screenings, diabetes education, body fat analysis, immunizations, medication therapymanagement services, and patient counseling. A speaking program highlights legislation and issues important to pharmacy and the future of health care. Past speakers have included Directors of the RI Department of Health, Governors, Lieutenant Governors, state Senators, state Representatives, members and staff from the Board of Pharmacy, Presidents of both state pharmacy associations (RIPA andRISHP), and selected student pharmacist leaders. Past Gubernatorial proclamations and citations have been issued to commemorate the event and pharmacists’ role in patient care. Throughout the afternoon, student pharmacists have the opportunity to interact with pharmacists at the tables, learn about legislative initiatives that impact pharmacy, and meet with state legislators. Student pharmacists have also been recognized on the House and Senate floors as the sessions open. To formally incorporate this experience into our curriculum as a co-curricular standard, students will be encouraged to perform a formal writing reflection after participation to self-evaluate their professional development. American Journal of Pharmaceutical Education 2015; 79 (5) Article S4.

Enhanced Student Awareness and Recognition of Scholarly Teaching

• Changes in U.S. population demographics characteristics require the preparation of culturally diverse competent healthcare providers who are capable of practicing in an increasingly diverse society.1 • Training in cultural diversity competence has been recognized as a pre-requisite to fostering the transformation of healthcare1 • As response, the accreditation agencies of health-related academic programs have included new requirements of implementing cultural diversity competence along the curriculum.2,3 • Although demonstration of students’ cultural diversity competence and multicultural communication skills are required in most of the accreditation standards for healthrelated programs, more evidence is needed to determine the best teaching and learning practices for achieving these competencies.A Program to Foster Global Citizenship in Pharmacy Education. Ana Maria Castejon, Nova Southeastern University, Dawn Dacosta, Nova Southeastern University, Jaroslav Toth, Comenius University in Bratislava, Jan Kyselovic. Objectives: Understanding the practice of pharmacy from a global perspective is not a traditional curricular outcome in most US pharmacy programs. The objective of this CoCurricular activity was to provide students with an understanding, and appreciation for pharmaceutical and medical practices outside the UnitedStates. A total of 35 student pharmacists participated in aTravel Study Program (TSP) to Slovakia during the summer of 2013 at Comenius University in Bratislava, Slovakia. Topics covered included pharmacognosy, molecular drug design, European pharmaceutical regulatory agencies and the practice of the profession in Slovakia and the European Union (EU). Live lectures, laboratory practices at the host institution together with multiple site visits to different professional practice settings were included in the TSP. Through reflective exercises we assessed the students’ ability to: 1. Compare the practice of pharmacy in the US versus Slovakia and the EU 2. Identify the professional benefits of attending a structured pharmacy TSP Method: The 35 students completed reflective academic assignments and cultural competency activities before and after the three-week visit to Bratislava. The students’ reflective exercises were analyzed using narrative and content analysis, allowing us to capture the multiple meanings and dimensions of the experiences. Results: The students’ narrations reflected a major impact on their professional growth, intercultural sensitivity and competencies. Participants identified major differences in legal and regulatory aspects of the profession. They highlighted the establishment of connections and international learning networks. Implications:We believe that these programs promote global citizenship, while fostering learning and cultural exchange within the pharmacy profession.

Effect of Diabetes Medications on Cardiovascular Risk and Surrogate Markers in Patients with Type 2 Diabetes

Objective: To evaluate the effect of diabetes medications on the risk of cardiovascular disease and surrogate markers. Data Sources: Literature was accessed through MEDLINE (1950–July 2008) and PubMed using multiple terms for diabetes, cardiovascular risk, surrogate markers, and diabetes medications. In addition, reference citations from publications were reviewed. Study Selection and Data Extraction: English-language articles that met the above criteria, with clinical relevance, were evaluated. Data Synthesis: Evidence regarding the effect of diabetes medications on cardiovascular risk is sparse, with information on their effects on surrogate markers more widely available. Recent evidence demonstrates that glycemic control alone may not reduce the risk of macrovascular events. Multiple trials were reviewed to determine the effect of diabetes medications on this risk, as well as the effect on surrogate markers (eg, blood pressure, cholesterol, body weight). Metformin and acarbose demonstrated significant reductions in macrovascular events, including myocardial infarction. Data regarding sulfonylureas, thiazolidinediones, and insulin are conflicting. Pioglitazone may reduce cardiovascular events, except heart failure, whereas rosiglitazone may increase these events. Until direct evidence can be obtained, the full effect of diabetes medications on cardiovascular risk is unknown. Conclusions: Current literature provides little support that diabetes medications may lower the risk of cardiovascular events while some agents may increase this risk. Of the drugs available, metformin may be the least detrimental. Current literature regarding other diabetes medications provides conflicting results on their effect on cardiovascular outcomes. In the meantime, practitioners should treat all targets of cardiovascular risk in patients with diabetes. ACPE Universal Program Numbers: 407-000-09-050-H01-P (Pharmacists); 407-000-09-050-H01-T (Technicians)