Nanci L. Murphy

Report of the 2010-2011 Standing Committee on Advocacy: Leveraging faculty engagement to improve public policy.

According to the Bylaws of the American Association of Colleges of Pharmacy (AACP), the Advocacy Committee: “will advise the Board of Directors on the formation of positions on matters of public policy and on strategies to advance those positions to the public and private sectors on behalf of academic pharmacy.” COMMITTEE CHARGE President Rodney Carter charged the 2010-2011 Advocacy Committee to: “examine the question how can AACP and its members most effectively leverage faculty scholarship/research to impact on public policy at the state and federal level?” The Committee met in-person in October in Arlington, VA to discuss the charge and determine the approach to meeting the charge. After a wide-ranging discussion guided by the Chair the Committee agreed that a case study approach would meet the intent of the charge and serve the broader Academy by providing examples of evidence-based advocacy. Committee members agreed that the case studies could include completed, ongoing, or developing examples of how faculty scholarship and research did or failed to impact public policy. A framework for case study submission was developed and agreed to by the Committee. Case Study Framework: Each advocacy committee member will present one initiative that supports the integration of the pharmacist or recognizes academic pharmacy as a resource for evidence-based public policy development as a case study that provides a “roadmap for implementation” for AACP members. Each case study will be included as a section in the report. Each section will use the following format: State the healthcare reform/advocacy issue and the opportunity or expectation for the integration of the pharmacist; Describe the development of the partnership with the academic or community-based partner and their understanding and expectation of the integration of the pharmacist into issue activities or how pharmacy faculty can contribute to furthering public policy development; Describe through examples of teaching, research, or service, current activity at the college or school level to address the issue; List the AACP/other resources that provide evidence of academic activity that support the selected issue; and Recommendations regarding additional resources or evidence needed to advance the role of the pharmacist into the activities supporting the healthcare reform/advocacy initiative. BACKGROUND Leveraging public policy development to your advantage requires strong evidence that supports or opposes the policy. Public policy is advanced by science-based contributions.1,2 It is helpful to keep in mind that there is no guarantee that evidence improves the final policy since politics can be a dominant influence. However the strength of the evidence can contribute to its consideration in public policy.3 How and to whom the evidence is presented remains an essential element of influencing public policy. The creation of new knowledge and evaluation of existing knowledge are responsibilities of every faculty member of a college or school of pharmacy. Therefore, leveraging public policy development requires 1) identification of public policy of personal or professional interest and those supporting or opposing the policy, 2) assessing the policy for personal or collective contribution opportunities, and 3) determining the best approach for contributing the evidence. For instance, a significant piece of public policy, the Patient Protection and Affordable Care Act, includes provisions that seek to increase access to medication therapy management. The specific public concern being poor medication management is costly in terms of health and economic outcomes. This public concern was leveraged by evidence generated, translated and provided by pharmacy faculty. This evidence included examples of research, some of it supported by federal grants,4 demonstrating improved health outcomes associated with the provision of MTM services. Influencing public policy through evidence-sharing will continue to be an important goal of academic and professional organizations. The Patient Protection and Affordable Care Act creates many opportunities for academic pharmacy to leverage its implementation through the creation of new knowledge or evaluate current knowledge and translating both new and current knowledge into programs and services that meet the intent of the law.5 Members of the Academy are already providing significant contributions to the literature supporting the integration of the pharmacist across the continuum of care competent to provide patient-centered, team-based care.6,7 Likewise, daily activities such as interactions with state-based organizations, community partners, health insurance payers and even accrediting organizations provide opportunities for your position to be articulated and supported through evidence-sharing. The ability to leverage policy development requires an understanding and appreciation of other individuals and groups that will be engaged in the creation of new policy and its eventual implementation. Understanding and appreciation, regardless of whether you agree or disagree, requires the development of relationships with individuals, institutions and organizations involved in influencing public policy you deem important or relevant to your personal or professional goals. Understanding the advocacy or public policy goals of others is the first step in determining how what information you will provide to leverage their goals to your advantage. Through discussions with other individuals and groups you begin the second step, to assess the relevance of their goals to yours. Identification of goal alignment is an important step toward influencing public policy. Shared goals strengthen advocacy. The recognition of this strength regularly results in the establishment of coalitions and task forces that combine individual or organizational goals into a larger presence to influence public policy development, implementation and evaluation. Coalitions and other groups built upon mutual advocacy goals are sustained and strengthened through the evidence they are able to share with those developing or implementing the policy. Toward this end, pharmacy faculty are able to leverage public policy by working with others that share their goals, creating and communicating evidence that supports those goals.

A Faculty Toolkit for Formative Assessment in Pharmacy Education

This paper aims to increase understanding and appreciation of formative assessment and its role in improving student outcomes and the instructional process, while educating faculty on formative techniques readily adaptable to various educational settings. Included are a definition of formative assessment and the distinction between formative and summative assessment. Various formative assessment strategies to evaluate student learning in classroom, laboratory, experiential, and interprofessional education settings are discussed. The role of reflective writing and portfolios, as well as the role of technology in formative assessment, are described. The paper also offers advice for formative assessment of faculty teaching. In conclusion, the authors emphasize the importance of creating a culture of assessment that embraces the concept of 360-degree assessment in both the development of a student’s ability to demonstrate achievement of educational outcomes and a faculty member’s ability to become an effective educator.

Interprofessional education and practice guide No. 4: Developing and sustaining interprofessional education at an academic health center

Abstract Increasingly health professions schools and academic health centers are required to include interprofessional education (IPE) as a standard part of their core curricula to maintain accreditation. However, challenges continue to surface as faculty struggle to develop and participate in IPE activities while balancing increasing workloads and limited resources, and also trying to keep current in the changing profession-specific accreditation and standards. This guide shares lessons learned from developing and sustaining IPE activities at the University of Washington (UW) based in the United States. In 2008, the UW Schools of Nursing and Medicine were awarded funds to develop, implement, and evaluate an interprofessional program focused on team communication. This funding supported the creation of two annual large-scale IPE events, provided infrastructure support for the Center for Health Sciences Interprofessional Education, Research and Practice (CHSIERP), and supported numerous interprofessional activities and initiatives in the health professions curricula. Our experiences over the years have yielded several key lessons that are important to consider in any IPE effort. In this guide we report on these lessons learned and provide pragmatic suggestions for designing and implementing IPE in order to maximize long-term success.

Leadership Development of Student Pharmacists

Redesigning the health system model(s) to provide improved access, coordination, and utilization of resources, and quality of care is an important step towards achieving better health for all. This will require the work of many creative and forward-thinking individuals who collaborate effectively with others and are capable of generating successful organizational change in complex, high pressure, and challenging environments. To ensure the continued expansion and success of these efforts, schools, colleges, and universities must develop and sustain high-impact learning environments and curricula that foster the ability to positively influence this process. The AACP 2008-2009 Argus Commission examined issues related to building a sustainable system of leadership development for pharmacy, and student pharmacists were a focus in their report.1 One of the proposed policy statements from that report, “curricular modifications should occur such that competencies for leading change in pharmacy and health care are developed in all student pharmacists, using a consistent thread of didactic, experiential and co-curricular learning opportunities,” clearly indicates the need for the curricula at all colleges and schools of pharmacy to have a focus on developing leadership skills. Many change leadership competencies can and should be reflected throughout the core curricular components, via lecture-based courses (required and elective), practice laboratories, small-group discussions and projects, case studies, and introductory and advanced pharmacy practice experiences (IPPEs and APPEs). In addition, extracurricular activities, service learning, and other experiences provided to student pharmacists throughout their formal professional education can serve to instill and promote change leadership attributes. Continued study of the impact of PharmD curricula is also needed. Applying Kirkpatricks Model of Evaluation,2,3 programs appear to have made steady progress towards evaluating the reaction (satisfaction and perceived value of training) and learning (development of knowledge, skills, abilities) of student pharmacists. It is the behavior (transfer of the learning to the practice or other settings) and results (the impact on individual patients, health care settings, population, and community health) that need further study through enhanced partnerships among academia, practice, and other organizations. The editors of this issue also reconnected with several of the student pharmacists (now pharmacists) who participated in the Argus Commission Report and recent graduates from 4 pharmacy practice organizations. Their viewpoints, many of which reinforce the Argus Commission’s original recommendations, are summarized below: (1) Colleges and schools should strive to create an environment where leadership is not only recognized but valued. Faculty members who are actively involved in professional organizations, policy development, and everyday practice as change agents themselves send a strong message to students of the importance they place on these types of activities. In addition, encouraging and providing financial support for student pharmacists to attend professional meetings raises awareness of new and emerging pharmacy roles and networking opportunities. (2) Creating a supportive network of role models and mentors (faculty members, peers, and practitioners) is important to professional growth. Mentors are needed who encourage student pharmacists to see not only the challenges but also the possibilities, who spark curiosity, and in the words of one of the pharmacists interviewed, “not necessarily provide the right answer, but help frame the question.” Providing multiple levels of involvement and the encouragement of mentors who have achieved a healthy balance between their work (or school, if peer mentors) and their personal life has increased student engagement for those “on the fence” and prevented burnout for those already involved. (3) Providing multiple opportunities for learning outside of the classroom with multiple professions is essential. Applying previous learning to new, unscripted, and sometimes ambiguous situations creates the courage to test novel solutions, build team and coalitions, and challenge the status quo. Identifying needs and innovative approaches to addressing those needs (eg, coordinating health promotion/disease prevention and early detection activities in the community), capitalizing on the profession’s strengths, and embracing new roles are examples of ways student pharmacists can promote better health as leaders and change agents. Embedding opportunities to expand pharmacy services, conduct research, and participate in policy development or advocacy in IPPEs and APPEs and intern experiences, allow student pharmacists to practice skills they can carry forward in their careers. Active involvement in professional organizations and co-curricular activities are strongly encouraged. The critical issue of professional practice development in the AACP strategic plan addresses creating change agents and leaders in student pharmacists and graduates.4 The idea for a theme issue focused on student leadership development to be published in the Journal was developed by several faculty members who have worked and published in the area of student leadership and the AACP Director of Professional Alliance Development. The primary objectives for the issue were to promote awareness of the need for a focus on student leadership development, disseminate guidance documents for use by AACP member colleges and schools and the broader Journal readership, and facilitate implementation of educational programs to achieve competencies related to student leadership and change agent development. All AACP members were invited to submit manuscript proposals. Authors submitted an abstract and detailed outline within a predetermined set of themes: (1) research-focused work in areas of student leadership development; (2) the role of classroom, experiential, co-curricular, international/global, or interprofessional education in leadership development; (3) the role of student organizations in leadership development; (4) best practices in leadership instruction, including outcomes and quality indicators; and (5) the role of leadership abilities in the recruitment, selection, progression, and/or graduation of student pharmacists. Sixty-two proposals from 59 different colleges and schools of pharmacy were received. A committee of 17 members from the AACP Leadership Development Special Interest Group was formed to review the proposals. An evaluation rubric was developed based on the manuscript proposal’s abstract and scholarly contribution. Six manuscripts were selected, and the non-selected submissions were encouraged to seek publication in the future. The articles contained within this theme issue represent a diverse collection of information on student leadership development. The report of a 2010 AACP Council of Faculties Task Force examines how colleges and schools of pharmacy are preparing pharmacy faculty and student pharmacists to be leaders and advocates for the profession.5 Using a modified Delphi process, Traynor, Janke, and Boyle provide the academy with valuable information in 2 articles regarding student pharmacist leadership competencies and guidelines regarding student leadership development in the curricula.6,7 Patterson and colleagues provide an innovative method to offer formal leadership instruction to second- and third-year PharmD students with the assistance of graduate students and faculty members.8 Sucher and colleagues provide another example of using an elective course for student pharmacist development.9 Using various mechanisms to encourage student reflection, this course exposes student pharmacists to multiple facets, techniques, and tools used to develop and assess leadership. Chesnut and Tran-Johnson describe a student leadership development series that uses a longitudinal, co-curricular approach to emphasize the application of leadership concepts.10 This series has been available for 6 years and provides student pharmacists the opportunity to participate in multiple leadership platforms and activities as well earn points that can lead to the award of travel funds to attend a conference or meeting to further enhance their leadership skills. Developing effective leaders and change agents is an important step in addressing the current and emerging challenges of the US healthcare system. Colleges and schools of pharmacy have a responsibility to incorporate leadership development opportunities throughout their curriculum in order to provide future practitioners with the knowledge, attitudes, and skills needed to implement positive change. The Leadership Development Special Interest Group formed in 2011 is creating a toolkit that can be shared among colleges and schools and other organizations based on a recommendation from the 2008-2009 Argus Commission Report. We hope that the articles in this theme issue will also provide helpful strategies in addressing academic pharmacy’s important charge of leadership development.

Leveraging a faculty fellowship programme to develop leaders in interprofessional education

abstract This article reports findings from an interprofessional education (IPE) study of a longitudinal faculty fellowship that aimed to develop IPE leaders at an academic institution based in the United States. Eight applicants were competitively selected to participate in an IPE track of the fellowship, alongside 14 faculty members who entered through a separate selection process. One year after graduation, a survey of the IPE fellows was undertaken to evaluate programme outcomes using open-ended questions based on an adaptation of Kirkpatrick’s four-level training evaluation model. Results indicated that respondents valued participating in a longitudinal programme where they could learn about and practice teaching and leadership skills and conduct education scholarship. While learning on an interprofessional basis, the fellows reported establishing relationships that endured after graduation. This report suggests that adding IPE activities to existing faculty fellowship programmes can be an effective means of building faculty capacity to advance institutional IPE initiatives.

Developing Student Pharmacist Leadership Skills Through Core Curricular Modules Addressing the Triple Aim Goals

Objective. To develop, deliver, and evaluate an innovative curriculum designed to increase student pharmacists’ skills and confidence in addressing unmet patient care needs and the Institute for Healthcare Improvement’s (IHI) Triple Aim goals in the community pharmacy setting. Methods. Course modules developed collaboratively between the University of Washington and Washington State University focused on student pharmacist exposure to and direct application of leadership theory in addressing real world challenges. Both programs delivered the curriculum to all second-year student pharmacists during the fall 2015 and fall 2016 semesters. Student teams were asked to identify a new or enhanced service for a community pharmacy based on a needs assessment and the IHI’s Triple Aim goals. Students completed precourse, postcourse, and retrospective assessments of their confidence, comfort level in leadership theory application, and project implementation. Effectiveness of the project pitch and team dynamics were assessed. Precourse, postcourse, and retrospective assessments of individual student progress in leadership, innovation, self-awareness, and professionalism also were completed. Results. For all confidence questions, a significant relationship was found between mean precourse and postcourse scores. A comparison of students’ postcourse scores and their retrospective reflection scores indicated an increase in confidence to lead. At the conclusion of the course, the students reported improved confidence in their ability to communicate decisions (73%), create a vision (64%), and form a guiding coalition (55%). Conclusion. A five-module curriculum with corresponding project proposal successfully increased the confidence and comfort level of student pharmacists’ in their leadership skillset.

AACP Special Taskforce White Paper on Diversifying Our Investment in Human Capital

EXECUTIVE SUMMARY The 2015-2017 American Association of Colleges of Pharmacy (AACP) Special Taskforce on Diversifying our Investment in Human Capital was appointed for a two-year term, due to the rigors and complexities of its charges. This report serves as a white paper for academic pharmacy on diversifying our investment in human capital. The Taskforce developed and recommended a representation statement that was adapted and adopted by the AACP House of Delegates at the 2016 AACP Annual Meeting. In addition, the Taskforce developed a diversity statement for the Association that was adopted by the AACP Board of Directors in 2017. The Taskforce also provides recommendations to AACP and to academic pharmacy in this white paper.