Nancy Fjortoft

Measuring empathy in pharmacy students.

Objective. To validate the Jefferson Scale of Empathy-Health Profession Students version (JSE-HPS) in pharmacy students. Methods. The JSE-HPS (20 items), adapted from the original Jefferson Scale of Empathy for use among students in the healthcare professions, was completed by 187 first-year pharmacy students at Midwestern University Chicago College of Pharmacy. Results. Two factors, “perspective-taking” and “compassionate care,” emerged from factor analysis in this study, accounting for 31% and 8% of the variance, respectively. These factors are similar to the prominent ones reported in previous research involving physicians and medical students, supporting the construct validity of this instrument for pharmacy students. In the current study, mean JSE-HPS score was comparable to those reported for medical students, and consistent with previous findings with medical students and physicians. Women scored significantly higher than men. Conclusions. Findings support the construct validity and reliability of the JSE-HPS for measuring empathy in pharmacy students.

Impact of a workshop about aging on the empathy scores of pharmacy and medical students.

Objective. To measure changes in pharmacy and medical students’ empathy scores after a 40-minute workshop during which students observed and discussed a theatrical performance about the challenges of aging. Methods. First-year pharmacy and medical students (n = 187 and n = 183, respectively) participating in the workshop observed and discussed a 10-minute performance in which students enacted problems and concerns faced by elderly patients. The Jefferson Scale of Empathy (JSE) was administered just prior to the workshop (pretest), immediately afterward (posttest 1), and 7 or 26 days afterward (posttest 2). Results. Empathy increased significantly from pretest to posttest 1 for students of each profession (p <0.01). Improvement in empathy scores declined by the time the JSE was readministered to pharmacy students 7 days later and to medical students 26 days later (posttest 2). Similar patterns of improved and declining empathy were found when the data were analyzed by gender and medical student specialty interest (ie, primary vs non-primary care specialties). Conclusion. Empathy scores increased but were not sustained for both pharmacy and medical students after a brief workshop on aging that required limited personnel resources.

Validation of an Instrument to Measure Pharmacy and Medical Students’ Attitudes Toward Physician-Pharmacist Collaboration

Objectives. To assess the validity and reliability of an instrument to measure pharmacy students’ attitudes toward physician-pharmacist collaboration, and compare those attitudes to the attitudes of medical students. Methods. One hundred sixty-six first-year pharmacy students and 77 first-year medical students at Midwestern University completed the Scale of Attitudes Toward Physician-Pharmacist Collaboration. Results. Findings confirmed the validity and reliability of the Scale of Attitudes Toward Physician-Pharmacist Collaboration in pharmacy students, as observed previously for medical students. Pharmacy students’ mean score was significantly higher (56.6 ± 7.2) than that of medical students (52.0 ± 6.1). Maximum likelihood factoring confirmed the 3-factor solution of responsibility and accountability, shared authority, and interdisciplinary education for pharmacy students. Conclusions. The Scale of Attitudes Toward Physician-Pharmacist Collaboration can be used for the assessment of interdisciplinary educational programs, for patient outcome assessment of interprofessional collaboration, and for group comparisons. Findings that pharmacy students expressed more positive attitudes toward collaboration than medical students have implications for interdisciplinary education.

Interprofessional workshop to improve mutual understanding between pharmacy and medical students.

Objective. To measure changes in pharmacy and medical students’ physician-pharmacist collaboration scores resulting from a workshop designed to promote understanding of the others’ roles in health care. Methods. More than 88% of first-year pharmacy (n = 215) and medical (n = 205) students completed the Scale of Attitudes Toward Physician-Pharmacist Collaboration on 3 occasions in order to establish a baseline of median scores and to determine whether the scores were influenced by an interprofessional workshop. Results. Participation in the interprofessional workshop increased pharmacy students’ collaboration scores above baseline (p=0.02) and raised the scores of medical students on the education component of the collaboration survey instrument (p=0.015). The collaboration scores of pharmacy students greatly exceeded those of medical students (p<0.0001). Conclusion. A workshop designed to foster interprofessional understanding between pharmacy and medical students raised the physician-pharmacist collaboration scores of both. Crucial practical goals for the future include raising the collaboration scores of medical students to those of pharmacy students.

Critical Thinking and Reflection Exercises in a Biochemistry Course to Improve Prospective Health Professions Students’ Attitudes Toward Physician-Pharmacist Collaboration

Objective. To determine the impact of performing critical-thinking and reflection assignments within interdisciplinary learning teams in a biochemistry course on pharmacy students’ and prospective health professions students’ collaboration scores. Design. Pharmacy students and prospective medical, dental, and other health professions students enrolled in a sequence of 2 required biochemistry courses. They were randomly assigned to interdisciplinary learning teams in which they were required to complete case assignments, thinking and reflection exercises, and a team service-learning project. Assessment. Students were asked to complete the Scale of Attitudes Toward Physician-Pharmacist Collaboration prior to the first course, following the first course, and following the second course. The physician-pharmacist collaboration scores of prospective health professions students increased significantly (p<0.001). Conclusions. Having prospective health professions students work in teams with pharmacy students to think and reflect in and outside the classroom improves their attitudes toward physician-pharmacist collaboration.

Evaluation of the impact of a continuing professional development worksheet on sustained learning and implementing change after a continuing pharmacy education activity.

BACKGROUND Continuing professional development (CPD) continues to gain acceptance as a model for health care professionals to engage in lifelong learning. Little is known about how CPD participants use the experience to develop learning plans and implement new knowledge into practice. OBJECTIVE The primary objective of this study was to evaluate the effectiveness of instruments designed to guide the pharmacist through a CPD process to plan and participate in continuing professional education activities at a national meeting. METHODS The study was a case-control study of pharmacists randomized from the participants of the 2010 American Pharmacists Association Annual Meeting. The test group (n=47) was instructed to complete CPD planning worksheets designed to facilitate planning of their continuing pharmacy education activities before the meeting. The control group (n=58) did not have instructions beyond the meeting program. Both groups completed 3 surveys assessing components of the CPD processes: 1 before and 2 after the meeting. The surveys focused on confidence in abilities to identify, plan, and evaluate learning as well as implementation of practice change. RESULTS Nearly all the test groups reported successful application of learning (95%) and achieving their designed learning plan (87%). Practice changes were implemented in more than half (60%) of the test groups after using a CPD process to plan their learning activities. There were no significant differences among groups regarding the outcome measures. CONCLUSIONS Participants successfully used a CPD approach to meet their learning plans and achieve meaningful learning outcomes. Integration of CPD components into educational activities may help to promote practice change.

Development of a Center for Teaching Excellence

This article describes the development, implementation, and assessment of a Center for Teaching Excellence at Midwestern University Chicago College of Pharmacy. The purpose of the Center was to create a systematic framework to promote, enhance, and assess the scholarship of teaching and learning. Assessment of the Centers activities suggests a positive impact on the teaching abilities of faculty. This report is intended to offer other schools or colleges of pharmacy considerations for center development.

The Challenge of the Accreditation Council for Pharmacy Education’s Standard Four: Identifying, Teaching, Measuring

The Accreditation Council for Pharmacy Education approved new standards for the doctor of pharmacy degree (Standards 2016),1 the educational outcomes in which are based on the American Association of Colleges of Pharmacy ‘s Center for the Advancement of Pharmacy Education (CAPE) Educational Outcomes 2013.2 The center used a broad approach in seeking input on defining the outcomes, and the majority of the feedback suggested inclusion of “an affective domain that would address personal and professional skills, attitudes, and attributes required for the delivery of patient-centered care.” This affective domain has been further delineated as self-awareness, leadership, innovation and entrepreneurship, and professionalism.2 The key element of professionalism is that “the graduate is able to exhibit behaviors and values that are consistent with the trust given to the profession by patients, other healthcare providers, and society.”1 Professionalism is the domain most familiar to pharmacy education. It was systematically examined in 2003,3 and since that time, numerous papers have been published on professionalism that further describe it, demonstrate teaching professionalism, and discuss how to measure it. Altruism, accountability, excellence, duty, honor, and integrity are commonly accepted as traits of a professional.3 These characteristics can be behaviorally anchored, observed, and evaluated by faculty members and preceptors both in the classroom and in practice experiences. Instruments have been developed to measure professionalism,4 and it has been assessed across the curriculum.5 Teaching professionalism can occur through direct instruction. Pharmacy education demonstrates this in laboratory courses and through the use of the humanities,6,7 but teaching professionalism most commonly occurs through mentoring and providing role models.8 Pharmacy education has a broad body of literature to draw from in planning to meet the educational outcome of professionalism. Leadership is also familiar to pharmacy education. According to Standards 2016, the key element of leadership is that “the graduate is able to demonstrate responsibility for creating and achieving shared goals, regardless of position.”1 There have been numerous calls to develop pharmacy leaders over the past several decades, and pharmacy education has responded. Leadership skills and competencies can be defined9 and taught. Various courses and cocurricular activities have been developed and described in the literature.10-12 Objective and subjective measures have been used to assess change in students’ knowledge about leadership skills, satisfaction with the course or activity, and increased confidence.10-12 Standards 2016, however, calls on pharmacy education to provide evidence that graduates can “demonstrate responsibility for creating and achieving shared goals, regardless of position.”1 This level of competency may be difficult to achieve within a 3-4 year curriculum and equally difficult to measure. Self-awareness is a relatively newer concept to pharmacy education. The educational outcome in Standard 2016 for self-awareness call for graduates who are “able to examine and reflect on personal knowledge, skills, abilities, beliefs, biases, motivation, and emotions that could enhance or limit personal and professional growth.”1 Self-awareness is embedded with self-assessment and reflection, both critical elements in the continuous professional development model that ACPE has adopted. This model is built on the premise that all learning must begin with a reflection or self-assessment of learning needs, followed by a plan for learning. Then comes the learning experience, an evaluation of the learning, and finally its application.13 This concept has been extensively examined in other health professions, in particular, medical education. Pharmacy education is beginning to explore and understand the dimensions of self-assessment, its value in critical thinking, and how to improve these skills through reflective writing.14-17 Rubrics have been developed and used to structure and evaluate self-awareness through reflective writing.18 Colleges and schools of pharmacy have been using portfolios as a framework for students to reflect on their learning and to collect evidence that documents their learning.19 This practice provides a sound foundation for achieving the educational outcomes required by this standard. Finally, for the Standards 2016 domain of innovation and entrepreneurship, the graduate should be able “to engage in innovative activities by using creating thinking to envision better ways of accomplishing professional goals.”1 Embedded in this domain are two elements: risk taking and creativity. Anecdotally, pharmacy and pharmacy education are not known for either of these characteristics. Some work has been accomplished in measuring students’ proclivity toward entrepreneurship, and some discussion on teaching students these skills has occurred.20,21 However, more work is needed in this area to help pharmacy education deliver on this educational outcome and determine levels of competency. We need to look toward other professions to help us determine how to further define this domain, teach it, and measure it. The guidance document for ACPE Standards 2016 goes on to say “several groups within the academy are working to develop comprehensive descriptions of these important concepts and more standardized approaches to assessment. Colleges and schools are encouraged to share mechanisms they develop to assess Standard 4 elements through scholarship publications and presentations.”22 This statement is a challenge to all of us to think critically about these four domains, use existing literature, develop curricula, and develop cocurricular activities to help students achieve these critical educational outcomes for their success and ultimately for better patient outcomes.

Pharmacy Practice Department Chairs’ Perspectives on Part-Time Faculty Members

Objective. To identify the benefits and consequences of having part-time faculty members in departments of pharmacy practice from the department chair’s perspective. Methods. A stratified purposive sample of 12 pharmacy practice department chairs was selected. Eleven telephone interviews were conducted. Two investigators independently read interview notes and categorized and enumerated responses to determine major themes using content analysis. The investigators jointly reviewed the data and came to consensus on major themes. Results. Benefits of allowing full-time faculty members to reduce their position to part-time included faculty retention and improved individual faculty work/life balance. Consequences of allowing part-time faculty positions included the challenges of managing individual and departmental workloads, the risk of marginalizing part-time faculty members, and the challenges of promotion and tenure issues. All requests to switch to part-time status were faculty-driven and most were approved. Conclusions. There are a variety of benefits and consequences of having part-time faculty in pharmacy practice departments from the chair’s perspective. Clear faculty and departmental expectations of part-time faculty members need to be established to ensure optimal success of this working arrangement.

Use of adjunct faculty members in classroom teaching in departments of pharmacy practice.

Objective. To determine trends among departments of pharmacy practice regarding use of adjunct faculty members for classroom-based teaching and to assess departmental support provided to these faculty members. Methods. Chairs of pharmacy practice departments in US colleges and school of pharmacy were contacted by e-mail and asked to complete an 11-item electronic survey instrument. Results. Chair respondents reported an average of 5.7 adjunct faculty members hired to teach required courses and 1.8 adjunct faculty members hired to teach elective courses. Compensation averaged