Naser Z. Alsharif

A Three-Year Study of the Impact of Instructor Attitude, Enthusiasm, and Teaching Style on Student Learning in a Medicinal Chemistry Course

Objective. To determine the effect of instructor attitude, enthusiasm, and teaching style on learning for distance and campus pharmacy students. Methods. Over a 3-year period, distance and campus students enrolled in the spring semester of a medicinal chemistry course were asked to complete a survey instrument with questions related to instructor attitude, enthusiasm, and teaching style, as well as items to measure student intrinsic motivation and vitality. Results. More positive responses were observed among distance students and older students. Gender did not impact student perspectives on 25 of the 26 survey questions. Student-related items were significantly correlated with instructor-related items. Also, student-related items and second-year cumulative grade point average were predictive of students’ final course grades. Instructor enthusiasm demonstrated the highest correlation with student intrinsic motivation and vitality. Conclusion. While this study addresses the importance of content mastery and instructional methodologies, it focuses on issues related to instructor attitude, instructor enthusiasm, and teaching style, which all play a critical role in the learning process. Thus, instructors have a responsibility to evaluate, reevaluate, and analyze the above factors to address any related issues that impact the learning process, including their influence on professional students’ intrinsic motivation and vitality, and ability to meet educational outcomes.

Cultural Humility and Interprofessional Education and Practice: A Winning Combination

At Creighton University, we had a panel discussion on interprofessional education by addressing the question: How do you bridge the required autonomy of professionals in the health sciences with the need to work across disciplines? It was an interesting discussion. One panelist addressed the complexity of the healthcare system, the episodic approach to patient care, the need to work/bridge across disciplines in an interdependent approach, and the importance of recognizing individual competencies but also common interprofessional competencies.1 Another panelist emphasized the importance of remembering the patient autonomy rather than the healthcare professional autonomy. A third panelist emphasized that autonomy is relative since it is based on a trust that the professional will act in the best interest of society and that we have to also address the domination of one profession over another. A fourth panelist emphasized the barriers to interprofessional practice including time, payment structure, physical impediments, training, and environmental and licensure changes. One comment that resonated and stuck with me during the discussion was the comment by one panelist that our health professions graduates would walk across the stage without knowing what the other graduates from the other health professions do or how they would contribute to the healthcare team. How true! While, as health professions educators, we may not be able to do much about the existing dynamics and politics of the current healthcare team to improve interprofessional practice, there is much we can and should do as part of educating future practitioners. It is encouraging to see the increased emphasis on interprofessional education in pharmacy colleges and schools. For example, some pharmacy colleges and schools have gone as far as building their student education experience based on such a model2 or with emphasis on interprofessional education.3 The experience of such schools and the experience of their graduates as they go out into the workforce, the challenges and successes they encounter, should be shared for all to learn from. Also, as part of an interprofessional education supplement in 2009, the Journal published manuscripts with definitions, student competencies and guidelines for implementation,4 and keys for success.5 Further, the 2011 report of an expert panel from all the major academic health associations including the American Association of Colleges of Pharmacy, highlighted the core competencies for interprofessional collaborative practice.1 Key aspect for implementation of interprofessional education at the college and school level is having a flexible, dynamic curriculum planned with interprofessional education in mind with shared experiences across the health disciplines. Some pharmacy colleges and schools have introduced a culture competency course6 in the curriculum with the goal to sensitize students about the needs of all their patients and especially those who are vulnerable. Certainly, sensitizing students to the other members of the healthcare team also could be incorporated as part of the framework for a culturally competent practice. The 2011 report identified 2 competencies related to the above: embrace the cultural diversity and individual differences that characterize patients, populations, and the health care team, and respect the unique cultures, values, roles/responsibilities, and expertise of other health professions.1 Thus, culture competency as a core competency for pharmacy graduates and other healthcare profession students can play an important part in interprofessional education. One major aspect of that is to teach students cultural humility.7 While this as a concept has been around for a while, not much emphasis has been given to it in the training and preparation of healthcare professionals in general and pharmacists in particular. Cultural humility is defined as a lifelong process of self-reflection and self-critique.7 As it relates to the patient, this means that the future provider develops and practices a process of self-awareness and reflection to identify his/her own preconceptions and worldview as compared to that of the patient, and to strive to respect any differences while in the process of optimizing patient care. Certainly, I think this self-awareness and reflection can also be applied to a provider’s own actions, including interactions with other healthcare professionals. Thus, students in healthcare professions need to be taught and become aware of the contributions of other healthcare professionals who are part of the healthcare team; give credit for and when credit is due for other providers; accept responsibility for their own actions and acknowledge their own mistakes; recognize the limits of their own knowledge, expertise, and authority; seek out new knowledge and accept and respect other opinions. To put it simply, humility can be defined as being “egoless,” humble, or “down to earth.” As with any other virtue or attitude, it is hard to instill in individuals and is best taught by role modeling and narrative examples. Thus, health professions academics across all the disciplines can be role models in all of this by their own interactions with students (eg, emphasizing to students that it is ok to say “I do not know,” admitting making a mistake), colleagues (eg, incorporating concepts and principles from other disciplines and health professions, highlighting contributions of other disciplines), and by emphasizing within the curriculum many of the above virtues and actions of a healthcare student and future provider, including when they interact with other healthcare professionals. The curriculum could be embedded longitudinally in both classroom lectures and practical experiences that would expose students to the core educational outcomes for other healthcare professionals, emphasize the core common competencies among them,1 provide simulation interactions in different settings and to challenge them with difficult practical situations that may involve turf issues within and outside their own profession. The goal of all of the above would be to emphasize the importance of cultural humility in reflecting on one’s own beliefs and actions and the interaction with other healthcare professionals. Narration by faculty members of examples that demonstrate cultural humility can also go a long way in developing an egoless attitude rather than an attitude of arrogance or entitlement. One example I shared with the group is discussing with students patient safety in the context of intravenous administration of drugs in a required parenteral course, recalling how I mixed a magnesium sulfate IV drip for a pre-eclamptic 6-month pregnant lady with trace elements rather than magnesium sulfate. I share with the students how, had it not been for the awareness of the nurse who was taking care of the patient, the baby may have been delivered premature and suffered the many possible adverse consequences of that. After the nurse increased the rate of the drip to 2 gm/hour, the contractions kept coming. She made a professional decision to order a new bag which was mixed correctly and when the new bag was hung, the contractions stopped. I go on to explain how I worked with the physician to research any possible consequences from administering approximately 200 ml from the bag I prepared containing trace elements. We developed a report which we communicated to the patient and her family, acknowledging the mistake that occurred and providing information to help the patient and her family address the situation based on factual and scientific information. Another colleague who is a physician shared how he has kept an x-ray film for a patient who he misdiagnosed as a reminder in his office, and that he shares this with his students. Certainly, as healthcare students and future practitioners, working as part of an effective healthcare team with interprofessional practice in mind, culture competency as a core competency is much needed towards their current and future peers/colleagues as well as their patients. Cultural humility is a tool that is a key for a successful framework for a culturally competent practice. Instilling that in current and future healthcare students is a must to start them on a life-long journey of self-awareness and reflection to become better practitioners and responsible and more appreciative member of the larger healthcare team. Health care educators, institutions, curricula, organizations, and providers can play a major role in ensuring that current and future healthcare students and practitioners embody cultural humility in the classroom, in training, in life, and in clinical practice. Optimizing patient outcomes depends on it.

Current Practices in Global/International Advanced Pharmacy Practice Experiences: Preceptor and Student Considerations

The objective of this article is to describe the key areas of consideration for global/international advanced pharmacy practice experience (G/I APPE) preceptors, students and learning objectives. At the 2013 Annual Meeting of the American Association of Colleges of Pharmacy (AACP), the GPE SIG prepared and presented an initial report on the G/IAPPE initiatives. Round table discussions were conducted at the 2014 AACP Annual Meeting to document GPE SIG member input on key areas in the report. Literature search of PubMed, Google Scholar and EMBASE with keywords was conducted to expand this report. In this paper, considerations related to preceptors and students and learning outcomes are described. Preceptors for G/I APPEs may vary based on the learning outcomes of the experience. Student learning outcomes for G/I APPEs may vary based on the type of experiential site. Recommendations and future directions for development of G/IAPPEs are presented. Development of a successful G/I APPE requires significant planning and consideration of appropriate qualifications for preceptors and students.

Globalization of pharmacy education: what is needed?

The era of globalization has affected every sector of society including education. Pharmacy education has a history in global outreach with many collaborative educational, clinical, and research endeavors across continents.1-7 Such opportunities have proven to be fruitful, enriching, and rewarding.1,3,5-7 I have traveled to several countries in the Middle East over the last 17 years, presenting at schools of pharmacy and serving as an external assessor for pharmacy programs, and I found that many pharmacy institutions there are struggling with the same issues we are struggling with here in the United States and in other parts of the world. With the increased role pharmacists can play in the healthcare system on a local and global level, establishment of purposeful best practices in the development of pharmacy curriculum; exchanges of faculty members, administrators, professional and graduate students; successful models of pharmacy practice; addressing regulatory issues and other key areas in pharmacy, is needed more than ever before. Several organizations and groups are working on different aspects of this including the American Associations of Colleges of Pharmacy,1,2 International Pharmaceutical Federation (FIP), 5,8-10 Global Pharmacy, and the World Health Organization.5 The American Association of Colleges of Pharmacy’s special interest group on global pharmacy has 5 subcommittees working on best practices in advanced pharmacy practice experiences. Certainly, pharmacy in the era of globalization can benefit from the lessons learned from economic globalization. Rather than what appears to many to be an attempt to make nations and ethnic identities disappear, emphasis should be on reconstruction of the education system with respect for ethnic, regional, and national identities, but embedding the curriculun with a clear and purposeful global perspective. Also, instead of having Western societies as the main reference point and Western education as the norm for learning at all levels, local needs should be a critical driver as well as any local practice models or educational experiences that the West can learn from. Further, the concern for social, political, economic implications (loss of jobs due to shifting resources, violent demonstrations, international terrorism, etc), the above should be countered with a sincere effort to ensure that global pharmacy education is purposeful to meet workforce needs of local and regional communities, improve health and opportunities similar to what FIP’s Global Pharmacy Education Taskforce is attempting to do.5 So what is needed for success in the era of globalization of pharmacy education? Based on my experience and exploration of this issue for the last several years, I think success can be achieved by addressing the following 5 key strategies: (1) Share expertise and resources to benefit the parties involved (governments, institutions, sites, students, faculty members, local population, etc) and establish innovative ways to meet needs and share expenses (eg, use of distance education technology); (2) Respect historic factors and ethical dilemmas which may have influenced pharmacy education and practice in a region of the world; respect cultural linguistic, religious, political, and traditional beliefs and values; and respect local perpectives of key stakeholders for the educational model to be adopted; (3) Consider local manpower needs: ensure resources needed to build the infrastructure for educational institutions; establish collaborations for training at the entry level, and graduate and professional levels; create and expand on career pathways for PhDs and clinical faculty members; develop new job opportunities for graduates; and a manpower that address local, regional, and global health issues and decrease overall health disparities within a society and globally; (4) Establish accreditation standards in individual or regional countries; address internal and external factors impacting pharmacy education and practice; involve pharmacy college and school associations and professional pharmacy organizations; engage local ministries of labor, health, and education; engage other health professions associations and professional organizations; address guidelines established, for example, by the FIP Global Pharmacy Education Taskforce; and address guidelines or dstrategic plans by other stakeholders (eg, World Health Organization); (5) Empower students by providing them with the knowledge, skills, and attitudes (eg, culture competency and humility) to meet the needs of the current and future generations on a local and global level; ensure accountability of the institutions, professional organizations, and political system to provide job opportunities for future graduates; and address the training of support personnel who can work in different setting. Globalization of pharmacy education is a worthy endeavor for the academy and other stakeholders. It will help us to address the common issues we face in pharmacy academia and practice by sharing with, learning from, collaborating with and building trust and understanding among governments, institutions, and individuals for sustainable relationships in pharmacy education and practice. As a goal, it should be part of the strategic planning of institutions; encourage innovation in curriculum design and delivery; and empower, inspire, and motivate faculty members and students to contribute to solving the issues facing the global village. On an individual professional level, it should be about enrichment, professional development, opportunities for collaboration, and appreciation and understanding of other cultures. On a student level, it is seeking out new horizons, perspectives, and opportunities to make a difference, and striving for culture competency and humility.

Curriculum integration: a self-driven continuum.

There is much interest in curriculum integration in pharmacy as evidenced by Journal articles on integrating learning exercises,1 technologies,2 skills laboratory activities,3 courses,4 and even the entire pharmacy curriculum,5 as well as the publications of Viewpoints on the subject.6 Brain research7 and an era of accountability have driven this. Pearson and Hubbal8 published a review of curricular integration in pharmacy and addressed barriers to integration including time and effort, the established culture, and lack of evidence on the effectiveness of integration. One aspect that was not addressed is the principled responsibility upon faculty members to ensure that the student experience is integrated. This means that faculty members bear responsibility to understand in depth what other faculty members are teaching, Accreditation Council for Pharmacy Education standards 10.2, 13.1 and 13.4.9 Thus, integration first and most, has to be self-driven. What does self-driven mean? Well, as faculty members in a professional program, we want students to see the big picture and to challenge them to make connections between the different disciplines they are learning. For example, science faculty members often stand in front of students and ask. “Do you remember this from anatomy? Biochemistry?” Clinical faculty members may state, “You should know this from pathophysiology or pharmacology!” This is somewhat hypocritical if we do not spend the time and effort to ascertain this so that we help facilitate their learning better. For many years in K-12, the idea of integration and for teachers to spend the time and effort to integrate concepts and disciplines have been more of the norm than the exception.10 However, much of the success of these undertakings depend on the commitment of the teachers and their creativity to develop integrated lesson plans.10 There is much for pharmacy educators to learn from the experience of K-12 teachers and we all should uphold an individual responsibility to carry ourselves up the ladder to become a more competent integrative educator. This continuum up the ladder should start with what we all do, identify courses and concepts which are prerequisites to our course. This should be taken seriously by pinpointing key concepts taught in our courses and tracking back to previous courses to determine the concepts needed to help the students master the content in our courses. The second step is to have purposeful communication with faculty members who are teaching in these prerequisite courses to ensure that these concepts are taught to the depth that we would expect them to be addressed and at the level at which the students should be evaluated. This will help with the third step in the continuum, to reinforce these prior concepts by revisiting them and integrating them with concepts in our courses, for example using technology2 or devising integrated activities in skills laboratory,3 teaching concepts across several disciplines (multidisciplinary),8 developing thematic lesson plans based on different disciplines but a common theme (interdisciplinary),8 and developing higher level assessments integrating these concepts. A must for science faculty in this whole process is to demonstrate the clinical relevance of their content and to tie it to future course work (eg, therapeutics).9 A challenge for clinical and social/administrative faculty members is to make this process bidirectional and to emphasize science. The educational outcomes for the course should be a guide to help in this process including, for example, science faculty members revisiting core competencies from the social and administrative sciences to reinforce specific educational outcomes (eg, professionalism, communication skills). Hence, the emphasis is on supporting the whole curriculum. The highest level for any faculty member in this continuum is to invest the time and effort to conduct a scholarship of teaching and learning (SoTL)11 study to evaluate if his/her methodologies or pedagogy are helping students see the big picture and integrate concepts. Collaborating with faculty members from other disciplines on these projects would help to truly meet Guideline 10.29 (awareness by faculty members of each other’s courses including content, depth, methodologies used, and relationship to adopted curricular competencies and outcomes). Sharing findings of such studies with the curriculum, assessment committee, and the larger academic community is crucial in this effort. Therefore, I strongly believe embracing this continuum will overcome the barriers identified above as it should be easier to overcome the time and effort and the established culture with a power of one rather than the whole faculty. Also, by conducting SoTL, evidence for the value of integration can be established. Consequently, this continuum commitment by each faculty member would be the impetus for making connections across the whole curriculum, ultimately making the learner more responsible for seeing the big picture.

Intraprofessional Sensitivity: A Must for the Academy and the Profession

The buzz term in healthcare professions education and practice is interprofessional education. Several articles have been published on this topic.1-5 However, little attention is given to intraprofessional education or what I term intraprofessional sensitivity, to emphasize the importance for academics, graduates, and practitioners to be sensitized to and aware of the diverse role and contributions of professionals within pharmacy and to seek to communicate and collaborate with them to optimize the educational process and patient care. A review of the literature resulted in few articles related to intraprofessional education, training, and sensitivity.6-10 However, publication by the American Dental Association11 (Point 1) and the American Physical Therapy Association12 (Goal 16), specifically address intraprofessional education. In 1995, we published a paper13 in which we identified valuing current practice skills as one of the challenges for implementing pharmaceutical care in a clear message to acknowledge the skills of baccalaureate-educated pharmacists during the push to an all PharmD degree. Since then and for several years before, pharmacy has evolved more and more into a clinical profession with major changes to the curriculum and pharmacists taking on many new responsibilities and specialty practice. However, pharmacy academia and the profession have not emphasized the need for intraprofessional sensitivity in teaching pharmacy students and among pharmacy academics or practitioners. From the academic side, the guidelines and standards for the PharmD degree set forth by the Accreditation Council For Pharmacy Education (ACPE)14 are key to this discussion. Standard 9 of the document identifies the goal of the pharmacy curriculum as enabling graduates to practice as a member of or on an interprofessional team. Standard 12 highlights the competencies and outcome expectations for the graduates. Neither of the above standards mentions achieving those within an intraprofessional approach. Standard 13 identifies the curricular core; however, none of the core areas address working with, acknowledging, or communicating with pharmacists in the different practice settings. Standard 14 discusses both early and advanced pharmacy practice experiences, but there is no emphasis on preceptors addressing with the students and highlighting ways in which they could establish interactions or collaboration with other pharmacists. Another important aspect to this discussion is while standard 13 clearly highlights the importance of all the sciences, standard 25 specifically identifies the importance of faculty members respecting their colleagues. Appendix B stresses the importance of students being competent in core basic science areas that are “critical to the foundation and delivery of effective patient care.” Unfortunately, however, some new and established programs have gradually started the process of devaluing the importance of the basic sciences, some administrators and faculty members have undermined the important role the sciences and science faculty play in the curriculum, and some science faculty members have developed an antagonistic relationships with clinical faculty members. All of the above deemphasize intraprofessional education within the academy and its members. From the practice side, none of the major pharmacy organizations based on a literature review has published a white paper on intraprofessional sensitivity. Going back to the manuscript we published in 1995 – at a time when some PharmD graduates were proclaiming their superiority in providing clinical services as compared to baccalaureate-educated pharmacists - we asked for pharmacists to exhibit the same degree of care and support for each other as the era of pharmaceutical care unfolded. Regrettably, throughout the last 25 years of practice, I have seen turf conflicts among pharmacists within the same hospital, lack of respect among pharmacists, and/or no attempts at continuity of care between pharmacists (eg, hospital to community, hospital to nursing home, etc), and administrators who cater to the needs of other administrators or healthcare professionals at the expense of their own pharmacy employees. For our profession to prosper as pharmacy practice evolves, ACPE standards, educational outcomes, and the curriculum should specifically address the importance of intraprofessional sensitivity. The roles of basic, social, administrative and clinical faculty members have to be highlighted, respected, and appreciated. Courses (eg, healthcare systems, communication skills, and skills laboratories) should provide an in-depth look at the diverse scope of pharmacy practice, the role of pharmacists, pharmacy technicians or interns under each, and challenge students by different activities including simulations to explore models for how pharmacy practitioners in these areas can support, respect, collaborate, and complement each other to optimize patient care. In addition, innovative practice models among pharmacists (eg, hospital, ambulatory, community, regulatory, etc) and between academia and practice should be encouraged and promoted to develop research opportunities, address public health issues, and ensure continuation of care. Residency programs can play a major role in providing such opportunities. Further, administrators in academia and practice have to advocate for and support intraprofessional sensitivity efforts. The ultimate goal should be to instill the respect and care needed to be sensitized to all our pharmacy colleagues who contribute to our beloved profession.

Current Practices in Hosting Non-US Pharmacy Students at US Pharmacy Schools in Experiential Clerkships

Objective: To provide specific considerations for hosting non-U.S. pharmacy students at U.S.-based colleges/schools of pharmacy (C/SOP) for experiential clerkships and training. Findings: A literature review (2000-2016) in PubMed, Google Scholar and IPA databases was conducted using specific keywords. Recommendations and future directions for development of experiential rotations for non-U.S. students in U.S. experiential rotations are presented for both the home and host country. Summary articles and best practices across the disciplines, as well as expert opinion, were found across U.S. models for hosting non-U.S. students in advanced practice rotations in the medical disciplines. Consistent themes regarding legal agreements, acculturation, standardized calendars and social and safety considerations were considered for inclusion in the final document. Conclusion: Development of a successful experiential rotation/training for non-U.S. students requires consideration for well-developed objectives, qualified preceptors, multitude of legal and cultural considerations and recommendations for longevity and sustainability.

Knowledge, Skills—and Accountability?

Since I started teaching 20 years ago, the educational emphasis has been on graduating students with the right knowledge, skills, and attitudes.1 In the field of pharmacy over the years, more effort has been placed on fine tuning student knowledge and skills of to meet current and future practice needs.2 To this end, curricula were modified to foster appropriate knowledge, for example by increasing the number of hours of therapeutics courses and, more recently, adding courses in public health or cultural competency. Introductory professional practice experiences (IPPEs) and Skills Laboratory courses were also introduced to fine tune skills required for future practice.1 While the above curricula additions were shown to be keys to graduating students who could be successful on a health care team, pharmacy programs were still missing an emphasis on one major aspect to make this work: instilling accountability into programs to ensure students had a productive attitude toward learning and becoming a professional. The lack of accountability resulted in many issues such as a sense of entitlement3 among students and increased concerns by faculty members and administrators about more prevalence of academic and nonacademic misconduct.4-7 Accountability is synonymous with responsibility or answerability.8 Students and faculty members alike have to be accountable for their actions, and with the emphasis on personal and professional development in the Center for the Advancement of Pharmacy Education 2013 Educational Outcomes, accountability is an especially important goal for students.9 McGuire suggested that attitude is the most difficult thing to change in an individual,10 so pharmacy programs have to exert a more concerted effort to ensure a culture of accountability that may contribute to positive attitudes among students. That can be accomplished in a number of ways. First, strategies should be implemented to motivate students to learn. We have all been faced with blank stares and uncomfortable silences from students after asking them concept questions on material from courses in prior or current semesters. So, how do faculty members prepare a curriculum and assessment activities to enhance true learning rather than the “cramp, pass, and dump” learning many of our students confess to adopting? Faculty members can play a major part by being role models and demonstrating enthusiasm about what we do inside and outside the classroom. Faculty members can also make their discipline relevant to students and utilize active-learning techniques and a variety of teaching styles. Studies have shown that the intrinsic motivation of students is enhanced by instructor enthusiasm and teaching style.11 Second, thought should be given to expectations of the students’ behavior in the nonacademic and academic settings in general, the whole curriculum, and individual courses. At all levels, students should be challenged to “examine and reflect on personal knowledge, skills, abilities, beliefs, biases, motivation, and emotions that could enhance or limit personal and professional growth.”9 Regarding nonacademic expectations, to what degree do we hold students accountable for adhering to all published policies, meeting deadlines, coming to class on time, behaving appropriately in the classroom (eg, not surfing the web or checking social media), and abiding by the laws of the city, state, and nation? Simultaneously, how often do we evaluate student workload issues to ensure students are not under stress, assess that expectations and policies are clear and doable, and gauge whether support from faculty and administrators is available when needed? One academic expectation I struggle with is having students demonstrate in the classroom or in practice experience that they live up to the motto that they are the drug experts on a medical team. Moreover, how much should we allow them, as drug experts, to rely on electronic resources to find answers rather than their own acquired knowledge or skills? Third, policies and procedures have to be well thought out so that both nonacademic and academic misconduct are dealt with in a fair and judicious manner. Such policies should be implemented consistently to ensure students are accountable for such behaviors even if that means, for example, they will not graduate within the typical time frame or be dismissed from the program. A self-assessment document available from the Accreditation Council for Pharmacy Education12 allows one to track a college or school’s on-time graduation rates and academic dismissal percentages for the past 5 years compared to the national rate. Such rates are important to evaluate what if any changes are needed in the program; however, a rate higher than the national one should not be looked at negatively if a rationale (eg, abiding by nonacademic and academic policies) is provided. Finally, while we currently reward students for academic achievement, more emphasis should be placed on rewarding students for appropriate behaviors both in and outside the classroom. Administrators, faculty members, and staff who demonstrate respect in their interactions with students can go a long way in this regard. As we prepare students in their didactic and practice experiences to enter the workforce, it is of utmost importance that they are equipped with appropriate knowledge and skills to care for their patients. More critically, we have to foster a culture of accountability in all aspects of students’ lives so they will be more motivated and excited about continuing to learn, meeting expectations, and exhibiting positive attitudes and behaviors towards their profession, colleagues, and society at large.

Purposeful Global Engagement in Pharmacy Education.

These are exciting times for global pharmacy engagement in the United States. There is greater emphasis on global outreach by many schools and colleges of pharmacy.[1-4][1] Many pharmacy schools have appointed individuals to lead such outreach efforts and the curriculum has been embedded with

Students’ Perception of Self-Efficacy Following Medicinal Chemistry Skills Laboratory Exercises

Objective. To analyze student perceptions of self-efficacy in meeting medicinal chemistry course related educational outcomes and skills following a medicinal chemistry skills laboratory. Methods. Four activities were implemented in a pharmacy skills laboratory (PSL) for second-year pharmacy students. Students (n=121) worked individually on exercises for three of the four activities. Pre/post-laboratory surveys on self-efficacy were administered. The McNemar test was performed to evaluate students’ self-efficacy above 70% related to course outcomes before and after the exercises in each activity. An independent t test was conducted to compare the mean of students’ responses on meeting course outcomes based on the 70% anchor for the perspective confidence on meeting course outcomes. Results. The post-PSL scores on all self-efficacy questions improved. The majority of students reported skill development in all exercises. Students and clinical faculty qualitative responses indicated they felt exercises were effective. Conclusion. A PSL can serve as a valuable opportunity to address course related educational outcomes and specific skill development and can help students assess their self-efficacy in meeting them.