Pamela U. Joyner

Global Experiential and Didactic Education Opportunities at US Colleges and Schools of Pharmacy

Objective. To assess the characteristics of global experiential and didactic education offerings in the pharmacy curricula. Methods. A 2-stage web-based review of US colleges and schools of pharmacy identified country locations of international advanced pharmacy practice experiences (APPE), globally focused didactic courses, and whether these offerings were interprofessional. Schools were contacted to confirm their offerings and were asked about student participation and demand. Results. Sixty-four percent of responding schools confirmed an international APPE offering in 67 different countries with an average graduating class participation of 6.1%. Forty-seven percent of responding schools confirmed a globally focused course offering with an average graduating class participation of 13.1%. Almost two thirds of international APPEs and a majority of courses were designated as interprofessional. Student demand did not outweigh supply for either. Conclusion. Colleges and schools of pharmacy in the United States are continuing to develop global education opportunities for students in the classroom and throughout the world.

Development of a Course Review Process

Objective. To describe and assess a course review process designed to enhance course quality. Design. A course review process led by the curriculum and assessment committees was designed for all required courses in the doctor of pharmacy (PharmD) program at a school of pharmacy. A rubric was used by the review team to address 5 areas: course layout and integration, learning outcomes, assessment, resources and materials, and learner interaction. Assessment. One hundred percent of targeted courses, or 97% of all required courses, were reviewed from January to August 2010 (n=30). Approximately 3.5 recommendations per course were made, resulting in improvement in course evaluation items related to learning outcomes. Ninety-five percent of reviewers and 85% of course directors agreed that the process was objective and the course review process was important. Conclusion. The course review process was objective and effective in improving course quality. Future work will explore the effectiveness of an integrated, continual course review process in improving the quality of pharmacy education.

Rural Health in Pharmacy Curricula

The 2010 Patient Protection and Affordable Care Act proposes strategies to address the workforce shortages of primary care practitioners in rural America. This review addresses the question, “What specialized education and training are colleges and schools of pharmacy providing for graduates who wish to enter pharmacy practice in rural health?” All colleges and schools accredited by the Accreditation Council for Pharmacy Education or those in precandidate status as of December 2011 were included in an Internet-based review of Web sites. A wide scope of curricular offerings were found, ranging from no description of courses or experiences in a rural setting to formally developed programs in rural pharmacy. Although the number of pharmacy colleges and schools providing either elective or required courses in rural health is encouraging, more education and training with this focus are needed to help overcome the unmet need for quality pharmacy care for rural populations.

Professional Organizations for Pharmacy Students on Satellite Campuses

Objective. To evaluate the structure and impact of student organizations on pharmacy school satellite campuses. Methods. Primary administrators from satellite campuses received a 20-question electronic survey. Quantitative data analysis was conducted on survey responses. Results. The most common student organizations on satellite campuses were the American Pharmacists Association (APhA) (93.1%), American Society of Health-System Pharmacists (ASHP) (89.7%), Christian Pharmacists Fellowship International (CPFI) (60.0%), state organizations (51.7%), and local organizations (58.6%). Perceived benefits of satellite campus organizations included opportunities for professional development, student engagement, and service. Barriers to success included small enrollment, communication between campuses, finances, and travel. Conclusion. Student organizations were an important component of the educational experience on pharmacy satellite campuses and allowed students to develop professionally and engage with communities. Challenges included campus size, distance between campuses, and communication.

Prospective student pharmacist interest in a rural pharmacy curriculum.

Objective. To determine prospective student pharmacists’ interest in a rural pharmacy health curriculum. Methods. All applicants who were selected to interview for fall 2011 enrollment at the UNC Eshelman School of Pharmacy were invited to participate in a Web-based survey. Questions addressed participants’ willingness to participate in a rural health pharmacy curriculum, interest in practicing in a rural area, and beliefs regarding patient access to healthcare in rural areas. Results. Of the 250 prospective student pharmacists invited to participate, 91% completed the survey instrument. Respondents agreed that populations living in rural areas may have different health needs, and students were generally interested in a rural pharmacy health curriculum. Conclusions. An online survey of prospective student pharmacists was an effective way to assess their interest in a rural pharmacy program being considered by the study institution. Location of the rural program at a satellite campus and availability of housing were identified as factors that could limit enrollment.

Addressing Rural Health Disparities Through Pharmacy Curricula

Approximately 75% of the United States is rural. (1) While 20% of the US population lives outside of urban areas, only 9% of physicians and 12% of pharmacists practice in rural areas. (2,3) This lack of access to primary care is compounded by the significant need for primary care by citizens in rural areas. More than 1 in 3 adults living in rural America is in poor to fair health, with nearly half having at least 1 major chronic illness. (4) Individuals in rural areas have higher rates of smoking as well as obesity, diabetes, and other chronic diseases. (5) In its 2005 report on rural health care, the Institute of Medicine asserted that many of the challenges faced by those living in rural areas can be attributed to the lack of access to basic health care services. Furthermore, this report described 5 strategies to address the lack of care in rural areas, and 1 strategy was to increase the supply of primary care health professionals in rural areas through improved education and training. (4) Although the report did not specify types of providers, specially trained pharmacists may be able to address the health care disparities found in rural areas. Although the shortage of primary care clinicians has persisted for decades, there is evidence that medical education has made progress in eliminating deficiencies in access to rural health care. (6-8) The following universities, in addition to Jefferson Medical College, all have histories of a strong curricular commitment to rural health care: Alabama, Arizona, Illinois-Rockford, Minnesota, and Washington. Much of the University of Washingtons involvement in rural health care has been through a coalition of the Universitys School of Medicine and 5 states in the Northwest, entitled WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho). With regard to rural health, pharmacy education is in its infancy and can be described as trailing medical education in its efforts. Based on a survey of Web sites of accredited pharmacy colleges and schools, (9) 3 were found that promote programmatic and longitudinal curricular offerings in education and training in rural pharmacy health. (10-12) If less than 3% of accredited pharmacy colleges and schools are promoting and providing formal curricular programming in rural pharmacy health, pharmacy education is probably not meeting the need for qualified pharmacy practitioners in rural areas. RURAL-FOCUSED PHARMACY PROGRAMS When considering creation of a rural-focused pharmacy curriculum, the UNC Eshelman School of Pharmacy first looked to local resources such as the statewide Area Health Education Centers (AHEC) Program. The AHEC system is designed to train and retain health care professionals across the state and has met this objective to an extent; therefore, AHEC could be a vital partner in a rural health-based pharmacy curriculum. Across the state of North Carolina, additional allies were identified who were willing to engage in the education of pharmacists with a rural health interest. The school also researched several programs throughout the country and surveyed prospective students. The information gathered suggested that the approach to fulfilling the rural health education need must be multi-faceted, including aspects of recruitment, admission processes, curricular innovation, and rural experiential training. Medical educators have found that a medical school applicant from a rural area is more likely to practice in a rural area. (6,7,13) This trend is juxtaposed with deficits in educational resources for rural areas that may place such applicants at a disadvantage compared to counterparts from metropolitan areas. Students with an interest in rural pharmacy practice may be encouraged to participate in rural health programs through tuition waivers, early admission, or the chance to obtain an additional designation or certification. Additionally, pharmacists are now included in the National Health ServiceCorps (NHSC) State Loan Repayment Program which gives grants to states to operate their own loan repayment programs for primary care providers in medically underserved areas. …

New directions in pharmacy education

AphA–AppM Pharmacy has embraced technology for decades. This tradition enables practitioners within our profession to increase productivity and improve safe medication practices in diverse and enumerable ways. Technology in pharmacy education has been described as “almost ubiquitous.”1 This is unique in higher education, which is seemingly criticized for sluggish technology uptake amidst a widely digital native student population.2 Evidence suggests that the challenge in pharmacy education may no longer be whether we should integrate technology but rather which technologies should be integrated.

Creating a new rural pharmacy workforce: Development and implementation of the Rural Pharmacy Health Initiative

Purpose. An innovative certificate program aimed at expanding the rural pharmacy workforce, increasing the number of pharmacists with expertise in rural practice, and improving healthcare outcomes in rural North Carolina is described. Summary. Predicted shortages of primary care physicians and closures of critical access hospitals are expected to worsen existing health disparities. Experiential education in schools and colleges of pharmacy primarily takes place in academic medical centers and, unlike experiential education in medical schools, rarely emphasizes the provision of patient care in rural U.S. communities, where chronic diseases are prevalent and many residents struggle with poverty and poor access to healthcare. To help address these issues, UNC Eshelman School of Pharmacy developed the 3‐year Rural Pharmacy Health Certificate program. The program curriculum includes 4 seminar courses, interprofessional education and interaction with medical students, embedding of each pharmacy student into a specific rural community for the duration of training, longitudinal ambulatory care practice experiences, community engagement initiatives, leadership training, development and implementation of a population health project, and 5 pharmacy practice experiences in rural settings. Conclusion. The Rural Pharmacy Health Certificate program at UNC Eshelman School of Pharmacy seeks to transform rural pharmacy practice by creating a pipeline of rural pharmacy leaders and teaching a unique skillset that will be beneficial to healthcare systems, communities, and patients.