Susan M. Meyer

Clinical prevention and population health: Curriculum framework for health professions

Abstract The Clinical Prevention and Population Health Curriculum Framework is the initial product of the Healthy People Curriculum Task Force convened by the Association of Teachers of Preventive Medicine and the Association of Academic Health Centers. The Task Force includes representatives of allopathic and osteopathic medicine, nursing and nurse practitioners, dentistry, pharmacy, and physician assistants. The Task Force aims to accomplish the Healthy People 2010 goal of increasing the prevention content of clinical health professional education. The Curriculum Framework provides a structure for organizing curriculum, monitoring curriculum, and communicating within and among professions. The Framework contains four components: evidence base for practice, clinical preventive services–health promotion, health systems and health policy, and community aspects of practice. The full Framework includes 19 domains. The title “Clinical Prevention and Population Health” has been carefully chosen to include both individual- and population-oriented prevention efforts. It is recommended that all participating clinical health professions use this title when referring to this area of curriculum. The Task Force recommends that each profession systematically determine whether appropriate items in the Curriculum Framework are included in its standardized examinations for licensure and certification and for program accreditation.

Advancing Pharmacogenomics Education in the Core PharmD Curriculum through Student Personal Genomic Testing

Objective. To develop, implement, and evaluate “Test2Learn” a program to enhance pharmacogenomics education through the use of personal genomic testing (PGT) and real genetic data. Design. One hundred twenty-two second-year doctor of pharmacy (PharmD) students in a required course were offered PGT as part of a larger program approach to teach pharmacogenomics within a robust ethical framework. The program added novel learning objectives, lecture materials, analysis tools, and exercises using individual-level and population-level genetic data. Outcomes were assessed with objective measures and pre/post survey instruments. Assessment. One hundred students (82%) underwent PGT. Knowledge significantly improved on multiple assessments. Genotyped students reported a greater increase in confidence in understanding test results by the end of the course. Similarly, undergoing PGT improved student’s self-perceived ability to empathize with patients compared to those not genotyped. Most students (71%) reported feeling PGT was an important part of the course, and 60% reported they had a better understanding of pharmacogenomics specifically because of the opportunity. Conclusion. Implementation of PGT in the core pharmacy curriculum was feasible, well-received, and enhanced student learning of pharmacogenomics.

Changes in Student Performance and Confidence with a Standardized Patient and Standardized Colleague Interprofessional Activity.

Objective. To assess the impact of a standardized patient and standardized colleague interprofessional activity on student performance and perceived confidence in communicating with patients and physicians. Methods. Students in the third professional year were presented with a practice and final activity including a standardized patient interaction, SOAP note preparation, and standardized colleague interaction. Student performance was measured by assessment rubrics on practice and final activities. Students’ perceived confidence was measured via presurvey and postsurvey. Results. Students performed significantly better from the practice to the final activity with regard to communicating with patients, SOAP note, and the overall activity with a mean difference (95% CI) of 9.2 (6.9-11.5), 3.6 (1.3-5.8), and 3.9 (2.0-5.7), respectively. There was a positive significant change from presurvey to postsurvey in students’ confidence talking to patients and physicians on majority of questions. Conclusion. This study demonstrates that active learning and integrated assessments improve overall student performance. Integration of interprofessional education also has positive effects on students’ perceived confidence.

Development of an antimicrobial stewardship-based infectious diseases elective that incorporates human patient simulation technology.

Objective. To design an elective for pharmacy students that facilitates antimicrobial stewardship awareness, knowledge, and skill development by solving clinical cases, using human patient simulation technology. Design. The elective was designed for PharmD students to describe principles and functions of stewardship programs, select, evaluate, refine, or redesign patient-specific plans for infectious diseases in the context of antimicrobial stewardship, and propose criteria and stewardship management strategies for an antimicrobial class at a health care institution. Teaching methods included active learning and lectures. Cases of bacterial endocarditis and cryptococcal meningitis were developed that incorporated human patient simulation technology. Assessment. Forty-five pharmacy students completed an antimicrobial stewardship elective between 2010 and 2013. Outcomes were assessed using student perceptions of and performance on rubric-graded assignments. Conclusion. A PharmD elective using active learning, including novel cases conducted with human patient simulation technology, enabled outcomes consistent with those desired of pharmacists assisting in antimicrobial stewardship programs.

The status of women in US academic pharmacy.

Objective. To describe the status of women in pharmacy education with particular focus on a 10-year update of a previous study. Methods. Information was obtained from national databases, published reports, scholarly articles, and association websites. Comparisons were made between men and women regarding degree completion, rank, tenure status, leadership positions, research awards, salaries, and career advancement. Results. There have been modest gains in the number of women serving as department chairs and deans. Salary disparities were found between men and women at several ranks within pharmacy practice. Men were more apt to be tenured or in tenure-track positions and received 89.4% of the national achievement awards tracked since 1981. Conclusion. The problem cannot be simply attributed to the pipeline of those entering academia. Barriers to advancement differ between men and women. We recommend that individuals, institutions, and associations implement strategies to decrease barriers and reduce bias against women.

Evaluation of medical marijuana topics in the PharmD curriculum: A national survey of schools and colleges of pharmacy

INTRODUCTION To summarize the status of medical marijuana instruction in the PharmD curriculum and capture future plans for the incorporation of medical marijuana content. METHODS One hundred and forty United States schools and colleges of pharmacy were contacted to complete an anonymous survey regarding inclusion of medical marijuana topics in their curriculum, future plans for inclusion, and evaluation of perceived importance of specific topics. RESULTS Forty nine percent (68/140) of schools and colleges completed the survey and 62% (44/68) include medical marijuana content in their curriculum. Of the schools and colleges that do not include it, 23% (6/26) plan to incorporate medical marijuana topics within the next 12 months. In regards to perceived importance of specific topics related to medical marijuana, all topics received a median score of three on a scale of one to five, with one being of high importance. CONCLUSION With more states legalizing medical marijuana, schools and colleges of pharmacy need to evaluate inclusion of medical marijuana topics in their curriculum to prepare student pharmacists to effectively care for patients using this product.

Entrustable Professional Activities as a Novel Framework for Pharmacy Education

Entrustable professional activities (EPAs) are units of measure for a particular profession that describe the professional’s unique abilities and work. EPAs can be used in two ways: as a link between individual competencies for mastery and overall professional responsibilities in practice; and as a mechanism for faculty to assess the student’s progression using levels of decreasing supervision. Currently used in medical education, implementation and utilization of EPAs within pharmacy education has potential benefits and challenges. This article will describe, highlight benefits of, and share mitigation strategies for implementing EPAs within pharmacy education.

Using the Pharmacist Interaction Tracking Tool for Capturing Student-Patient Interactions in Direct and Simulated Patient Care Activities

Objective. To create and implement a standardized data collection tool for capturing student-patient interactions in direct and simulated patient care activities. Design. Faculty members and students determined key elements, design, and an implementation plan for the tool, which was to be used by students across professional years to quantify numbers and types of interactions with patients for tracking student progression toward achievement of curricular outcomes. Assessment. During the 2013-2014 academic year, 27 778 entries were completed, with 17 767 (64%) advanced pharmacy practice experiences, 7272 (26%) introductory pharmacy practice experiences, and 2739 (10%) simulation. Direct patient care interactions occurred with 11 090 patients and 10 983 providers, with 14 252 drug-related problems identified. Data was used by students for their professional portfolios, by administrators for curricular assessment, and to student impact on patient care. Conclusion. The PITT Form enabled the collection of data from actual and simulated patient care activities, allowed for curricular assessment of activities across years, and was used by individual students.