Currents in Pharmacy Teaching and Learning最新文献_第3页

Evaluation of medication appropriateness index in cardiovascular outpatient clinic: A cross-sectional study 评估心血管门诊的用药适当性指数：横断面研究

IF 1.3 Q3 EDUCATION, SCIENTIFIC DISCIPLINES

Currents in Pharmacy Teaching and Learning

Pub Date : 2025-02-01 DOI: 10.1016/j.cptl.2024.102262

Qusai Y. Al-Share, Rawand A. Khasawneh, Abeer M. Rababa'h, Fadi N. Asfar, Yara N. Mohammad

Background

Older adults often have polypharmacy and multimorbidity. Cardiovascular diseases (CVDs) are the most common multimorbidities in older adults and are linked to wide range of adverse drug effects and drug-related problems. The medication appropriateness index (MAI) has been widely used in several patient settings to assess Potentially Inappropriate Medication (PIM) prescribing in older adults.

Objectives

The purpose of this study was to evaluate PIM prescribing in cardiovascular disease outpatient clinic. It also aimed at assessing the validity of the MAI to detect and quantify PIMs specifically in CVD outpatient clinics.

Methods

This was a cross-sectional, single-center study in cardiovascular outpatient setting. Demographic, clinical, and medication information from older adults (≥ 65 years old) were collected and reviewed. Two clinical pharmacists randomly selected 70 patients, evaluated 539 medications, and assessed their appropriateness using the MAI. The Statistical Package for the Social Sciences (SPSS) descriptive and logistic regression analyses was to calculate the number of PIMs, the MAI scores, and factors associated with PIM prescribing.

Results

Our data showed that 87.1 % of patients had at least one PIM and the number of PIMs per patient was 2.10. Approximately 60 % of the patients had an MAI weighted score of zero (no prescription error). The mean MAI score per patient was 17.61 and the mean MAI score per medication was 2.72. The overall agreement between the two raters was 87.3 % with moderate chance-adjusted agreement as indicated by the kappa static of 0.43. The factors that were associated with increased PIM prescribing were the total number of medications and being ≥85 years old.

Conclusion

A relatively high prevalence of PIMs was found in the studied population. The MAI is a reliable and valid tool to detect PIM prescribing in CVD outpatient clinics. It mandates implementing specific measures to reduce PIMs.

背景：老年人通常患有多种疾病。心血管疾病（CVDs）是老年人最常见的多病症，与广泛的药物不良反应和药物相关问题有关。用药适当性指数（MAI）已被广泛应用于多种患者环境中，以评估老年人潜在用药不当（PIM）的情况：本研究旨在评估心血管疾病门诊中的潜在用药不当处方。研究还旨在评估 MAI 在心血管疾病门诊中检测和量化 PIM 的有效性：这是一项在心血管病门诊进行的横断面单中心研究。收集并审查了老年人（≥ 65 岁）的人口统计学、临床和用药信息。两名临床药剂师随机抽取了 70 名患者，评估了 539 种药物，并使用 MAI 评估了这些药物的适当性。通过社会科学统计软件包（SPSS）的描述性分析和逻辑回归分析，计算了PIM的数量、MAI评分以及与PIM处方相关的因素：数据显示，87.1% 的患者至少使用过一次 PIM，每位患者使用 PIM 的次数为 2.10 次。约 60% 的患者 MAI 加权得分为零（无处方错误）。每位患者的平均 MAI 得分为 17.61，每种药物的平均 MAI 得分为 2.72。两位评分者之间的总体一致性为 87.3%，卡帕静态值为 0.43，表明存在中等程度的机会调整一致性。与 PIM 处方增加相关的因素是药物总数和年龄≥85 岁：结论：在所研究的人群中，PIMs 的发生率相对较高。MAI 是检测心血管疾病门诊中 PIM 处方的可靠有效工具。它要求采取具体措施减少 PIMs。

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引用次数: 0

COEPA ready: Innovative pedagogy for integrating social determinants of health in PharmD curricula COEPA 准备就绪：将健康的社会决定因素纳入药学博士课程的创新教学法。

IF 1.3 Q3 EDUCATION, SCIENTIFIC DISCIPLINES

Currents in Pharmacy Teaching and Learning

Pub Date : 2025-02-01 DOI: 10.1016/j.cptl.2024.102267

Jennifer Bhuiyan , Regina Arellano , Dana G. Carroll , Christine Chim , Sharon Connor , Devra K. Dang , Juanita A. Draime , Tara P. Driscoll , Lauren Jonkman , Abby A. Kahaleh , Rakhi Karwa , Kristi W. Kelley , Katie F. Leslie , Brittney A. Meyer , Nicole M. Sifontis

Background

The American Association of Colleges of Pharmacy Curriculum Outcomes and Entrustable Professional Activities (COEPA) recognize the need for social determinants of health (SDH) education for pharmacy learners. However, there is a dearth of published strategies for incorporating comprehensive SDH education in Doctor of Pharmacy curricula. The objectives of this study were to: 1) highlight unpublished exemplars of SDH teaching models and 2) propose strategies for teaching SDH.

Methods

A survey was distributed to relevant AACP Special Interest Groups and Sections soliciting previously unpublished exemplars of SDH teaching models. The survey collected descriptions of the teaching model, relevant SDH domains as outlined in Healthy People 2030, and the level of influence on health outcomes according to the socioecological model. Deidentified survey submissions were analyzed and categorized by type (didactic, IPPE/APPE, or both), course type (elective or required), year taught, interprofessional education components (if applicable), innovation, assessment domains and tools, course structure, SDH domains, and the socioecological model.

Results

Eight programs submitted diverse exemplars of which six (75 %) were part of required didactic courses for P1-P3 learners. Teaching models included individual lectures and activities, didactic and experiential courses, and implementation of longitudinal curricular experiences. Seven (87.5 %) of the exemplars covered all five SDH domains, and seven (87.5 %) covered all levels of influence within the socioecological model. Exemplars featured simulations (50 %) and case-based learning activities (62.5 %). Three (37.5 %) featured interprofessional education and research components.

Conclusion

These exemplars provide faculty with varied models for implementing SDH-related teaching opportunities within their institutions.

背景：美国药学院课程成果和委托专业活动协会（COEPA）承认，有必要对药学学习者开展健康的社会决定因素（SDH）教育。然而，将全面的 SDH 教育纳入药学博士课程的策略却鲜有公布。本研究的目标是1) 强调未出版的 SDH 教学模式范例；2) 提出 SDH 教学策略：向相关的 AACP 小组和分会分发了一份调查问卷，征集之前未发表的 SDH 教学模式范例。调查收集了教学模式的描述、《2030 年健康人群》中列出的相关 SDH 领域，以及根据社会生态模式对健康结果的影响程度。对提交的去身份调查报告进行了分析，并按类型（授课式、IPPE/APPE 或两者兼有）、课程类型（选修或必修）、授课年份、跨专业教育内容（如适用）、创新、评估领域和工具、课程结构、SDH 领域和社会生态模型进行了分类：八项计划提交了不同的范例，其中六项（75%）是为小一至小三学生开设的必修教学课程的一部分。教学模式包括个人讲座和活动、说教式和体验式课程，以及实施纵向课程体验。七个范例（87.5%）涵盖了所有五个 SDH 领域，七个范例（87.5%）涵盖了社会生态模式中的所有影响层面。示范课程以模拟（50%）和基于案例的学习活动（62.5%）为特色。三个范例（37.5%）包含跨专业教育和研究内容：这些范例为教师提供了在其所在机构内实施与 SDH 相关的教学机会的各种模式。

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引用次数: 0

Integrating entrustable professional activities using an integrated curriculum design framework in pharmacy education 运用综合课程设计框架整合药学教育中可信赖的专业活动。

IF 1.3 Q3 EDUCATION, SCIENTIFIC DISCIPLINES

Currents in Pharmacy Teaching and Learning

Pub Date : 2025-02-01 DOI: 10.1016/j.cptl.2024.102269

Kingston Rajiah

Purpose

The integration of Entrustable Professional Activities (EPAs) using the Integrated Curriculum Design Framework (ICDF) is a promising yet underexplored strategy in pharmacy education. This reflective work identifies gaps in traditional approaches to competency-based education and highlights the alignment of the “Professional Practice Skills” Year 2 module at a UK university with EPAs and ICDF. By bridging these gaps, this work highlights the importance of equipping students with the competencies necessary for independent practice.

Description

The “Professional Practice Skills” module was transformed to align with ICDF and EPAs. Stakeholder engagement, including input from students, educators, and practitioners, guided the selection of EPAs reflective of real-world pharmacy tasks such as patient counselling, prescribing, prescriber interaction, and providing medicine query information. Learning outcomes were redefined to incorporate these EPAs, and teaching strategies were adapted to include experiential learning activities, such as simulated patient scenarios and reflective tasks. Assessment methods shifted from knowledge-based to competency-based evaluations, ensuring students could demonstrate practical readiness for professional roles.

Analysis

Integrating EPAs and ICDF revealed challenges, such as resistance to change and the need for significant resource investment in designing simulations. However, the shift encouraged collaborative teaching practices and enhanced student engagement. Students demonstrated improved confidence and ability to apply theoretical knowledge in practice, showcasing the value of a competency-based approach.

Conclusions

This integration process highlights the importance of aligning curriculum design with professional competencies.

Implications

The work has broader implications for pharmacy education, offering a replicable model for other healthcare institutions seeking to enhance professional readiness.

目的：利用综合课程设计框架（ICDF）整合 "可委托专业活动"（EPAs）是药学教育中一项前景广阔但尚未得到充分探索的策略。这项反思性工作确定了能力本位教育传统方法中的差距，并强调了英国一所大学的 "专业实践技能 "二年级模块与 EPAs 和 ICDF 的一致性。通过弥合这些差距，这项工作强调了让学生具备独立实践所需能力的重要性：对 "专业实践技能 "模块进行了改革，使其与国际教育发展论坛和 EPAs 保持一致。利益相关者的参与，包括学生、教育者和从业者的意见，指导了反映真实世界药学任务的 EPAs 的选择，如病人咨询、处方、处方者互动和提供药品查询信息。重新定义了学习成果以纳入这些 EPA，并调整了教学策略以纳入体验式学习活动，如模拟患者情景和反思任务。评估方法从以知识为基础的评估转变为以能力为基础的评估，确保学生能够证明自己已经为专业角色做好了实际准备：分析：整合 EPA 和 ICDF 面临着挑战，例如对变革的抵制以及在设计模拟情景时需要投入大量资源。然而，这种转变鼓励了协作式教学实践，提高了学生的参与度。学生们在实践中应用理论知识的信心和能力都得到了提高，展示了基于能力的方法的价值：结论：这一整合过程强调了课程设计与专业能力相一致的重要性：这项工作对药学教育具有更广泛的意义，为其他医疗机构提供了一个可复制的模式，以提高专业准备水平。

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引用次数: 0

Validation of an instrument to assess student pharmacist self-authorship 一种评估学生药剂师自我写作能力的工具的验证。

IF 1.3 Q3 EDUCATION, SCIENTIFIC DISCIPLINES

Currents in Pharmacy Teaching and Learning

Pub Date : 2025-02-01 DOI: 10.1016/j.cptl.2024.102264

Caitlin M. Gibson , Meredith L. Howard , Robert C. Haight

Introduction

Self-authorship is the creation of one's own perspective by contextually evaluating evidence, constructing independent beliefs, and maintaining capacity to consider outside perspectives. Transitioning between cognitive self-authorship stages is common during higher education. Despite correlation to several co-curricular subdomains, instruments to measure self-authorship are limited, however, one such instrument has been developed within medical education and would benefit use within pharmacy education.

Methods

All student pharmacists at two public, 4-year pharmacy programs were invited to complete a voluntary, anonymous survey measuring self-authorship. The instrument was adapted from existing validated survey instruments. To ensure validity and reliability among, structural equation modeling and Chronbach's alpha was used to analyze three factors (Career Development, Data Interpretation & Decision Making, and Ethics & Values).

Results

A total of 157 surveys were completed. The mean age of respondents was 28 years and 79.17 % were female. Validation analysis found that results from the two institutions have an acceptable fit for the Career Development and Data Interpretation & Decision Making factors, with the Ethics and Values factor having a poor model fit (RMSEA = 0.08, 0.09, 0.29 respectively). Each factor yielded a good level of internal consistency for the current stage of research (α = 0.49, 0.52, 0.72 respectively).

Conclusions

This development of an instrument assessing self-authorship among student pharmacists has wide-reaching applicability to assess and inform students in their journey towards exploring personal and professional values. The adaptation of this instrument has resulted in one which is valid and reliable for the current stage of research within student pharmacists. Future steps including using this instrument to determine if particular educational interventions or progression across curricular elements impact self-authoring.

简介自我作者是指通过对证据进行背景评估、构建独立信念和保持考虑外部观点的能力来创造自己的观点。在高等教育期间，在认知自我作者阶段之间过渡是很常见的。尽管与多个共同课程子域相关，但用于测量自我作者身份的工具却很有限，不过，在医学教育中已经开发出了一种这样的工具，在药学教育中使用将大有裨益：方法：邀请两个公立四年制药学专业的所有学生药剂师完成一项自愿、匿名的自我著作权测量调查。调查表是根据现有的有效调查表改编的。为了确保问卷的有效性和可靠性，我们使用结构方程模型和 Chronbach's alpha 分析了三个因子（职业发展、数据解释与决策制定、道德与价值观）：共完成了 157 份调查问卷。受访者的平均年龄为 28 岁，79.17% 为女性。验证分析发现，两所院校的结果在 "职业发展 "和 "数据解读与决策 "这两个因子上的拟合度可以接受，而 "道德与价值观 "因子的模型拟合度较差（RMSEA 分别为 0.08、0.09 和 0.29）。在现阶段的研究中，每个因子都具有良好的内部一致性（α 分别为 0.49、0.52 和 0.72）：学生药剂师自我认同感评估工具的开发具有广泛的适用性，可用于评估和指导学生探索个人和职业价值的过程。对这一工具的调整使其在现阶段的学生药剂师研究中具有有效性和可靠性。未来的步骤包括使用该工具确定特定的教育干预措施或课程内容的进展是否会影响自我创作。

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引用次数: 0

Integrating a naloxone-focused population health management experience into an ambulatory care advanced pharmacy practice experience

IF 1.3 Q3 EDUCATION, SCIENTIFIC DISCIPLINES

Currents in Pharmacy Teaching and Learning

Pub Date : 2025-01-31 DOI: 10.1016/j.cptl.2025.102293

Joseph Berendse , Harrison Johnson , Cactus Aanenson , John Kappes , Mike Lemon

Introduction

Population-health management (PHM) is using healthcare analytics to target clinical interventions across a population. Many pharmacists are asked to engage in PHM, as these efforts improve outcomes. Veterans Health Administration has developed a population health dashboard (the Overdose Education and Naloxone Distribution [OEND] Dashboard) to identify patients eligible for naloxone, an opioid overdose reversal agent.

Integrating PHM experiences within pharmacy education is supported by current curricular outcomes. Thus, the primary purpose of this project is to determine whether a naloxone-focused PHM experience has positive outcomes in terms of students' perceived skills, knowledge, and attitudes related to PHM and naloxone counseling.

Methods

This single-site, prospective, observational study examined fourth-year student pharmacists on their ambulatory care advanced pharmacy practice experience (APPE). Students used the OEND Dashboard to independently make naloxone interventions throughout the rotation. A survey containing multiple Likert scale questions was administered at the beginning and end of the APPE to assess changes in students' perceived skills, knowledge, and attitudes related to PHM and naloxone counseling. Results were assessed using a two-tailed Wilcoxon Signed-Rank test for paired data.

Results

Between August 2022 and August 2024, 30 students completed an APPE at the study site. Overall, there were positive changes on all six Likert scale items assessing the domains of perceived skills, knowledge, and attitudes. In the post-survey, 96.2 % (27/28) of students responded “Agree” or “Strongly Agree” to “I believe that my efforts on this rotation had a direct impact on patient safety.”

Conclusions

Integration of a naloxone-focused PHM experience had positive outcomes in terms of students' perceived skills, knowledge, and attitudes toward the concepts of PHM and naloxone counseling.

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引用次数: 0

Bridging disciplines: An evaluation of learning about Interprofessional roles and responsibilities through an interactive group activity

IF 1.3 Q3 EDUCATION, SCIENTIFIC DISCIPLINES

Currents in Pharmacy Teaching and Learning

Pub Date : 2025-01-31 DOI: 10.1016/j.cptl.2024.102268

Sally R. Earl , Lesley Thweatt , Emmy Parkes , Amy Fisher , Carolyn Wiles Higdon , Heather Landry Shirley , Susan P. Wehring , Younghee Lim , Patricia K. Digby , Seth T. Lirette , Kim G. Adcock

The World Health Organization (WHO) defines interprofessional education (IPE) as “when two or more professions learn about, from and with each other”, and considers IPE a necessary component of a “collaborative practice-ready” workforce.¹ In this article we describe an interprofessional educational activity that focused on increasing students' knowledge of healthcare professionals' roles and responsibilities. Faculty members representing six healthcare related disciplines collaborated to develop an interactive group activity. Students from athletic training, nutrition, nursing, pharmacy, social work and speech-language pathology programs participated in a 1-h interactive session focusing on comparing and contrasting 20 common roles and responsibilities between each discipline. Each student completed a knowledge assessment prior to and after the interactive session. Using a matched pair pre-post design, we compared students' scores on their knowledge of interprofessional roles and responsibilities before and after the intervention. The findings revealed that students displayed an overall increase in knowledge. This intervention demonstrates that an interprofessional group-based activity can be a useful tool to increase students' understanding of various healthcare roles and their responsibilities. By improving knowledge, these students could be better prepared to participate in an interprofessional healthcare team, thereby improving the quality of patient-centered care.

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引用次数: 0

A mosaic of medicine: Acquainting pharmacy education with the rich tapestry of African-descent immigrant cultures

IF 1.3 Q3 EDUCATION, SCIENTIFIC DISCIPLINES

Currents in Pharmacy Teaching and Learning

Pub Date : 2025-01-30 DOI: 10.1016/j.cptl.2025.102296

Olajumoke Amuwo

There is an increasing number of African-descent immigrants to the United States, often from the Caribbean, South America, and Africa. These immigrants tend to have different healthcare needs than native-born Black Americans because they come from diverse backgrounds with unique cultural health practices and beliefs. While these immigrants may be healthier when they initially present to the United States, research has found that this health advantage is not long-lasting. Acculturation, cultural beliefs, systemic, and social factors have been closely linked to the health and well-being of Black immigrants, especially with increased years of residency in the United States. Culturally competent care involves understanding the influence of culture, ethnicity, and social factors on health. It is crucial that student pharmacists are trained in understanding the cultural considerations of our continuously evolving and diverse patients. While pharmacy schools have begun incorporating cultural competency and implicit bias training in PharmD curricula, there is still room for improvement to bring about meaningful change in health outcomes. This review calls for an end to oversimplified views of Black immigrant health, advocates for better recognition of distinct African-descent cultures, and recommends tools and strategies to incorporate this population into multicultural pharmacy education.

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引用次数: 0

Assessment of student well-being and identification of associated factors

IF 1.3 Q3 EDUCATION, SCIENTIFIC DISCIPLINES

Currents in Pharmacy Teaching and Learning

Pub Date : 2025-01-30 DOI: 10.1016/j.cptl.2025.102298

Nicole Pizzutelli, Jaime Maerten-Rivera, Nicole Albanese, Kalpesh Desai, Jennifer Rosenberg, Christine Stumm, Ashley E. Woodruff

Objective

The current study assessed the well-being of PharmD students in the first through third professional years (PY) utilizing an internally developed survey.

Methods

A survey was administered in Spring 2022 to students at one school, which contained five-point Likert scale items measuring factors of well-being (life balance, connectivity, inclusivity, and faculty support), in addition to background variables and an open-ended item asking what program changes would improve students' well-being. Descriptive statistics were examined along with ordinary least squares regression models with PY, gender, ethnicity, and residency (local versus non-local) examined as predictors. Open-ended responses were coded using a thematic analysis approach.

Results

A total of 253 (75 % response rate) students completed the survey. The summation of, “life balance” items had the lowest mean (M = 2.84, SD = 0.77) and, “inclusivity” items (M = 3.60, SD = 0.88) had the highest mean. PY2 and PY3 students both had higher scores on the life balance items, PY2 students had higher scores on the faculty support items. Females had lower scores on the life balance items. Blacks/Hispanics had lower scores on items pertaining to inclusivity and connectivity. Students commented that improving faculty-student engagement, the scheduling or frequency of exams, and improving student-student engagement could improve well-being.

Conclusion

It is important to develop a methodical plan to assess and address student well-being. This study assessed multiple factors of well-being and found differences based on professional year, gender, and race/ethnicity. Based on the results of the study, relevant changes were made at our institution.

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引用次数: 0

Cultural competency in pharmacy education: Bringing the intangible to life through object-based learning

IF 1.3 Q3 EDUCATION, SCIENTIFIC DISCIPLINES

Currents in Pharmacy Teaching and Learning

Pub Date : 2025-01-30 DOI: 10.1016/j.cptl.2025.102282

Janet M.Y. Cheung , Alix Thoeming , Jennifer A. Ong , Jessica Pace , Jane Thogersen , Eve Guerry

Introduction

Cultural competence is a core professional skill that plays a key role for bridging health inequities among culturally and liniguisticallty diverse populaitons. However, student receptiveness and perceived relevance of content remains a challenge for integrating training in the earlier stages of the curriculum. This study describes the application and preliminary evaluation of object-based learning (OBL) as a pedagogical approach to stimulate student engagement with concepts of cultural competency among first year pharmacy undergraduates.

Methods

A bespoke OBL workshop was implemented in a unit of study with 320 first year undergraduate pharmacy students enrolled. Students worked in small teams of 5to–6 people, handling a curated collection of health-related art, specimens and artefacts across cultures in a 2-h workshop. Across three activities, students critically analysed the collection items.

Results

A total of 169 and 66 students responded to the baseline and post-workshop questionnaire respectively, giving rise to 46 matched pairs who were mostly female (63 %, n = 29) with a mean age of 18.93 (SD =1.36). Nearly half of the respondents self-identified as “Asian” with three quarters speaking a language other than English at home. Post-workshop changes were observed in students' ability to define cultural competence (Z = -2.236, p = 0.025) as well as their perceived levels of cultural competency advancing from “cultural pre-competency” to “cultural competency” (Z = −2.524, p = 0.012). At baseline, students endorsed a high level of agreement with respect to the importance of pharmacists providing culturally appropriate care and the relevance of cultural competence to their future pharmacy career, both of which remained unchanged post-workshop.

Conclusions

OBL is a promising approach to introducing concepts of cultural competency to a first year pharmacy student cohort. There is scope to expand OBL approaches in other areas of skill development in pharmacy education.

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引用次数: 0

Enhancing multicultural pharmacy education through ethical debates: Fostering critical thinking and cultural competence

IF 1.3 Q3 EDUCATION, SCIENTIFIC DISCIPLINES

Currents in Pharmacy Teaching and Learning

Pub Date : 2025-01-30 DOI: 10.1016/j.cptl.2025.102294

Kingston Rajiah

Purpose

This reflective practice examines the integration of ethical debates as an assessment method in pharmacy education, focusing on their role in fostering critical thinking, ethical reasoning, and cultural competence.

Description

Rooted in principles of Multicultural Pharmacy Education and Diversity, Equity, Inclusion, and Belonging, ethical debates engage students in articulating and defending ethical positions across diverse cultural contexts.

Interpretation

Benefits include an enhanced understanding of cultural influences on ethical decision-making, promotion of respect for diverse viewpoints, and preparation for practice in multicultural healthcare settings.

Conclusion

Reflecting on feedback processes reveals opportunities for improvement in providing more personalised, culturally contextual feedback to support student development effectively. This reflection highlights the transformative impact of ethical debates on both teaching practices and student learning, highlighting their implications for enhancing pharmacy education and fostering inclusive healthcare practices.

Implications

Future actions include refining feedback mechanisms and promoting faculty development to align with MPE principles and support continuous student learning and professional development.

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引用次数: 0