PHARMACY PRACTICE EXPERIENTIAL PROGRAMS IN THE CONTEXT OF CLINICAL EDUCATION

Objective: To identify studies describing and/or assessing pharmacy practice experiential programs focusing on clinical education.Methods: A systematic literature review was carried out. The databases searched included Lilacs, Medline/Pubmed, Eric and Scopus. The search strategy was devised based on a combination of subject headings related to pharmacy practice experiential programs, pharmacy education, and clinical practice in pharmacy. Two reviewers independently performed article selection, applying eligibility criteria defined. The level of agreement between the reviewers (Kappa coefficient) was calculated. Information about the clinical practice and settings used, description of pharmacy practice experiential model and type of evaluation study performed was collected from the articles selected using a pre structured form.Results: Of the 474 items retrieved in the initial search, 31 articles met the eligibility criteria. An increase in the number of publications in the 2000s was noted, predominantly (n=22, 71.0%) from North America. Pharmaceutical care was the most commonly used term to denote clinical practice in pharmacy. The practice sites ranged from hospitals (n=13, 41.9%), outpatient clinics (n=12, 38.7%), community pharmacies (n=7, 22.6%) and other community institutions (n=10, 32.3%), whereas some experiences involved a combination of these settings. The most common organizational arrangement involved pharmacists from the healthcare service as preceptors supervising students in the field, and teachers as educators, tutors and researchers within universities. In some situations, however, teachers and more advanced students acted as preceptors. Educational outcomes and/or results related to the service delivered by students and preceptors were assessed, where the quantitative method was the most frequently employed approach in both cases.Conclusion: The studies revealed that the partnership among university, health services and community is a promising initiative for improving the quality of pharmaceutical services offered to society and of pharmaceutical education.

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Integration of a Virtual Dispensing Simulator “MyDispense” in an Experiential Education Program to Prepare Students for Community Introductory Pharmacy Practice Experience

Pharmacy ◽

10.3390/pharmacy9010048 ◽

2021 ◽

Vol 9 (1) ◽

pp. 48

Author(s):

Ashley E. Johnson ◽

Jillian Barrack ◽

Jill M. Fitzgerald ◽

Diana M. Sobieraj ◽

Lisa M. Holle

Keyword(s):

Community Pharmacy ◽

Experiential Education ◽

Self Care ◽

Pharmacy Practice ◽

Pharmacy Education ◽

P Value ◽

Community Practice ◽

Practice Experience ◽

Group A ◽

Group B

Background: Technology is increasingly used to enhance pharmacy education. We sought to evaluate student learning and preparedness for community introductory pharmacy practice experiences (IPPEs) after implementation of “MyDispense” into experiential education. Methods: Both first-year pharmacy students and assigned community IPPE preceptors were eligible. Students were stratified based on previous community pharmacy experience (< or ≥ 50 h), then randomized to complete MyDispense exercises before IPPE (group A) or after 24–32 h of IPPE (group B). We evaluated preceptors’ assessment of student readiness using a 6-item Likert scale survey and students’ readiness and opinion of MyDispense using an anonymous 9-item survey. Descriptive statistics were used to characterize data. The Mann–Whitney U test was used to compare groups and a p-value < 0.05 was considered statistically significant. Results: Of 177 eligible students, 155 were randomized and 56 completed study. Group A included 32 students; 56.3% had prior community practice experience. Group B included 24 students; 50% had prior community practice experience. Forty-eight preceptors were enrolled. Students who completed exercises before rotation received higher preceptor scores for patient counseling of self-care and of medications (p < 0.05 for both). Students self-assessed their counseling skills lower than all other skills; 30.4% and 42.9% of students felt mostly or always prepared to counsel for self-care and medications, respectively. Students found MyDispense straightforward, realistic, and appreciated the ability to practice in a safe, electronic, community pharmacy, patient-care environment. Conclusion: Simulation-based software, such as MyDispense, can enhance learner understanding of the prescription fill and counseling process in a community pharmacy practice setting.

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A Novel Approach to Pharmacy Practice Law Instruction

Pharmacy ◽

10.3390/pharmacy9020075 ◽

2021 ◽

Vol 9 (2) ◽

pp. 75

Author(s):

Matthew Deneff ◽

Lisa M. Holle ◽

Jill M. Fitzgerald ◽

Kathryn Wheeler

Keyword(s):

Student Perceptions ◽

Pharmacy Practice ◽

Pharmacy Education ◽

Survey Study ◽

State Laws ◽

Institutional Review ◽

Novel Approach ◽

Study Results ◽

Course Changes ◽

Main Component

Pharmacy law instruction is often taught as a didactic course; however practical application of pharmacy law is a main component of pharmacy practice. Technology-based simulations are becoming more frequently used to enhance didactic pharmacy education. The goal of this study was to evaluate the utility of and student perceptions on the usefulness of MyDispense community pharmacy simulation for additional law instruction that if successful might prompt curricular revamping. This Institutional Review Board–approved, two-year, qualitative, prospective, survey study was conducted in a case study class where students completed MyDispense exercises focused on common legal issues that arise in practice, both individually before and within groups during class. Participating students completed a qualitative survey directed at use of MyDispense for pharmacy law review, which included a series of close-ended questions graded on a Likert scale and open-ended questions thematically grouped. Thirty-eight (41%) and twenty-eight (31%) students completed surveys in 2017 and 2018, respectively. The majority of respondents felt exercises improved their understanding of pharmacy laws, focused on challenging areas, and were more interesting than additional lectures. However, certain topics were reported as irrelevant based on practice experiences or not ideal for simulation, and students desired exercises on state laws versus pharmacy policies. Students reported the MyDispense simulation exercises helped them to recall pharmacy laws and focus on topics that were challenging. These study results prompted curricular revamping to incorporate MyDispense throughout the curriculum for practice in recognizing and solving legal scenarios, along with didactic course changes.

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Clinical practice guidelines for comprehensive patient assessment in emergency care: A quality evaluation study

Nordic Journal of Nursing Research ◽

10.1177/20571585211006980 ◽

2021 ◽

pp. 205715852110069

Author(s):

Åsa Falchenberg ◽

Ulf Andersson ◽

Birgitta Wireklint Sundström ◽

Anders Bremer ◽

Henrik Andersson

Keyword(s):

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Emergency Care ◽

Quality Evaluation ◽

Evaluation Study ◽

Evidence Based ◽

Patient Assessment ◽

Care Needs ◽

Home Based

Emergency care nurses (ECNs) face several challenges when they assess patients with different symptoms, signs, and conditions to determine patients’ care needs. Patients’ care needs do not always originate from physical or biomedical dysfunctions. To provide effective patient-centred care, ECNs must be sensitive to patients’ unique medical, physical, psychological, social, and existential needs. Clinical practice guidelines (CPGs) provide guidance for ECNs in such assessments. The aim of this study was to evaluate the quality of CPGs for comprehensive patient assessments in emergency care. A quality evaluation study was conducted in Sweden in 2017. Managers from 97 organizations (25 emergency medical services and 72 emergency departments) were contacted, covering all 20 Swedish county councils. Fifteen guidelines were appraised using the validated Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool. The results revealed that various CPGs are used in emergency care, but none of the CPGs support ECNs in performing a comprehensive patient assessment; rather, the CPGs address parts of the assessment primarily related to biomedical needs. The results also demonstrate that the foundation for evidence-based CPGs is weak and cannot confirm that an ECN has the prerequisites to assess patients and refer them to treatment, such as home-based self-care. This may indicate that Swedish emergency care services utilize non-evidence-based guidelines. This implies that ECN managers and educators should actively seek more effective ways of highlighting and safeguarding patients’ various care needs using more comprehensive guidelines.

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National assessment of pharmaceutical workforce and education using the International Pharmaceutical Federation’s global development goals: a case study of Qatar

Journal of Pharmaceutical Policy and Practice ◽

10.1186/s40545-021-00305-y ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Banan Abdulrzaq Mukhalalati ◽

Meram Mohamed Mahmoud Elsayed Ibrahim ◽

Majdoleen Omar Al Alawneh ◽

Ahmed Awaisu ◽

Ian Bates ◽

...

Keyword(s):

Public Health ◽

Workforce Development ◽

Health Workforce ◽

Qualitative Content Analysis ◽

Pharmacy Practice ◽

Policy Formation ◽

Pharmacy Education ◽

Global Development ◽

Pharmacy Workforce ◽

Development Goals

Abstract Background The sustainable development goals were launched by the United Nations in 2015. Its fifth goal was describing the achievement of universal health coverage by 2030. This goal reaffirms the importance of investing in the development and training of the global health workforce. In alliance with this, the International Pharmaceutical Federation (FIP) has published reports about pharmacy workforce planning in several countries. However, data about Qatar were not included in these reports. In 2017, FIP developed a transformational roadmap of pharmaceutical workforce and education. One systematic framework component of the roadmap is the Pharmaceutical Workforce Development Goals (DG[w]s) that were released in late 2016 and subsequently incorporated into the more comprehensive Global Development Goals1 in 2020, encompassing not only workforce development, but additionally practice and pharmaceutical science development. This study aimed to evaluate the current situation of pharmacy workforce and education in Qatar in relation to the original 13 Pharmaceutical Workforce Development Goals (DG[w]s). The objective was to identify the gaps in pharmacy workforce and education and to recommend evidence-led strategies to be included in both the Ministry of Public Health and the Qatar University College of Pharmacy workforce development plans. Methods Three rounds of conventional Delphi technique were conducted with expert panels of key decision-makers in pharmacy practice from the College of Pharmacy at Qatar University and the Ministry of Public Health, utilizing the FIP’s self-assessment survey. Qualitative content analysis was used to analyze and prioritize the identified gaps from the collected data. DG[w] was considered “met” if all the provided indicators were achieved, “partially met” if at least one of the indicators were achieved, and “not met” if none of the indicators were achieved Results The lack of competency framework (DG[w]5), workforce data (DG[w]12), and workforce policy formation (DG[w]13) are three major gaps in the provision of pharmaceutical workforce and pharmacy education in Qatar, influencing other DG[w]s. These gaps need to be addressed by the formation of Qatar Pharmaceutical Association through which academic, practice, and policymaking sectors can work together in developing health workforce intelligence system. Conclusion The results indicated that DG[w]s are interrelated and a gap in one goal can negatively influence others. Results and recommendations of this research will facilitate the implementation of strategic plans across leading pharmacy sectors to meet health needs in Qatar and achieve the third pillar of the Qatar National Vision 2030.

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Professionals’, patients’ and families’ views on the use of opioids for chronic breathlessness: A systematic review using the framework method and pillar process

Palliative Medicine ◽

10.1177/02692163211032114 ◽

2021 ◽

pp. 026921632110321

Author(s):

Florence Reedy ◽

Mark Pearson ◽

Sarah Greenley ◽

Joseph Clark ◽

David C Currow ◽

...

Keyword(s):

Systematic Review ◽

Clinical Practice ◽

A Priori ◽

Synthesis Method ◽

Patient Characteristics ◽

Severe Illness ◽

Pharmacological Interventions ◽

Eligibility Criteria ◽

Treatment Regimens ◽

Appraisal Tool

Background: In combination with non-pharmacological interventions, opioids may safely reduce chronic breathlessness in patients with severe illness. However, implementation in clinical practice varies. Aim: To synthesise the published literature regarding health professionals’, patients’ and families’ views on the use of opioids for chronic breathlessness, identifying issues which influence implementation in clinical practice. Design: Systematic review and synthesis using the five-stage framework synthesis method. Data sources: Three electronic databases (MEDLINE, Embase via OVID, ASSIA via Proquest) were searched (March 2020) using a predefined search strategy. Studies were also citation chained from key papers. Papers were screened against a priori eligibility criteria. Data were extracted from included studies using the framework synthesis method. Qualitative and quantitative data were synthesised using the pillar process. Included studies were critically appraised using the Mixed-Methods Appraisal Tool. Results: After de-duplication, 843 papers were identified. Following screening, 22 studies were included. Five themes were developed: (i) clinician/patient characteristics, (ii) education/knowledge/experience, (iii) relationship between clinician/family, (iv) clinician/patient fear of opioids and (v) regulatory issues. Conclusions: There are significant barriers and enablers to the use of opioids for the symptomatic reduction of chronic breathlessness based on the knowledge, views and attitudes of clinicians, patients and families. Clinicians’ interactions with patients and their families strongly influences adherence with opioid treatment regimens for chronic breathlessness. Clinicians’, patients’ and families’ knowledge about the delicate balance between benefits and risks is generally poor. Education for all, but particularly clinicians, is likely to be a necessary (but insufficient) factor for improving implementation in practice.

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Accomplishing CAPE Domain 3 During APPE Rotations: Student Perceptions

Journal of Pharmacy Practice ◽

10.1177/08971900211000689 ◽

2021 ◽

pp. 089719002110006

Author(s):

Susan M. Smith ◽

Jamielynn Sebaaly ◽

Lisa Brennan ◽

Wesley Haltom ◽

Lisa Meade ◽

...

Keyword(s):

Problem Solving ◽

Student Perceptions ◽

Learning Experiences ◽

Pharmacy Practice ◽

Private University ◽

Patient Advocacy ◽

Pharmacy Education ◽

Geographical Regions ◽

Care Outcomes ◽

Domain 3

Introduction: The purpose of this study is to examine student perceptions of accomplishment among 6 subdomains of Center for Advancement of Pharmacy Education (CAPE) Domain 3 “Approach to Practice and Care” outcomes in Advanced Pharmacy Practice Experiences (APPE) across distinct geographical regions. Methods: An 18-item electronic survey was distributed to 88 student pharmacists at a private university completing APPEs in 5 distinct regions and 2 concentrated learning experiences during their penultimate rotation. The survey assessed whether students had at least 1 opportunity to achieve Domain 3 outcomes. Students were prompted to report a percentage of perceived successful accomplishment of outcomes if they stated they had at least 1 opportunity for achievement. Results: Survey response rate was 52% (n = 46). Respondents reported a median accomplishment of at least 85% for each question. For 2 questions, respondents reported a median accomplishment of 99%. Students perceived successful accomplishment for most of the questions related to communication outcomes, while the lowest completion percentages were noted in outcomes related to patient advocacy (85%) and problem solving (88%). Student perceptions of accomplishment among the 6 subdomains were similar across regions and concentrated learning experiences. Conclusions: Students felt confident in accomplishing the outcomes associated with CAPE Domain 3. Regional assignments did not impact student perceptions of outcome accomplishment. Preceptors may play a pivotal role in providing students with opportunities to further polish their skills and increase confidence, specifically in the areas of patient advocacy and problem solving.

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Questions Collaborative Dexamethasone Trial

PEDIATRICS ◽

10.1542/peds.89.6.1266a ◽

1992 ◽

Vol 89 (6) ◽

pp. 1266-1266

Author(s):

ROSAMOND JONES ◽

ADRIAN GRANT ◽

Keyword(s):

Clinical Practice ◽

Random Sample ◽

Human Beings ◽

Eligibility Criteria ◽

Clinical Uncertainty ◽

Trial Entry ◽

Selection Of

In Reply.— We are glad to respond to Dr MacMahon's letter about the generalizability of the results of our trial. Basing trial entry on `clinical uncertainty' is actually one of the strengths of this trial.1 No trial can ever include a random sample of all human beings who meet the eligibility criteria; there is always selection of subjects (whatever the entry criteria). Inevitably, therefore, at some point there has to be a leap of faith from the evidence to clinical practice.2

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An analysis of pedagogic research in physiotherapy education

South African Journal of Physiotherapy ◽

10.4102/sajp.v62i1.146 ◽

2006 ◽

Vol 62 (1) ◽

Cited By ~ 1

Author(s):

D. J. Mothabeng

Keyword(s):

Clinical Practice ◽

South African ◽

Clinical Education ◽

Teaching Methods ◽

Review Paper ◽

Three Dimensional ◽

Research Focus ◽

Pedagogic Research ◽

Research In Education ◽

Physiotherapy Education

Purpose: The focus of this retrospective review paper is toexplore and analyse pedagogic research development in physiotherapy education in South Africa.Methods: A content analysis of publications by educators in the SA Journal of Physiotherapy between 1989 and 2003 was conducted to identify and classify the pedagogic articles. Further analysis of physiotherapy education articles was performed to determine the primary foci of the education research, using a three- dimensional pedagogic outcomes research framework.Data analysis: Descriptive statistics in terms of frequencies, means and percentages was used for the analysis. Results: The results revealed that most of the educators’ articles focused on clinical practice. Only 23% of the articles were about education and the majority of those were on clinical education (72%), with few articles on curriculum issues and teaching methods. Conclusion: The research focus of South African Physiotherapy educators is more on the clinical practice, and not on education. The importance of linking research, clinical practice and education cannot be overemphasized, hence the need to develop research in education.

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Abstract 17027: Generalizability of the US FDA Label for Dapagliflozin to Patients With Heart Failure With Reduced Ejection Fraction in the GWTG-HF Registry

Circulation ◽

10.1161/circ.142.suppl_3.17027 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Muthiah Vaduganathan ◽

Stephen Greene ◽

Shuaiqi Zhang ◽

maria v grau-sepulveda ◽

Adam D Devore ◽

...

Keyword(s):

Clinical Practice ◽

Ejection Fraction ◽

Care Facility ◽

Eligibility Criteria ◽

Discharge Data ◽

Reduced Ejection Fraction ◽

Type 2 Dm ◽

The Us ◽

Us Fda

Background: In May 2020, dapagliflozin was approved by the US FDA as the first SGLT-2 inhibitor for HF with reduced ejection fraction (HFrEF) based on the pivotal DAPA-HF trial. Limited data are available characterizing its generalizability to US clinical practice. Methods: We studied patients with HFrEF (≤40%) hospitalized at 406 sites in the Get With The Guidelines (GWTG)-HF registry admitted between Jan 2014 - Sept 2019. We excluded patients who left against medical advice, transferred to an acute care facility or to hospice, or had missing critical data. We applied the FDA label (excluding eGFR<30 mL/min/1.73 m 2 , dialysis, or type 1 DM) and eligibility criteria of DAPA-HF to the GWTG-HF registry sample. Results: Among 154,714 patients hospitalized with HFrEF, 125,497 (81.1%) would be candidates for dapagliflozin under the FDA label. Across 355 sites with ≥10 hospitalizations, median proportion of FDA label candidates was 81.1% (77.8%-84.6%). This proportion was similar across all study years (80.4-81.7%) and higher among those without type 2 DM than with type 2 DM (85.5% vs. 75.6%). Among GWTG-HF participants, the most frequent reason for not meeting the FDA label was eGFR<30 mL/min/1.73 m 2 (n=28,605). Among patients with available paired admission and discharge data, 14.2% had eGFR<30 mL/min/1.73 m 2 at both time points, while 3.8% developed eGFR<30 mL/min/1.73 m 2 by discharge. While there were more women, more Black patients, and less Asian patients in GWTG-HF, clinical characteristics were qualitatively similar between DAPA-HF trial and GWTG-HF registry participants. Compared with the DAPA-HF trial cohort, there was lower use of evidence-based HF therapies among GWTG-HF patients ( Table ). Conclusions: These data from a large, contemporary US hospitalized HF registry suggest that 4 out of 5 patients with HFrEF (with or without type 2 DM) would be candidates for initiation of dapagliflozin, and support its broad generalizability to US clinical practice.

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Extended Reality in Patient Care and Pharmacy Practice: A Viewpoint

Journal of Contemporary Pharmacy Practice ◽

10.37901/jcphp18-00030 ◽

2020 ◽

Vol 66 (4) ◽

pp. 22-27

Author(s):

Jody Takemoto ◽

Brittany Parmentier ◽

Rachel Bratelli ◽

Thayer Merritt ◽

Leanne California Health Sciences University

Keyword(s):

Virtual Reality ◽

Pain Management ◽

Patient Care ◽

Mixed Reality ◽

Pharmacy Practice ◽

Educational Practice ◽

Improve Patient Care ◽

Pharmacy Education ◽

Evolution Of Technology ◽

Improve Patient

The evolution of technology has given practitioners and educators more tools to better treat, manage, and educate both patients and future pharmacists. The objective of this viewpoint publication is to describe the current use of extended reality (XR) in pharmacy and propose ways in which pharmacy practice and education may benefit from incorporation of this technology. While these tools have been used for decades by many other professions, pharmacy is starting to adopt XR in professional and educational practice. XR (virtual reality, mixed reality, and augmented reality) is being used in various aspects of pharmacy care and education, such as pain management, diabetes self-care, cross-checking of prescriptions, treatments for addiction, and (in limited ways) patient and pharmacy education. There is great potential for further integration of XR into pharmacy practice and pharmacy education to ultimately improve patient care and education as well as pharmacy education.

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