OBJECTIVE:To determine the impact of competency-based sessions within a Doctor of Pharmacy curriculum by comparing student performance and perception of stress and preparedness during an Objective Structured Clinical Examination (OSCE). METHODS:In the spring of 2023, an educational intervention was implemented for third professional year students at the Ohio State University College of Pharmacy. Students had the opportunity to demonstrate competency through 4 skills-based preliminary sessions prior to a final OSCE within an Advanced Pharmacy Practice Experience readiness course. The difference in the average number of stations with satisfactory performance on the final OSCE was compared between cohorts before and after the intervention. For the postintervention cohort, student perceptions of stress and preparedness were assessed through course survey data. RESULTS:The study analyzed the results of 127 students in the preintervention cohort and 118 students in the postintervention cohort. Following the educational intervention, there was a nonstatistically significant decrease in the average number of final OSCE stations with satisfactory performance (mean [SD] 3.31 [0.78] vs 3.12 [0.94]). Three of the 4 stations showed similar or improved performance between cohorts, while 1 showed a decrease in performance. Most respondents reported an increase in perceived preparedness (n = 77, 93.9%) and a decrease in stress (n = 66, 80.5%). CONCLUSION:Despite a nonsignificant decrease in the average number of final OSCE stations with satisfactory performance, students in the postintervention cohort performed similarly on 3 of the 4 stations and felt less stressed and more prepared.

Background and purposeNear-peer teaching is an innovative approach to teaching the skills of supervising and precepting while benefiting students with different levels of experience and academic training. This study describes near-peer activities in skills-based laboratory courses that provided opportunities for one-on-one teaching to benefit learners in the introductory lab courses while simultaneously training more advanced students for future supervisory and precepting roles.Educational activity & settingThree community pharmacy near-peer teaching simulations were designed and implemented: 1) Patient Counseling and Medication Adherence, 2) Dispensing and Patient Counseling, and 3) Drug Utilization Review and Prescriber Calls. These activities took place over two semesters of a pharmacy skills lab with all first- and third-year Doctor of Pharmacy students.FindingsIn Autumn 2019, 80% (111/139) of P1s and 67% (80/119) of P3s responded to the course evaluation survey. In Spring 2020, 73% (100/137) of P1s and 68% (80/118) of P3s responded to the course evaluation survey. The P3s reported increased confidence in their ability to provide meaningful feedback, while P1s reported increased confidence in communicating with patients and healthcare providers. Performance data revealed that most P1s and P3s completed dispensing and communication activities accurately using a near-peer approach. Overall, the P1s and P3s felt the activities were valuable learning experiences.SummaryThe near-peer activities described in this study fill a gap in the training of pharmacy graduates for future precepting and supervisory roles. Evaluation of these near-peer activities suggest that both junior and senior learners benefit from simulated preceptor-intern interactions, supporting this innovative approach to address supervisory and precepting responsibilities.

Objective. To determine the impact of the holistic redesign of top 200 medications learning activities within a Doctor of Pharmacy (PharmD) curriculum by comparing student performances on a comprehensive examination before and after the redesign. Methods. During a curricular revision at The Ohio State University College of Pharmacy that began with the class of 2020, learning activities involving the top 200 medications were implemented that involved repeated retrieval and mastery concepts, alignment with therapeutic coursework, and autonomous learning regarding the top 200 medications. A high-stakes comprehensive top 200 medications examination was administered to students at the end of their third professional year both before and after implementation of these activities. The difference in the percentage of students who achieved a satisfactory score on the comprehensive examination was compared between cohorts prior to and following the curricular redesign. Results. The study analyzed results from 134, 130, and 120 students from three PharmD classes (one before and two after the redesign of top 200 medications activities). Following the redesign, a higher percentage of students achieved a satisfactory score of 85% on the examination (class of 2020: 116/130, 89.2%; class of 2022: 107/120, 89.2%) compared to before the redesign (class of 2019: 88/134, 65.7%). Conclusion. The combination of repeated retrieval and mastery, alignment with therapeutic coursework, and development of autonomous learning can significantly increase student knowledge and retention of top 200 medications.

Objective. To assess the impact of the Patient Voices series on Doctor of Pharmacy (PharmD) students.Methods. A series of patient speakers and integrated simulation activities focused on underserved populations, otherwise known as the Patient Voices series, was embedded into a pharmacy skills laboratory curriculum. First-year PharmD students' self-ratings of confidence were compared on pre- and post-course surveys. Using evaluations from first-year introductory pharmacy practice experiences (IPPEs), student self-evaluation data were compared to preceptor evaluations of student performance. Open-ended responses to course evaluations from first- and second-year PharmD students and student reflections from third-year PharmD students were assessed using conventional content analysis to identify and characterize student perceptions.Results. Significant increases were observed in first-year students' confidence to show empathy (mean, 4.2 to 4.7) and to interact with patients from underserved communities (mean, 2.2 to 4.2). Preceptor ratings of students' empathy were consistent with the students' self-rated abilities, while students' self-ratings on cultural sensitivity were higher than the preceptors' ratings. Qualitative analysis of course evaluation surveys and reflections revealed common themes identified by students, such as understanding different perspectives, increased empathy for patients, and the value of including this content in the curriculum.Conclusion. Student confidence to interact with patients from a variety of underserved populations increased following introduction of the Patient Voices series into the PharmD curriculum. Students perceived the series to be a valuable learning experience.

Objective. To evaluate the interrater reliability of a universal evaluator rubric used to assess student pharmacist communication skills during patient education sessions.Methods. Six US schools and colleges of pharmacy each submitted 10 student videos of a simulated community pharmacy patient education session and recruited two raters in each of the five rater groups (faculty, standardized patients, postgraduate year one residents, student pharmacists, and pharmacy preceptors). Raters used a rubric containing 20 items and a global assessment to evaluate student communication of 12 videos. Agreement was computed for individual items and overall rubric score within each rater group, and for each item across all rater groups. Average overall rubric agreement scores were compared between rater groups. Agreement coefficient scores were categorized as no to minimal, weak, moderate, strong, or almost perfect agreement.Results. Fifty-five raters representing five rater groups and six pharmacy schools evaluated student communication. Item agreement analysis for all raters revealed five items with no to minimal or weak agreement, 10 items with moderate agreement, one item with strong agreement, and five items with almost perfect agreement. Overall average agreement across all rater groups was 0.73 (95% CI, 0.66-0.81). The preceptor rater group exhibited the lowest agreement score of 0.68 (95% CI, 0.58-0.78), which significantly deviated from the overall average.Conclusion. While strong or almost perfect agreement scores were not observed for all rubric items, overall average interrater reliability results support the use of this rubric in a variety of raters to assess student pharmacist communication skills during patient education sessions.

When students fail to meet minimum competence standards on summative pharmacy skills-based assessments, remediation can be used to ensure student readiness for progression. Skills-based remediation is challenging as a high volume of resources is required to develop an action plan that addresses the heterogeneity in student needs and to create and execute another assessment equivalent to the initial assessment. Although many Doctor of Pharmacy (PharmD) programs face these same challenges, there is no consensus on how to best address them. Recently, faculty from six PharmD programs convened to share ideas and approaches to overcoming these challenges. This commentary aims to define remediation as it pertains to summative skills-based assessments, share our consensus views regarding remediation best practices, and highlight areas where there is more work to be done. Our intent is to advance the ongoing conversation and empower institutions to develop their own effective and impactful skills-based remediation policies, procedures, and activities.

BACKGROUND:Population health management uses proactive, targeted interventions to improve health outcomes.OBJECTIVES:To compare the effectiveness of and time required for 2 pharmacist-driven population health management interventions to improve vitamin B12 monitoring in patients taking metformin.METHODS:Physicians were randomized to 1 of 2 population health management interventions. For all patients of physicians assigned to the patient portal intervention, a pharmacist communicated need for vitamin B12 monitoring directly to the patient using an electronic patient portal. For all patients of physicians assigned to the office visit intervention, a pharmacist communicated monitoring recommendations to the physician prior to a scheduled office visit through the electronic health record. The proportion of patients in each group who received vitamin B12 monitoring 30 days after the intervention was quantified.RESULTS:A total of 489 patients of 26 physicians within 5 general internal medicine clinics who had taken metformin for at least 1 year and had not received vitamin B12 monitoring within the past year were identified. The intervention delivered as part of an office visit resulted in increased serum vitamin B12 monitoring compared with the intervention using electronic communication through a patient portal (odds ratio = 4.05; 95% CI = 1.22, 13.46; P = 0.03). The office visit intervention and the patient portal intervention took an average of 8.2 and 0.9 minutes per patient, respectively.CONCLUSIONS:Population health management completed during the course of office visits was more effective at increasing vitamin B12 monitoring and required more time than an intervention delivered through an electronic patient portal.