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1.  Faculty Perceptions of the Educating Pharmacy Students to Improve Quality (EPIQ) Program 
Objective. To investigate users’ initial perceptions of and potential applications for the Educating Pharmacy Students and Pharmacists to Improve Quality (EPIQ) program, a 5-module education program designed to educate pharmacists and pharmacy students about quality improvement in pharmacy practice.
Methods. The 5-module EPIQ program was distributed to pharmacy faculty members, pharmacy practitioners, and other health professionals across the country upon request. A 6-item survey instrument was sent to the first 97 people who requested the program.
Results. Twenty-seven (56%) of the 55 respondents had reviewed the EPIQ program and 22 (82%) intended to use some or all of the content to teach about quality improvement or patient safety primarily in pharmacy management and medication safety courses.
Conclusion. Initial perceptions of the EPIQ program were positive; however, further evaluation is needed after more extensive implementation of the program in pharmacy colleges and schools and other settings.
doi:10.5688/ajpe758163
PMCID: PMC3220344  PMID: 22102753
medication safety; qualitative research; science of safety; education; pharmacy curriculum
2.  Preceptor Perceptions of Pharmacy Student Team Quality Assurance Projects 
Objectives
To assess preceptors' opinions of the impact of quality assurance projects.
Methods
Students were given the opportunity to directly apply material learned in class in a “real world” environment by completing a quality assurance project in a community or health-system pharmacy. All preceptors (n = 38) were contacted via telephone and given the opportunity to respond to open-ended questions concerning their experience with student-team quality assurance projects.
Results
Preceptors indicated the quality assurance projects benefited their practice sites by providing additional resources (53%, n = 19), decreased medication errors (22%, n = 8), and increased awareness of the importance of quality assurance (22%, n = 8). Ninety-four percent of respondents (n = 34) perceived the projects had a positive impact on patient care and 92% (n = 33) perceived a positive impact on themselves.
Conclusions
Preceptors felt that quality assurance projects performed by pharmacy-student teams were beneficial to patient care, the practice site, and themselves. The quality assurance projects have broad applications and can be added to a medication safety class or to the introductory pharmacy practice experience (IPPE) sequence.
PMCID: PMC2703284  PMID: 19564990
preceptor; quality assurance; curriculum
3.  Physicians' opinions of a health information exchange 
Background
Arizona Medicaid developed a Health Information Exchange (HIE) system called the Arizona Medical Information Exchange (AMIE).
Objective
To evaluate physicians' perceptions regarding AMIE's impact on health outcomes and healthcare costs.
Measurements
A focus-group guide was developed and included five domains: perceived impact of AMIE on (1) quality of care; (2) workflow and efficiency; (3) healthcare costs; (4) system usability; and (5) AMIE data content. Qualitative data were analyzed using analytical coding.
Results
A total of 29 clinicians participated in the study. The attendance rate was 66% (N=19) for the first and last month of focus-group meetings and 52% (N=15) for the focus group meetings conducted during the second month. The benefits most frequently mentioned during the focus groups included: (1) identification of “doctor shopping”; (2) averting duplicative testing; and (3) increased efficiency of clinical information gathering. The most frequent disadvantage mentioned was the limited availability of data in the AMIE system.
Conclusion
Respondents reported that AMIE had the potential to improve care, but they felt that AMIE impact was limited due to the data available.
doi:10.1136/jamia.2010.006502
PMCID: PMC3005874  PMID: 21106994
4.  Ability of pharmacy clinical decision-support software to alert users about clinically important drug–drug interactions 
Objective
Pharmacy clinical decision-support (CDS) software that contains drug–drug interaction (DDI) information may augment pharmacists' ability to detect clinically significant interactions. However, studies indicate these systems may miss some important interactions. The purpose of this study was to assess the performance of pharmacy CDS programs to detect clinically important DDIs.
Design
Researchers made on-site visits to 64 participating Arizona pharmacies between December 2008 and November 2009 to analyze the ability of pharmacy information systems and associated CDS to detect DDIs. Software evaluation was conducted to determine whether DDI alerts arose from prescription orders entered into the pharmacy computer systems for a standardized fictitious patient. The fictitious patient's orders consisted of 18 different medications including 19 drug pairs—13 of which were clinically significant DDIs, and six were non-interacting drug pairs.
Measurements
The sensitivity, specificity, positive predictive value, negative predictive value, and percentage of correct responses were measured for each of the pharmacy CDS systems.
Results
Only 18 (28%) of the 64 pharmacies correctly identified eligible interactions and non-interactions. The median percentage of correct DDI responses was 89% (range 47–100%) for participating pharmacies. The median sensitivity to detect well-established interactions was 0.85 (range 0.23–1.0); median specificity was 1.0 (range 0.83–1.0); median positive predictive value was 1.0 (range 0.88–1.0); and median negative predictive value was 0.75 (range 0.38–1.0).
Conclusions
These study results indicate that many pharmacy clinical decision-support systems perform less than optimally with respect to identifying well-known, clinically relevant interactions. Comprehensive system improvements regarding the manner in which pharmacy information systems identify potential DDIs are warranted.
doi:10.1136/jamia.2010.007609
PMCID: PMC3005877  PMID: 21131607
5.  Healthcare Professional Students’ Knowledge of Drug-Drug Interactions 
Objectives. To evaluate changes in medical, pharmacy, and nurse practitioner students’ drug-drug interaction (DDI) knowledge after attending an educational program.
Design. A DDI knowledge assessment containing 15 different drug pairs was administered to participants before and after a 45-minute educational session.
Evaluation. Pharmacy, medical, and nursing students scored significantly higher on the posttest assessment for DDI recognition (median change 3, 9, and 8, respectively) and management strategy (median change 5, 9, 8, respectively), indicating a significant improvement in DDI knowledge as a result of the educational session. Pharmacy students scored significantly higher on the pretest; however, no difference was observed between the students’ posttest scores. Posttest scores for all student groups were significantly greater than their respective pretest scores (p < 0.001).
Conclusions. Significant improvement in healthcare professional students’ DDI knowledge was observed following participation in the educational session.
doi:10.5688/ajpe7510199
PMCID: PMC3279016  PMID: 22345718
drug-drug interaction; drug interaction knowledge; medical education; pharmacy education; nurse practitioner education
6.  Science of Safety Topic Coverage in Experiential Education in US and Taiwan Colleges and Schools of Pharmacy 
Objective. To compare the science of safety (SoS) topic coverage and associated student competencies in the experiential education curricula of colleges and schools of pharmacy in the United States and Taiwan.
Methods. The experiential education director, assistant director, or coordinator at a random sample of 34 US colleges and schools of pharmacy and all 7 Taiwan schools of pharmacy were interviewed and then asked to complete an Internet-based survey instrument.
Results. Faculty members in both countries perceived that experiential curricula were focused on the postmarketing phase of the SoS, and that there is a need for the pharmacy experiential curricula to be standardized in order to fill SoS coverage gaps. Inter-country differences in experiential SoS coverage were noted in topics included for safety biomarkers that signal potential for drug-induced problems and pharmacogenomics.
Conclusions. Experiential SoS topic coverage and student ability gaps were perceived within and between US and Taiwan colleges and schools of pharmacy.
doi:10.5688/ajpe7510202
PMCID: PMC3279028  PMID: 22345721
science of safety; experiential education; survey research; international
7.  The Science of Safety Curriculum in US Colleges and Schools of Pharmacy 
Objective. To describe the integration of science of safety (SoS) topics in doctor of pharmacy (PharmD) curricula of US colleges and schools of pharmacy.
Methods. A questionnaire that contained items pertaining to what and how SoS topics are taught in PharmD curricula was e-mailed to representatives at 107 US colleges and schools of pharmacy.
Results. The majority of the colleges and schools responding indicated that they had integrated SoS topics into their curriculum, however, some gaps (eg, teaching students about communicating risk, Food and Drug Administration [FDA] Sentinel Initiative, utilizing patient databases) were identified that need to be addressed.
Conclusions. The FDA and the American Association of Colleges of Pharmacy (AACP) should continue to collaborate to develop resources needed to ensure that topics proposed by the FDA in their SoS framework are taught at all colleges and schools of pharmacy.
doi:10.5688/ajpe757141
PMCID: PMC3175655  PMID: 21969727
medication safety; pharmacy education; curriculum; science of safety
8.  Perspectives on Educating Pharmacy Students About the Science of Safety 
Objective. To identify opinions about pharmacy graduates’ science of safety (SoS) educational needs.
Methods. Semi-structured interviews were performed with 25 educators and researchers at US pharmacy colleges and schools and 5 individuals from associations engaged in drug safety-related issues.
Results. Themes that emerged from the 30 interviews with key informants included: pharmacists should meet minimum SoS requirements; medication safety education is inconsistent; and barriers exist to improving SoS curricula. Student deficiencies noted included the lack of: student acceptance of a “culture of safety”: ability to effectively communicate verbally about medication safety; knowledge of the drug development process; and quality improvement skills. Key informants did not agree on how to address these gaps.
Conclusions. While educators, researchers, and other leaders in drug safety-related issues thought that US colleges and schools of pharmacy covered portions of SoS well, there were perceived deficiencies. Minimum standards should be set to assist with curricular adoption of SoS.
doi:10.5688/ajpe757142
PMCID: PMC3175660  PMID: 21969728
medication safety; patient safety pharmacy education; science of safety; education
9.  Pharmacy Students’ Retention of Knowledge of Drug-Drug Interactions 
Objectives. To evaluate pharmacy students' drug-drug interaction (DDI) knowledge retention over 1 year and to determine whether presenting DDI vignettes increased knowledge retention.
Methods. A knowledge assessment tool was distributed to fourth-year pharmacy students before and after completing a DDI educational session. The questionnaire was re-administered after 1 year to assess knowledge retention. During the intervening year, students had the option of presenting DDI case vignettes to preceptors and other health professionals as part of their advanced pharmacy practice experiences (APPEs).
Results. Thirty-four of 78 pharmacy students completed both the post-intervention and 1-year follow-up assessments. Students’ knowledge of 4 DDI pairs improved, knowledge of 3 DDI pairs did not change, and knowledge of the remainder of DDI pairs decreased. Average scores of the 18 students who completed all tests and presented at least 1 vignette during their APPEs were higher on the 1-year follow-up assessment than students who did not, suggesting greater DDI knowledge retention (p = 0.04).
Conclusion. Although pharmacy students’ overall DDI knowledge decreased in the year following an educational session, those who presented vignettes to health professionals retained more DDI knowledge, particularly on those DDIs for which they gave presentations. Other methods to enhance pharmacy students’ retention of DDI knowledge of clinically important DDIs are needed.
doi:10.5688/ajpe756110
PMCID: PMC3175677  PMID: 21931448
drug-drug interaction; assessment
10.  Teaching the Science of Safety in US Colleges and Schools of Pharmacy 
This paper provides baseline information on integrating the science of safety into the professional degree curriculum at colleges and schools of pharmacy. A multi-method examination was conducted that included a literature review, key informant interviews of 30 individuals, and in-depth case studies of 5 colleges and schools of pharmacy. Educators believe that they are devoting adequate time to science of safety topics and doing a good job teaching students to identify, understand, report, manage, and communicate medication risk. Areas perceived to be in need of improvement include educating pharmacy students about the Food and Drug Administration's (FDA's) role in product safety, how to work with the FDA in post-marketing surveillance and other FDA safety initiatives, teaching students methods to improve safety, and educating students to practice in interprofessional teams. The report makes 10 recommendations to help pharmacy school graduates be more effective in protecting patients from preventable drug-related problems.
PMCID: PMC3138345  PMID: 21769153
safety; curriculum; pharmacy education; FDA; quality
11.  Medication Error Identification Rates by Pharmacy, Medical, and Nursing Students 
Objective
To assess and compare prescribing error-identification rates by health professional students.
Methods
Medical, pharmacy, and nursing students were asked to complete a questionnaire on which they evaluated the accuracy of 3 prescriptions and indicated the type of error found, if any. The number of correctly identified prescribing errors and the number of correct types of errors identified were compared and error identification rates for each group were calculated.
Results
One hundred seventy-five questionnaires were returned (87% response rate). Pharmacy students had a significantly higher error-identification rate than medical and nursing students (p < 0.001). No significant differences were found between medical and nursing students (p = 0.88). Compared to medical students, pharmacy students more often were able to identify correctly the error type for each prescription (p < 0.001; p = 0.023; p = 0.001).
Conclusions
Of the 3 student groups, pharmacy students demonstrated a significantly higher error-identification rate, which may be associated with the greater number of pharmacology and pharmacotherapeutics course hours that pharmacy students complete.
PMCID: PMC3073098  PMID: 21519414
prescription; medication error; simulation
12.  Impact of the Career Explorers Program on High School Students' Perceptions of the Pharmacy Profession 
Objective
To determine the effect of a 5-week Career Explorers Program (CEP) on high school students' perceptions of pharmacists' characteristics, duties, and training.
Methods
A 16-item survey instrument with attitudinal, frequency, and relative quantity response options was completed by all CEP students on the first and last day of the program. The survey assessed students' attitudes concerning pharmacist characteristics, duties, and training.
Results
All students who participated in the CEP in 2003 completed the survey instrument (n = 50). Seventy percent of respondents' answers to the attitudinal subscale questions significantly changed from preassessment to postassessment.
Conclusion
A 5-week CEP provided high school students with more realistic perceptions of pharmacists' roles, duties, and training before the students entered the pharmacy program.
PMCID: PMC2508715  PMID: 18698385
experiential learning; career choice; pharmacists; high school students
13.  Educating Pharmacy Students to Improve Quality (EPIQ) in Colleges and Schools of Pharmacy 
Objective. To assess course instructors’ and students’ perceptions of the Educating Pharmacy Students and Pharmacists to Improve Quality (EPIQ) curriculum.
Methods. Seven colleges and schools of pharmacy that were using the EPIQ program in their curricula agreed to participate in the study. Five of the 7 collected student retrospective pre- and post-intervention questionnaires. Changes in students’ perceptions were evaluated to assess their relationships with demographics and course variables. Instructors who implemented the EPIQ program at each of the 7 colleges and schools were also asked to complete a questionnaire.
Results. Scores on all questionnaire items indicated improvement in students’ perceived knowledge of quality improvement. The university the students attended, completion of a class project, and length of coverage of material were significantly related to improvement in the students’ scores. Instructors at all colleges and schools felt the EPIQ curriculum was a strong program that fulfilled the criteria for quality improvement and medication error reduction education.
Conclusion The EPIQ program is a viable, turnkey option for colleges and schools of pharmacy to use in teaching students about quality improvement.
doi:10.5688/ajpe766109
PMCID: PMC3425924  PMID: 22919085
quality improvement; medication error; pharmacy education; pharmacy student; assessment; curriculum

Results 1-13 (13)