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1.  Reenvisioning Assessment for the Academy and the Accreditation Council for Pharmacy Education's Standards Revision Process 
Assessment has become a major aspect of accreditation processes across all of higher education. As the Accreditation Council for Pharmacy Education (ACPE) plans a major revision to the standards for doctor of pharmacy (PharmD) education, an in-depth, scholarly review of the approaches and strategies for assessment in the PharmD program accreditation process is warranted. This paper provides 3 goals and 7 recommendations to strengthen assessment in accreditation standards. The goals include: (1) simplified standards with a focus on accountability and improvement, (2) institutionalization of assessment efforts; and (3) innovation in assessment. Evolving and shaping assessment practices is not the sole responsibility of the accreditation standards. Assessment requires commitment and dedication from individual faculty members, colleges and schools, and organizations supporting the college and schools, such as the American Association of Colleges of Pharmacy. Therefore, this paper also challenges the academy and its members to optimize assessment practices.
PMCID: PMC3776895  PMID: 24052644
assessment; standards; accreditation
2.  Health Literacy Influences Heart Failure Knowledge Attainment but Not Self-Efficacy for Self-Care or Adherence to Self-Care over Time 
Nursing Research and Practice  2013;2013:353290.
Background. Inadequate health literacy may be a barrier to gaining knowledge about heart failure (HF) self-care expectations, strengthening self-efficacy for self-care behaviors, and adhering to self-care behaviors over time. Objective. To examine if health literacy is associated with HF knowledge, self-efficacy, and self-care adherence longitudinally. Methods. Prior to education, newly referred patients at three HF clinics (N = 51, age: 64.7 ± 13.0 years) completed assessments of health literacy, HF knowledge, self-efficacy, and adherence to self-care at baseline, 2, and 4 months. Repeated measures analysis of variance with Bonferroni-adjusted alpha levels was used to test longitudinal outcomes. Results. Health literacy was associated with HF knowledge longitudinally (P < 0.001) but was not associated with self-efficacy self-care adherence. In posthoc analyses, participants with inadequate health literacy had less HF knowledge than participants with adequate (P < 0.001) but not marginal (P = 0.073) health literacy. Conclusions. Adequate health literacy was associated with greater HF knowledge but not self-efficacy or adherence to self-care expectations over time. If nurses understand patients' health literacy level, they may educate patients using methods that promote understanding of concepts. Since interventions that promote self-efficacy and adherence to self-care were not associated with health literacy level, new approaches must be examined.
PMCID: PMC3741959  PMID: 23984058
3.  A qualitative analysis of coronary heart disease patient views of dietary adherence and web-based and mobile-based nutrition tools 
Dietary adherence can be challenging for patients with coronary heart disease (CHD), as they may require multiple dietary changes. Choosing appropriate food items may be difficult or take extensive amounts of time without the aid of technology. The objective of this project was to (1) examine the dietary challenges faced by patients with CHD, (2) examine methods of coping with dietary challenges, (3) explore the feasibility of a web-based food decision support system, and (4) explore the feasibility of a mobile-based food decision support system.
Food for the Heart (FFH), a website-based food decision support system, and Mobile Magic Lens (MML), a mobile-based system, were developed to aid in daily dietary choices. Three CHD patient focus groups were conducted and focused on CHD-associated dietary changes as well as the FFH and MML prototypes. A total of 20 CHD patients and 7 informal caregivers participated. Qualitative, content analysis was performed to find themes grounded in the responses.
Five predominant themes emerged: 1) decreasing carbohydrate intake and portion control are common dietary challenges, 2) clinician and social support makes dietary adherence easier, 3) FFH could make meal-planning and dietary adherence less complicated, 4) MML could save time and assist with healthy choices, and 5) additional features need to be added to make both tools more comprehensive.
FFH and MML may be tools that CHD patients would value in making food choices and adhering to dietary recommendations, especially if additional features are added to assist patients with changes.
PMCID: PMC3391709  PMID: 22760245
dietary adherence; web and mobile based nutrition tools; coronary heart disease
4.  Validation of an Empathy Scale in Pharmacy and Nursing Students 
Objective. To validate an empathy scale to measure empathy in pharmacy and nursing students.
Methods. A 15-item instrument comprised of the cognitive and affective empathy domains, was created. Each item was rated using a 7-point Likert scale, ranging from strongly disagree to strongly agree. Concurrent validity was demonstrated with the Jefferson Scale of Empathy – Health Professional Students (JSE-HPS).
Results. Reliability analysis of data from 216 students (pharmacy, N=158; nursing, N=58) showed that scores on the empathy scale were positively associated with JSE-HPS scores (p<0.001). Factor analysis confirmed that 14 of the 15 items were significantly associated with their respective domain, but the overall instrument had limited goodness of fit.
Conclusions. Results of this study demonstrate the reliability and validity of a new scale for evaluating student empathy. Further testing of the scale at other universities is needed to establish validity.
PMCID: PMC3687127  PMID: 23788805
empathy; psychometrics; pharmacy students; nursing students
5.  Health Literacy and Self-Care of Patients with Heart Failure 
Background and Research Objective
Today’s complex health care system relies heavily on sophisticated self-care regimens. To navigate the system and follow self-care protocols, patients must be able to understand and use health information, which requires health literacy. However, nearly 90 million Americans lack the necessary health literacy skills to adequately care for themselves in the face of a complex healthcare system and self-care regimens. Understanding how to effectively care for one’s self is thought to improve heart failure symptoms and patient outcomes, but little is actually known about how health literacy influences self-care in patients with heart failure. The purpose of this pilot study was to examine the relationship between health literacy and self-care of patients with heart failure.
Subjects and Methods
Patients with a diagnosis of heart failure were recruited from a variety of community settings. Participants completed the Short-Form Test of Functional Health Literacy (measured health literacy), the Self-Care Index of Heart Failure (measured self-care maintenance, management, and confidence), and a demographic questionnaire. Spearman’s Rho correlations were used to assess the strength of the relationship between health literacy level and self-care scores.
Results and Conclusions
Among the 49 participants recruited, health literacy was positively related to self-care maintenance (Rs=0.357, p=0.006). Health literacy had a negative relationship with self-care management (Rs=−0.573, p=0.001). There was no association between health literacy and self-care confidence (Rs=0.201, p=0.083). This project provides preliminary data regarding the association between health literacy and self-care in heart failure, showing support for higher health literate patients performing more self-care maintenance, which has been shown to improve patient outcomes in heart failure. Patients with higher health literacy trended toward having greater self-care confidence, which can increase the likelihood of performing self-care, but this finding was not significant. It was unexpected to find that lower health literate patients performed more self-care management.
PMCID: PMC3134625  PMID: 21263340
health literacy; self-care; heart failure
6.  A Graduate Student Mentoring Program to Develop Interest in Research 
Objective. To assess the impact of a graduate student mentoring program on student interest in research and postgraduate education and on graduate student confidence in mentoring.
Methods. Undergraduate and pharmacy students (mentees) and graduate students (mentors) were matched and participated in the study, which required them to engage in at least 2 discussions regarding research and careers. Mentees completed a pre- and post-assessment of their perceptions of research, postgraduate training plans, and perceptions about mentors. Mentors completed a pre- and post-assessment of their perceptions about themselves as mentors and their confidence in mentoring.
Results. Although there were no significant differences among the mentees’ perceptions of research or the mentors’ confidence in mentoring, qualitative analysis indicated that the mentees’ perceptions of research improved and that the mentors believed their mentoring skills improved.
Conclusions. Based on the results of the qualitative analysis, implementing a graduate student mentoring program may help improve students’ perceptions of research and graduate students’ confidence in mentoring, which could increase student interest in postgraduate education and prepare mentors for future leadership roles.
PMCID: PMC3425919  PMID: 22919080
mentoring; research; graduate students; pharmacy students
7.  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.
PMCID: PMC3425924  PMID: 22919085
quality improvement; medication error; pharmacy education; pharmacy student; assessment; curriculum
8.  An Introductory Pharmacy Practice Experience on Improving Medication Adherence 
Objective. To evaluate the impact of a medication adherence activity on introductory pharmacy practice experience students’ perceptions of patient adherence as well as student development of empathy and confidence in patient counseling.
Design. Students participated in a personal medication simulation using an automated medication dispenser. Students then identified a patient with nonadherence and provided counseling on use of the dispenser. After 4 to 6 weeks, students interviewed the patient about their experience with the dispenser and assessed changes in adherence.
Assessment. One hundred fifty-three students completed the assignment and 3 surveys instruments. Following the experience, the majority of students agreed or strongly agreed that they developed more empathy for patients with multiple medications and felt confident counseling a patient in the use of a dispenser (92.0% and 88.2%, respectively). Most students (91.4%) reported feeling that their patient education session was successful.
Conclusion. An introductory pharmacy practice experience involving an automated medication dispenser and patient counseling to improve medication adherence resulted in the development of empathy and improved student confidence.
PMCID: PMC3327240  PMID: 22544959
medication adherence; compliance; simulation; introductory pharmacy practice experience
9.  Book Club Elective to Facilitate Student Learning of the Patient Experience With Chronic Disease 
To evaluate the impact of a book club experience on pharmacy students' learning about chronic illness.
Students read autobiographies/biographies regarding the patient experience of chronic illness. Similar to a traditional book club, small group discussions were held based on questions submitted by students. Other activities included written reflections, a final paper, and an oral presentation.
A retrospective pretest and posttest were administered at the end of the course. Students indicated improvement in the key aspects of the course with significant differences (p < 0.01) between retrospective pretest and posttest scores for all course objectives assessed. Students also indicated that the course contributed to their development as pharmacists, motivated them to learn about new topics, and helped them reconsider their attitudes.
A book club elective course was successful in helping students understand the patient experience.
PMCID: PMC2865403  PMID: 20498730
chronic illness; autobiographies; small group discussion; empathy; compassion; patient care; elective course
10.  Laboratory Session to Improve First-year Pharmacy Students' Knowledge and Confidence Concerning the Prevention of Medication Errors 
To implement a laboratory session into the first-year pharmacy curriculum that would provide active-learning experiences in the recognition, resolution, and prevention of medication errors.
Students participated in medication error-prone prescription processing and counseling simulations, role-played communication strategies after a medication error occurred, and discussed an introductory pharmacy practice experience focused on prescription processing and prevention of medication errors.
Students completed an assessment prior to and after completion of the laboratory on their knowledge of and confidence in identifying medication errors. Students' knowledge and awareness of medication errors improved as did confidence in their ability to (1) recognize and avoid errors, (2) utilize methods to prevent errors, (3) communicate about errors with involved parties, and (4) select and report medication errors on an appropriate form.
Students' awareness of the pharmacist's role in medication error reduction improved and confidence in their ability to recognize, prevent, and communicate medication errors increased.
PMCID: PMC2769543  PMID: 19885068
assessment; medication error; introductory pharmacy practice experience (IPPE); role play; active-learning
11.  Active-Learning Laboratory Session to Teach the Four M's of Diabetes Care 
To implement an active-learning methodology for teaching diabetes care to pharmacy students and evaluate its effectiveness.
Laboratory instruction was divided into 4 primary areas of diabetes care, referred to by the mnemonic, the 4 M's: meal planning, motion, medication, and monitoring. Students participated in skill-based learning laboratory stations and in simulated patient experiences. A pretest, retrospective pretest, and posttest were administered to measure improvements in students' knowledge about diabetes and confidence in providing care to diabetes patients.
Students knowledge of and confidence in each area assessed improved. Students enjoyed the laboratory session and felt it contributed to their learning.
An active-learning approach to teaching diabetes care allowed students to experience aspects of the disease from the patient's perspective. This approach will be incorporated in other content areas.
PMCID: PMC2690891  PMID: 19513160
diabetes; active-learning techniques; practice laboratory

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