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1.  The haplotype-resolved genome and epigenome of the aneuploid HeLa cancer cell line 
Nature  2013;500(7461):207-211.
Summary
The HeLa cell line was established in 1951 from cervical cancer cells taken from a patient, Henrietta Lacks, marking the first successful attempt to continually culture human-derived cells in vitro1. HeLa’s robust growth and unrestricted distribution resulted in its broad adoption – both intentionally and through widespread cross-contamination2 – and for the past sixty years it has served a role analogous to that of a model organism3. Its cumulative impact is illustrated by the fact that HeLa is named in >74,000 or ~0.3% of PubMed abstracts. The genomic architecture of HeLa remains largely unexplored beyond its karyotype4, in part because like many cancers, its extensive aneuploidy renders such analyses challenging. We performed haplotype-resolved whole genome sequencing5 of the HeLa CCL-2 strain, discovering point and indel variation, mapping copy-number and loss of heterozygosity (LOH), and phasing variants across full chromosome arms. We further investigated variation and copy-number profiles for HeLa S3 and eight additional strains. Surprisingly, HeLa is relatively stable with respect to point variation, accumulating few new mutations since early passaging. Haplotype resolution facilitated reconstruction of an amplified, highly rearranged region at chromosome 8q24.21 at which the HPV-18 viral genome integrated as the likely initial event underlying tumorigenesis. We combined these maps with RNA-Seq6 and ENCODE Project7 datasets to phase the HeLa epigenome, revealing strong, haplotype-specific activation of the proto-oncogene MYC by the integrated HPV-18 genome ~500 kilobases upstream, and permitting global analyses of the relationship between gene dosage and expression. These data provide an extensively phased, high-quality reference genome for past and future experiments relying on HeLa, and demonstrate the value of haplotype resolution for characterizing cancer genomes and epigenomes.
doi:10.1038/nature12064
PMCID: PMC3740412  PMID: 23925245
2.  Educational Testing and Validity of Conclusions in the Scholarship of Teaching and Learning 
Validity and its integral evidence of reliability are fundamentals for educational and psychological measurement, and standards of educational testing. Herein, we describe these standards of educational testing, along with their subtypes including internal consistency, inter-rater reliability, and inter-rater agreement. Next, related issues of measurement error and effect size are discussed. This article concludes with a call for future authors to improve reporting of psychometrics and practical significance with educational testing in the pharmacy education literature. By increasing the scientific rigor of educational research and reporting, the overall quality and meaningfulness of SoTL will be improved.
doi:10.5688/ajpe779186
PMCID: PMC3831397  PMID: 24249848
psychometrics; educational testing; scholarship of teaching and learning; reliability; validity
4.  Longitudinal Teaching of Evidence-Based Decision Making 
Objective. To determine whether longitudinal design and delivery of evidence-based decision making (EBDM) content was effective in increasing students’ knowledge, skills, and confidence as they progressed through a doctor of pharmacy (PharmD) curriculum.
Design. Three student cohorts were followed from 2005 to 2009 (n=367), as they learned about EBDM through lectures, actively researching case-based questions, and researching and writing answers to therapy-based questions generated in practice settings.
Assessment. Longitudinal evaluations included repeated multiple-choice examinations, confidence surveys, and written answers to practice-based questions (clinical inquiries). Students’ knowledge and perception of EBDM principles increased over each of the 3 years. Students’ self-efficacy (10-items, p<0.0001) and perceived skills (7-items, p<0.0001) in applying EBDM skills to answer practice-based questions also increased. Graded clinical inquiries verified that students performed satisfactorily in the final 2 years of the program.
Conclusions. This study demonstrated a successful integration of EBDM throughout the curriculum. EBDM can effectively be taught by repetition, use of real examples, and provision of feedback.
doi:10.5688/ajpe7610197
PMCID: PMC3530059  PMID: 23275662
evidence-based decision making; longitudinal evaluation; curriculum; evidence-based medicine
5.  A Model for Partnering First-Year Student Pharmacists With Community-Based Older Adults 
Objectives. To design, integrate, and assess the effectiveness of an introductory pharmacy practice experience intended to redefine first-year student pharmacists’ views on aging and medication use through their work with a healthy, community-based older-adult population.
Design. All students (N = 273) completed live skills training in an 8-hour boot camp provided during orientation week. Teams were assigned an independently living senior partner, completed 10 visits and reflections, and documented health-related information using an electronic portfolio (e-portfolio).
Assessment. As determined by pre- and post-experience survey instruments, students gained significant confidence in 7 skill areas related to communication, medication interviews, involving the partner in health care, and applying patient-care skills. Student reflections, in-class presentations, and e-portfolios documented that personal attitudes toward seniors changed over time. Senior partners enjoyed mentoring and interacting with students and many experienced health improvements as a result of the interaction.
Conclusions. The model for partnering first-year student pharmacists with community-based older adults improved students’ skills and fostered their connections to pharmacist roles and growth as person-centered providers.
doi:10.5688/ajpe76585
PMCID: PMC3386036  PMID: 22761526
geriatrics; senior partner; senior mentor; introductory pharmacy practice experience
6.  Evaluating pharmacists' ability to counsel on tobacco cessation using two standardized patient scenarios 
Patient education and counseling  2011;83(3):319-324.
Objectives
To evaluate the impact that role-playing two pre/post standardized patient scenarios within a tobacco cessation training program had on pharmacists' counseling skills. Second, to analyze the validity of the observation coding tool used to evaluate pharmacist's role-play performance.
Methods
Pharmacists performed two role-playing scenarios which incorporated national guidelines, the 5A's counseling process, and the “preparation” and “action” phases of the transtheoretical model. Pharmacists' performance was evaluated with an observation coding tool.
Results
Pharmacists' (n=25) counseling performance improved significantly post-training (p<0.02: Action Scenario; p<0.004: Preparation Scenario). More than 50% of pharmacists provided patient-directed tobacco consultation services in the one year following training. The observation tool score for the “action phase” scenario was highly associated with pharmacists' subsequent delivery of tobacco cessation services in community practice.
Conclusion
Role-playing facilitated pharmacists' skill development. The evaluation tool and Action Scenario may be powerful for predicting pharmacists' delivery of tobacco cessation services.
Practice Implications
Incorporating role-playing and structured tools for performance evaluation can help enhance pharmacist performance during training and predict service delivery in community practice. Together they could facilitate tailored feedback to help pharmacists struggling with the difficult task of extending cognitive service roles in practice.
doi:10.1016/j.pec.2010.12.010
PMCID: PMC3110982  PMID: 21237610
Tobacco cessation counseling; transfer of learning; standardized patient; role-play; pharmacist
7.  Development of a Scale to Measure Pharmacists’ Self-Efficacy in Performing Medication Therapy Management Services 
Background
Measuring community pharmacists’ self-efficacy in performing medication therapy management (MTM) services can be useful for tailoring interventions and predicting participation.
Objective
To identify relevant survey constructs related to the Wisconsin Pharmacy Quality Collaborative (WPQC) MTM program and to evaluate scale validity.
Methods
The 31-item MTM Self-efficacy Scale was developed using previous research, identifying critical program components, and beta-testing. After administration to pharmacists in the 53 WPQC pilot sites, summary statistics and exploratory factor analysis (EFA) were conducted. Parallel analysis was used to determine the optimal number of factors. Internal consistency reliabilities were calculated.
Results
Baseline participation rate was 94% (N=76). The 11-point scale (0–10) item means ranged from 2.83±3.05 to 7.82±2.19. Parallel analysis produced a 3-factor solution, accounting for 56% of the variance. Low factor loadings or unacceptably high cross-loadings resulted in 17 item deletions. The final EFA on the remaining 14 items retained the original 3-factor solution and increased the proportion of explained variance (72%). The factors relate to MTM tasks (alpha = 0.92), personal interactions (alpha = 0.86), and goal setting (alpha = 0.84). Overall Cronbach’s alpha = 0.90.
Conclusion
Constructs for measuring self-efficacy were identified that may aid in future research predicting whether pharmacists engage in and persist in providing MTM services.
doi:10.1016/j.sapharm.2010.05.001
PMCID: PMC2904078  PMID: 20511114
Self-efficacy; Medication therapy management; Community pharmacy; Scale validation; Research methods
8.  Effect of a tobacco cessation continuing professional education program on pharmacists' confidence, skills, and practice-change behaviors 
Objective
To evaluate the impact of a tobacco cessation training program on pharmacists' confidence, skills, and practice-change behaviors.
Design
Quasiexperimental study.
Setting
Wisconsin during 2002–2003.
Participants
25 community pharmacists.
Intervention
A continuing education training program was developed and implemented using home and live training components consisting of the national tobacco cessation guidelines, including the 5A's counseling process. The home study component included lectures and readings in CD-ROM format. Consistent with self-efficacy theory, the live training was based on exercises that included modeling, rehearsal, and feedback to learners.
Main outcome measures
Knowledge assessment, pre- and postsurveys assessing confidence and skill levels, and service provision indicators.
Results
Self-efficacy and perceived ability to counsel patients to quit using tobacco improved significantly after the combined program. No significant change in confidence or perceived skills occurred following home study alone, suggesting value in using a combination of teaching strategies (problem solving, modeling, rehearsal, and feedback). Of participants, 92% received a passing knowledge score and 75% attempted to implement a tobacco cessation service posttraining; more than 50% assisted patients up to 1 year posttraining. A relationship between self-efficacy and service provision was found when practice settings were considered.
Conclusion
This program increased pharmacists' knowledge and self-efficacy to counsel patients on tobacco use. Further, the majority of pharmacy participants attempted to implement a tobacco cessation service.
doi:10.1331/JAPhA.2010.09034
PMCID: PMC2863290  PMID: 20097634
Self-efficacy; continuing education; counseling (patient); tobacco cessation

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