Letters
Letters Career and preceptor development through preceptorship of advanced pharmacy practice experiences
P
harmacists continue to fight for the financial incentives necessary to provide services inherent to our practice. While we deserve compensation for our services, we often struggle to find mechanisms for such funding. This concept parallels a different type of funding issue currently facing pharmacists. With the increased number of doctor of pharmacy (Pharm.D.) students has come a rapid increase in the demand for advanced pharmacy practice experience (APPE) rotations. When health care institutions agree to accept APPE students on nonfaculty rotations, it’s customary for the school of pharmacy (SOP) to pay a stipend to the institution accepting the student. The amount varies among schools but can be as much as $1500 per student for a sixweek rotation. Allowing this development funding to be used for professional and educational purposes would accomplish two goals. This funding would (1) increase pharmacists’ incentive to serve as preceptors to APPE students, thus increasing the number of APPE rotations, and (2) increase pharmacists’ opportunities for future career development. This money, however, is frequently dispersed
to the institution as a whole and not always earmarked for pharmacist development. This practice needs to change. The rapid increase in the number of Pharm.D. graduates has recently created a large amount of discussion. The number of Pharm.D. graduates increased by 70% from 2001 to 2011, attributable to the anticipated shift in pharmacy practice from traditional dispensing to more patient-focused roles.1,2 In 2000, as the Pharm.D. became the minimum degree required to enter the profession, these new roles seemed inevitable. Our roles have no doubt grown but have yet to fully reach projected expectations.1,2 A major repercussion of the increased supply of pharmacists has been greater anxiety regarding their ability to compete in the upcoming work force. For those interested in becoming APPE preceptors, development funding provided by SOPs is a perfect vehicle for enhancing future career opportunities. Advanced certifications will be key to validate our patient care abilities and achieve the profession’s patient care goals. A passing score on the North American Pharmacist Licensure Examination is
The Letters column is a forum for rapid exchange of ideas among readers of AJHP. Liberal criteria are applied in the review of submissions to encourage contributions to this column. The Letters column includes the following types of contributions: (1) comments, addenda, and minor updates on previously published work, (2) alerts on potential problems in practice, (3) observations or comments on trends in drug use, (4) opinions on apparent trends or controversies in drug therapy or clinical research, (5) opinions on public health issues of interest to pharmacists in health systems, (6) comments on ASHP activities, and (7) human interest items about life as a pharmacist. Reports of adverse drug reactions must present a reasonably clear description of causality.
898
Am J Health-Syst Pharm—Vol 71 Jun 1, 2014
considered a minimum requirement before a pharmacist can attain licensure.3 Further postgraduate credentialing has become increasingly preferred among employers. The Board of Pharmacy Specialties recently released a white paper outlining the role of selected pharmacist postgraduate certifications and how they distinguish a pharmacist’s breadth of patient and practice focus as well as his or her level of knowledge, skills, and experience. 4 As another example, a recently released document by the Hematology/Oncology Pharmacy Association described board certification in oncology pharmacy as one of the few mechanisms of creating a “formalized standard of practice.”5 As displayed in recent California legislation, advanced certifications are also becoming required to bill for direct patient care services.6 This landmark legislation grants pharmacy provider status to advanced practice pharmacists (APPs). APPs will increasingly be required to continue the development of programs such as pharmacistmanaged diabetes mellitus, hypertension, hypercholesterolemia, anticoagulation, and pain clinics. The impact that development funding will have on APPE preceptors is likely to be symbiotic. As the number of APPE Continued on page 900
Short papers on practice innovations and other original work are included in the Notes section rather than in Letters. Letters commenting on an AJHP article must be received within three months of the article’s publication. Letters should be submitted electronically through http://ajhp.msubmit.net. The following conditions must be adhered to: (1) the body of the letter must be no longer than two typewritten pages, (2) the use of references and tables should be minimized, and (3) the entire letter (including references, tables, and authors’ names) must be typed double-spaced. After acceptance of a letter, the authors are required to sign an exclusive publication statement and a copyright transferal form. All letters are subject to revision by the editors.
Letters Continued from page 898
students grows, there will be a proportional need for APPE preceptors who can model engaged, professional practice. Advanced certifications can aid in this need as they serve to enhance and validate pharmacist-provided patient care.4,5,7 Guideline 25.1 of the Accreditation Council for Pharmacy Education standards and guidelines explains, “Pharmacy practice faculty should possess additional professional training . . . and either have or be working toward credentials (for example, specialty certification) relevant to their practice and teaching responsibilities.”8 As both faculty and nonfaculty preceptors receive more financial incentives and opportunities to become APPs, more APPE rotations will be available and APPE education should improve and broaden. This will ultimately increase the core competency of our students and, subsequently, the profession. While a major use of these funds is for the attainment of advanced certifications, other appropriate uses should also be recognized. Professional meetings have become progressively important to the profession, serving as a means to share ideas and practices across states, countries, and continents. Unfortunately, a major obstacle to development opportunities is the out-of-pocket expense. The current austere times make these types of budget items difficult for pharmacy directors to justify. Appropriate development opportunities should be encouraged, and development funding can be used to cover costs incurred. Development funding should be held within the pharmacy department for easy and appropriate disbursement. Institutions not able to accept or hold development funding within their pharmacy department may be able to have funds held by the SOP and disbursed at mutually agreed on times. Practicing pharmacists interested in increasing their professional opportunities should be encouraged to engage in these career-building discussions with their pharmacy directors and local SOPs.
900
1. Brown DL. A looming joblessness crisis for new pharmacy graduates and the implications it holds for the academy. Am J Pharm Educ. 2013; 77:article 90. 2. Knapp K. Finding a path through tough times. Am J Pharm Educ. 2013; 77:article 91. 3. National Association of Boards of Pharmacy. NAPLEX blueprint. www.nabp.net/ programs/examination/naplex/naplexblueprint/ (accessed 2013 Oct 25). 4. Board of Pharmacy Specialties. White paper: five-year vision for pharmacy specialties. www.accp.com/docs/positions/misc/ BPS_Whitepaper_Jan2013.pdf (accessed 2013 Oct 25). 5. Hematology/Oncology Pharmacy Association. Scope of hematology/oncology pharmacy practice. www.hoparx.org/ uploads/files/2013/HOPA13_Scopeof PracticeBk.pdf (accessed 2013 Oct 25). 6. American Pharmacists Association. California provider status bill heads to governor; compounding, track-and-trace passes House; APhA to FDA: standardize, integrate REMS programs. www.pharmacist.com/ california-provider-status-bill-headsgovernor-compounding-track-and-tracebill-passes-house-apha (accessed 2013 Nov 5). 7. Board of Pharmacy Specialties. Candidate’s guide. www.bpsweb.org/pdfs/ CandidatesGuide.pdf (accessed 2013 Oct 25).
8. Accreditation Council for Pharmacy Education. Accreditation standards and guidelines: professional program in pharmacy leading to the doctor of pharmacy degree, version 2.0, effective February 2011. www.acpe-accredit.org/pdf/ FinalS2007Guidelines2.0.pdf (accessed 2013 Nov 27).
Nicholas P. Forcello, Pharm.D., BCPS, BCOP, Assistant Professor of Pharmacy Practice [email protected] Noreen Todd, B.S.Pharm., M.H.A., Coordinator of Experiential Education Bruce Edgren, Pharm.D., Associate Professor and Chair Department of Pharmacy Practice and Administration Jennifer Tan, Pharm.D., Assistant Professor of Pharmacy Practice School of Pharmacy University of Saint Joseph Hartford, CT 06103
The authors have declared no potential conflicts of interest. DOI 10.2146/ajhp130751
Drug information skills: An abandoned necessity?
T
he clinical specialists at our children’s hospital conduct a pediatric pharmacotherapy elective for local colleges of pharmacy. A drug information lecture is integrated into the teaching of this course in a one-hour format. This lecture is formulated to complement the mandatory concentrated drug information course, which the students have already completed, by focusing on the use of resources to answer unusual and patientspecific questions. In conjunction with the drug information lecture, case-based homework is assigned to each student. These cases are based on rare pediatric indications for which little, but adequate, information is available for review. The case questions walk the learner through an exercise of
Am J Health-Syst Pharm—Vol 71 Jun 1, 2014
evaluating the question asked and answering it using a systematic drug information retrieval process.1 The student is also prompted to gather background information, such as evaluating FDAapproved indications and recommended pediatric dosing. Finally, the student is asked to develop a simplistic recommendation based on the information gathered regarding this patient case. The submissions for these homework assignments have grown increasingly worrisome over the past few years. In the most recent iteration of the course, eight students participated, and each was assigned a case. Only one submitted a response deserving full credit by using all available references to provide a recommendation that was not only evidence
Copyright of American Journal of Health-System Pharmacy is the property of American Society of Health System Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
Letters Career and preceptor development through preceptorship of advanced pharmacy practice experiences
P
harmacists continue to fight for the financial incentives necessary to provide services inherent to our practice. While we deserve compensation for our services, we often struggle to find mechanisms for such funding. This concept parallels a different type of funding issue currently facing pharmacists. With the increased number of doctor of pharmacy (Pharm.D.) students has come a rapid increase in the demand for advanced pharmacy practice experience (APPE) rotations. When health care institutions agree to accept APPE students on nonfaculty rotations, it’s customary for the school of pharmacy (SOP) to pay a stipend to the institution accepting the student. The amount varies among schools but can be as much as $1500 per student for a sixweek rotation. Allowing this development funding to be used for professional and educational purposes would accomplish two goals. This funding would (1) increase pharmacists’ incentive to serve as preceptors to APPE students, thus increasing the number of APPE rotations, and (2) increase pharmacists’ opportunities for future career development. This money, however, is frequently dispersed
to the institution as a whole and not always earmarked for pharmacist development. This practice needs to change. The rapid increase in the number of Pharm.D. graduates has recently created a large amount of discussion. The number of Pharm.D. graduates increased by 70% from 2001 to 2011, attributable to the anticipated shift in pharmacy practice from traditional dispensing to more patient-focused roles.1,2 In 2000, as the Pharm.D. became the minimum degree required to enter the profession, these new roles seemed inevitable. Our roles have no doubt grown but have yet to fully reach projected expectations.1,2 A major repercussion of the increased supply of pharmacists has been greater anxiety regarding their ability to compete in the upcoming work force. For those interested in becoming APPE preceptors, development funding provided by SOPs is a perfect vehicle for enhancing future career opportunities. Advanced certifications will be key to validate our patient care abilities and achieve the profession’s patient care goals. A passing score on the North American Pharmacist Licensure Examination is
The Letters column is a forum for rapid exchange of ideas among readers of AJHP. Liberal criteria are applied in the review of submissions to encourage contributions to this column. The Letters column includes the following types of contributions: (1) comments, addenda, and minor updates on previously published work, (2) alerts on potential problems in practice, (3) observations or comments on trends in drug use, (4) opinions on apparent trends or controversies in drug therapy or clinical research, (5) opinions on public health issues of interest to pharmacists in health systems, (6) comments on ASHP activities, and (7) human interest items about life as a pharmacist. Reports of adverse drug reactions must present a reasonably clear description of causality.
898
Am J Health-Syst Pharm—Vol 71 Jun 1, 2014
considered a minimum requirement before a pharmacist can attain licensure.3 Further postgraduate credentialing has become increasingly preferred among employers. The Board of Pharmacy Specialties recently released a white paper outlining the role of selected pharmacist postgraduate certifications and how they distinguish a pharmacist’s breadth of patient and practice focus as well as his or her level of knowledge, skills, and experience. 4 As another example, a recently released document by the Hematology/Oncology Pharmacy Association described board certification in oncology pharmacy as one of the few mechanisms of creating a “formalized standard of practice.”5 As displayed in recent California legislation, advanced certifications are also becoming required to bill for direct patient care services.6 This landmark legislation grants pharmacy provider status to advanced practice pharmacists (APPs). APPs will increasingly be required to continue the development of programs such as pharmacistmanaged diabetes mellitus, hypertension, hypercholesterolemia, anticoagulation, and pain clinics. The impact that development funding will have on APPE preceptors is likely to be symbiotic. As the number of APPE Continued on page 900
Short papers on practice innovations and other original work are included in the Notes section rather than in Letters. Letters commenting on an AJHP article must be received within three months of the article’s publication. Letters should be submitted electronically through http://ajhp.msubmit.net. The following conditions must be adhered to: (1) the body of the letter must be no longer than two typewritten pages, (2) the use of references and tables should be minimized, and (3) the entire letter (including references, tables, and authors’ names) must be typed double-spaced. After acceptance of a letter, the authors are required to sign an exclusive publication statement and a copyright transferal form. All letters are subject to revision by the editors.
Letters Continued from page 898
students grows, there will be a proportional need for APPE preceptors who can model engaged, professional practice. Advanced certifications can aid in this need as they serve to enhance and validate pharmacist-provided patient care.4,5,7 Guideline 25.1 of the Accreditation Council for Pharmacy Education standards and guidelines explains, “Pharmacy practice faculty should possess additional professional training . . . and either have or be working toward credentials (for example, specialty certification) relevant to their practice and teaching responsibilities.”8 As both faculty and nonfaculty preceptors receive more financial incentives and opportunities to become APPs, more APPE rotations will be available and APPE education should improve and broaden. This will ultimately increase the core competency of our students and, subsequently, the profession. While a major use of these funds is for the attainment of advanced certifications, other appropriate uses should also be recognized. Professional meetings have become progressively important to the profession, serving as a means to share ideas and practices across states, countries, and continents. Unfortunately, a major obstacle to development opportunities is the out-of-pocket expense. The current austere times make these types of budget items difficult for pharmacy directors to justify. Appropriate development opportunities should be encouraged, and development funding can be used to cover costs incurred. Development funding should be held within the pharmacy department for easy and appropriate disbursement. Institutions not able to accept or hold development funding within their pharmacy department may be able to have funds held by the SOP and disbursed at mutually agreed on times. Practicing pharmacists interested in increasing their professional opportunities should be encouraged to engage in these career-building discussions with their pharmacy directors and local SOPs.
900
1. Brown DL. A looming joblessness crisis for new pharmacy graduates and the implications it holds for the academy. Am J Pharm Educ. 2013; 77:article 90. 2. Knapp K. Finding a path through tough times. Am J Pharm Educ. 2013; 77:article 91. 3. National Association of Boards of Pharmacy. NAPLEX blueprint. www.nabp.net/ programs/examination/naplex/naplexblueprint/ (accessed 2013 Oct 25). 4. Board of Pharmacy Specialties. White paper: five-year vision for pharmacy specialties. www.accp.com/docs/positions/misc/ BPS_Whitepaper_Jan2013.pdf (accessed 2013 Oct 25). 5. Hematology/Oncology Pharmacy Association. Scope of hematology/oncology pharmacy practice. www.hoparx.org/ uploads/files/2013/HOPA13_Scopeof PracticeBk.pdf (accessed 2013 Oct 25). 6. American Pharmacists Association. California provider status bill heads to governor; compounding, track-and-trace passes House; APhA to FDA: standardize, integrate REMS programs. www.pharmacist.com/ california-provider-status-bill-headsgovernor-compounding-track-and-tracebill-passes-house-apha (accessed 2013 Nov 5). 7. Board of Pharmacy Specialties. Candidate’s guide. www.bpsweb.org/pdfs/ CandidatesGuide.pdf (accessed 2013 Oct 25).
8. Accreditation Council for Pharmacy Education. Accreditation standards and guidelines: professional program in pharmacy leading to the doctor of pharmacy degree, version 2.0, effective February 2011. www.acpe-accredit.org/pdf/ FinalS2007Guidelines2.0.pdf (accessed 2013 Nov 27).
Nicholas P. Forcello, Pharm.D., BCPS, BCOP, Assistant Professor of Pharmacy Practice [email protected] Noreen Todd, B.S.Pharm., M.H.A., Coordinator of Experiential Education Bruce Edgren, Pharm.D., Associate Professor and Chair Department of Pharmacy Practice and Administration Jennifer Tan, Pharm.D., Assistant Professor of Pharmacy Practice School of Pharmacy University of Saint Joseph Hartford, CT 06103
The authors have declared no potential conflicts of interest. DOI 10.2146/ajhp130751
Drug information skills: An abandoned necessity?
T
he clinical specialists at our children’s hospital conduct a pediatric pharmacotherapy elective for local colleges of pharmacy. A drug information lecture is integrated into the teaching of this course in a one-hour format. This lecture is formulated to complement the mandatory concentrated drug information course, which the students have already completed, by focusing on the use of resources to answer unusual and patientspecific questions. In conjunction with the drug information lecture, case-based homework is assigned to each student. These cases are based on rare pediatric indications for which little, but adequate, information is available for review. The case questions walk the learner through an exercise of
Am J Health-Syst Pharm—Vol 71 Jun 1, 2014
evaluating the question asked and answering it using a systematic drug information retrieval process.1 The student is also prompted to gather background information, such as evaluating FDAapproved indications and recommended pediatric dosing. Finally, the student is asked to develop a simplistic recommendation based on the information gathered regarding this patient case. The submissions for these homework assignments have grown increasingly worrisome over the past few years. In the most recent iteration of the course, eight students participated, and each was assigned a case. Only one submitted a response deserving full credit by using all available references to provide a recommendation that was not only evidence
Copyright of American Journal of Health-System Pharmacy is the property of American Society of Health System Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
