Peer-Reviewed Articles

Atypical Antipsychotics in the Treatment of Anorexia Nervosa
Daphne T. Crawford, Maisha Kelly Freeman, and Marshall E. Cates

Pharmacy Morning Report Pilot Study: Adapting the Medical Model of Case-based Teaching to the Pharmacy Curriculum
Angela R. Thomason, Bruce A. Waldrop, and Robert P. Henderson

Evaluation of Student Pharmacists' Perceptions of Skills and Attitudes to Provide Medication Therapy Management Services
Jody L. Lounsbery, Charmaine D. Rochester, and Deborah A. Sturpe

Factors Associated with Database Searching Among Pharmacy Faculty and Students: PubMed vs. Google Scholar
Maisha Kelly Freeman, Stacy A. Lauderdale, Michael G. Kendrach and Thomas W. Woolley

National Survey of Introductory Pharmacy Practice Experience Programs
Patricia L. Darbishire, Trish Devine, Michael R. Holowatyj, and Andrew N. Schmelz

The Effects of Learning Preferences and Instructional Content Delivery Methods on Pharmacy Student Learning: Evaluation
of a Computer Animation Pharmacology Tutorial
Bruce A. Waldrop, Nathan B. Lamb, and David R. Luthin

Classroom Incorporation and Students' Perceptions of Preparedness for Oral Examination in a Therapeutics Course
Lisa M. Lundquist and Justine S. Gortney

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Atypical Antipsychotics in the Treatment of Anorexia Nervosa

Daphne T. Crawford, PharmD, Staff Pharmacist, CVS/Pharmacy, Birmingham, AL

Maisha Kelly Freeman, PharmD, BCPS, Assistant Professor, Drug Information Specialist, McWhorter School of Pharmacy, Samford University, Birmingham, AL

Marshall E. Cates, PharmD, BCPP, FASHP, Professor of Pharmacy Practice, McWhorter School of Pharmacy, Samford University, Birmingham, AL

Abstract

Objective: To review the published literature pertaining to the use of atypical antipsychotics in the treatment of anorexia nervosa (AN).

Methods: PubMed (1966- April 2008), International Pharmaceutical Abstracts (1970- April 2008), and PsychInfo (1966- April 2008) were searched using the terms atypical antipsychotics, olanzapine, risperidone, quetiapine, paliperidone, ziprasidone, aripiprazole and anorexia nervosa.

Results: Effective treatment of AN with atypical antipsychotics has been documented in case reports, a retrospective study, and open trials. Olanzapine, risperidone, quetiapine and aripiprazole improve the psychiatric symptoms (e.g., delusions, depression, anxiety) associated with AN and appear to be well tolerated with a main side effect of mild sedation.

Conclusions: Published literature indicates that atypical antipsychotics may be effective in ameliorating psychiatric symptoms, reducing psychiatric comorbidities, and promoting weight gain in AN, but further investigation to determine the appropriate dosage and duration of these drugs warranted before implementing atypical antipsychotics into standard practice.

Key Words: atypical antipsychotics, olanzapine, risperidone, quetiapine, paliperidone, ziprasidone, aripiprazole, anorexia nervosa

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Pharmacy Morning Report Pilot Study: Adapting the Medical Model of Case-based Teaching to the Pharmacy Curriculum

Angela R. Thomason, PharmD, Assistant Professor of Pharmacy Practice, Department of Pharmacy Practice, McWhorter School of Pharmacy, Samford University, Birmingham, AL

Bruce A. Waldrop, RPh, PhD, Assistant Professor of Pharmacology, Department of Pharmaceutical, Social, and Administrative Sciences, McWhorter School of Pharmacy, Samford University, Birmingham, AL

Robert P. Henderson, PharmD, FASHP, FCCP, BCPS, Professor of Pharmacy Practice, Vice Chair Pharmacy Practice Department, McWhorter School of Pharmacy, Samford University, Birmingham, AL

Abstract

Objective: Develop and evaluate a curriculum-spanning, problem-based learning activity which will integrate and strengthen basic and clinical pharmacy sciences knowledge by utilizing a patient-centered, progressive disclosure case study.

Methods: One-hour discussion sessions were conducted over a 3-month period for first- (P1), second- (P2), and third-year (P3) pharmacy students. All sessions were led by 2 fourth-year (P4) students and attended by clinical and basic sciences faculty. The presentation of the patient cases were modeled after the medical morning report, in which pertinent information was progressively disclosed by presenters in response to the audience and facilitators' questions. After discussion of recommendations and pharmacotherapeutic treatment plans, the P4 students concluded with a summary of the patients' outcomes. A survey was administered to the P1, P2, and P3 students to determine the effectiveness of the learning activity.

Results: Seventy-five percent (n=43) of the participants (n=57) completed the survey. All students either Strongly Agreed or Agreed that the PMR (Pharmacy Morning Report) activity was a positive learning experience and most students either Strongly Agreed or Agreed that the activity helped them apply basic and clinical pharmacy sciences knowledge in a patient case scenario. Conclusions: Adapting the medical model of morning report for use in a professional pharmacy curriculum allows for curriculum-wide integration of basic and clinical sciences in a problem-based learning environment. The success of this pilot program warrants further evaluation and possible integration into the pharmacy curriculum.

Keywords: pharmacy morning report, case discussion

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Evaluation of Student Pharmacists' Perceptions of Skills and Attitudes to Provide Medication Therapy Management Services

Jody L. Lounsbery, Pharm.D., Assistant Professor, Department of Pharmaceutical Care and Health Systems, College of Pharmacy, University of Minnesota, Minneapolis, MN (At time of study Dr. Lounsbery was Ambulatory Care Resident, School of Pharmacy, University of Maryland, Baltimore, MD)

Charmaine D. Rochester, Pharm.D., CDE, BCPS, Assistant Professor, Department of Pharmacy Practice and Science, Director, Postgraduate (PGY2) Pharmacy Residency in Ambulatory Care, School of Pharmacy, University of Maryland, Baltimore, MD

Deborah A. Sturpe, Pharm.D., BCPS, Assistant Professor, Department of Pharmacy Practice and Science, School of Pharmacy, University of Maryland, Baltimore, MD

Abstract

Objectives: The objectives of this study were to (1) evaluate student pharmacists' perceptions of skills and attitudes toward providing medication therapy management (MTM) services, (2) assess the association between prior direct patient care experiences and perceptions of skills and attitudes, and (3) determine what effect an introductory pharmacy practice experience (IPPE) has on student pharmacists' perceptions of skills and attitudes.

Methods: A survey was distributed to student pharmacists in October 2007 and April 2008. Only students enrolled in the IPPE were surveyed at both times, in October and again in April. A Likert-type scale was used to assess responses to competencies to provide MTM, intentions to provide MTM, and attitudes towards implementing MTM. Descriptive statistics were used to describe demographics. Chi-square, Wilcoxon rank sum, and McNemar's were utilized for inferential statistical analysis.

Results: Over 89% of student pharmacists perceive providing MTM is important in moving the profession forward. Regardless of year in school and amount of direct patient care experiences, only 27.6% perceive an ability to obtain compensation for providing MTM services. Five competencies, including the ability to perform a comprehensive medication review; select or modify medication therapy; formulate a medication treatment plan; provide resources designed to enhance patient adherence, and critically evaluate medical literature and practice evidence-based medicine, showed significant differences as a reflection of the IPPE course.

Conclusions: Additional experiential experiences focused on providing MTM services may be beneficial in shaping perceptions of student pharmacists' abilities and attitudes regarding these services.

Key Words: medication therapy management, direct patient care, student education, pharmaceutical care, pharmacy education

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Factors Associated with Database Searching Among Pharmacy Faculty and Students: PubMed vs. Google Scholar

Maisha Kelly Freeman, Pharm.D., BCPS, Assistant Professor, Drug Information Specialist, Samford University, McWhorter School of Pharmacy, Birmingham, AL

Stacy A. Lauderdale, Pharm.D., BCPS, Assistant Professor, Drug Information Specialist, Samford University, McWhorter School of Pharmacy, Birmingham, AL

Michael G. Kendrach, Pharm.D., Professor, Director, Samford University Drug Information Center Birmingham, AL

Thomas W. Woolley, Ph.D., Professor, Brock School of Business, Samford University, Birmingham, AL

Abstract

Objective: Google Scholar use among medical professionals has increased since its introduction in November 2004 and in 2005, Google Scholar linked more visitors to biomedical journal Websites than PubMed. The purpose of this study was to determine the factors associated with database searching (PubMed and Google Scholar) among pharmacy faculty and students including: primary reasons for searching, frequency and satisfaction of database access, and the number of Web pages participants are willing to review to answer a drug-related question.

Methods: A 26-item survey was developed and delivered to Samford University, McWhorter School of Pharmacy faculty (n=35) and fourth-year students (n=113). Survey results were entered into SPSS, Version 15.0, and analyzed via descriptive and inferential statistics. The research was IRB approved.

Results: Approximately 77% (n=27) of the faculty and 64% (n=72) of the students responded to the survey. Approximately 52% and 15% of responders denied use of Google Scholar and PubMed, respectively. The top 3 reasons for searching Google Scholar were ease of use, speed, and availability of free, full-text articles; whereas the top 3 reasons for PubMed searching were efficiency and accuracy of searches and availability of free, full-text articles. Approximately 37% and 68% of responders used Google Scholar and PubMed 1-5 times weekly, respectively. More responders were satisfied with search features of PubMed (86%) compared to Google Scholar (32%). The most frequent response for pages to search was 1-5 for Google Scholar (50%) versus 6-10 for PubMed (36%).

Conclusions: The availability of free, full-text articles was a top reason for using both PubMed and Google Scholar. Responders felt that the search features of PubMed were superior compared to Google Scholar and were more willing to search additional PubMed pages compared to Google Scholar.

Key words: Google Scholar, PubMed, database searching

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National Survey of Introductory Pharmacy Practice Experience Programs

Patricia L. Darbishire, PharmD, Clinical Assistant Professor of Pharmacy Practice and Director of Introductory Pharmacy Practice Experience, Department of Pharmacy Practice, Purdue School of Pharmacy, West Lafayette, IN

Trish Devine, PharmD, Assistant Professor, Introductory Pharmacy Practice Experience Coordinator, Department of Pharmacy Practice, Butler University College of Pharmacy and Health Sciences, Indianapolis, IN

Michael R. Holowatyj, PharmD, Pharmacy Practice Resident, Clarian Health, Indianapolis, IN

Andrew N. Schmelz, PharmD, Post-Doctoral Teaching Fellow, Department of Pharmacy Practice, Purdue School of Pharmacy, West Lafayette, IN

Objective: The objective of this study was to identify commonalities and provide a descriptive overview of key program elements and oversight of U.S. introductory pharmacy practice experience (IPPE) programs.

Methods: A web-based questionnaire, consisting of 40 questions, was sent to 91 schools of pharmacy. The questionnaire addressed the following IPPE program topics, in addition to school demographics: program oversight, experience site selection, program structure, relationship to didactic curriculum, and quality assurance issues.

Results: Forty-six schools of pharmacy responded resulting in a response rate of 50.5%. Results identified commonalities in each of the key areas, as well as identifying multiple discrepancies in interpretation of the 2007 Accreditation Council for Pharmacy Education (ACPE) Standards and Guidelines (Standards 2007) for IPPEs. Only 21 of 42 respondents indicated they believed their IPPE program was currently in compliance with Standards 2007.

Conclusion: The survey results demonstrate a need for clarification by ACPE stakeholders in several areas addressed within the Standards 2007. No other previous research surveys were found addressing the key issues identified in this survey, revealing the need for additional research on IPPE programs within pharmacy school curricula.

Key Words: Introductory pharmacy practice experience, IPPE, pharmacy experiential learning surveys, Accreditation Council for Pharmacy Education, Standards 2007

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The Effects of Learning Preferences and Instructional Content Delivery Methods on Pharmacy Student Learning: Evaluation of a Computer Animation Pharmacology Tutorial

Bruce A. Waldrop, PhD, Assistant Professor of Pharmacology, McWhorter School of Pharmacy, Samford University, Birmingham, AL

Nathan B. Lamb, PharmD, University of Alabama at Birmingham, UAB University Hospital, Department of Pharmacy, Birmingham, AL

David R. Luthin, PhD, Assistant Professor of Pharmacology, McWhorter School of Pharmacy, Samford University, Birmingham, AL

Objective:To develop an interactive computer-assisted learning (CAL) application as a method of instruction for antiplatelet pharmacology and evaluate its effectiveness based on student learning preference.

Methods: Second-year pharmacy students completed a personality inventory to assess learning preference based on either the Sensing or Intuition domains as determined by the Keirsey Temperament Sorter (KTS). Students were randomly allocated to either the "traditional" group, who had access to an online study guide containing text and pictures or the "animation" group, who had access to an online interactive CAL tutorial. Baseline knowledge of the topic was assessed via pre-tests. After a 3-day study period, all students were assessed on their comprehension of the topic via post-tests. Mean post-test scores were compared via two-way ANOVA.

Results: Eighty-five students were identified as Sensing and 30 were identified as Intuition based on the Information Seeking preference pairing in the KTS. There was no significant main effect of learning preference or content delivery method on post-test scores. There was also no significant interaction of delivery method and learning style. Sensing students preferred the interactive CAL tutorial over the traditional handout.

Conclusions: Although Sensing students preferred the interactive CAL tutorial over the handout, the tutorial was no more effective as a primary instructional tool than the traditional study guide in this group of students. However, this study provides direction for further evaluation of adjunctive interactive CAL tutorials to accommodate students who prefer sensory-rich instruction.

Keywords: animation, tutorial, pharmacy education, learning

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Classroom Incorporation and Students' Perceptions of Preparedness for Oral Examination in a Therapeutics Course

Lisa M. Lundquist, PharmD, BCPS, Clinical Assistant Professor, Mercer University, College of Pharmacy and Health Sciences, Department of Pharmacy Practice, Atlanta, Georgia

Justine S. Gortney, PharmD, BCPS, Clinical Assistant Professor, Mercer University, College of Pharmacy and Health Sciences, Department of Pharmacy Practice, Atlanta, Georgia

Abstract

Objective:To describe the incorporation of an oral examination in a therapeutics course and to determine students' perceptions of preparedness.

Methods: A case-based oral examination was administered to all second professional year students enrolled in a Cardiovascular / Renal therapeutics course. Prior to the oral examination students completed a survey to assess their perceptions of their preparedness, and the results were compared to performance. Students were asked to rate the adequacy of their preparedness on a 4-point Likert scale with 1 = extremely unprepared, 2 = unprepared, 3 = prepared, and 4 = extremely prepared.

Results: One hundred forty-one students (96%) completed the survey. Mean perception of preparedness for the oral examination was 3.41 ± 0.34. Students that achieved 90 – 100 on their oral examination perceived preparedness as 3.45 ± 34; 80 – 89 perceived preparedness as 3.34 ±0.34; 70 – 79 perceived preparedness as 3.17 ± 0.32. Students who scored less than 70 had the lowest perception of preparedness at 3.15 ± 0.49.

Conclusion: The case-based oral examination represents an additional tool that may contribute to the development of a student’s connection between knowledge, effective communication, and pharmacy practice.

Key words: oral examination, assessment, therapeutics, student perception

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Oct 2008