Research Note
Incorporation of a mock pharmacy and therapeutics committee as an entrustable professional activity supporting task

https://doi.org/10.1016/j.cptl.2021.03.010Get rights and content

Abstract

Introduction

Entrustable professional activities (EPAs) denote activities and tasks students should be able to perform by graduation irrespective of their practice setting. Formulary decision-making includes several core EPA related skills, such as utilization of drug information, written, and verbal skills. The objective of this study was to describe an EPA supporting task aimed at improving utilization of evidence-based medicine skills and its impact on student self-perceived confidence, rating of skills needed, and competence.

Methods

Teams comprised of six to seven students were assigned a drug and instructed to complete the following activities: (1) background literature search, (2) drug monograph, (3) five-min presentation to simulate a live pharmacy and therapeutics (P&T) committee meeting, and (4) vote on a formulary drug in each drug class. Students completed a pre/post five-point Likert scale self-efficacy survey and a perceived importance survey. A scoring rubric assessed monograph and presentation elements (max points 30). Survey items were analyzed using Wilcoxon signed-rank test. Descriptive statistics were used for assignment grades.

Results

One hundred ninety students completed the pre/post self-efficacy and perceived importance survey. Confidence showed statistically significant improvement (P < .001) in nine target skill areas. In ranking importance, all 12 assessed skills exhibited a statistically significant increase following the activity.

Conclusions

A mock P&T activity represents an innovative way to evaluate an EPA supporting task that allows students to improve their evidence-based analysis, written, and verbal communication skills.

Introduction

Defined as “specific tasks or responsibilities that trainees are entrusted to perform without direct supervision once they have attained sufficient competence,” entrustable professional activities (EPAs) are a recent (2017) recommendation within schools and colleges of pharmacy.1 However, the implementation of these activities has not been mandated or standardized.1 Core EPAs have been published and denote activities and tasks students should be able to perform by graduation irrespective of their practice setting.2 There are six domains within the core EPAs: (1) patient care provider, (2) interprofessional team member, (3) population health promoter, (4) information master, (5) practice manager, and (6) self-developer.2 It is up to institutions to determine how they want to implement EPAs within their curriculum.

On experiential rotations or as pharmacists in practice, students may engage in tasks related to the information master and population health promoter domains. Several example supporting tasks in these domains were provided by the 2016–17 Academic Affairs Standing Committee of the American Association of Colleges of Pharmacy (AACP).2 A pharmacy and therapeutics (P&T) committee, which is typically charged with policy development, communication and education, and formulary management, could be an ideal activity to meet these EPA domains and prepare students for future practice.3 Within formulary development, P&T committees are tasked with specifying the drugs that should be ideal agents to use based on safety, efficacy, and cost-effectiveness.4 These committees usually include a combination of physicians, nurses, and pharmacists. In a literature review on the structure and operation of P&T committees, Durán-García et al.5 noted the universal participation of hospital pharmacists and identified that pharmacists played a pivotal role in the area of drug selection. Despite the general expectations of pharmacist involvement in P&T committees, examples preparing students for these activities have been limited.6,7

It has also been reported that pharmacy students struggle with biomedical literature evaluation,8 and graduated of the Class of 2016 at the University of Tennessee College of Pharmacy requested more practice with scientific literature and drug information skills in the AACP graduating student survey.9 To address this gap, enhance student EPA domain development, and prepare students for practice engagement, a new P&T activity was implemented. The research objectives were to describe the implementation of this activity and evaluate the impact of this activity on student self-perceived confidence, rating of importance of skills needed for this activity, and competence.

Section snippets

Methods

The mock P&T activity was integrated into the third-year course Interprofessional Education and Clinical Simulation V (IPECS 5), a fall semester course that culminates a series focused on the integration of clinical simulation and skills-based applications that are essential for pharmacy practice. This mock P&T committee activity builds on the foundations outlined in three previous courses: Information, Technology, & Safety (second year fall), Pharmacy Management (second year spring), and

Results

One hundred one students completed the pre/post assignment surveys in 2017, and 89 students completed these instruments in 2018, representing 53% and 56% of these cohorts, respectively. Students' perceptions describing their confidence in the practice of evidence-based medicine exhibited statistically significant improvement for all nine items (all P < .001). The two largest differences (Table 1) were seen in the questions related to confidence in writing skills (mean [SD] change 0.65 [0.83])

Discussion

Our study showed that a team-based activity deliberating a formulary decision increased the self-perceived confidence in skills used in the activity and improved student-perceived importance of those skills. As seen by the experiences of Law et al.6 and Cavanaugh et al.,7 the implementation of monographs allows for integration of learning across different concepts, most notably highlighting the relevance of pharmacoeconomics. Our students' perceived importance of pharmacoeconomics showed the

Conclusions

Published research on classroom activities concerning the development, conduction, perceptions, and assessment of EPAs is sparse. A mock P&T activity represents an innovative way to evaluate an EPA supporting task that allows students to improve their evidence-based analysis, written, and verbal communication skills. Students also exhibited improved confidence in their writing skills and drug monograph preparation. These skills can transcend into their experiential experience and into future

Declaration of Competing Interest

None.

Acknowledgements

The authors thank Dr. Aleda Chen for her thoughtful review of this manuscript.

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