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The goal of the Army’s influenza prevention program is to protect all Soldiers, healthcare professionals, and beneficiaries from influenza and its complications to maximize force readiness. Commanders have the daunting and challenging task of ensuring 100% of Soldiers and Military Treatment Facility (MTF) assigned employees are vaccinated against influenza by a specified timeframe. Outpatient Pharmacy Services at the MTF are in the perfect position to provide enhanced accessibility to the influenza vaccination to assist in meeting this requirement. Irwin Army Community Hospital at Fort Riley, Kansas, became the first MTF to offer a pharmacist-administered influenza vaccination program in the outpatient setting, as a walk-in service to all Soldiers, MTF employees, and beneficiaries, in 2016. Since then over 1,500 flu shots have been administered with no documented adverse events, and a potential cost-savings between $23,205 to $61,880. Here we describe the planning and implementation of such a program, which can easily be reproduced at any MTF outpatient pharmacy with minimal efforts and resources, enabling outpatient pharmacists to provide a convenient and accessible alternative for seasonal flu vaccination, with the ultimate goal of maximizing force readiness. Article Type: Idea Paper

Pharmacy has traditionally been a highly regulated profession. In a recent study, the state with the largest pharmacy regulatory word count had 6.7 times as many words as the state with the lowest word count. Given the wide variation in state pharmacy regulations, this paper seeks to spark discussion on how we can assess public safety outcomes in states based on the overall volume of pharmacy regulation with a focus on: 1) fitness to practice; 2) controlled substance outcomes; and 3) compounding safety. In examining these categories, existing data sources are limited and suboptimal, though formal disciplinary actions against pharmacy licensees are very infrequent. Thus, it seems preferable for states to have a regulatory framework that allows boards of pharmacy to deal with the rare public safety issues that occur, while not holding back the vast majority of pharmacists from practicing to the top of their education and training.

Background: When available, empirical evidence should help guide decision-making. Following each administration of a learning assessment, data becomes available for analysis. For learning assessments, Kane’s Framework for Validation can helpfully categorize evidence by inference (i.e., scoring, generalization, extrapolation, implications). Especially for test-scores used within a high-stakes setting, generalization evidence is critical. While reporting Cronbach’s alpha, inter-rater reliability, and other reliability coefficients for a single measurement error are somewhat common in pharmacy education, dealing with multiple concurrent sources of measurement error within complex learning assessments is not. Performance-based assessments (e.g., OSCEs) that use raters, are inherently complex learning assessments. Primer: Generalizability Theory (G-Theory) can account for multiple sources of measurement error. G-Theory is a powerful tool that can provide a composite reliability (i.e., generalization evidence) for more complex learning assessments, including performance-based assessments. It can also help educators explore ways to make a learning assessment more rigorous if needed, as well as suggest ways to better allocate resources (e.g., staffing, space, fiscal). A brief review of G-Theory is discussed herein focused on pharmacy education. Moving Forward: G-Theory has been common and useful in medical education, though has been used rarely in pharmacy education. Given the similarities in assessment methods among health-professions, G-Theory should prove helpful in pharmacy education as well. Within this Journal and accompanying this Idea Paper, there are multiple reports that demonstrate use of G-Theory in pharmacy education.

Background: Patient assistance programs, including medication management and counseling, have the potential to improve care in chronic disease states with complex therapies. Incorporating technology as a tool to foster adherence is becoming more commonplace in practice. Objectives: The purpose of this report is to identify barriers of medication adherence and review the impact of patient assistance programs and technology on medication adherence. Methods: A literature search was conducted in secondary databases, PubMed/MEDLINE and EBSCOhost of peer-reviewed systematic reviews, experimental, quasi-experimental, and observational reports published in English within the last fifteen years. Terms searched included patient assistance program, pharmacist role, technology, adherence or compliance, income and health. Results: Ten studies met our prespecified criteria. Male sex, several self-reported chronic diseases, negative expectancy of treatment, engagement in polypharmacy, financial hardships and lower education level correlated with lower medication adherence. Patient care assistance programs and utilization of technology (e.g., use of a mobile application) improved medication adherence. Conclusions: Patient assistance programs and technological tools, such as mobile applications, are necessary resources in improving medication adherence. Article Type: Idea Paper

The changing profession of pharmacy demands student preparation in dynamic courses that address the evolving healthcare landscape. Identifying an evidence-based approach to develop such coursework and content, however, can be a considerable challenge for curriculum innovators. This manuscript explores how curriculum design models can be applied as a guide to promote purposeful development of new curriculum, with the goal of promoting students as APPE, practice, and career-ready practitioners. Authors specifically describe a case study example for the process of creating a novel rural health course using the Taba curriculum design model as a guide for selecting course content, objectives, teaching strategies, learning experiences, and evaluative measures. Through the incorporation of the Taba model, this manuscript presents an evidence-based approach to curriculum development which can be replicated across schools and colleges of pharmacy. The described approach to curriculum design, which integrates models to guide the creative process, is a systematic approach to developing curriculum with purpose. Additional opportunities exist for curriculum innovators across the academy to explore incorporation of curriculum design models to guide course development, as well as to drive curricular assessment strategies and further curriculum refinement. Article Type: Idea Paper

The purpose of this paper is to shed light on the importance of didactic and experiential training in community engagement for students conducting Health Services Research (HSR) in pharmacy. The incorporation of community-based learning (CBL) courses can be beneficial for graduate students because they provide an opportunity to gain important skills in stakeholder engagement and developing sustainable research partnerships. Early exposure and mentorship of graduate students through CBL courses could minimize the risk of students entering communities in their future careers with harmful tactics such as stereotypes and implicit biases. In this paper, we draw upon previous research to identify an educational gap in community preparedness. Accordingly, we developed a community-engagement course for masters and doctoral graduate students in the HSR program at the University of Wisconsin-Madison School of Pharmacy. This paper provides an example of how other graduate programs may incorporate training in community engagement within their curriculum. In addition, we summarize how CBL courses can help address foundational graduate student knowledge gaps and offer suggestions for the formation of a CBL course.