TEACHING INNOVATIONS IN THE PHARMD BRIDGING PROGRAM

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April 1, 2015 School of Pharmacy

TE AC HI N G INNOVATI O N S IN

THE PH ARM D BRIDGIN G

PROGR AM

R o s e m a r y K i l l e e n , D i r e c t o r, D i s t a n c e E d u c a t i o n a n d C o n t i n u i n g P r o f e s s i o n a l D e v e l o p m e n t S t e p h a n i e C h i u , E x p e r i e n t i a l C o u r s e C o o r d i n a t o r – B r i d g i n g R i t a D h a m i , A d j u n c t C l i n i c a l A s s i s t a n t P r o f e s s o r J e f f N a g g e , A d j u n c t C l i n i c a l A s s i s t a n t P r o f e s s o r School of Pharmacy April 1, 2015 School of Pharmacy

S E S S I O N O U TL I N E

• Welcome and lunch

• Program overview – Rosemary Killeen • Online problem-based learning – Jeff Nagge • Advanced professional practice – Rita Dhami

• Clinical rotations and the application of recognition of prior learning – Stephanie Chiu

• Q & A

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Program Overview

R o s e ma r y K i l l e e n D i r e c t o r, D i s t a n c e E d u c a t i o n a n d C o n t i n u i n g P r o fe s s i o n a l D e v e l o p me n t School of Pharmacy April 1, 2015 School of Pharmacy

PROGR AM AT A GL ANC E

School of Pharmacy

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P R O G R AM B Y T H E N U M B E R S

• Graduate cohorts eligible for program = 4

• Total alumni eligible for program = 416

• Projected participation in program = 220

• Re-admission prioritized by graduation year

School of Pharmacy

P R O G R AM B Y T H E N U M B E R S

• Applicants to date = 146 (as of March 25/15)

• 63 currently enrolled (Winter 2015)

• 67 more applied for Winter or Spring 2015

• 16 applications for later entry points

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Online Problem-Based Learning

J e f f N a g g e Ad j u n c t C l i n i c a l As s i s t a n t P r o fe s s o r School of Pharmacy April 1, 2015 School of Pharmacy

O U T L I N E

• Capstone therapeutics course undergraduate program

PHARM 422 (IPFC-9)

• Therapeutics course entry-level PharmD bridging program

PHARM 495

• Similarities to IPFC-9 • Unique approaches

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C AP S TO N E T H E R AP E U T I C S C O U R S E :

U N D E R G R AD U AT E P R O G R AM

• PHARM 422 (IPFC-9)

Delivered using traditional problem-based learning (PBL) technique

• No lectures

Student meet weekly in groups of eight, with a pharmacist tutor

• Given a new clinical case each week • Develop learning objectives as a group

• Use the following week to independently research the objectives

• Meet the following week to discuss what they’ve learned, and how it applies to the case

School of Pharmacy April 1, 2015 School of Pharmacy

T H E R AP E U T I C S C O U R S E :

E N T RY- L E V E L P H AR M D B R I D G I N G

P R O G R AM

• Desire to use PBL: Student engagement

May improve knowledge retention and improve self-directed learning skills

Graduates of PBL programs tend to have superior cognitive and social skills

It bears a striking resemblance to real life

• Patient issues are often “ill-defined”, information is frequently updated, health care is practiced in team environments

Koh GC et al. CMAJ 2008;178:34–41

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T H E R AP E U T I C S C O U R S E :

E N T RY- L E V E L P H AR M D B R I D G I N G

P R O G R AM

• Challenge:

How to run a PBL course with students who are located across North America?

• Solution:

Adobe Connect® meeting rooms

• All students must have a webcam, and be in an environment that has an internet connection meeting minimal bandwidth requirements

T H E R AP E U T I C S C O U R S E :

E N T RY- L E V E L P H AR M D B R I D G I N G

P R O G R AM

• Groups of seven plus a pharmacist tutor

Meet in Adobe Connect® rooms once every two weeks to discuss their researched learning objectives for the case

Cases include:

• Analgesic selection in complex patient, drug-induced liver disease, HIV, testosterone

supplementation, de-prescribing in older patients • Specific content much less important than

developing clinical problem-solving skills

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T H E R AP E U T I C S C O U R S E :

E N T RY- L E V E L P H AR M D B R I D G I N G

P R O G R AM

Assessment

Tutorial participation rubric (midterm and final) • Quantity of participation

• Quality of participation

• Contribution to group process and leadership • Professional behaviour

Concept application exercise

• Students “create their own case” from practice • Document use of the PBL cycle to address a

medication-related health issue for an actual patient School of Pharmacy April 1, 2015 School of Pharmacy

T H E R AP E U T I C S C O U R S E :

E N T RY- L E V E L P H AR M D B R I D G I N G

P R O G R AM

• Feedback: Pilot: August 2014 • Technology • Process

First semester (Winter 2015) • Anecdotal

• Formal course evaluations not completed yet

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Advanced Professional Practice

PHARM 496

Course Overview

R i t a D h a mi Ad j u n c t C l i n i c a l As s i s t a n t P r o fe s s o r School of Pharmacy April 1, 2015 School of Pharmacy

C O U R S E I N F O R M AT I O N

• 12 week online self-study modules practice-based course, plus

• On-site practice-based skills workshop

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Fundamental Skills

(PC Process: Info Gather, ID/ Resolve DRPs, Monitor, F/U) Communication

Begin your ACTION Plan

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Expanded Scope of Practice skills

Immunization & Health Promotion Prescribing (Refills, Emergency Rx, Adapts, Minor Ailments)

Lab & Physical Assessment

Case Presentation Workshop Preparation Action Plan

Management/Leadership

Compensation for Services Change Management Administrative Operations Management

Public Health

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Management/Leadership

Compensation for Services Change Management Administrative Operations Management

Public Health Practice Research Research Principles Research Proposal April 1, 2015 School of Pharmacy

W O R K S H O P

• 1 full-day workshop • Consists of

Clinical skills demonstration Standardized patient interactions

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Clinical Rotations and the

Application of Recognition of Prior Learning

S t e p h a n i e C h i u E x p e r i e n t i a l C o u r s e C o o r d i n a t o r – B r i d g i n g School of Pharmacy April 1, 2015 School of Pharmacy

O V E RV I E W O F C L I N I C AL R O TAT I O N S

Program complete Level 1 competence

Admission into PharmD Bridging Program

PHARM 495 Advanced Topics in Patient

Focused Care

Level 2 competence

PHARM 496 Advanced Professional Practice

PHARM 498 Clinical Rotation 2 PHARM 499 Clinical Rotation 3 PHARM 498 Clinical Rotation 2 PHARM 497 Clinical Rotation 1

Clinical Skills / Recognition of Prior Learning (mandatory)

Level 3 competence

Clinical Rotation

Courses

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O V E RV I E W O F C L I N I C AL R O TAT I O N S

• Competency assessments to be consistent with those

used in entry-to-practice (E2P) 4th_{year patient care} rotations.

• Same learning outcomes as the E2P 4th_{year patient} care rotations linked to Association of Faculties of Pharmacy of Canada educational outcomes.

School of Pharmacy

R E C O G N I T I O N O F P R I O R L E AR N I N G

( R P L ) : D E F I N I T I O N

“[RPL] defines processes that allow individuals to identify, document, have assessed and gain recognition for their prior learning. The learning may be formal, informal, non-formal, or experiential. The context of the learning is not key to the process as the focus is on the learning. [RPL] processes can be undertaken for several purposes, including self-knowledge, credit or advanced standing at an academic institution, for employment, licensure, career planning or recruitment.”

Canadian Association for Prior Learning Assessment. What is Prior Learning Assessment & Recognition (PLAR)/ Recognition of Prior Learning (RPL)? http://capla.ca/what-is-pla/. Accessed March 23, 2015.

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W H Y I N T E G R AT E R P L I N T H E

B R I D G I N G P R O G R AM ?

• Typical Bridging Program student: University of Waterloo alumni

Licensed pharmacist with several years experience out in practice

Adult learner • Benefits of RPL

Flexible and attractive program Avoid duplication of learning

Avoid wasting of resources (e.g., time + money)

School of Pharmacy

I N T E G R AT I O N O F R P L I N TO T H E

C L I N I C AL R O TAT I O N S

• RPL process built into PHARM 497. • 3 assessment methods in PHARM 497:

1 2 3

Clinical Experience Portfolio

Case Submission Oral Defense

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C L I N I C AL E X P E R I E N C E P O R T F O L I O

• Measures selected competencies

Supportive of case submission and oral defense assessments

• Practice site exposure requirements

At least 320 hours of direct patient care in EACH of an institutional setting and a primary care setting (from time of graduation to time of submitting the portfolio - includes internship).

School of Pharmacy April 1, 2015 School of Pharmacy Case(s) to submit: 1 Panelist(s): ₀ Occurs: early in rotation Case(s) to defend: 0

A

Case(s) to submit: 4 Panelist(s): ₁ Occurs: mid-rotation Case(s) to defend: 1

B

Case(s) to submit: 5 Panelist(s): ₃ Occurs: near end of rotation Case(s) to defend: 3

C

Assessors Practising clinicians, with at least 5 years

experience

Pharmacists with significant preceptor

experience

No Waterloo Pharmacy graduates (to avoid COI)

C AS E S U B M I S S I O N + O R AL D E F E N S E

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I N T E R P R O F E S S I O N AL

C O L L AB O R AT I O N ( I P C )

• IPC measured in all three assessment methods. • IPC competencies from the National Interprofessional

Competency Framework.

• A passing grade for all of the IPC components in total is

70% same passing grade as the E2P rotations.

• Students who do not achieve an overall grade of 70% or higher for this will find that their overall course grade is capped at 80%. School of Pharmacy April 1, 2015 School of Pharmacy

P H AR M 4 9 7 : O V E R AL L G R AD I N G

C

A

B

Case submission and oral defense Interprofessional components • Must pass or maximum score capped at 80% (i.e., at least 1 additional rotation) Clinical experience portfolio • Confirms level of competence • Additional rotations may be required • Cannot decrease number of rotations Less than 70% 70% to 79% 80% to 89% 90% to 100% Remedial action required Fail Level 1 competence Level 2 competence Level 3 competence PHARM 499

PHARM 498 PHARM 498 No additional rotations required

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AS S ES S O RS

• 3 groups of assessors:

Clinical experience portfolio Case submission

Oral defense

• Training sessions for all assessors Concept of RPL + program Assessment rubrics + process Inter-rater reliability

• No Waterloo BSc Pharmacy graduates

Quality Assurance School of Pharmacy April 1, 2015 School of Pharmacy

TRI AN G U L AT I O N OF EVIDENCE

Direct Evidence Indirect Evidence Self-assessment/ narrative

Pedersen, A. Recognition of prior learning primer. Presented at CAPLA conference 2014; November 2, 2014; Ottawa, ON. http://capla.ca/2014_conference/pages/e/.

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P R I N C I P L E S O F S O U N D AS S E S S M E N T

• Clear learning outcomes/expectations

• Systematic process • Technical requirements: Validity Sufficiency Authenticity Currency Reliability

Pedersen, A. Recognition of prior learning primer. Presented at CAPLA conference 2014; November 2, 2014; Ottawa, ON. http://capla.ca/2014_conference/pages/e/.

Q U AL I T Y R E Q U I R E M E N T S O F

AS S E S S M E N T S

• Rigorous • Transparent • Fair • Flexible

• Fit for purpose

1. Pedersen, A. Recognition of prior learning primer. Presented at CAPLA conference 2014; November 2, 2014; Ottawa, ON. http://capla.ca/2014_conference/pages/e/.

2. Red River College. Technical requirements of sound assessment. PLAR-1200 - RPL Foundation; 2012.

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W H AT AR E O T H E R P H AR M AC Y

B R I D G I N G P R O G R AM S D O I N G ?

Institution Type of Study Launch Date Inclusion of RPL

University of Alberta

Full-time 2013 New pharmacy graduates (2004 entry and beyond) from U of A receive credit for 6 wks. towards experiential rotations Part-time 2016

(anticipated)

Plans for up to 18 wks. credit for prior experience

University of British Columbia

Part-time 2016 (anticipated)

Plans for at most 50% of the coursework + experiential requirements could be waived University of Saskatchewan No info available After Sept. 2017

Possible RPL or the ability to ‘test out’ of certain components

University of Toronto Part-time 2015 No Université de Montréal

and Université Laval joint program

Part-time 2014 “Credit by challenge” for some didactic courses; clinical rotation elements cannot be “challenged” or earned by RPL

Info from universities’ websites as of February 3, 2015

School of Pharmacy

W H AT AR E O T H E R P H AR M AC Y

B R I D G I N G P R O G R AM S D O I N G ?

• Considering a Bridging Program; however, no mention of RPL on their website as of February 2015:

Dalhousie University

Memorial University of Newfoundland University of Manitoba

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W H AT AR E O T H E R P H AR M AC Y

B R I D G I N G P R O G R AM S D O I N G ?

Institution Inclusion of RPL

Idaho State University (last cohort admitted November 2014)

Didactic courses: challenge exams or board certification in pharmacotherapy

Experiential rotations: waiver of one clinical rotation based on experience + patient case write-ups

Shenandoah University Experiential rotations: RPL portfolio (maximum 2 of 3 rotations) University of Colorado Experiential rotations: RPL portfolio (maximum 4 of 6 rotations) University of Florida No

Western University of Health Sciences

Candidate joins second year of the E2P PharmD program

USA pharmacy programs available to Canadian pharmacists

Info from universities’ websites as of October 31, 2014

School of Pharmacy

Thank you for your time.

Any questions?

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