A Progressive, Collaborative Process to Improve a Curriculum and Define an Assessment Program.

Objective: To revise the University of Oklahoma College of Pharmacy's professional program outcomes and create an assessment map using results from previous peer review and mapping of all professional courses and curricular streams of knowledge, skills, and attitudes (KSAs).

Design: After consolidating 15 original program outcomes into 11 more precise outcome statements, defining KSAs for each, and getting faculty approval of them, the committee detailed measurable program expectations upon graduation for each outcome and created an assessment map identifying where KSAs were taught, how they were to be assessed, and the expected ability level (novice, competent, proficient) for each across the curriculum.

Assessment: The committee's work identified deficits, inconsistencies, and disproportionalities in professional program assessment.

Practice experiences at a single institutional practice site to improve advanced pharmacy practice examination performance.

Objective: To determine whether sequential assignment of students to the same facility for institutional practice experiences improves their advanced pharmacy practice experience (APPE) examination scores.

Design: Student volunteers were assigned to the same healthcare facility for all institutional introductory pharmacy practice experiences (IPPEs) and advanced pharmacy practice experiences (APPEs). Other students completed institutional IPPEs and APPEs at separate healthcare facilities, ranging from 2 to 4 different facilities per student.

Incremental development of an integrated assessment method for the professional curriculum.

Objective: To incrementally create and embed biannual integrated knowledge and skills examinations into final examinations of the pharmacy practice courses offered in the first 3 years of the pharmacy curriculum that would account for 10% of each course's final course grade.

Design: An ad hoc integrated examination committee was formed and tasked with addressing 4 key questions. Integrated examination committees for the first, second, and third years of the curriculum were established and tasked with identifying the most pertinent skills and knowledge-based content from each required course in the curriculum, developing measurable objectives addressing the pertinent content, and creating or revising multiple-choice and performance-based questions derived from integrated examination objectives.

Collaboration between a college of pharmacy and a for-profit health system at an academic medical center.

Purpose: The genesis and growth of a successful 14-year partnership between the University of Oklahoma (OU) college of pharmacy and the OU Medical Center (OUMC) department of pharmacy are described.

Summary: Pursuant to a 1998 joint operating agreement, the medical center and pharmacy school have achieved a high degree of collaboration on a wide range of educational and clinical initiatives. The close relationship has conferred a number of benefits on both institutions, including (1) expanded experiential education opportunities for pharmacy students, (2) joint faculty and staff funding arrangements that have facilitated the development and accreditation of OU pharmacy residency programs, and (3) patient care initiatives that have increased awareness of pharmacists' important contributions in areas such as venous thromboembolism prophylaxis, antibiotic stewardship, and core measures compliance.

A pharmacist visit improves diabetes standards in a patient-centered medical home (PCMH).

Many patients with diabetes do not receive recommended standards of care. Diabetes patients were seen by a pharmacist in a diabetes assessment service (DAS) 1 week prior to a physician appointment to complete diabetes standards. Completion rates of American Diabetes Association (ADA) standards were compared between patients of 5 physicians offered the DAS intervention and a concurrent cohort of randomly selected patients of nonparticipating physicians.

Identification of barriers to appropriate dietary behavior in low-income patients with type 2 diabetes mellitus.

Objective: To identify barriers to appropriate dietary behavior in an urban, low-income population of patients with type 2 diabetes and to examine a new instrument in the identification of these barriers in this population.

Methods: A cross-sectional survey was developed, validated, and anonymously administered to low-income adults with type 2 diabetes in an academic family medicine physician group practice with a pharmacist-operated diabetes education and comanagement service. The survey consisted of three key subscales: determinants of food selection, importance of life challenges, and barriers to appropriate eating.

Assessment of streams of knowledge, skill, and attitude development across the doctor of pharmacy curriculum.

Objective: To continue efforts of quality assurance following a 5-year curricular mapping and course peer review process, 18 topics ("streams") of knowledge, skills, and attitudes were assessed across the doctor of pharmacy (PharmD) curriculum.

Design: The curriculum committee merged the 18 topics into 9 streams. Nine ad hoc committees ("stream teams") of faculty members and preceptors evaluated the content, integration, and assessment for their assigned streams across the 4 professional years.

A review of pharmacist contributions to diabetes care in the United States.

This paper summarizes the outcomes associated with pharmacist involvement in diabetes care in all pharmacy practice settings. Published literature was identified through a search of MEDLINE (1960 to September, week 1, 2008) and International Pharmaceutical Abstracts using the search terms "pharmacist," "pharmaceutical care," and "diabetes mellitus." Only articles reporting clinical or behavior change outcomes were selected for review; papers written outside the United States and citations only in abstract form were not reviewed.

Using team-based learning in an endocrine module taught across two campuses.

Objectives: To implement a team-based learning (TBL) format in an endocrine module to promote students' active learning in a course delivered to 2 campuses.

Methods: Course lectures were transformed into 13 TBL sessions consisting of content pre-assignments (self-directed learning), in-class readiness assurance tests (accountability), and team problem solving of patient cases and faculty-led class discussion (knowledge application). Student performance was evaluated through multiple assessments during the TBL sessions and on unit examinations.

Use of an audience response system (ARS) in a dual-campus classroom environment.

Objectives: To implement an audience response system in a dual-campus classroom that aggregated data during graded (attendance and quizzes) and non-graded classroom activities (formative quizzes, case discussions, examination reviews, and team activities) and explore its strengths, weaknesses, and impact on active learning.

Design: After extensive research, an appropriate audience response system was selected and implemented in a dual-classroom setting for a third-year required PharmD course. Students were assigned a clicker and training and policies regarding clicker use were reviewed.

Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers for prevention and treatment of nephropathy associated with type 2 diabetes mellitus.

Renal complications resulting from type 2 diabetes mellitus are costly and common. Finding optimal therapy is important for the prevention and management of diabetic nephropathy. Research has focused on antihypertensive agents that modify the renin-angiotensin-aldosterone system.

Antidepressant-induced sweating.

Objective: To report a case of excessive sweating probably caused by paroxetine, review the literature on antidepressant-induced sweating, and provide recommendations for the management of antidepressant-induced sweating.

Case Summary: A 59-year-old white female presented to a pharmacist-staffed pharmacotherapy clinic with episodes of excessive sweating. The episodes occurred primarily on her head and back of the neck.

Second-generation thiazolidinediones and hepatotoxicity.

Objective: To report a case of hepatotoxicity probably caused by pioglitazone, summarize case reports of hepatotoxicity induced by rosiglitazone or pioglitazone, and make recommendations regarding routine liver enzyme measurement in patients taking these agents.

Case Summary: A 39-year-old black woman with type 2 diabetes mellitus, hypertension, and congestive heart failure presented to a pharmacist-staffed diabetes comanagement service. She reported fatigue, dark brown urine, nausea, itching, and loss of appetite.

Diabetes mellitus non-glucose monitoring: point-of-care testing.

Objective: To review and evaluate reimbursable point-of-care testing devices yielding immediate results, other than glucometers, that are available to evaluate and monitor diabetes and its complications and to describe how pharmacists may use these devices.

Data Sources: A MEDLINE search (1966-March 2003) was performed using the following search terms: point-of-care systems, clinical diabetes monitoring, decision support systems, glycosylated hemoglobin, and microalbumin. Pertinent company and product Web sites and customer service departments were accessed for information about point-of-care devices and supplies.