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Future training needs in the pharmaceutical sciences: academia -- industry.

The markets for the traditional output of schools of pharmacy, namely education, research and graduates, are changing. The main private client in these markets, the pharmaceutical industry, is moving fast to become more efficient, under pressure from overly costly drug development. The challenges to the industry that emanate from the fantastic rate of advances in the biomedical sciences and pharmaceutical development are considerable. The many agents that were unheard of 10 years ago, such as gene-regulators, together with new technologies, all require new approaches to fundamental pharmaceutical issues. The concept of disciplines in graduate education may have to be reconsidered in the light of the multidisciplinary problems to be tackled. In addition, graduates will need to acquire a range of non-disciplinary skills, such as better communication or team working, in order to be effective in the commercial market place. The concept of 'research schools' following either a local or network model may provide the way forward to help academia meet the graduate education needs of industry. The objectives and mission of such institutions must be clearly defined to ensure that the current scientific environment is embraced fully.

Drug Industry↗

Rho Chi Lecture Award. The shape of the Rho Chi key.

Lack of curricular balance long has been a problem in pharmacy education. Presently, excessive emphasis on individualized instruction and a failure to develop and implement innovative instructional methodologies in clinical pharmacy have resulted in programs that are severely distorted in terms of resource utilization. A proposal is made to restore a proper balance to the curriculum, to encourage elimination of outmoded instructional areas, and to promote the utilization of novel teaching techniques. If properly constructed, such a program should allow conferral of the Doctor of Pharmacy degree and examination for licensure after a period of 5 1/2 academic years. It is suggested that the Rho Chi Society use its vast human resources to assist in the development of such a program.

Curriculum↗

Pharmaceutical terms reflecting the change in practice in Japan.

The implementation of Iyaku Bungyo, the changed regulations for drug distribution and the proposed change of pharmacy education from a four-year program to a six-year program are rapidly changing the practice of pharmacy. However, pharmacists' activities still remain at the level of simple dispensing and selling of drugs. Also, the terms that describe the essence of pharmacists' activities, such as services in patient care areas are still unclear. In order to solve and improve the problem of terminology for pharmacists' activities the use of terms related to pharmacists' services were examined in historical context. It was found that the terms "Rinsho yakugaku" and "Iryo yakugaku" have been used as having a similar meaning. Further, the term "Iryo yakugaku" was used to denote the comprehensive scope of pharmacists' services including "Rinsho yakugaku". It was verified that "Rinsho yakugaku" is a valid translation for "clinical pharmacy". "Iryo yakugaku" has a more comprehensive translation than "pharmaceutical care", therefore, it appears that "Iryo yakugaku" is a suitable translation for "pharmaceutical services". Hence, we proposed "Iryo yakugaku" as the English translation for "pharmaceutical services" and "Chiryo yakugaku" as the Japanese translation for "pharmaceutical care". There is a need, however for further clarification and definition of pharmacists' activities.

Education, Pharmacy↗

Pharmacy practice, research, education, and advocacy for older adults.

In the United States, older adults have become the fastest growing segment of the population and are expected to double in number to 70 million by 2030. As a whole, older adults have different health care needs than younger patients, and some of these needs should be met by pharmacists. Clinical pharmacy practice affecting older adults occurs in a variety of settings, including community, ambulatory care, primary care, hospital, assisted living, nursing home, home health care, hospice, and Alzheimer's disease units. Although specialty training in geriatrics or gerontology is not required for pharmacists to care for older adults, it is extremely helpful. Pharmacy education related to the care of older adults has improved slightly in the past several years but will need to increase even more to provide all pharmacists with the basic skills and knowledge to care for this unique group of patients. In addition, pharmacotherapy research targeting older adults needs to increase. Although it can be challenging, funding for this type of research is available. Patient and political advocacy is also important to support this growing population.

Aged↗

Commitments for the future of pharmacy: a review and opinion of the Pharm.D. curricular debate.

For over 30 years, the content and form of the pharmacy curriculum and the title of the degree to be awarded have been subjects of controversy among pharmacy educators and practitioners. Scores of articles have been written about a universal Pharm .D. degree, all of which present different angles and opinions. Those who favor a universal Pharm .D. desire an improved image for the profession, greater employment opportunities, preparation for future pharmacy roles, the elimination of the multi- tiered structure, and decreasing costs for services. Those who oppose the entry-level Pharm .D. degree stress a need for multiple levels of education to meet the varying demands of practice, emphasize the oversaturation of the job market and increased costs to schools to adopt the new curriculum, and protest bestowing a doctoral title for reasons of self-esteem. The authors of this article consider it timely to present and evaluate these arguments, to provide the reader with a comprehensive review of the debate, and to call for unity within the profession as it considers the future educational needs of pharmacy practitioners.

Cost-Benefit Analysis↗

The feasibility of implementing an evidence-based core set of clinical pharmacy services in 2020: manpower, marketplace factors, and pharmacy leadership.

Development of a national plan to implement a core set of clinical pharmacy services in United States hospitals by 2020 requires assertive leadership from pharmacy organizations and state boards of pharmacy, and a commitment from the profession. Factors that may affect the development are grouped into three areas: manpower, marketplace variables, and pharmacy leadership. Although the number of pharmacy school graduates (7000) was about the same in 1990 and 2000, a greater number of pharmacy schools and high student enrollment, coupled with the Accreditation Council for Pharmacy Education's acceptance of foreign-trained pharmacists, suggest that the number of pharmacists will increase substantially in the near future. We estimate that the net increase in pharmacists (new pharmacy graduates less pharmacists who retire or die) in the United States will be 139,929 from 2000-2020, for a total of 335,040 pharmacists (71% increase). The number of pharmacy technicians increased substantially (66%), from 150,000 in 1996 to 250,000 in 2002. The number of residents in programs accredited by the American Society of Health-System Pharmacists increased 148%, from 435 in 1990 to 1080 in 2002. We conservatively project an increase of 33,000 pharmacists who complete residencies from 2000-2020. The pharmacy marketplace has changed dramatically over the last 12 years, with 10,754 independent community pharmacies closing (2.46 pharmacies/day) and 8459 chain outlets opening (1.93 chains/day). In recent years, mail-order pharmacies have expanded faster than other retail outlets and now process over 18% of U.S. prescriptions. Increased use of robotic systems (some can process 5000 prescriptions/hr) and technicians will diminish the demand for dispensing pharmacists. In addition, up to 10% of U.S. retail prescriptions may be filled outside the country's borders. These data indicate that there will be a sufficient supply of pharmacists and technicians in the future. Thus, it is feasible, based on manpower, marketplace factors, and pharmacy leadership, to implement a core set of clinical pharmacy services for patients in U.S. hospitals by 2020.

Education, Pharmacy↗

Use and effectiveness of pharmacy continuing-education materials.

The use and effectiveness of pharmacy continuing-education (CE) materials were studied. A 31-item survey was administered to pharmacists via an Internet portal. A recruitment letter, which included a description of the study and the Internet address to access the survey, was mailed to 2000 pharmacists. Only pharmacists who were currently practicing pharmacy in a community pharmacy or in a health care setting were included in the analysis. Pharmacists were asked to indicate the format of CE they generally used, formats used in the six months prior to the survey, and the format of their most recent CE. They were also asked to assess the effectiveness of CE programs and their ability to enhance pharmacists' knowledge and clinical practice behavior. Descriptive statistics were computed for all variables. Chi-square analyses were performed to compare subgroup responses. Of the 373 pharmacists completing the survey, 365 met the inclusion criteria. Of these respondents, 31% worked in a chain pharmacy, 25% in an inpatient pharmacy, and 23% in an independent pharmacy. Pharmacists most commonly obtained CE from printed materials (92%), lectures and seminars (75%), Internet-based materials (53%), and symposia (44%). Respondents found all types of CE programs effective in improving their knowledge, but less effective in enhancing their clinical practice behavior. Pharmacists perceived different types of CE programs as valuable resources for their educational needs. Printed materials, lectures, and seminars were the most commonly used CE formats. Pharmacists considered CE programs very effective in enhancing their knowledge and less valuable in improving their pharmacy practice activities.

Adult↗

Effective teaching and learning strategies.

Over the past decade, leaders in pharmacy education and the profession in the United States focused on responding to the role of the pharmacist in the rapidly changing health care environment. This response included moving to the Doctor of Pharmacy as the entry-level degree in the profession. Less understood and often overlooked are pharmacy's responses to equally dramatic changes in the national higher education environment. One trend in higher education is the use of active teaching and learning methodologies, many of which are based on cognitive science research on human learning. The primary purpose of this paper is to focus on teaching and learning by describing the philosophy and policy changes of the new American Council on Pharmaceutical Education accreditation standards advocating active teaching and learning strategies, by discussing the implications for pharmacy faculty teaching roles and responsibilities, and by providing examples of active teaching and learning strategies and relevant literature embedded in the standards.

Accreditation↗

Birth order and communication skills of pharmacy students.

Pharmacy educators are training graduates in a concept of practice called pharmaceutical care. The movement towards patient care requires consideration of the personal and social qualities of trainees. All individuals attracted to pharmacy may not desire involvement in patient care. This preliminary study of pharmacy students of the relationships among birth order, empathy, and assertiveness behaviors using the Interpersonal Communication Inventory showed the incidence of firstborn students in this sample was not significantly higher than in the general population but the incidence of those born second was significantly lower. Regression analysis of individual items gave significant correlations between birth order and three items on the inventory. While few conclusions can be drawn, a clear direction for further research is indicated.

Adult↗

Training and support program for pharmacists in rural Victoria.

The 'Rural Pharmacist Training and Support Program' was a pilot project that was conducted by the Monash University Centre for Rural Health. It examined the implementation of Pharmacy Board of Victoria Guidelines to Residential Care Facilities in the Loddon Mallee region of Victoria. Through a series of workshops, pharmacists were encouraged to discuss and address difficulties that were impeding implementation of the guidelines. These included upskilling in clinical pharmacy and ways to overcome the shortage of pharmacists in rural areas. Furthermore, the project was a catalyst for eight additional outcomes. This project highlighted the challenges facing rural pharmacists as they seek to implement the guidelines and resulted in a number of recommendations that addressed workforce issues, training and continuing education, Pharmacy Board requirements, improved communication with other health professionals and undergraduate training.

Education, Pharmacy, Continuing↗

Peer tutoring programs in health professions schools.

OBJECTIVE: Peer tutoring programs may be one method of maintaining quality of pharmacy education in the face of growing student enrollment and a small faculty body. A critical review of the literature was performed to ascertain whether peer tutoring programs improve or maintain the academic performance of health care professional students. METHODS: Various electronic databases and abstracts from past American Association of Colleges of Pharmacy's annual meetings were searched to identify pertinent research. Only those articles with quantitative data, an experimental design, and comparative statistical analysis were included for review. RESULTS: Most studies found that peer tutoring had a positive impact on academic performance. These results may not be readily generalizable as there were numerous methodological flaws and limited descriptions of the programs and participants. IMPLICATIONS: Studies with better designs and more detail are needed to answer definitively whether peer tutoring is of benefit. Details of what resources were required should be included in the study to allow the reader to determine the feasibility of the intervention.

Education, Pharmacy↗

Practice functions necessary for the delivery of pharmaceutical care.

Pharmaceutical care is a concept outlining the responsibilities of individual pharmacists to individual patients. Although widely accepted on a philosophical basis, there is a lack of comprehensive information about the functions and responsibilities pharmacists undertake when providing pharmaceutical care. Pharmacy educators and practitioners at the faculty of pharmacy, University of Toronto, developed and informally tested a process that details the practice functions required of pharmacists when providing pharmaceutical care as originally defined.

Humans↗