Brazilian Journal of Pharmaceutical Sciences, 2022
BACKGROUND The growing demand for more effective health services worldwide, seeking the rational ... more BACKGROUND The growing demand for more effective health services worldwide, seeking the rational use of medicines, cost reduction, minimization of problems related to the use of medicines, and the need for medication safety, high light the importance of a process of persistent evaluation, monitoring, and adequacy of hospital pharmacy activities (Magarinos-Torres,Osorio-de-Castro, Pepe 2007a). Several models of practices have been implemented around the world, and in some places the presence of policies and standards have helped to choose the model to be followed(Doloresco,Vermeulen,2009). In the United States for example, pharmacists follow the standard procedures developed by the American Society of Hospital Pharmacists-ASHP (ASHP,2013);while the United Kingdom follows the strategic plan for hospital pharmacy services of the public health system, released by the government(NHS, 2000; Audit Commission, 2001). In Brazil, unlike the countries described above, there are three defined but not always harmonic models: pharmaceutical society, government, and class counsel.
O papel dos farmacêuticos na assistência a doentes com insuficiência renal crónica tem sido docum... more O papel dos farmacêuticos na assistência a doentes com insuficiência renal crónica tem sido documentado na literatura internacional e este estudo teve como objetivo compilar os serviços farmacêuticos prestados para que possam vir a ser considerados para eventual adaptação à realidade Portuguesa. Conduziu-se uma busca nas fontes secundárias Medline, International Pharmaceutical Abstracts, Pharmacy Abstracts e The Cochrane Library para recolher estudos descrevendo intervenções farmacêuticas em doentes com insuficiência renal crónica. No final, e após aplicação dos critérios de inclusão e exclusão, foram incluídos e analisados 37 estudos (correspondendo a 38 artigos). As intervenções farmacêuticas reportadas nos estudos foram: revisão do perfil farmacoterapêutico para identificação de problemas relacionados com a medicação, ajuste e otimização da terapêutica, identificação e correção de discrepâncias nos processos clínicos, avaliação da adequação da terapêutica durante a admissão e alta hospitalares, monitorização de parâmetros laboratoriais, implementação de protocolos de atuação na anemia, hiperparatiroidismo secundário, e hiperlipidemia, educação dos doentes, promoção da adesão à terapêutica, participação nas visitas médicas e reuniões multidisciplinares, comunicação e interação com outros profissionais de saúde, e fornecimento de informação sobre a escolha de fármacos e regimes terapêuticos. Em conclusão, a análise da literatura internacional revelou uma multiplicidade de potenciais intervenções farmacêuticas em doentes com insuficiência renal crónica que evidenciam o potencial de atuação do farmacêutico no processo de uso de medicamentos destes doentes e na melhoria dos resultados clínicos.
Journal of Paediatrics and Child Health, Jun 30, 2021
AimNon‐evidence‐based practice and inappropriate paediatric fever management by care givers is co... more AimNon‐evidence‐based practice and inappropriate paediatric fever management by care givers is common. The aim of this study was to survey a large sample of Australian parents and care givers utilising a validated Fever Management Tool, to determine the current knowledge, beliefs and attitudes of Australian care givers regarding fever management.MethodsThis study employed a cross‐sectional survey conducted via a third‐party market research company. Univariate analysis of demographic factors and their influence on knowledge scores were tested. A multivariate linear regression model was specified using all available independent univariate predicators to determine the demographic factors influencing care givers fever knowledge.ResultsData from 1000 questionnaires were analysed. The participants' total knowledge scores were evenly distributed with a mean score of 15.4/29 correct answers in the True/False questionnaire, a median score of 16 and a standard deviation of 4.27. It highlighted that Australian care givers had poor knowledge in questions related to ‘teething’, ‘physical cooling methods’ and ‘medication dosing’. In the multivariate analysis, 28.9% of the total variance was explained (R2 value = 0.289, P < 0.001) with 5 of 11 factors contributing.ConclusionOverall, this cross‐sectional survey has provided a strong understanding of the current knowledge, attitude and beliefs of Australian care givers in regards to fever management in their children. Total knowledge of fever management was generally poor in Australia with many participants harbouring misconceptions and non‐evidence‐based practices. Future interventions improving fever management practices should be tailored to the specific weaknesses faced by Australian care givers in order to promote long term change.
Journal of Paediatrics and Child Health, Sep 9, 2020
AimThe symptoms of childhood fever are often inappropriately managed by care givers resulting in ... more AimThe symptoms of childhood fever are often inappropriately managed by care givers resulting in overuse of health resources and medication errors. Understanding care giver's knowledge, attitudes and beliefs about fever management using a validated questionnaire is warranted. The aim of this study was to develop and validate a comprehensive Fever Management Questionnaire.MethodsThe questionnaire items were developed through a content analysis of the literature and current fever management guidelines. For the knowledge component, a multidisciplinary panel of 12 experts assessed content validity of items (n = 35) through a one‐round Delphi process. The construct validity of the attitudes and belief items (19 items) were assessed using principal components analysis utilising response data collected from 149 Australian parents and care givers.ResultsBased on the responses from the panel of experts, six items were removed, six items required substantive modification, 13 items required minor modification with the remaining eight items retained in original form. For the Attitudes and Beliefs items, a parsimonious solution with three principal components resulted after removal of six cross‐loading items. The factor loadings of each item displayed a strong correlation to one of three components with scores ranging from 0.791 down to 0.541. The resulting Cronbach's α for the tool was 0.729.ConclusionPsychometric testing of this two‐part Fever Management Questionnaire has resulted in a tool with acceptable validity and reliability. This tool should now be used to gather the knowledge and attitudes of care givers surrounding fever management to further understand factors that lead to inappropriate fever management.
Research in Social & Administrative Pharmacy, Oct 1, 2018
Background: In an ever-changing environment, pharmacy education is in the race to catch up and ex... more Background: In an ever-changing environment, pharmacy education is in the race to catch up and excel to produce competent pharmacists. Examining academic institutions, including schools of pharmacy, their internal systems and framework, it seems appropriate to view these institutions using multiple lenses. Bolman and Deal conceptualized a method to examine organizations using four constructs (structural, human resource, political, and symbolic). The Eastern Mediterranean Region (EMR), with deep-rooted pharmacy education and practice was the setting for this research. Objectives: To explore factors affecting academic reform in undergraduate pharmacy education in the EMR from stakeholders' and students' perspectives; and to apply Bolman and Deal's four-frame organizational change model to explore how these issues might be viewed. Methods: A multiple-method approach was employed and involved collecting, analyzing and integrating qualitative semi-structured interview data with open-ended questions in a survey. Cross-sector stakeholder sample from various EMR countries was recruited and interviewed. Final year pharmacy students from one school of pharmacy in Jordan were surveyed. Results: Emergent themes were indicative that academic reform was addressed by all frames of the Bolman and Deal model. Structural and political frames received substantial weighing pointing to the importance of curricular reform, collaboration and leadership. A need for skillful and role-model teaching academic staff was highlighted, and in harmony with the human resource frame. Issues within the symbolic frame were readily apparent in the data and spanned the other three frames in relation to heritage, customs and cultural barriers. Conclusions: Issues pertinent to academic reform in pharmacy were presented. Viewing change in pharmacy schools from multiple perspectives highlighted the need for structural changes to pharmacy programs, human resource management, political will, leadership, and collaboration. The importance of understanding cultural aspects of organizations is critical as it is these that provide identity to any organization and help reformers better manage change.
Currents in Pharmacy Teaching and Learning, Oct 1, 2019
Obtaining accurate patient medication histories and performing medication reconciliation are core... more Obtaining accurate patient medication histories and performing medication reconciliation are core pharmacy practice skills that optimize patient safety at transitions of care. Competency-based learning and assessment of medication reconciliation skills are essential methods in undergraduate pharmacy education. The aim of this study was to investigate the impact of an in-classroom simulation-and feedback-driven training activity on pharmacy students' medication reconciliation skills, self-perceived confidence, and overall student satisfaction. Methods: Over a three-day learning activity in 2016, pharmacy students from a private university in Jordan were assessed by roleplay on their ability to conduct a simulated patient medication interview, obtain the Best Possible Medication History, reconcile the history against a hospital medication chart, identify discrepancies, and document findings. Students received immediate feedback and observed peers undergo the assessment process. Pre-and post-simulation questionnaires and supplementary focus groups enabled collection of quantitative and qualitative data pertaining to student self-perceived confidence, perceptions, experiences, and usefulness of the course. Results: Assessment-based competency scores demonstrated significant improvement in student performance during the activity. Self-perceived confidence scores significantly improved after the medication reconciliation training intervention. Focus group content analysis yielded positive responses such as students valuing receiving feedback on performance and recommendations for future training. Conclusions: Simulation with feedback was a useful tool to teach pharmacy students medication reconciliation in Jordan. Subsequent to the study, medication reconciliation and interactive teaching methods were added to curriculum to supplement traditional teaching modalities.
When providing pharmaceutical care to the pediatric population, pharmacists need to take extra ca... more When providing pharmaceutical care to the pediatric population, pharmacists need to take extra care, and be vigilant to try to prevent some of the common drug-related problems that have previously been reported too commonly for this cohort. Through the medication review process (see Chap. 6), pharmacists make recommendations on appropriate dose adjustments, intercept potentially harmful medication errors, determine patient adherence, identify drug-related problems, and take action where necessary such as educating parents and children themselves. Considering that pediatric patients are more likely to experience adverse drug misadventures, they may need a narrower follow-up period than their adult counterparts, and pharmacists are able to apply advanced pharmaceutical and therapeutic knowledge to monitor for adverse, as well as positive outcomes.Some important general principles when treating children should be followed: 1. If the infant is very young (less than 3-6 months), then most often a referral would be appropriate. 2. If the child is very ill (lethargic, listless, and inconsolable), referral is required. 3. If a medication is to be given, then make sure the dose explained to the caregiver is correct (many medicines will be dosed according to weight). 4. Show the caregiver how to effectively administer/use the medication (e.g., show them how to use a syringe for measuring liquid medications). 5. Involve the child (when old enough to take part) in their own care and encourage communication between the child and their parents, because at some stage the child will be responsible for their own medication use.
Background Electronic medication management (eMM) has been shown to reduce medication errors; how... more Background Electronic medication management (eMM) has been shown to reduce medication errors; however, new safety risks have also been introduced that are associated with system use. No research has specifically examined the changes made to eMM systems to mitigate these risks. Objectives To (1) identify system-related medication errors or workflow blocks that were the target of eMM system updates, including the types of medications involved, and (2) describe and classify the system enhancements made to target these risks. Methods In this retrospective qualitative study, documents detailing updates made from November 2014 to December 2019 to an eMM system were reviewed. Medication-related updates were classified according to “rationale for changes” and “changes made to the system.” Results One hundred and seventeen updates, totaling 147 individual changes, were made to the eMM system over the 4-year period. The most frequent reasons for changes being made to the eMM were to prevent medication errors (24% of reasons), optimize workflow (22%), and support “work as done” on paper (16%). The most frequent changes made to the eMM were options added to lists (14% of all changes), extra information made available on the screen (8%), and the wording or phrasing of text modified (8%). Approximately a third of the updates (37%) related to high-risk medications. The reasons for system changes appeared to vary over time, as eMM functionality and use expanded. Conclusion To our knowledge, this is the first study to systematically review and categorize system updates made to overcome new safety risks associated with eMM use. Optimization of eMM is an ongoing process, which changes over time as users become more familiar with the system and use is expanded to more sites. Continuous monitoring of the system is necessary to detect areas for improvement and capitalize on the benefits an electronic system can provide.
The American Journal of Pharmaceutical Education, Mar 1, 2020
Objective. To explore models of teaching in, resources available to, and delivery of a standardiz... more Objective. To explore models of teaching in, resources available to, and delivery of a standardized course in pharmacy ethics. Methods. An email invitation was sent to the educator responsible for teaching pharmacy ethics at each of 19 institutions in Australia and New Zealand. Over a six-to eight-week period, semi-structured interviews were conducted in person, by email, or by phone, and were audio-recorded where possible, transcribed verbatim, and entered into data analysis software. Using an inductive analysis approach, themes related to the topics and issues discussed in the interview process were identified. Results. Of the educators invited to participate, 17 completed an interview and were included in this study. Participants reported a paucity of resources available for teaching pharmacy ethics at schools in Australia and New Zealand. Compounding this issue was the lack of expertise and ad-hoc process educators used to create their courses. Assessment methods varied between institutions. Participants felt schools needed to move toward a more standardized pharmacy ethics course with clear and defined guidelines. Conclusion. This study identified many areas in pharmacy ethics that need improvement and revealed the need to develop resources and course structure that adhere to the highest level of Miller's pyramid, while using known frameworks to evaluate ethical competency.
Brazilian Journal of Pharmaceutical Sciences, 2022
BACKGROUND The growing demand for more effective health services worldwide, seeking the rational ... more BACKGROUND The growing demand for more effective health services worldwide, seeking the rational use of medicines, cost reduction, minimization of problems related to the use of medicines, and the need for medication safety, high light the importance of a process of persistent evaluation, monitoring, and adequacy of hospital pharmacy activities (Magarinos-Torres,Osorio-de-Castro, Pepe 2007a). Several models of practices have been implemented around the world, and in some places the presence of policies and standards have helped to choose the model to be followed(Doloresco,Vermeulen,2009). In the United States for example, pharmacists follow the standard procedures developed by the American Society of Hospital Pharmacists-ASHP (ASHP,2013);while the United Kingdom follows the strategic plan for hospital pharmacy services of the public health system, released by the government(NHS, 2000; Audit Commission, 2001). In Brazil, unlike the countries described above, there are three defined but not always harmonic models: pharmaceutical society, government, and class counsel.
O papel dos farmacêuticos na assistência a doentes com insuficiência renal crónica tem sido docum... more O papel dos farmacêuticos na assistência a doentes com insuficiência renal crónica tem sido documentado na literatura internacional e este estudo teve como objetivo compilar os serviços farmacêuticos prestados para que possam vir a ser considerados para eventual adaptação à realidade Portuguesa. Conduziu-se uma busca nas fontes secundárias Medline, International Pharmaceutical Abstracts, Pharmacy Abstracts e The Cochrane Library para recolher estudos descrevendo intervenções farmacêuticas em doentes com insuficiência renal crónica. No final, e após aplicação dos critérios de inclusão e exclusão, foram incluídos e analisados 37 estudos (correspondendo a 38 artigos). As intervenções farmacêuticas reportadas nos estudos foram: revisão do perfil farmacoterapêutico para identificação de problemas relacionados com a medicação, ajuste e otimização da terapêutica, identificação e correção de discrepâncias nos processos clínicos, avaliação da adequação da terapêutica durante a admissão e alta hospitalares, monitorização de parâmetros laboratoriais, implementação de protocolos de atuação na anemia, hiperparatiroidismo secundário, e hiperlipidemia, educação dos doentes, promoção da adesão à terapêutica, participação nas visitas médicas e reuniões multidisciplinares, comunicação e interação com outros profissionais de saúde, e fornecimento de informação sobre a escolha de fármacos e regimes terapêuticos. Em conclusão, a análise da literatura internacional revelou uma multiplicidade de potenciais intervenções farmacêuticas em doentes com insuficiência renal crónica que evidenciam o potencial de atuação do farmacêutico no processo de uso de medicamentos destes doentes e na melhoria dos resultados clínicos.
Journal of Paediatrics and Child Health, Jun 30, 2021
AimNon‐evidence‐based practice and inappropriate paediatric fever management by care givers is co... more AimNon‐evidence‐based practice and inappropriate paediatric fever management by care givers is common. The aim of this study was to survey a large sample of Australian parents and care givers utilising a validated Fever Management Tool, to determine the current knowledge, beliefs and attitudes of Australian care givers regarding fever management.MethodsThis study employed a cross‐sectional survey conducted via a third‐party market research company. Univariate analysis of demographic factors and their influence on knowledge scores were tested. A multivariate linear regression model was specified using all available independent univariate predicators to determine the demographic factors influencing care givers fever knowledge.ResultsData from 1000 questionnaires were analysed. The participants' total knowledge scores were evenly distributed with a mean score of 15.4/29 correct answers in the True/False questionnaire, a median score of 16 and a standard deviation of 4.27. It highlighted that Australian care givers had poor knowledge in questions related to ‘teething’, ‘physical cooling methods’ and ‘medication dosing’. In the multivariate analysis, 28.9% of the total variance was explained (R2 value = 0.289, P < 0.001) with 5 of 11 factors contributing.ConclusionOverall, this cross‐sectional survey has provided a strong understanding of the current knowledge, attitude and beliefs of Australian care givers in regards to fever management in their children. Total knowledge of fever management was generally poor in Australia with many participants harbouring misconceptions and non‐evidence‐based practices. Future interventions improving fever management practices should be tailored to the specific weaknesses faced by Australian care givers in order to promote long term change.
Journal of Paediatrics and Child Health, Sep 9, 2020
AimThe symptoms of childhood fever are often inappropriately managed by care givers resulting in ... more AimThe symptoms of childhood fever are often inappropriately managed by care givers resulting in overuse of health resources and medication errors. Understanding care giver's knowledge, attitudes and beliefs about fever management using a validated questionnaire is warranted. The aim of this study was to develop and validate a comprehensive Fever Management Questionnaire.MethodsThe questionnaire items were developed through a content analysis of the literature and current fever management guidelines. For the knowledge component, a multidisciplinary panel of 12 experts assessed content validity of items (n = 35) through a one‐round Delphi process. The construct validity of the attitudes and belief items (19 items) were assessed using principal components analysis utilising response data collected from 149 Australian parents and care givers.ResultsBased on the responses from the panel of experts, six items were removed, six items required substantive modification, 13 items required minor modification with the remaining eight items retained in original form. For the Attitudes and Beliefs items, a parsimonious solution with three principal components resulted after removal of six cross‐loading items. The factor loadings of each item displayed a strong correlation to one of three components with scores ranging from 0.791 down to 0.541. The resulting Cronbach's α for the tool was 0.729.ConclusionPsychometric testing of this two‐part Fever Management Questionnaire has resulted in a tool with acceptable validity and reliability. This tool should now be used to gather the knowledge and attitudes of care givers surrounding fever management to further understand factors that lead to inappropriate fever management.
Research in Social & Administrative Pharmacy, Oct 1, 2018
Background: In an ever-changing environment, pharmacy education is in the race to catch up and ex... more Background: In an ever-changing environment, pharmacy education is in the race to catch up and excel to produce competent pharmacists. Examining academic institutions, including schools of pharmacy, their internal systems and framework, it seems appropriate to view these institutions using multiple lenses. Bolman and Deal conceptualized a method to examine organizations using four constructs (structural, human resource, political, and symbolic). The Eastern Mediterranean Region (EMR), with deep-rooted pharmacy education and practice was the setting for this research. Objectives: To explore factors affecting academic reform in undergraduate pharmacy education in the EMR from stakeholders' and students' perspectives; and to apply Bolman and Deal's four-frame organizational change model to explore how these issues might be viewed. Methods: A multiple-method approach was employed and involved collecting, analyzing and integrating qualitative semi-structured interview data with open-ended questions in a survey. Cross-sector stakeholder sample from various EMR countries was recruited and interviewed. Final year pharmacy students from one school of pharmacy in Jordan were surveyed. Results: Emergent themes were indicative that academic reform was addressed by all frames of the Bolman and Deal model. Structural and political frames received substantial weighing pointing to the importance of curricular reform, collaboration and leadership. A need for skillful and role-model teaching academic staff was highlighted, and in harmony with the human resource frame. Issues within the symbolic frame were readily apparent in the data and spanned the other three frames in relation to heritage, customs and cultural barriers. Conclusions: Issues pertinent to academic reform in pharmacy were presented. Viewing change in pharmacy schools from multiple perspectives highlighted the need for structural changes to pharmacy programs, human resource management, political will, leadership, and collaboration. The importance of understanding cultural aspects of organizations is critical as it is these that provide identity to any organization and help reformers better manage change.
Currents in Pharmacy Teaching and Learning, Oct 1, 2019
Obtaining accurate patient medication histories and performing medication reconciliation are core... more Obtaining accurate patient medication histories and performing medication reconciliation are core pharmacy practice skills that optimize patient safety at transitions of care. Competency-based learning and assessment of medication reconciliation skills are essential methods in undergraduate pharmacy education. The aim of this study was to investigate the impact of an in-classroom simulation-and feedback-driven training activity on pharmacy students' medication reconciliation skills, self-perceived confidence, and overall student satisfaction. Methods: Over a three-day learning activity in 2016, pharmacy students from a private university in Jordan were assessed by roleplay on their ability to conduct a simulated patient medication interview, obtain the Best Possible Medication History, reconcile the history against a hospital medication chart, identify discrepancies, and document findings. Students received immediate feedback and observed peers undergo the assessment process. Pre-and post-simulation questionnaires and supplementary focus groups enabled collection of quantitative and qualitative data pertaining to student self-perceived confidence, perceptions, experiences, and usefulness of the course. Results: Assessment-based competency scores demonstrated significant improvement in student performance during the activity. Self-perceived confidence scores significantly improved after the medication reconciliation training intervention. Focus group content analysis yielded positive responses such as students valuing receiving feedback on performance and recommendations for future training. Conclusions: Simulation with feedback was a useful tool to teach pharmacy students medication reconciliation in Jordan. Subsequent to the study, medication reconciliation and interactive teaching methods were added to curriculum to supplement traditional teaching modalities.
When providing pharmaceutical care to the pediatric population, pharmacists need to take extra ca... more When providing pharmaceutical care to the pediatric population, pharmacists need to take extra care, and be vigilant to try to prevent some of the common drug-related problems that have previously been reported too commonly for this cohort. Through the medication review process (see Chap. 6), pharmacists make recommendations on appropriate dose adjustments, intercept potentially harmful medication errors, determine patient adherence, identify drug-related problems, and take action where necessary such as educating parents and children themselves. Considering that pediatric patients are more likely to experience adverse drug misadventures, they may need a narrower follow-up period than their adult counterparts, and pharmacists are able to apply advanced pharmaceutical and therapeutic knowledge to monitor for adverse, as well as positive outcomes.Some important general principles when treating children should be followed: 1. If the infant is very young (less than 3-6 months), then most often a referral would be appropriate. 2. If the child is very ill (lethargic, listless, and inconsolable), referral is required. 3. If a medication is to be given, then make sure the dose explained to the caregiver is correct (many medicines will be dosed according to weight). 4. Show the caregiver how to effectively administer/use the medication (e.g., show them how to use a syringe for measuring liquid medications). 5. Involve the child (when old enough to take part) in their own care and encourage communication between the child and their parents, because at some stage the child will be responsible for their own medication use.
Background Electronic medication management (eMM) has been shown to reduce medication errors; how... more Background Electronic medication management (eMM) has been shown to reduce medication errors; however, new safety risks have also been introduced that are associated with system use. No research has specifically examined the changes made to eMM systems to mitigate these risks. Objectives To (1) identify system-related medication errors or workflow blocks that were the target of eMM system updates, including the types of medications involved, and (2) describe and classify the system enhancements made to target these risks. Methods In this retrospective qualitative study, documents detailing updates made from November 2014 to December 2019 to an eMM system were reviewed. Medication-related updates were classified according to “rationale for changes” and “changes made to the system.” Results One hundred and seventeen updates, totaling 147 individual changes, were made to the eMM system over the 4-year period. The most frequent reasons for changes being made to the eMM were to prevent medication errors (24% of reasons), optimize workflow (22%), and support “work as done” on paper (16%). The most frequent changes made to the eMM were options added to lists (14% of all changes), extra information made available on the screen (8%), and the wording or phrasing of text modified (8%). Approximately a third of the updates (37%) related to high-risk medications. The reasons for system changes appeared to vary over time, as eMM functionality and use expanded. Conclusion To our knowledge, this is the first study to systematically review and categorize system updates made to overcome new safety risks associated with eMM use. Optimization of eMM is an ongoing process, which changes over time as users become more familiar with the system and use is expanded to more sites. Continuous monitoring of the system is necessary to detect areas for improvement and capitalize on the benefits an electronic system can provide.
The American Journal of Pharmaceutical Education, Mar 1, 2020
Objective. To explore models of teaching in, resources available to, and delivery of a standardiz... more Objective. To explore models of teaching in, resources available to, and delivery of a standardized course in pharmacy ethics. Methods. An email invitation was sent to the educator responsible for teaching pharmacy ethics at each of 19 institutions in Australia and New Zealand. Over a six-to eight-week period, semi-structured interviews were conducted in person, by email, or by phone, and were audio-recorded where possible, transcribed verbatim, and entered into data analysis software. Using an inductive analysis approach, themes related to the topics and issues discussed in the interview process were identified. Results. Of the educators invited to participate, 17 completed an interview and were included in this study. Participants reported a paucity of resources available for teaching pharmacy ethics at schools in Australia and New Zealand. Compounding this issue was the lack of expertise and ad-hoc process educators used to create their courses. Assessment methods varied between institutions. Participants felt schools needed to move toward a more standardized pharmacy ethics course with clear and defined guidelines. Conclusion. This study identified many areas in pharmacy ethics that need improvement and revealed the need to develop resources and course structure that adhere to the highest level of Miller's pyramid, while using known frameworks to evaluate ethical competency.
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Papers by Rebekah Moles