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Global Conference Innovations in Pharmacy Education Activity Number: 0217-0000-15-150-L01-P, 1.50 hours of CPE credit; Activity Type: A Knowledge-Based Activity Wednesday, October 21, 2015 9:45 a.m. to 11:15 a.m. Continental Ballroom 5 Moderator: William A. Kehoe, Pharm.D., FCCP, BCPS Professor of Clinical Pharmacy and Psychology; Chair, Department of Pharmacy Practice, University of the Pacific Stockton, California Agenda 9:45 a.m. Re-engineering Pharmacy Education: How Can we Best Prepare Graduates for Clinical Pharmacy Practice Now and In the Future Paul O. Gubbins, Pharm.D., FCCP Associate Dean, Vice Chair & Professor, UMKC School of Pharmacy at MSU Division of Pharmacy Practice & Administration, University of Missouri-Kansas City, Springfield, Missouri 10:30 a.m. ”Flip this Classroom”: Exploring the Use of the Flipped Classroom Model in Pharmacy Education Mary T. Roth McClurg, Pharm.D., MHS, FCCP Associate Professor, Division of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina Jacqueline McLaughlin, PhD, MS Assistant Professor, Educational Innovation and Research; Director, Office of Strategic Planning and Assessment, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Conflict of Interest Disclosures Paul O. Gubbins: no conflicts to disclose. William A. Kehoe: no conflicts to disclose. Jacqueline McLaughlin: no conflicts to disclose. Mary T. Roth McClurg: no conflicts to disclose. Learning Objectives 1. Review the emerging roles of clinical pharmacists in the healthcare environment and how these relate to preparation of pharmacy graduates in the next 20 years. 2. Discuss the impact of new accreditation standards on development and modification of pharmacy curricula to meet the needs of the changing healthcare environment. 3. Discuss the role of interprofessional and service learning experiences in the experiential training of student pharmacists. © American College of Clinical Pharmacy 1

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Global Conference

Innovations in Pharmacy Education Activity Number: 0217-0000-15-150-L01-P, 1.50 hours of CPE credit; Activity Type: A Knowledge-Based Activity Wednesday, October 21, 2015 9:45 a.m. to 11:15 a.m. Continental Ballroom 5 Moderator: William A. Kehoe, Pharm.D., FCCP, BCPS Professor of Clinical Pharmacy and Psychology; Chair, Department of Pharmacy Practice, University of the Pacific Stockton, California Agenda

9:45 a.m. Re-engineering Pharmacy Education: How Can we Best Prepare Graduates for Clinical Pharmacy Practice Now and In the Future

Paul O. Gubbins, Pharm.D., FCCP Associate Dean, Vice Chair & Professor, UMKC School of Pharmacy at MSU Division of Pharmacy Practice & Administration, University of Missouri-Kansas City, Springfield, Missouri

10:30 a.m. ”Flip this Classroom”: Exploring the Use of the Flipped Classroom Model

in Pharmacy Education Mary T. Roth McClurg, Pharm.D., MHS, FCCP

Associate Professor, Division of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina

Jacqueline McLaughlin, PhD, MS Assistant Professor, Educational Innovation and Research; Director, Office of Strategic Planning and Assessment, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

Conflict of Interest Disclosures Paul O. Gubbins: no conflicts to disclose. William A. Kehoe: no conflicts to disclose. Jacqueline McLaughlin: no conflicts to disclose. Mary T. Roth McClurg: no conflicts to disclose. Learning Objectives

1. Review the emerging roles of clinical pharmacists in the healthcare environment and how these relate

to preparation of pharmacy graduates in the next 20 years. 2. Discuss the impact of new accreditation standards on development and modification of pharmacy

curricula to meet the needs of the changing healthcare environment. 3. Discuss the role of interprofessional and service learning experiences in the experiential training of

student pharmacists.

© American College of Clinical Pharmacy 1

Global Conference

4. Explain the pedagogical benefits of using the flipped classroom model for delivery of pharmacy education compared to traditional teaching methods.

5. Explore the challenges of using the flipped classroom model. 6. Discuss the required resources and best approach to incorporating flipped classrooms into pharmacy

curricula, particularly for teaching therapeutics. Self-Assessment Questions

Self-assessment questions are available online at www.accp.com/gc15.

© American College of Clinical Pharmacy 2

Re-engineering Pharmacy Education: How Can we Best Prepare Graduates for Clinical Pharmacy Practice Now and In the FuturePaul O. Gubbins, Pharm.D., FCCPOctober 21, 2015

2015 ACCP Global Conference on Clinical Pharmacy

Conflict of Interests

The presenter has no conflicts of interest toreport

Learning Objectives

Review the emerging roles of clinical pharmacists in thehealthcare environment and how these relate topreparation of pharmacy graduates in the next 20 years.

Discuss the impact of new accreditation standards ondevelopment and modification of pharmacy curricula tomeet the needs of the changing healthcare environment.

Discuss the role of interprofessional and service learningexperiences in the experiential training of studentpharmacists.

Pharmacy Practice(History)

Profession’s role in U.S.healthcare systemcontinues evolving from

product focused

to patient “oriented”

to frontline of patient-centered care, wellness &disease prevention

Shord SS, et al. Pharmacotherapy 2013;33(4):e34–e42)

Pharmacy Practice(History)

Clinical pharmacists’value as integralinterprofessionalhealth care teammember proven….

again….

& again….

& again……

“Maximizingtherolesandscopeofpharmaciststodeliveravarietyofpatient‐centeredprimarycareandpublichealth,incollaborationwithphysicians,isaprovenandexistingparadigmofcarethatcanbeefficientlyimplemented.”

GibersonS,etal.AreporttotheU.S.SurgeonGeneral.Washington,DC:U.S.PublicHealthServiceOfficeoftheChiefPharmacist;2011 Dec .

“Maximizingtherolesandscopeofpharmaciststodeliveravarietyofpatient‐centeredprimarycareandpublichealth,incollaborationwithphysicians,isaprovenandexistingparadigmofcarethatcanbeefficientlyimplemented.”

GibersonS,etal.AreporttotheU.S.SurgeonGeneral.Washington,DC:U.S.PublicHealthServiceOfficeoftheChiefPharmacist;2011 Dec .

WHAT IS SHAPING FUTURE CLINICAL PRACTICE?

© American College of Clinical Pharmacy 3

Pharmacy Practice(Forces driving change)*

Technology

An aging population

Continued evolution of healthcare reform

Pharmacy workforce supply & demand

* In no particular order

Technology(Internet)

Low cost, fast method for many to accessmedical care & locate health resources

Empowers patient to actively participate inmanaging their health with their provider

Allows institutions, health professionals,health providers, & the public to interaction &collaborate (distance education, telemed, etc)

Srivastava S, et al. Comput Math Methods Med. 2015;2015:894171. doi: 10.1155/2015/894171

Technology(Mobile Platforms)

7 billion (≈ 95.5% ofworld pop.) mobilesubscriptionsworldwide

64% of Americansown smartphones, &for many it is a keyentry point to theonline world

Pew Research Center, April, 2015, “The Smartphone Difference” Available at: http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/ Accessed September 18, 2015

Technology(Mobile Platforms)

62% of smartphone owners use it to accesshealth information

Generations differ in readiness to adopttechnology, which will evolve over time

Practitioners must be cognizant of differences& adapt to patient preferences

LeRouge C, et al. J Med Internet Res. 2014 Sep 8;16(9):e200. doi: 10.2196/jmir.3049.

THE AGING POPULATION

Aging Population(Impact of Baby Boomers)

Entire generation willbe ≥ 65 in 2030

U.S population 65 +

2010: 13%

2030: 19%

Drive pop ≥ 65 tomore than doublefrom 2010 to 2050

The Next Four Decades The Older Population in the United States: 2010 to 2050. U.S. Department of Commerce Economics and Statistics Administration, U.S. Census Bureau, May 2010

© American College of Clinical Pharmacy 4

Chronic illnesses & medication use common

hypertension 43%; anti-hypertensives 35.4%

dyslipidemias 73.5%; dyslipidemics 25.9%

diabetes 15.5%; anti-diabetics 11.3%

Obesity common (38.7%)

Infrequent regular exercise or no regularphysical activity common

Aging Population(Health of the Baby Boomers)

King DE, et al. JAMA Intern Med. 2013;173(5):385-6

HEALTH CARE REFORM

Health Care Reform(The PPACA)

Largest change inU.S. health policysince Medicare &Medicaid enacted in1965.

Main provisions firmlyestablished in U.S.health policy

Shaw FE, et al. Lancet 2014; 384: 75–82

Health Care Reform(Basic Goals)

Provide security of health insurance touninsured Americans

Increase the quality of care

Restrain the growth of costs

Advance population health

Shaw FE, et al. Lancet 2014; 384: 75–82

Health Care Reform(Impact on Practice)

Added ≈ 16 million toinsurance rolls so far

CBO estimates ACAwill add 26 million toinsurance rolls by2017

Shaw FE, et al. Lancet 2014; 384: 75–82

Health Care Reform(Impact on Practice)

Creation & evaluation of new clinical caremodels (i.e. ACO)

Provisions that strengthens link between costof care & quality of care

Hospital Readmission Reduction program

Healthcare-Acquired Condition program

Shifts spending from rewarding volume ofcare provided to rewarding value provided

Shaw FE, et al. Lancet 2014; 384: 75–82

© American College of Clinical Pharmacy 5

WORKFORCE SUPPLY & DEMAND

0

2000

4000

6000

8000

10000

12000

14000

16000

First Professional (B.S. & Pharm.D.) Total*

Pharmacy Graduates(1996-2014)

Contains Pharm.D. degrees conferred for all years and professional B.S. degrees conferred prior to July 1, 2005

http://www.aacp.org/resources/research/institutionalresearch/Pages/TrendData.aspx

Pharmacy Workforce 2014(Practicing Pharmacists)

75% of all licensed pharmacists

≈ 32% ≤ 40 years old

≈ 31% ≥ 55 years old

Full-time professionals averaged 44.2 hrs/wk

Gaither CA, et al. 2014 National Pharmacist Workforce Survey. http://www.aacp.org/resources/research/pharmacyworkforcecenter/Pages/default.aspx

Pharmacy Workforce 2014(Practice Settings)

SettingProportion of Pharmacists

(%)Change from 2009

Community (i.e. independent, chain, mass merchandiser, & supermarket pharmacies)

44.1 ↓

Hospital 29.4 ↑

Other Patient Care 16.7 ↑

Other Non-Patient Care 7.5 ↑

Gaither CA, et al. 2014 National Pharmacist Workforce Survey.http://www.aacp.org/resources/research/pharmacyworkforcecenter/Pages/default.aspx

Pharmacy Workforce 2014(Work Place Activities)

FT Pharmacist Activity 2014 Time of Effort

(%)2009 Time of Effort

(%)

Patient care services associated with medication dispensing

49 55

Patient care services not associated with medication dispensing*

21 16

Business/organization management

13 14

Education 7 5

Research 4 4

Other Activities 6 5

*35.3% of community pharmacist indicated time spent on patient care increased

Gaither CA, et al. 2014 National Pharmacist Workforce Survey.http://www.aacp.org/resources/research/pharmacyworkforcecenter/Pages/default.aspx

Pharmacy Workforce 2014(Current Services Provided)

Most common: MTM (60%), immunizations(53%) & adjusting meds (52%)

48% in chain sites & 57% in supermarketsites offer health screenings.

77% of hospitals offered Med Rec

> 25% of other patient care settings &hospital pharmacies have CPAs in place

Gaither CA, et al. 2014 National Pharmacist Workforce Survey.http://www.aacp.org/resources/research/pharmacyworkforcecenter/Pages/default.aspx

© American College of Clinical Pharmacy 6

Pharmacy Workforce 2014(Pharmacist Workloads Perceptions)

Nearly two-thirds believe workload high orexcessively high

Full-time pharmacists workload

64% believe it increased or greatly increased inpast year

45% believe it had negative or very negativeeffects on mental/emotional health

In chain & mass market settings workloadnegatively impacted time spent with patients

Gaither CA, et al. 2014 National Pharmacist Workforce Survey.http://www.aacp.org/resources/research/pharmacyworkforcecenter/Pages/default.aspx

Pharmacy Workforce 2014(Work Place Labor Reductions)

Work Place Adjustment 2014 (%) 2009 (%)

Restructuring of pharmacist work schedules to save labor costs

35 26

Mandatory reductions in pharmacist hours

17 13

Pharmacist layoffs 9 6

Early retirement incentives for pharmacists

6 4

Gaither CA, et al. 2014 National Pharmacist Workforce Survey.http://www.aacp.org/resources/research/pharmacyworkforcecenter/Pages/default.aspx

Pharmacy Workforce 2014(Aggregate Demand Index-Jul 2015)

Region Index Value

All Regions 3.62

Northeast 3.53

Midwest 3.71

South 3.64

West 3.56

Pharmacy Workforce Center. “Time-based Trends in Aggregate Demand Index.” http://pharmacymanpower.com/trends.jsp Accessed 09.19.2015

Health Care Reform &the Pharmacy Workforce

Profession in midst ofdynamic times

Direct patient careservices increasing

Opportunities for newroles likely to increase

“Iftheroleofpharmacistschangeswherepharmacistsspendsubstantiallymoretimeprovidingpatientcaremanagementservices,thendemandwillbehigherthanprojected.”

Department of Health and Human Services Health Resources and Services Administration Bureau of Health Professions. The Adequacy of Pharmacist Supply: 2004 to 2030. Rockville (MD): December 2008. Available at: http://bhpr.hrsa.gov/healthworkforce/reports/pharmsupply20042030.pdf, Accessed September 9, 2015

“Iftheroleofpharmacistschangeswherepharmacistsspendsubstantiallymoretimeprovidingpatientcaremanagementservices,thendemandwillbehigherthanprojected.”

Department of Health and Human Services Health Resources and Services Administration Bureau of Health Professions. The Adequacy of Pharmacist Supply: 2004 to 2030. Rockville (MD): December 2008. Available at: http://bhpr.hrsa.gov/healthworkforce/reports/pharmsupply20042030.pdf, Accessed September 9, 2015

Gaither CA, et al. 2014 National Pharmacist Workforce Survey.http://www.aacp.org/resources/research/pharmacyworkforcecenter/Pages/default.aspx

EMERGING ROLES OF CLINICAL PHARMACISTS IN THE HEALTHCARE ENVIRONMENT

Medication Management(Unmet Needs)

Medication Related Problems Examples

Clinician-influenced gaps in care

• inappropriate prescribing • ineffective prescribing• lack of care coordination• and inconsistent monitoring

Patient-influenced gaps

• health beliefs• health illiteracy• past medication

experiences• nonadherence

Systematic Gaps• processes lacking for

medication reconciliation• poor care transitions

Smith M, et al. Health Affairs 2013;32 (11):1963-1970

© American College of Clinical Pharmacy 7

Medication ManagementServices (MMS) Build “gold standard” list of current prescribed

& self-care medications

Assess appropriateness, efficacy, safety, &adherence of each med to achieve optimaltherapy goals

Develop personalized medication action plan

Document & communicate actionablerecommendations to patients & providers

Smith M, et al. Health Affairs 2013;32 (11):1963-1970

Pharmacy MMS(Integrated, Team-based Care)

Partner with patients, families, & providers tofocus on patient specific issues that are keyto achieving desired outcomes

Manage medication related problems,prevent ADE to avoid preventable medicationrelated hospitalizations & ED

Help ensure optimal drug therapy outcomesduring care transition

Smith M, et al. Health Affairs 2013;32 (11):1963-1970

Pharmacy MMS Models(Employed Model)

Employed by practice as a clinician staffmember

Suitable for large group practices orintegrated delivery systems

Must be able to afford hiring pharmacists fornon-dispensing activities

Smith M, et al. Health Affairs 2013;32 (11):1963-1970

Pharmacy MMS Models(Embedded)

Employed, (usually part time), at practice sitevia partnership between practice & a hospitalpharmacy or pharmacy school

Has responsibility for training pharmacystudents & residents in team-based care &medication management

Affordable: partner & practice shareresponsibility for pharmacist’s compensation

Smith M, et al. Health Affairs 2013;32 (11):1963-1970

Pharmacy MMS Models(Regional)

Employed by health system or physicianorganization & serves several practices in ageographic area

Typically focused on population health, maydevelop & deliver MMS in the practices

Can be involved in educational programs,quality improvement services, & outcomesresearch

Smith M, et al. Health Affairs 2013;32 (11):1963-1970

Pharmacy MMS Models(Shared Resource Network )

Contracted by a provider group, ACO, orpayer to provide MMS for specific patients

Meets with a patient in person in variety ofsettings, or via telemedicine connection

Attractive to smaller MD practices, ACOs,community-based health teams, & payers,network responsible for personnel

Smith M, et al. Health Affairs 2013;32 (11):1963-1970

© American College of Clinical Pharmacy 8

Integrated health care delivery system

Serves > 530,000 members (Denver/Boulder& its metro area, Colorado Springs, Pueblo,Loveland, & Ft. Collins)

Clinical pharmacists provide primary &specialty patient care as part of a PCMH

Centralized clinical pharmacy telephonicservices also provided

Regional Model Example(Kaiser Permanente Colorado-KPCO)

Heilmann RMF, et al. Ann Pharmacother 2013;47:124-31.

Regional Model Example(Kaiser Permanente Colorado-KPCO)

Clinical pharmacists knowledge & skills

complement other care team members

foster a collaborative team-based environment

Evidence-based patient care enabled throughCDTM agreements with physician partners

Heilmann RMF, et al. Ann Pharmacother 2013;47:124-31.

Pharmacist Activities(KPCO)

≈70% effort devoted to consulting with PCPor providing direct patient care

≈ 25% effort devoted to addressing regional& clinic-specific pop. management initiatives

≈ 5% effort devoted to non-patient careactivities

Heilmann RMF, et al. Ann Pharmacother 2013;47:124-31.

Large, urban, academic medical centerpartner with state department of corrections

Provides care for inmates in 28 adultcorrectional facilities using a interprofessionalapproach

Technology enables interactions similar totraditional face-to-face clinic visit

Shared Resource Example(UIC HIV Telemedicine Clinic)

Badowski M, et al. Am J Health-Syst Pharm 2012;(69):1630-3

Patient education

MMS addressing med adherence, identifyingand managing medication induced AEs,managing drug interactions, & makingtherapeutic recommendations

Subsidized via contract & savings from 340Bprogram

UIC HIV Telemed Clinic(Pharmacist Role)

Badowski M, et al. Am J Health-Syst Pharm 2012;(69):1630-3

CURRICULAR MODIFICATIONSTO MEET THE NEEDS OF THE CHANGING HEALTHCARE ENVIRONMENT

Standards 2016:

© American College of Clinical Pharmacy 9

Meeting Practice NeedsThrough Standards Revision

Current & futurecompetencies ofpharmacists

Practices to assessstudent learning & thequality of professionalpharmacy programs

“The status quo is not an option” in pharmacy practice, pharmacy education…“We must continue to advance the roles of pharmacists to meet the future needs of patients”

Opening remarks by Robert S.Beardsley, PhD, President of ACPE, at the ACPE Consensus Conference on Advancing Quality in Pharmacy Education September 12-14, 2012, Atlanta, GA.

“The status quo is not an option” in pharmacy practice, pharmacy education…“We must continue to advance the roles of pharmacists to meet the future needs of patients”

Opening remarks by Robert S.Beardsley, PhD, President of ACPE, at the ACPE Consensus Conference on Advancing Quality in Pharmacy Education September 12-14, 2012, Atlanta, GA.

Zellmer WA, et al. American Journal of Pharmaceutical Education 2013; 77 (3) Article 44.

Standards 2016(What’s Different) Philosophy and Emphasis based on stakeholder feedback

refined to ensure that graduating students are“practice-ready” & “team-ready”

greater emphasis on CAPE outcomes & the levelof student achievement of these outcome

emphasize assessment as a means of improvingthe quality of pharmacy education

Formatting, organization, guidance, moreinnovation

Accreditation Council for Pharmacy Education. Standards 2016. February 2, 2015. Chicago, IL

CAPE Outcomes(Version 4.0) Influenced by 3 pillars of pharmacy education

& consistent with IOM core competencies

pharmaceutical care, management of medication-use systems, public health

Added attention to

affective domain of pharmacy practice (e.g.communication, professionalism, etc.,)

patient safety

interprofessional health care.

Medina MS, et al. Am J Pharm Ed 2013; 77 (8) Article 162.

CAPE Outcomes(Version 4.0) Focused on the end product of Professional

Pharmacy program (i.e. the knowledge, skills, & attitudes all entry-level graduates should possess

Define the curricular priorities of the Doctor ofPharmacy programs

Aspirational & emphasize increased programexpectations

Medina MS, et al. Am J Pharm Ed 2013; 77 (8) Article 162.

CAPE Outcomes(Version 4.0)

Purposefully constructed around 4 broaddomains to guide education pharmacists whopossess: foundational knowledge that is integrated

throughout pharmacy curricula

essentials for practicing pharmacy & deliveringpatient-centered care

effective approaches to practice & care

the ability to develop personally and professionally

Medina MS, et al. Am J Pharm Ed 2013; 77 (8) Article 162.

CAPE Outcomes(Affective Domain) Included to recognize importance of

professional skills & personal attributes to practice

emphasizes self-awareness, innovationleadership, & professionalism needed for practice

bridges foundational scientific knowledge withessential skills & approaches to practice & care

Enables pharmacists to transform knowledge& skills into positive outcomes in all settings.

Medina MS, et al. Am J Pharm Ed 2013; 77 (8) Article 162.

© American College of Clinical Pharmacy 10

Standards 2016(Team & Practice Ready)New or ImprovedElement

Contribution to Preparing Students for ChangingHealth Care Environment

Earlier experientialexperiences

• Foundational knowledge throughout curriculum,patient interactions, patient safety

• Communication, interacting with patients & otherprofessionals about medicines

• Professionalism

InterprofessionalEducation

• team-based skills (clinical expertise, developingcollaborative relationships, accountability for patient outcomes)

• IPE competencies & professionalism,

Enhanced assessment • Critical thinking

Pharmacy Curriculum Outcomes Assessment

• Assessment outcome achievement• Foundational knowlege

Co-curriculum • Professionalism, leadership, critical thinking,personal & professional Development

CONTRIBUTION OF IPE & SERVICE LEARNING IN THE EXPERIENTIAL TRAINING OF STUDENT PHARMACISTS

The Value of IPE Activities

Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessionalcollaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative.

““When students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes” Who (2010)

““When students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes” Who (2010)

Importance of Co-CurricularActivities in Pharmacy Education

Standard 4.2 requires program to developstudent leadership (“..demonstrateresponsibility for creating & achieving sharedgoals, regardless of position”) emphasizes “..importance curricular AND co-

curricular experiences in advancing professionaldevelopment of students”

Key element 12.3 - develop means todocument competency in the affectivedomain-related expectations in Std 3 & 4

Accreditation Council for Pharmacy Education. Standards 2016. February 2, 2015. Chicago, IL

Realizing the Value of Co-curricular Activities Health care reforms created greater patient care

& disease management roles

Leadership within profession needed to closegap between the vision of ideal practice &current practice requires within the profession

Exposing students to leadership concepts &professionalism provides skills needed toidentify opportunities & deal with challenges intheir careers

Chestnut R, et al. Am J Pharm Ed 2013; 77 (10) Article 225

Perceived Benefits toCo-curricular Assessments Educates “the whole student”

Allows for the integration of academic,professional, & personal development

Foster the development of student knowledge &personal development outside of the classroom

Activities often provide leadership opportunities

Leadership is teaches beliefs & skills that will beuseful in patient-centered team based practice

Fontaine SJ, et al. Online Journal of Distance Learning Administration, 2014; 17(3) Available from http://www.westga.edu/~distance/ojdla/fall173/fontaine_cook173.html University of West Georgia, Distance Education Center. Accessed: September 20, 2015

© American College of Clinical Pharmacy 11

Perceived Drawbacks toCo-curricular Assessments

Co-curricular activities have been considered“extra-curriculuar” (i.e. voluntary based uponindividual student interest(s)) not required

“Curricularizing” these activities will encouragestudents to enage in them for the wrong motives(“have to” not “want to”)

New infrastructure needed to develop & performassessment of these activities

Concluding Remarks

Several forces driving change have havecreated a dynamic era for pharmacy practice

Education & training standards areresponding to prepare students for emergingnew practice models & opportunities

Learners of today will practice in a patientcentered, team-based environment that willbe supported by health-information andpatient focused technology tomorrow

© American College of Clinical Pharmacy 12

Flip this classroom: Exploring the use of the Flipped Classroom Model in Pharmacy Education October 21, 2015 9:45-11:15

Presenters

Mary Roth McClurg, PharmD, MHSAssociate Professor

Jacqui McLaughlin, PhD, MSAssistant Professor, Educational Innovation and Research

Division of Practice Advancement and Clinical Education

UNC Eshelman School of Pharmacy

Chapel Hill, NC

Learning Objectives

Explain the pedagogical benefits of using the flippedclassroom model for delivery of pharmacy educationcompared to traditional teaching methods.

Explore the challenges of using the flipped classroommodel.

Discuss the required resources and best approach toincorporating flipped classrooms into pharmacycurricula, particularly for teaching therapeutics.

What does “flipped classroom” mean?

Bergmann & Sam (2012)

instructors post material online for students to learn on their own so that class time can be dedicated to student-centered learning activities, like problem-based learning and inquiry-oriented strategies

Also called: inverted, backward, or reverse classroom

Examples in physics, economics, medicine, etc. Lage (2000) J Econ Educ

Deslauriers (2011) Science

McLaughlin, JE, et al. (2014). The flipped classroom: A Course redesign to foster learning and engagement in a health professions school. Academic Medicine, 89(2), 1-8.

Flipped Classroom:Defined

Flipped Classroom:Structure

1. Pre-class learning

2. In-class active learning

3. Assessment

Necessary but not mutually exclusive

Many variations of the flipped classroom aredescribed in the literature

Constructive Alignment

Table 1. Characteristics of ten flipped courses at UNC Eshelman School of Pharmacy (2012-2014)

IDYear/Course

typePre-Class Learning

FormatIn-Class Learning

StrategiesGraded

Assessments1 Year 1/ Science Text Case-based learning (CBL) Quizzes, exams

2 Year 1/ Science VideoPeer discussions,

structured problem solvingQuizzes, exams

3 Year 1/ Science Video & text Clickers, CBL Quizzes, exams

4 Year 1/ Science Video & text Clickers; peer discussion Quizzes, exams

5 Year 1/ Science Video Clickers, CBL, micro-lectures Quizzes, exams, paper

6 Year 1/ Science Video Clickers; micro-lectures Quizzes, exams, paper

7 Year 2/ Science Text CBL, micro-lectures Quizzes, exams

8Year 2/

PharmacotherapyText Clickers, CBL, micro-lecture Quizzes, exams

9Year 2/

PharmacotherapyText Clickers, CBL, micro-lecture Exams

10Year 2/

PharmacotherapyText Clickers, CBL, micro-lecture Quizzes, exams

© American College of Clinical Pharmacy 13

Flipped Classroom:Examples

1. McLaughlin, JE, et al. (2014). The flipped classroom: A Course redesign to foster learning and engagement in a health professions school. Academic Medicine, 89(2), 1-8.

2. McLaughlin JE, et al. (2013). The flipped satellite classroom: Student engagement, performance, and perception. American Journal of Pharmaceutical Education, 77(9), Article 196.

Benefits

Why implement the flipped classroom?

PHCY 411

Quantitative Approach (quasi-experimental)

N = 162

1. Exam grades and course evaluations from 2011 (traditional) and 2012 (flipped)

independent t-test

2. Pre-post survey responses from 2012 class prior to start of first class and at conclusion of last class (n = 150)

paired t-test

PHCY 411

Primary findings

Flipped class in 2012 performed better than traditional class in 2011 on final exam (p <.01)

Course evaluation metrics significantly higher in 11/14 items (p< .05)

In pre-survey, 73% of students preferred lectures. In post-survey, only 15% of students preferred lectures to the flipped model (p<.001)

Innate needs

Intrinsic MotivationSelf Determination Theory

(Deci & Ryan, 2002)

1. Autonomy2. Relatedness3. Competence

Challenges Required Resources

Technological support Pre-class materials

In-class activities

Assessments

Educator development

Time

Teaching assistant?

Others?

© American College of Clinical Pharmacy 14

Questions

Mary Roth McClurg, PharmD, MHS - [email protected]

Jacqui McLaughlin, PhD - [email protected]

© American College of Clinical Pharmacy 15