Transcript Presentation title goes here

Connecting global/international pharmacy
education (G/I PE) to CAPE 2013: rationale and
steps for curricular implementation
Jordan R. Covvey, Pharm.D., Ph.D., BCPS
Duquesne University Mylan School of Pharmacy;
Pittsburgh, PA
[email protected]
Shaun Ellen Gleason, Pharm.D., MGS
University of Colorado Skaggs School of Pharmacy
and Pharmaceutical Sciences; Aurora, CO
[email protected]
Learning outcomes
At the end of this webinar, the first in the Global Pharmacy Education (GPE) SIG’s three-part
series on G/I PE, the learner will be able to:

State the rationale for and benefits of G/I PE, including its current state in United States
pharmacy curricula and among the wider professional audience

Identify ideal G/I PE student competencies and how G/I PE ties to the CAPE 2013
Outcomes overall, and within specific domains and subdomains

Summarize key elements in the planning of G/I PE curricular implementation from
programmatic, didactic and experiential coursework perspectives

Discuss strategies for G/I PE curricular design and integration with reference to
Bloom’s and Krathwohl’s taxonomy
GPE SIG CAPE paper

Connecting global/international pharmacy education to the CAPE 2013 outcomes: a
report from the Global Pharmacy Education Special Interest Group

Available on the AACP website here

Collaborative effort of 10 members of the AACP GPE SIG

Multi-stage developmental process

Proposal development/submission – February 2015

Peer reviewer acceptance/feedback – April 2015
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Research and writing process – Summer 2015

Final paper submission/revisions – Fall 2015
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Publication – February 2016
Global/international pharmacy education

Public health


“science/art of preventing disease, prolonging life and promoting physical health”
International health

“application of the principles of public health to problems and challenges that affect
low and middle-income countries and to the complex array of global and local
forces that influence them”

Global health

“an area for study, research, and practice that places a priority on improving health
and achieving equity in health for all people worldwide”
Rationale/benefits of G/I PE

Medicine, nursing and other professions offer many forms of global health education
–
Curriculum tracks or concentrations, certificate programs, dual graduate degrees,
residency/fellowship training
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R&D in global health and development have wide-reaching benefits
–
“for every U.S. dollar spent… 64 cents go directly to domestic-based researchers and
product developers, generating jobs, research and technological capacity, and
additional investment”

Wider job market of businesses and organizations are adopting an increasingly global
mindset recognizing qualities in applicants with global experience
–
Curiosity, willingness to take risks, non-judgmental attitude, broad worldview
Current state of G/I PE in pharmacy

WHO GPE Taskforce
–

“Enable the sustainability of a pharmacy workforce that is relevant to local needs”
FIP Education Initiative statement
–
“…pharmacy education should be locally determined, socially accountable, globally
connected, and quality assured in order to meet the given health needs of communities”
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AACP has identified G/I PE activities as a growing priority in higher education
–
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“Global perspective on pharmacy education and patient welfare”
GPE SIG white papers on current practices in G/I APPEs
–
Part 1 - Home/host country or site and institution considerations
–
Part 2 - Preceptor and student considerations
G/I PE student competencies

Consensus development of competencies to guide curricular frameworks


Detailed competencies available in the CAPE paper
Focused on pharmacy’s role in:

Population health and patient-centered care

Addressing health disparities

Articulating varying models of healthcare

Developing cultural competency
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Empathy, humanistic communication and ethics

Developing global citizenship and social responsibility

Awareness of accountability to development goals
Mapping G/I PE to CAPE outcomes
Domain
Subdomain
1 – Foundational knowledge
1.1 Learner
2 – Essentials for practice and care
2.1 Patient-centered care
2.2 Medication use systems management
2.3 Health and wellness
2.4 Population-based care
3 – Approach to practice and care
3.1 Problem solving
3.2 Educator
3.3 Patient advocacy
3.4 Interprofessional collaboration
3.5 Cultural sensitivity
3.6 Communication
4 – Personal and professional development
4.1 Self-awareness
4.2 Leadership
4.3 Innovation and entrepreneurship
4.4 Professionalism
YOUR thoughts on the CAPE domains
To the audience (respond in the public chat feature):
Which domains/subdomains are most important to G/I PE and why?
How do you achieve them in your curriculum?
Mapping G/I PE to CAPE outcomes, cont.
Domain
Subdomain
1 – Foundational knowledge
1.1 Learner
2 – Essentials for practice and care
2.1 Patient-centered care
2.2 Medication use systems management
2.3 Health and wellness
2.4 Population-based care
3 – Approach to practice and care
3.1 Problem solving
3.2 Educator
3.3 Patient advocacy
3.4 Interprofessional collaboration
3.5 Cultural sensitivity
3.6 Communication
4 – Personal and professional development
4.1 Self-awareness
4.2 Leadership
4.3 Innovation and entrepreneurship
4.4 Professionalism
Mapping G/I PE to CAPE outcomes, cont.

Learner (1.1)


Health and wellness (2.3) and Population-based care (2.4)


Mastery and integration across all curricular areas to deliver globally effective care
Prevention and treatment with a community focus
Problem solver (3.1), Educator (3.2), Interprofessional collaboration (3.4),
Cultural sensitivity (3.5) and Communicator (3.6)


Working with and adapting to different communities, cultures and settings
Self-awareness (4.1), Leadership (4.2), Professionalism (4.4)

Necessary skills to challenging the affective domain and to commit to growth,
reflection and respect
Planning goals
Vision,
Mission,
STRATEGIC
PLAN
Champion
Celebrate!
CULTURE
Curricular
opportunities
CAPE/ACPE
CQI
Collaborate
Alsharif NZ et al; AACP White Paper: Current Practices in Global/International Advanced
Pharmacy Practice Experiences (Part 1): Home/host Country or Site and Institution
Considerations; Am J Pharm Educ. In press 2015
Curricular design: didactic overview

Types of experience




Required or elective course
Sub-section of a course
Lecture series
Creative ideas!




Team-based learning
Simulation
Inter-professional
Others – G/I health tracks, foreign languages
CAPE 2013 Outcomes: Knowledge, skills, attitudes, selfawareness, leadership
Curricular design: Experiential overview

IPPEs or APPEs

Research or practice experience

Inter-professional

International

Local: underserved clinics, refugee clinics, etc.

Pre/post experience learning activities
CAPE 2013 Outcomes: Knowledge, skills, attitudes, selfawareness, leadership
Curricular design: Co-curriculum
TONS of opportunities!!

Cultural competency

Service learning: local

Research

Professional meetings with global health focus
Current examples of G/I PE
Type of
G/I PE
Required
Elective
Didactic /
Experiential
Topics
Features
Global Health
Course
Elective
Didactic
Social disparities, health
and human rights, etc.
TBL; local
Public Health
Required
Didactic
Hepatitis B, travel
vaccines
Poster project;
local
Pre-APPE
Elective
Didactic
Culture, travel prep,
disease management
Small group
discussion; local
Experiential
Health promotion;
attitudes, values &
culture; systems
management
Advanced, IPE
Experiential
Dispensing issues,
pharmacist roles, patient
education, IPE issues
International;
capstone;
students apply
Medical mission
Experiential
Elective
Elective
CAPE 2013: Potential activities
CAPE 2013
domain/
subdomain
1.1
(Learner)
2.3
(Health and
wellness)
3.6
(Communicator)
Learning objective
Describe differences in
disease burden across
different parts of the world
Discuss how evidence-based
medicine integrates within
alternative healthcare models
Identify vaccinations as
appropriate to the patient and
geographic area
Discuss methods for
approaching language barriers
during counseling.
Sample activity
Journal club demonstrating use
of evidence-based medicine in
alternative healthcare settings or
modalities
Sample course
Evidence-based
medicine
(Required)
Global Health
(Elective)
Knowledge-based quiz on
appropriate vaccinations for
geographic area
ID
Pharmacotherapy
(Required)
Health screening event on
HIV/AIDS
Global Health
(Elective)
Assign reflection papers on
lessons learned from IPPE
encounter of non-English
speaking patients, including
assessment of steps for
continued learning.
IPPEs (Required)
YOUR G/I PE curricular ideas
To the audience (respond in the public chat feature):
What are some examples of G/I PE that you have done?
What challenges and/or best practices can you share?
Taxonomy levels

Achieve higher levels of Bloom’s and Krathwohl’s

Vertical and horizontal integration of both
 Cognitive knowledge with appropriate attitudes,
values and behaviors
 Role of pharmacist in global health
Bloom’s Taxonomy of Cognitive Learning
Cognitive taxonomy
Sample strategies
Knowledge
Define cultural sensitivity
Identify standards of practices in different G/I PE areas
Comprehension
Explain local cultural challenges and global health ramifications
Identify patients who would benefit from an interpreter
Recognize local healthcare needs of the community.
Application
Apply clinical thinking skills to limited drug formulary
Suggest prevention and treatment strategies
Tailor recommendations to local needs of communities
Use culturally sensitive methods of patient-interviewing
Analysis
Research/review meds and resources in a given area
Compare different models of healthcare delivery
Synthesis
Evaluation
Create a formulary for a resource-constrained area, based on research of available
medications, available resources, etc. of a given area
Create case-based questions
Recommend potential solutions to challenges in relation to global health
disparities
Write a reflection essay on medical mission, patient interaction, interprofessional
experience and leadership
Evaluate health system missions, policies, procedures related to patient-centered
culturally sensitive health care
Krathwohl’s Taxonomy of Affective Learning
Affective taxonomy
Strategies
Receiving: pays
attention to input
Emphasize the rationale/benefits of G/I PE
Link global health to what is happening locally and nationally
Encourage assertiveness of student engagement and discussion in class
Responding:
willingly participates
Emphasize student responsibility for learning.=
Create a ‘safe’ classroom for inquiry by emphasizing the low risk of participation
and potential harm if student is wrong in the controlled classroom environment of
the course
Valuing: attaches
worth to input and
participation
Illustrate how use of the oath of the pharmacist is essential to the student as a
professional
Emphasize the role of the pharmacist in addressing global health issues
Organization: adopts
value internally
Predictive clinical decision-making is used to build internal valuing of use of this
knowledge to improving the health of patients in general and addressing global
health issues
Characterization:
incorporates into daily
ways
Exhibited motivation for service activities and enrolling in G/I APPEs
Increased interest in pursuing residencies and careers in global education and
global health, pursuing Masters in Public Health (MPH)
Curricular integration - Example
G/I PE curricular integration
(TB patient care: fundamentals to global APPE)
P1
Med
chem
(TB
meds)
Pharmacology
(TB meds)
P2
Patient
assessment
and
communication
Pharmacotherapy
(ID)
Public
health
course
P3
Global
health
elective
Foreign
language/
communication
elective
 Horizontal: Multidisciplinary
 Vertical: P1 - P4
 Spiral: Didactics to experiential with both horizontal
and vertical integration
P4
Global
APPE in
nonEnglish
speaking
TBendemic
area
CAPE 2013
CAPE 2013 domain/subdomain
other outcomes
Example mapping to other competencies
(e.g. FIP Global Competency Framework, CO-14 Abilitiesbased Outcomes)
Continuous
1.1 (Learner) Develop, integrate, and
professional
apply knowledge from the
development
foundational sciences
(CPD)
Retrieve, evaluate, and utilize basic
science, professional, and lay information in
a critical and scientific manner that
enhances the practice of pharmacy
2.4 (Population-based care)
Describe influence of populationbased care on patient-centered care
and influence development of
practice guidelines and evidencebased practices
Manage medication use systems to
optimize patient and population outcomes
Health promotion
3.2 (Educator) Educate all
audiences by determining the most
effective and enduring ways to impart
information and assess
understanding
Patient consultation
and diagnosis
Develop and participate in health
promotion, disease prevention, and public
health policy
4.4 (Professionalism) Exhibit
behaviors and values that are
consistent with the trust given to the
profession by patients, other
healthcare providers, and society
Professional and
ethical practice
Exhibit the highest standards of
professional and ethical behavior in
pharmacy practice
Develop and participate in health
promotion, disease prevention, and public
health policy
YOUR G/I PE curricular ideas
To the audience (respond in the public chat feature):
How have YOU been able to integrate G/I PE activities
across your curriculum?
What challenges and/or best practices can you share?
Planning goals
Vision,
Mission,
STRATEGIC
PLAN
Champion
Celebrate!
CULTURE
Curricular
opportunities
CAPE/ACPE
CQI
Collaborate
Alsharif NZ et al; AACP White Paper: Current Practices in Global/International Advanced
Pharmacy Practice Experiences (Part 1): Home/host Country or Site and Institution
Considerations; Am J Pharm Educ. In press 2015
Summary

Global health education is an emerging priority, including
within pharmacy education and practice

Suggested G/I pharmacy student competencies include those
related to pharmacy’s role in global health, social
responsibility, patient-centered care and developing cultural
competency

G/I PE can be tied to outcomes in all domains of
CAPE 2013

Planning for G/I PE starts with a global mindset, followed by
programmatic planning, and mindful inclusion of G/I activities,
tied to CAPE 2013, across the curriculum, considering
taxonomy levels
Summary, cont.

Thank you for your time today and
to the authors who contributed so
greatly to the GPE SIG’s CAPE
paper:
 Shaun Gleason, Jordan Covvey,
Jeanine Abrons, Yen Dang, SeeWon Seo, Toyin Tofade, Gina
Prescott, Emily Peron, Santhi
Masilamani and Naser Alsharif

Be sure to sign up for the next
webinar in the GPE SIG series on
March 23rd at 10am EST!
Questions?
References

Gleason SE, Covvey JR, Abrons JP, Dang Y, Seo S, Tofade T, Prescott GM, Peron
EP, Masilamani S, Alsharif NZ. Connecting global/international pharmacy education
to the CAPE 2013 outcomes: a report from the global pharmacy education special
interest group. 56 p. Located at: AACP Center for the Advancement of Pharmacy
Education, Alexandria, VA.
http://www.aacp.org/resources/education/CAPE/pages/default.aspx

Alsharif NZ, et al; AACP White Paper: Current Practices in Global/International
Advanced Pharmacy Practice Experiences (Part 1): Home/host Country or Site and
Institution Considerations; Am J Pharm Educ. In press 2015.

Bloom BS, Engelhart MD, Furst EJ, Hill WH, Krathwohl DR. Taxonomy of
educational objectives: The classification of educational goals. Handbook I:
Cognitive domain. New York: David McKay Company, 1956.

Krathwohl DR, Bloom BS, Masia BB. Taxonomy of Educational Objectives: book 2;
affective domain. New York, Longman, 1964.