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Satisfaction among residents in ASHP-accredited pharmacy residency programs.

The level of work satisfaction among pharmacists in ASHP-accredited residencies was studied. In March 1996 a questionnaire designed to measure residency satisfaction was mailed to 697 individuals in ASHP-accredited pharmacy practice and specialty practice residencies. Subjects responded to 16 statements relating to intrinsic and extrinsic determinants of work satisfaction on a scale of 1 to 5, where 1 = strongly disagree and 5 = strongly agree. Questionnaires were returned by 413 (59%) of the residents. The respondents were predominantly women (76%), and most (86%) had at least a Pharm. D. degree. Hospitals were the primary work setting (88%). Of the 413 residents, 305 were in pharmacy practice residencies and 108 were in specialized residencies. None of the mean scores indicated disagreement (scores < 3) with the positively worded statements or agreement (scores > 3) with the negatively worded statements. The median and mode were equal to 2 (disagree) for the three negatively worded items and 4 (agree) for all but three positively worded items. Only 8% of the residents indicated that they would not accept the residency again if given the chance. Specialized residents tended to rate positively worded statements higher and negatively worded statements lower than pharmacy practice residents. Female residents indicated greater satisfaction than male residents. Pay and benefits were rated slightly better than neutral. Pharmacy residents appeared generally satisfied with their residencies. Specialized pharmacy residents were more satisfied than pharmacy practice residents, and women were more satisfied than men.

Education, Pharmacy↗

Resident-preceptor retreat for re-evaluating a pharmacy residency program.

The organization of a resident-preceptor retreat as one component of a process to re-evaluate a pharmacy residency program is described. Changes in the ASHP standards for residency training and recommendations from a recent reaccreditation survey as well as recent changes in the health-care environment prompted a re-evaluation of the existing 24-month residency and degree program at The Ohio State University Hospitals. Three task forces were created to evaluate issues in seven areas of residency training. Members of the task forces, which consisted of current residents and staff members with preceptorial responsibilities, discussed the issues assigned to them during a retreat at a state park. Recommendations made at the retreat were assigned to individual task force members for implementation. Within nine months of the retreat, 15 of 17 recommendations had been implemented. A retreat involving both residents and preceptors can be an effective forum for discussing and critically evaluating a pharmacy residency program.

Education, Pharmacy↗

Computer skills enhance a hospital pharmacy residency training program.

Hospital pharmacy residents participated in a program designed to introduce them to computer systems useful in pharmacy practice and to provide them with access to a variety of computer resources that could be helpful in completing their residency projects. Using existing computer facilities, various short courses and individual tutorials were employed to train residents in a variety of computer skills. These courses provided a useful vehicle for recent pharmacist graduates to acquire necessary computer skills not obtained during their academic training. Because the program provided residents with the tools needed for the management and analysis of large data sets, a marked increase occurred in the number of residency projects acceptable for publication in peer-reviewed pharmacy journals. Thus, residency projects improved in quality and faculty preceptors were more motivated to get involved in such projects.

Computers↗

Community pharmacy residency programs, 1997-1998.

OBJECTIVE: To obtain a descriptive "snapshot" of community pharmacy residency programs active in 1997-1998. DESIGN: Survey (telephone interview) of community pharmacy residency program directors. METHODS: An advance letter to residency directors stated the purpose of the study and requested written information on their residency program. Using a scripted questionnaire, telephone interviews were conducted with each residency director. RESULTS: Descriptive statistics were used to portray the data. There were 13 active community pharmacy residency programs with 20 filled residency sites nationwide at the time of the study. Results revealed that 9 (69%) programs were funded by multiple sources, 3 programs were funded solely by the affiliated college, and 1 program was funded solely by the affiliated pharmacy. Of the 10 residency programs that had been in existence for longer than 1 year, 7 (70%) had the same funding source as they did the first year. Respondents provided descriptions of the residency programs, along with insight into the challenges of creating such programs. At the time of publication (November 1999), there were 50 active community residency sites within the 21 active community pharmacy residency programs. Several other programs are planned for implementation in July 2000. CONCLUSION: In general, community pharmacy residency programs continue to grow in number, and funding has been sustained due to the programs' successful outcomes. The results of this study provide a framework for the improvement of existing community pharmacy residency programs and the development of additional ones.

Community Pharmacy Services↗

Workload and cost-benefit of hospital pharmacy residents.

The workload performed by three hospital pharmacy residents during typical clinical rotations was quantified then subjected to cost-benefit analysis. Daily activities and interventions were recorded on standardized forms for a four-week period. The cost of a resident to provide direct patient care services was compared to that of a staff pharmacist. In addition, the balance of the residents' salary and partial salaries of any pharmacists spending time with the residents were included in the cost analysis. The interventions were analyzed for their impact on patient care and potential cost avoidance by an external review committee. Collectively, more than 660 hours were recorded. Fifty-two percent of hospital time was spent on education-related activities and 32 percent on the provision of clinical services. Thirty interventions were submitted to a review panel of three physicians. Of the 90 evaluations, 76 percent were considered to have a positive impact on patient care, 22 percent no effect, and two percent a potentially detrimental effect. In one case, reviewers thought that hospitalization could have been prolonged had the intervention not occurred. Cost-benefit analysis yielded a ratio of 1.4 to 1 in favour of the residents. While the major benefit of a residency program is the perceived long-term benefit to the profession and patients, this study suggests that even during their residency year, hospital pharmacy residents provide cost-beneficial clinical services.

Cost-Benefit Analysis↗

Cost justifying a pharmacy residency program.

Cost justification of a pharmacy residency training program was prepared. The contributions of the pharmacy residents were tabulated and compared with the cost of the program to the hospital. Contributions were determined by identifying the activities performed by residents that could be quantified in financial terms. The residents' activities that benefited the hospital included administrative support, completion of special projects, scheduling staff assignments, and coordinating education programs. Costs were derived from salaries, fringe benefits, and training expense. An output value analysis was performed by comparing the contributions of the residents to the institution with the cost of the training program. The contributions of the residents exceeded the costs of the training program by a ratio of 1.3 to 1.

Budgets↗

Evolution and operation of a pharmacy residency on-call program.

A pharmacy residency on-call program designed to contribute to residents' competence in patient care and to extend the functions of the pharmacy department is described. The program, which was begun at the University of Kentucky Chandler Medical Center in 1984, offers a supportive environment in which the resident is held accountable for pursuing optimal outcomes of drug therapy. The program provides opportunities for the resident to engage in independent decision-making, care for a wide variety of patients, and manage acute illness. On-call services are provided in single 24-hour shifts beginning at 0800 each day. Residents assess and respond to supratherapeutic serum drug concentrations, perform pharmacokinetic monitoring, provide drug information, evaluate patients for specific drug therapy, obtain medication histories for HIV-seropositive patients, and participate in emergency patient management. Residents provide services in the absence of the primary pharmacist on nights, weekends, and holidays and devote a four-hour period to drug distribution. Each pharmacy resident participates in the on-call program, regardless of the chief focus of his or her residency. Residents' activities are documented electronically, and preceptors give feedback via e-mail. The program and its activities have evolved over the years to reflect changes in pharmacy practice. An on-call program for pharmacy residents provides a valuable learning experience while enhancing patient care.

Education, Pharmacy, Graduate↗

Career goals and expectations of men and women pharmacy residents.

Personal and professional characteristics of men and women hospital pharmacy residents were studied to identify differences that could affect future hospital pharmacy practice. Residents in 111 ASHP-accredited pharmacy residency programs received a survey containing questions on demographic information, reasons for selecting a residency, areas of professional interest, postresidency career goals, responsibilities to home and family, and advantages and disadvantages associated with gender. Of 286 residents receiving questionnaires, 226 responded; the percentages of men and women responding corresponded to the ratio of men and women in hospital pharmacy residencies. While men and women expressed educational goals that were not significantly different, more men than women had earned or were in the process of earning advanced degrees. No significant differences were evident between men's and women's plans for marriage and children, but 73% of the women indicated that they would take time out from their practice to raise children, compared with only 9% of the men. The majority of residents did not think their gender affected them in their residency programs, but in professional interactions more men saw gender as an advantage and more women as a disadvantage. Significantly more than women aspired to be hospital pharmacy directors. The results suggest that men are obtaining advanced training closer to the time they graduate from pharmacy school and that in the future women competing for promotions may be older than men competing for comparable positions. Those planning pharmacy staffing should consider the needs of women, and men, who expect to take time out from their careers for family responsibilities and possibly seek part-time positions when they return to the work force.

Adult↗

Workload measurement of a clinical pharmacy residency program.

The types of activities performed by four clinical pharmacy residents and the amount of time spent on each activity were studied using a workload measurement system. A workload measurement system was developed to record all activities performed by pharmacy residents. The system included 50 activities that were grouped under 11 general headings; residents' time was divided among 10 major areas of service. The following data were collected and analyzed each month during the six-month study period: units of work, weighted units of work, total productive hours, total service hours, and productivity. The residents participated in 39 of 50 clinical pharmacy activities. Activities performed most frequently included nursing-home-care-unit drug reviews, drug monitoring, and rounds. The most time-consuming activities were clinical education, administration, and drug-use review. Productivity ranged from 80 to 115% and was influenced by residents' assigned rotations. A workload measurement system for quantifying the time spent by residents performing various clinical pharmacy activities provided objective data that were used to restructure a clinical pharmacy residency program.

California↗

Teaching interviewing skills to pharmacy residents.

An instructional program for first-year pharmacy residents in the use of interviewing techniques when assessing the drug therapy of patients is described. The objectives of this project were to (1) teach the appropriate use of interviewing skills and (2) observe the performance of pharmacy residents in assessing the drug therapy of ambulatory patients. Instructional methods included a written self-instructional packet, videotaped lecture and demonstration skits, group discussion, and role playing. Following these, during a four-week period, the residents interviewed patients in the outpatient pharmacy and reviewed their performance on videotape with the instructor. Two simulated patient case situations using a resident posing as a patient who provided predetermined information were used to measure student performance in interviewing patients. An improvement in the ability of the residents to employ the interview techniques and to assess the therapy of patients was noted.

Communication↗

Training experiences of current and former community pharmacy residents, 1986-2000.

OBJECTIVE: To identify why current and former community pharmacy residents chose a community pharmacy residency program (CPRP), what factors in the program were emphasized and not emphasized, what opportunities were available to them postresidency, and, for former residents, what skills learned during their residency have been most useful in their careers to date. DESIGN: Mail survey. PARTICIPANTS: 1999-2000 residents and former residents dating back to 1986. MAIN OUTCOME MEASURES: Reasons residents chose a CPRP over other residency or employment opportunities and respondents' ratings of the emphasis placed on a variety of skills and activities in their training programs. RESULTS: A total of 44 surveys were included in the final analysis, 18 (41%) of which were completed by 1999-2000 CPRP residents performing their residency at the time of the survey. The most common reasons for choosing a CPRP over other types of programs were opportunities for developing innovative services and direct patient interaction. Communication skills, clinical skills, and level of patient interaction were reported as being most highly emphasized. Management of the distribution system was most frequently cited as having "low" or "no" emphasis in their residency. Respondents listed marketing skills as the most common area requiring improvement or additional focus in their residency. Former residents cited leadership skills and the development of patient care services as the factors in their residency having the greatest impact on their careers to date. Postresidency opportunities most frequently sought included faculty, staff pharmacist, and clinical pharmacist positions. CONCLUSION: Candidates are drawn to CPRPs because of the opportunities such residencies offer to develop innovative services and provide direct patient care. Residents feel that many programs fail to provide adequate training in the areas of marketing services and obtaining reimbursement. Residency program directors should consider these findings when evaluating and marketing their programs.

Career Choice↗

Unique needs of women pharmacy residents.

The needs of women residents in hospital pharmacy programs are discussed with respect to the responsibilities of preceptors to help residents prepare for a successful career. Women were a small minority within the profession of pharmacy until recently. More than half of the current hospital pharmacy residents are women, while over 95% of the preceptors of residency training programs are men. Hospital pharmacy preceptors can help meet the unique needs of women residents, so that women pharmacists can achieve the career successes of which they are capable. Preceptors can help women residents make career decisions and develop career goals and strategies. Preceptors should ensure that women residents develop the broad base of knowledge and skills necessary for advancement. Women residents should be encouraged to get involved in pharmacy organizations, and the importance of networking should be stressed. It is important that women residents develop a business style so that they are perceived as confident and competent. Preceptors must recognize that most women will have conflicts in their roles of career woman, wife, and mother. Preceptors can also help women residents by making managerial changes (e.g., offering part-time positions and flexible scheduling) that will facilitate integration of the professional and personal responsibilities of women.

Day Care, Medical↗