4. Pharmacy MS Graduate Program

Transcription

1 4. Pharmacy MS Graduate Program A. Background and Quality The combined Master of Pharmacy degree and administrative residency program at the University of Wisconsin is an integrated pharmacy training program designed to produce future leaders in the profession of pharmacy and develop future directors of pharmacy departments in health systems. Since 1962, the pharmacy administrative residency and master s degree program has significantly impacted the practice of pharmacy at the University of Wisconsin Hospital and Clinics (UWHC) through sustained, innovative participation of residents in the advancement of department goals and services. UWHC has one of the most unique, advanced clinical practice models and pharmacy service programs in the country. High level services are provided in terms of quality and safety across all dimensions of pharmacy performance including medication preparation and delivery, pharmacist patient care services, medication safety, medication use policy, pharmacy financial performance, education and training, and research. Achieving this high level of performance did not occur by accident. Rather, it has been achieved and sustained primarily due to the hard work of the pharmacy administrative residents through the application of their master s education in designing, promoting, implementing and demonstrating the value of innovative services through residency projects. The combined master s degree and administrative residency was started in 1962 by Winston J. Durant who set the standard for life long learning, active and sustained participation in professional organizations, and commitment to the profession and practice of pharmacy, to excellence, to risk taking and innovation, to cultivating a sense of professional pride and belonging, and to maintaining a healthy balance between professional and personal life. These standards continue to be the pinnacle of expectations of the program yet today, and they represent the shared vision, commitment and professional pride that bind all past graduates of the program. The program was initially developed with the objective to train future hospital pharmacy administrators of medium to large hospitals through a combined academic and hospital pharmacy residency program. Today a similar theme continues, as the program is designed to provide the resident with a solid background of academics and the administration of exemplary pharmaceutical services across integrated health systems. The primary objective is to develop health system pharmacy administrators and leaders who are trained and prepared to immediately assure management positions in large academic health systems. Although the objective of the program has remained similar since its inception, the structure of the academic requirements has changed to meet the needs and demands of the profession of pharmacy. Similarly, the residents master s research projects have addressed changing needs of the profession over the past five decades. These achievements can be viewed in the context of five eras of pharmacy resident contributions to UWHC pharmacy services and programs, with considerable overlaps in chronology. All of these programs were developed, promoted, and Pharmacy MS Graduate Program 4 1

2 implemented by the work of ambitious pharmacy residents, and they are all in existence and performed at a high level today. 1. Innovation in core pharmacy services (1960s and early 70s). UWHC was a national leader in establishing the following innovative programs: 100% unit dose dispensing, complete IV admixture system, fully computerized pharmacy order entry/dispensing system, pharmacist managed drug information center, and pharmacist managed medication administration records for inpatients. 2. Advancements in patient care services (1970s and 80s). Advanced pharmacist patient care roles that were implemented by residents include pharmacist performed medication histories and reconciliation for all inpatients, pharmacist discharge counseling for all inpatients, pharmacist patient care rounds participation in all care areas, pharmacokinetic dosing services, and the establishment of decentralized clinical pharmacy services for all inpatients from 0700 through 2300 and twenty four hour decentralized clinical services for all critical care services for all critical care patients. 3. New pharmacy business development and expansion of clinical services into ambulatory and alternate sites (1980s, 90s and 2000s). Notable outcomes from master s projects include the active participation of pharmacists in over twenty ambulatory clinics, the development of an integrated ambulatory (outpatient) pharmacy network throughout Dane County consisting of thirteen pharmacies, the provision of comprehensive pharmacy services at a 30 bed inpatient Hospice facility and for over 300 in home hospice patients throughout south central Wisconsin, and the provision of pharmacy management consultative services for hospitals in rural communities. 4. Drug policy and managed care pharmacy program development (1990s and 2000s). This program has developed into an operation responsible for developing, implementing, maintaining and monitoring policies related to the use of pharmaceuticals within the UW Health integrated health network, for conducting applied drug policy and health services research, for managing the pharmacy benefit for Unity Health Insurance managed care organization, and for coordinating the technology assessment programs for all technologies across UWHC. 5. Implementation of a fully automated medication use process (1990s and 2000s). Automated technologies which were implemented and evaluated by pharmacy residents include the world s second centralized robotic dispensing system (centralized Robot), automated dispensing cabinets, bar code medication administration scanning software at the point of care, smart IV infusion pump technology and med carousel dispensing technology. While the above stated programs are broad in scope, they represent just the tip of the iceberg in terms of total resident and graduate student contribution to patient care and safety at UWHC as a result of applying their master s education to the successful completion and implementation of master s research projects. Hundreds of other smaller scale medication safety projects (for example, implementation of the hospital s high alert medication policy) have been lead by pharmacy residents participating in the master s degree program. These students not only provide the manpower and leadership to implement new programs and Pharmacy MS Graduate Program 4 2

3 services, they also work to measure the impact of these projects on quality, error reduction, customer satisfaction and cost reduction. These outcomes provide the hospital with data to share with external accrediting bodies and to report publicly on the hospital s website. They also contributed in large part to the hospital being recognized twice since 2001 by the American Hospital Association as a finalist for their coveted Quest for Quality prize. In addition to working on master s projects, residents serve as advisors to the department management team throughout their two years in the program and often provide actionable recommendations for improving pharmacy services. They provide input for the pharmacy management team in every rotation evaluation on specific methods for improving pharmacy services. As a class, the joint master s degree/administrative residents provide the pharmacy director with a consultative report at the end of their program containing recommendations for improving department programs and organizational structure. Lastly, each resident completes a one hour exit interview with the pharmacy director and their career advisor and their collective parting suggestions for improving the department and the residency program are readily considered for adoption by the program s advisory committee. A few examples of resident suggestions from the past year that have been implemented include reorganization of central pharmacy management s organizational structure and implementation of guidelines on appropriate etiquette for department management staff. The advisory and consultative recommendations provided and the performance and quality improvement initiatives developed by the administrative pharmacy residents are applications of the skills acquired during their master s training and curriculum, which focuses on courses in business management, industrial and systems engineering, and pharmacy administration. Pharmacy graduate students are an integral part of the fabric of the Department of Pharmacy and UWHC. They are engaged as presenters at every staff meeting, every pharmacist team meeting and every standing department committee meeting. They often present at hospitallevel performance improvement and safety committees. Administrative residents are equally a part of the clinical pharmacy staff and the department management team, a strategy designed to place them on the fence in hopes that they can see issues and decisions from both staff and management perspectives, ultimately leading to improved department operational decision making. Thus, residents are integral to both the culture of practice and the culture of leadership within the pharmacy department at UWHC. All of the clinical pharmacists at the hospital are expected to precept residents, and many of them practice throughout their career at UWHC in large part due to their opportunity to precept and learn from pharmacy residents. A few years ago UWHC started a post MBA two year fellowship training program to train future hospital administrators. This program is increasingly being modeled after the pharmacy administrative residency program, and the pharmacy residents play an increasing role in working with, mentoring and developing these fellows throughout their program. The value of this recognition by the hospital is viewed as the highest level of respect that hospital administration has for the achievements and results of the administrative pharmacy residency program and master s degree curriculum. Pharmacy MS Graduate Program 4 3

4 The joint master s degree and administrative residency program has produced 170 graduates, most of whom practice in health system pharmacy administration but many of whom have excelled in other areas such as academia, industry and managed care. While they all have different strengths and interests, almost all are accomplished leaders in the profession and have made significant contributions for the profession at the local, state and national levels. While every graduate walks away from the program with slightly different impacts and experiences, affiliation with the Wisconsin administrative residency program creates perhaps the most unique bond in all of pharmacy known as The Wisconsin Network. While it would be impossible to fully assimilate the meaningful impact that the administrative residency and master s degree program has had on so many individuals who have survived its rigor, the program has clearly developed several very positive characteristics and attributes which has resulted in the creation of many great leaders. It is safe to say that the program has positively shaped the practice philosophy and influenced the career of every past resident. Having past graduates with diverse interests, skills and career paths speaks to the program s ability and willingness to customize training based on the interests and strengths of each candidate. The program has opened many doors to career paths of varying types, and has provided many with the skills and confidence to lead the development of new practice initiatives and new residency training programs across the country. The program also provides residents with sustained mentoring relationships post graduation to assist residents with decision making, personal growth and goal achievement well beyond the two years spent in the formal training program. The UWHC Department of Pharmacy is unconditionally proud of all past residents who postgraduation, are actively tracked throughout their careers and represented by a red pin on an international map in the department s conference room. Past residents gather annually at the American Society of Health System Pharmacists (ASHP) Midyear meeting for the Winston J. Durant Lecture Award Luncheon recognizing a graduate of the UWHC residency program who has significantly contributed to the advancement of health system pharmacy, to pharmacy resident training, and who is recognized as a leader in pharmacy at the state and national level. In addition, past UWHC pharmacy residents assemble every five years for a three day weekend in Madison to participate in a residency program reunion celebration. The 45 th reunion in 2008 was attended by over 200 participants. In summary, the joint administrative residency and master s degree program has had a dramatic impact on pharmacy services and the practice of pharmacy at UWHC, on the lives and careers of many past graduates who are leaders and teachers across the profession, and thus ultimately on the practice of pharmacy throughout the country. Pharmacy MS Graduate Program 4 4

5 B. Recruitment The purpose of the program s recruitment efforts is to recruit qualified and highly motivated pharmacists or pharmacy students for the combined Master of Science and administrative pharmacy residency program. Details of the structured and organized recruiting and interviewing process are outlined in Pharmacy Policy # (Appendix 1, p. A4 2). Annual recruitment efforts begin locally at the University of Wisconsin School of Pharmacy career fair in the late fall, where a recruitment booth is staffed by residents and program advisors to promote the program to upcoming graduates at the University s pharmacy school. In addition to local recruitment efforts, the administrative residency and master s degree program is represented every winter at the ASHP Midyear Clinical Meeting residency showcase where program information and applications are distributed to potential candidates from across the country. An administrative pharmacy resident working with the program director is responsible for coordinating preparation for the residency showcase. As prospective recruits are identified, an administrative resident is assigned to serve as the main contact for the recruit. The administrative resident remains in contact with the recruit throughout the application process to assist with any problems or questions that may arise during the process. The administrative pharmacy residency and master s degree program accepts a diverse pool of applicants from across the country, as well as a number of international applicants. All applicants must be graduates from an accredited college of pharmacy and must be eligible for licensure in the State of Wisconsin. Applicants must apply to the University of Wisconsin Graduate School and submit their official transcripts, curriculum vitae, letter of intent, and three letters of recommendation by January 15 th each year. Additionally, candidates must have a GPA of at least 3.0 and must take the GRE test by April 30 th to qualify for admission to the graduate school. A summary of accepted average student GPA and GRE scores is listed in Table 1. Table 4 1. Average GPA and GRE Scores of Accepted Applicants by Academic Year, GRE (Mean score) Academic Year GPA Verbal Quantitative Written Analytical Once a completed application packet is received, an interview may be arranged by a designated member of the administrative staff in the pharmacy department at UWHC. An interview schedule is sent to candidates prior to their visit to UWHC. The applicant s assigned resident contact assists in the coordination of travel and lodging arrangements as well as planning Pharmacy MS Graduate Program 4 5

6 events during the interview process. During the candidates visit, all current administrative pharmacy residents are required to meet with the candidate over lunch, and a designated resident will provide a tour of the hospital, the University campus, and the city of Madison. Additionally, all applicants will interview with the residency program director, the Director of Pharmacy, an Assistant Director of Pharmacy, and the Director of the Center for Drug Policy at UWHC, and the Vice President of Professional and Support Services at UWHC. Other members of the Department of Pharmacy administrative staff may participate in interviews as well. All candidates are evaluated on the same criteria, and although high academic achievements are important for success in the Master of Pharmacy program, other experiences of professional practice are also taken into consideration, keeping in mind that a correlation between grades and professional practice does not always exist. Criteria for acceptance into the program are as follows: Academic background/gpa Adaptability Communication skills (verbal) Communication skills (written) Enthusiasm Initiative Leadership Extracurricular activities Letter of interest Letters of recommendation Motivation Overall fit with the program Overall gut feeling about the candidate Personal and professional style Presentation/research experience Prior work/practice experience Questions asked by the candidate Relevant pharmacy rotations Residency and career goals Following candidates n site interviews a weighted criteria matrix is utilized to evaluate each candidate. Each criteria is weighted on a scale of 1 5 in respect to importance, and each interviewer ranks candidate on a 1 5 Likert scale with a score of 1 being reflective of a poor candidate for the program, a score of 3 being reflective of an average candidate, and a score of 5 significant of an excellent candidate for the program. The candidate s final score for each criterion is the product of the interviewer s score and the weighted score for each criterion. In addition to each interviewer rating the candidate, all current graduate students that interacted with the candidate rate the candidate on the same criteria. All graduate student ratings are averaged and submitted as one collective graduate student score. The interviewer scores and the graduate student score are combined to produce a total score for each candidate. Once all candidates have been interviewed, a selection committee will meet to discuss all applicants. An initial ranking of candidates is produced using the total scores assigned to each candidate based on the interviewer and graduate student ratings. If the selection committee feels that there should be a change in the rankings, it will be discussed during this meeting and changes will be made accordingly. Following the selection committee meeting, the final ranking of all applicants will be submitted to the National Matching Service. Results of the residency match are received in mid to late March. Individuals will receive written notification of acceptance outlining position requirements, salary, benefits, and expectations of the position. Pharmacy MS Graduate Program 4 6

7 The acceptance letter must be signed and returned to the program director signifying acceptance of the match. On average, the administrative residency and master s degree program receives applications per year. Approximately ten of those applicants will be offered on site interviews at UWHC. Three to five candidates are offered positions as administrative residents and master s students. A summary of applications and enrollment in the program by year is listed in Tables 2 and 3. Impressively, the program has a 100% acceptance rate, as every candidate offered a position as an administrative pharmacy resident at UWHC has accepted the offer. Furthermore, every applicant that has been offered a position as an administrative pharmacy resident at UWHC has been accepted into the graduate school at the University of Wisconsin. Table 4 2. Applications Received by Year, Year (fall) Total Female Minority Table 4 3. Enrollment by Year, Year (fall) Total Female Minority Pharmacy MS Graduate Program 4 7

8 C. Funding Administrative pharmacy residents receive funding from the University of Wisconsin Hospital and Clinics. All of their salary, fringe and tuition expenses are paid by the hospital pharmacy department. The administrative pharmacy residents salary is $35,500 the first year, and $36,500 the second year, with fringe benefits being approximately 32% of their salary. As a result of this funding, UWHC requires the residents to perform a number of duties throughout the two years of the program. The resident duties at the hospital are immense and they vary depending on which rotation the resident is on. Nonetheless, all of the residents get experience performing the same duties during their residency. A sampling of resident hospital duties includes clinical pharmacist staffing, performance of quality improvement initiatives, operations oversight, analysis of pharmaceutical contracts, coordinating the pharmacy technician workforce, training of new pharmacists and nurses, and human resources management. Resident duties are not just limited to the hospital; they also spend considerable time on coursework and teaching. All administrative pharmacy residents are appointed to teaching assistant (TA) positions at the UW School of Pharmacy, making them eligible for in state tuition while offering them an opportunity to teach. The in state graduate school tuition is paid by UWHC and is $10, per year. Residents are required to pay segregated fees (for other services and programs that support the university s mission) on their own, which cost $ per year. As TAs, administrative pharmacy residents assist with teaching lectures and leading discussion sessions for two courses taught at the School of Pharmacy: Drug Literature Evaluation, taught to all second year pharmacy students, and Medication Safety which is taught to all third year pharmacy students. The residents work closely with the instructors for these courses as they lead discussion sections, review lecture concepts, assist in the evaluation of student performance, and occasionally teach lectures. Residents also contact and coordinate the involvement of practicing clinical pharmacists for lectures in the courses. In addition to their TA roles at the school of pharmacy, all administrative residents assist with the precepting and teaching of students from the School of Pharmacy on clerkship rotations at UWHC. Pharmacy MS Graduate Program 4 8

9 D. Curriculum Coursework and Program Requirements The Master s program curriculum was originally developed by the Director of Pharmacy and the Resident Advisory Committee who oversee the Master s program. Every two years the pharmacy director and the committee evaluated and changed the coursework based on the changing roles of health system pharmacy leaders. Courses evolved with the times for the past 5 decades. Clinical focused courses were added in the 60 s and 70 s to support the clinical movement within pharmacy, organizational behavior and healthcare accounting and economics courses were added in the 80 s to better understand pharmacies operational and financial role within the institution, technology assessment and productivity improvement courses were added in the 90 s during the era of technology development and quality improvement, pharmacy informatics and medication safety courses were added in the 2000 s to teach residents the influence and importance or electronic health records and medication safety. Today, the program courses fall into one of three general areas of study, Business Management, Industrial Engineering and Systems Design, and Pharmacy Administration; each of these is essential for future pharmacy leaders. The curriculum is also meant to coincide with residents experiential rotations to facilitate the application of coursework material in real world settings. Residents are expected to take approximately 10 credits during their first and second semesters and 9 credits during their third and fourth semesters. Core courses typically make up 6 8 credits of coursework, leaving a few credits available for elective classes each semester. A sample curriculum is presented in Table 5. Elective course may differ for each student in the program while most core courses will stay the same. Descriptions of core and elective courses are listed in Appendices 2 (p. A4 6) and 3 (p. A4 7). The first semester core courses provide residents with human resource management and data analysis/informatics skills. The human resource management course is meant to teach residents how to manage, lead, support, and generally interact with the pharmacy staff they will manage. The material from the course is put to action during the clinical management rotation the residents undertake during their first year. Residents are asked to lead pharmacist team meetings, and be involved in hiring and disciplinary actions as well as other human resources activities. The data analysis/informatics course is meant to give residents a thorough understanding of how to use Microsoft Excel and Microsoft Access. These are crucial tools for virtually any projects the residents will take on in the residency. The informatics course also exposes residents to the many types of pharmacy technology and how different technological systems are integrated. Residents serve as TAs for the drug literature evaluation course in the spring, and they also take a patient safety course and a quality improvement course. The TA role provides residents an opportunity to teach and a chance to refresh their drug literature review skills. This refreshment is beneficial for the Drug Information, Drug Literature and Medication Use Policy Pharmacy MS Graduate Program 4 9

10 Table 4 4. Sample Curriculum for Master s of Pharmacy Students Required Courses Possible Elective Courses Year 1, Fall Ideally take 10 credits Course Title Course Number Credits Conf. of Research Workers in Health System Pharm. (Seminar) Phm Prac Advanced Independent Study, Research Phm Prac Human Resource Management MHR Health System Pharmacy Data Analysis and Informatics Phm Prac Introduction to Epidemiology POP HLTH Human Performance and Accident Causation I SY E Organization and Job Design I SY E Principles of Population Health Sciences POP HLTH Required Courses Year 1, Spring Ideally take 10 credits Course Title Course Number Credits Conf. of Research Workers in Health System Pharm. (Seminar) Phm Prac Advanced Independent Study, Research Phm Prac Drug Literature Evaluation Phm Prac Quality Improvement of Complex Systems OTM Patient Safety and Error Reduction in Health Care MED PHYS Possible Negotiations MHR Elective Organizational Behavior MHR Courses Managing Behavior in Organizations MHR Pharmacy MS Graduate Program 4 10

11 Table 4 4. Sample Curriculum for Pharmacy MS Students (cont.) Required Courses Possible Elective Courses Year 2, Fall Ideally take 9 credits Course Description Course Number Credits Conf. of Research Workers in Health System Pharm. (Seminar) Phm Prac Advanced Independent Study, Research Phm Prac Managing Technological and Organizational Change OTM Human Performance and Accident Causation I SY E Organization and Job Design I SY E Human Factors in Health Care and Patient Safety I SY E Entrepreneurial Management MHR Managerial Accounting ACCT IS Principles of Population Health Sciences POP HLTH Required Courses Possible Elective Courses Year 2, Spring Ideally take 9 credits Course Description Course Number Credits Conf. of Research Workers in Health System Pharm. (Seminar) Phm Prac Advanced Independent Study, Research Phm Prac Assessment of Medical Technologies (Vanness) OTM Advanced Health System Pharmacy Administration S&A Phm Medication Safety (TA and Lecture) Phm Prac Managing Behavior in Organizations MHR Negotiations MHR Entrepreneurial Management MHR Quality Assurance Systems I SY E Organizational Behavior MRH Patient Safety and Error Reduction in Health Care MED PHYS Notes: TOTAL = Credits; minimum = 36 Credits The sequence of course work is dependent on course availability and is instructor dependent. Pharmacy MS Graduate Program 4 11

12 rotation the residents have during their first year. Similarly, the patient safety course helps residents understand basic tools and terminology used when trying to improve patient safety; these are meant to be employed in the concentrated Medication Safety rotation that residents have in Year 1. Lastly, the quality improvement course introduces residents to various avenues to improving quality, and provides residents an opportunity to improve quality in a real world setting. The residents draw on the knowledge gained in this course for projects during their first and second years (and throughout their careers). Residents will constantly need to manage organizational change when they are done with the program, so a core course during the second year is Managing Technological and Organizational Change. The course is fitting since much of pharmacy operations revolves around technology. The residents are encouraged to be more involved with managing broader organizational change during their second year, and this course gives them the capability to do so. The resident core courses during the last semester include a Medical Technologies Assessment course and an Advanced Health System Pharmacy Administration course. Again, medical technology is an important piece of pharmacy operations, but also of virtually all medical practices today. These medical technologies are significant investments. The course is meant to ensure that residents understand how to evaluate medical technologies to help them decide which technology is appropriate for their department. The Advanced Health System Pharmacy Administration course teaches residents how to maximize the performance of their future pharmacy, drawing on many of the skills they ve learned in earlier coursework and/or in an experiential setting. It reviews different types of distribution systems and operations, and it prepares residents to leave UWHC and be a successful health system pharmacy administrator. Throughout the two years, residents are given 1 2 credit hours each semester to work on their Master s Project and to work, attend and present at a Conference of Research Workers in Health System Pharmacy seminar. The Master s Project hours give residents a chance to review and work on their Master s Project starting in their first semester. The seminar is a one credit course designed to help the graduate students develop an understanding of the complexity of health system administration and contemporary issues facing hospitals, particularly academic medical centers, and pharmacy departments. Over the course of the two year program, graduate students meet with each senior leader at UWHC, department directors and select physician leaders to help them understand hospital goals and priorities, how other areas of the hospital operate, leadership styles used by senior leaders and other directors, how pharmacy interacts with other departments in UWHC, and senior leader expectations of pharmacy services. This personal interaction provides the pharmacy graduate students with an incredible learning opportunity and helps to shape them into more wellrounded leaders in the future. Elective course options consist of courses that the program feels provide significant value to residents, but are not essential to being administrative pharmacy leaders. Residents are welcome to choose electives from the provided list of approved elective courses. If a resident would like to take a course that is not on the list, the resident is required to get approval to take Pharmacy MS Graduate Program 4 12

13 the course from the Master s of Pharmacy program director. Elective courses are listed in Appendix 3 (p. A4 7). Course Review Upon completion of the spring semester each year the program director meets with residents to review the previous year s coursework. The goal of this ongoing process is to ensure that courses are meeting expectations and continuing to provide value. The current course structure is compared to available courses and consideration is given to adjusting core and elective courses as appropriate to strengthen the degree program and ensure residents are being trained in core competencies and emerging areas of interest in healthcare administration. The latter is determined by utilizing information obtained from the program s extensive network of past residents. Table Alumni Survey Responses Regarding M.S. Education (n=18) Question: During your M.S. education in which of the following areas was: training PROVIDED, which skill or experiences have you USED since graduation, and which areas do you wish you had received ADDITIONAL TRAINING? Training Provided Skills Used Additional Training Teaching experience 94.4% (17) 94.4% (17) 11.1% (2) Lecture experience 88.9% (16) 83.3% (15) 11.1% (2) Oral communication; presentation skills 100.0% (18) 100.0% (18) 0.0% (0) Writing proposals for funding 68.8% (11) 43.8% (7) 37.5% (6) Manuscript preparation 94.4% (17) 50.0% (9) 22.2% (4) Critical Analysis 94.4% (17) 94.4% (17) 5.6% (1) Leadership and administrative skills necessary to manage the drug use system 94.4% (17) 100.0% (18) 5.6% (1) Technology assessment and strategic planning 100.0% (18) 88.9% (16) 0.0% (0) The use of automated systems to support comprehensive pharmacy services 100.0% (0) 94.4% (17) 0.0% (0) Medication safety standards required to ensure a safe medication use system across an integrated health system 100.0% (18) 94.4% (17) 0.0% (0) The principles of labor relations and pharmacy regulations and law 94.4% (17) 72.2% (13) 38.9% (7) Knowledge and expertise in managing a Center for Drug Policy 94.4% (17) 55.6% (10) 5.6% (1) The role of pharmacy in education and research as part of an academic medical center 100.0% (18) 77.8% (14) 5.6% (1) Locating and applying information 94.4% (17) 100.0% (0) 0.0% (0) Experience working with people of varied educational levels 100.0% (18) 100.0% (18) 0.0% (0) Experience working with people from diverse backgrounds (cultural, socioeconomic, etc.) 88.9% (16) 100.0% (18) 0.0% (0) Experience working in teams 100.0% (18) 100.0% (18) 0.0% (0) Pharmacy MS Graduate Program 4 13

14 Alumni of the program also provide feedback about how well the courses and training they received prepared them for their careers. Table 4 includes information from a recent alumni survey (see Appendix 4, p. A4 8, for full results of the alumni survey). Overall, the majority of alumni felt they received training in every area assessed, and they used the skills they were taught. Seventeen of 18 alumni respondents rated the quality of instruction in courses in the major as good or excellent (the remaining response was neutral). Notable areas where additional training would be useful were funding proposal and manuscript preparation, and pharmacy law and labor regulations. Additionally, 22.2% of the alumni respondents felt that they did not have adequate access to courses, facilities, and faculty outside the School of Pharmacy. Access to courses in the School of Business was cited most often as a problem in the alumni survey comments. In response to this deficiency, the director of the Master of Pharmacy program met with Professor Urban Wemmerlov in the summer of 2009 to discuss strategies to enhance graduate pharmacy student activity in the Business School. The program director plans to examine all opportunities for improvement to determine where additional training can be added for the residents to enhance the value of the program. Masters Project Proposal Timeline 1. List of potential projects provided to junior administrative residents in October of Year 1 of the program by the program director. 2. Junior administrative residents must select a project by the end of November of Year 1. a. Prior to selecting a project junior administrative residents should meet with the proposed project advisors to gain a better understanding of the project prior to making a decision. This information can be utilized to develop a preliminary proposal as highlighted below. b. Write out study framework (objectives, design, measures, outcomes for evaluation) c. Meet with Lee Vermeulen, individual project advisor(s), (and if possible, other residents) no later than December to frame up the actual research question/problem/topic so that a specific objective, good aims, and clear design are obtained. This must take place prior to presenting the proposal at the Resident Advisory Committee. Although it may not be possible for other residents to attend this meeting it is strongly encouraged that other residents be invited and that they try to attend if they are available. 3. Write project proposal with advisor 4. Present at the Resident Advisory Committee no later than February of Year 1. a. The presentation must be ed to the Resident Advisory Committee members 72 hours prior to the proposal presentation date. b. Give no more than a 10 minute presentation (w/o slides) to the Resident Advisory Committee. The presentation should describe: (a) What (b) Why (c) Who (d) Objective (e) Current project proposal (f) Project design Pharmacy MS Graduate Program 4 14

15 5. Feedback received from the Resident Advisory Committee should be discussed with the primary project advisor and an updated proposal should be sent electronically to the Resident Advisory Committee members. The proposal will not need to be brought back to the Resident Advisory Committee to present the changes unless specifically requested by the Resident Advisory Committee. 6. By February of Year 2, the resident must have their background and methods sections written and approved by their advisors for their final Master s paper. 7. By April to May of Year 2 the resident must present their final master s paper to their Research Advisor and the Director of Pharmacy. The resident must also present their masters project at the Great Lakes Conference. M.S. Degree Requirements It is the expectation that all master s degree requirements are met prior to June 30 of Year 2. I. Registration Procedure II. Consult the Graduate School Office or Linda Frei at the School of Pharmacy (2 1200) for questions on the following: A. Residence Requirement. Check with the Graduate School Office if a potential problem exists. B. Incomplete, In Progress, or Unreported Grades must be cleared to satisfactory letter grades before the warrant can be released. Grade change forms must be filled out for each semester. No degree will be conferred unless all grades (including In Progress) are cleared. C. Resident name will be printed on the diploma as it appears in the permanent record. Contact Records Office, A.W. Peterson Building, for official name change, if necessary. D. Obtain degree application from Graduate Office. Do by April of Year 2. III. The Master's degree will be conferred only if: A. All Inc., P, and Unreported grades are cleared to satisfactory letter grades. THIS INCLUDES ALL CREDITS FOR THE CURRENT SEMESTER. B. Resident must have completed 36 hours of coursework. Of these hours there must be at least 24 credits in formal coursework. The rest can be composed of seminar and independent study credits. C. Grading. The Graduate School requires a grade point average of B (3.00) or better in all courses taken as a graduate student. C and BC course grades are not considered satisfactory but can be offset by A and AB grades, respectively. A student will be terminated upon accumulating more than 7 credits of BC or lower during his/her graduate career in the School of Pharmacy. This may be appealed to the Graduate Studies Committee, School of Pharmacy. This criterion applies to formal courses, seminars, and research credits. Incomplete grades are treated as unsatisfactory if not completed in the next semester of residency. D. The Master s project is completed, written up and presented. E. Degree applications materials are returned to the Graduate Office. IV. Confirmation of completion of degree requirements. A. Faculty advisor of Master s project verifies completion of project. Pharmacy MS Graduate Program 4 15

16 B. Director of MS/residency program sends a letter to the Assistant Dean for Graduate Studies verifying completion of all master's degree requirements for each candidate completing the program. Residents request a warrant for graduation upon completion of all requirements. This is done by e mailing Linda Frei (Pharmacy Graduate Office) asking her to request a warrant on their behalf prior to the end of the Spring Semester. C. The Assistant Dean for Graduate Studies signs the degree application after receiving the letter of verification from the program director and sends to the Graduate School Office. V. Specific criteria for the satisfactory completion of requirement for the MS degree A. If a Master s degree candidate is to receive his/her degree on schedule (prior to June 30), their Master s project write up must be submitted to their advisor prior to the end of the Spring semester of Year 2. B. If this deadline is not met, the candidate must submit the project write up prior to the end of the summer window (in June; check: for exact date) if the degree is to be conferred during the Spring semester. If this criterion is not met, the resident will need to register every semester thereafter that the criteria are not met. C. The resident will be responsible for any fees accrued during this period. D. The paper submitted (technical report) should use the same conventions of style that would be used for manuscript submission. The paper should be formatted in the appropriate format for submission to a reputable, peer reviewed, national journal such as AJHP or other appropriate journal (depending on project). E. The paper should contain the sections described in section 3.c of the Residency Manual unless another manner is proscribed by the journal to which the paper will be submitted The diploma will be prepared and mailed to the address indicated on the Degree Application card weeks after the degree conferral date. Madison residents will receive a card telling them that the diploma is available and may be picked up. The Registrar's Office will mail diplomas of foreign students to their home countries by first class air mail. The Senior Summaries Office will, on request, supply a typed "Certificate of Graduation" which may be used for all official purposes until the diploma is available. Advising Residents learn and benefit from a formalized resident advising and mentoring process. Prior to beginning the residency program residents are required to fill out a brief survey that identifies their current experiences and interests. An overview of items assessed is presented in Figure 1. Refer to Appendix 5 (p. A4 33) for the complete survey. Pharmacy MS Graduate Program 4 16

17 I. LICENSURE, CERTIFICATION, AND PROFESSIONAL EDUCATION - Rate yourself on your ability to perform/participate in the following functions as a member of the health care team (the following are examples of the many functions evaluated). Rating Function Describe Experience; Other Comments Medication interviews and patient assessment New drug therapy teaching/counseling (inpatient/outpatient) [List continues] - List any pertinent course work/certification you have completed that may enhance your experience in a given practice area (communication, nutrition courses, pharmacoeconomics, EMT courses, statistics, drug literature, computers, electives, team building, etc..). - Do you feel comfortable with your current writing skills? Yes No - List any written publications you have completed (formal publications, newsletter articles, drug monographs) within the past 5 years. - Describe your supervisory experience with pharmacy technicians or others. - Describe any past teaching experiences. II. PROFESSIONAL EXPERIENCE III. COMPUTER SKILLS IV. PROFESSIONAL INTERESTS AND CAREER GOALS - Describe your current general and specialty practice interests. - Rank EACH OF the following clinical areas in terms of: o your level of interest (5 = highest, 1 = lowest) AND o your degree of experience (5= highest, 1 = lowest) Interest Ranking Experience Ranking Practice Areas Intensive/Critical Care Trauma Burn [List continues] Figure 4 1. Overview of Pre Residency Survey Pharmacy MS Graduate Program 4 17

18 This information is utilized to select a program advisor who meets with the resident on a monthly basis during the first year and twice monthly during the second year. The advisor reviews their progress in rotations and projects and provides support and assistance in achieving their individual residency program goals. During the second year, one of the monthly meetings focuses specifically on career counseling unique to each resident. The career counseling sessions challenge each resident to perform a self evaluation, as seen in Appendix 6 (p. A4 39). Examples of questions assessed in the self evaluation include: - What is your main practice management interest? - Identify personal shortcomings that can impede you from achieving your career choice to the maximum. - Evaluate whether your personal life needs are consistent with your career interests. State examples that include social requirements and/or religious persuasion. - Identify individuals who could be considered as role models for you and state why. These sessions provide the resident with an opportunity to have in depth discussions about his/her career aspirations with their advisor. The career counseling process is not an inflexible set of procedures, but rather an ongoing and broadening growth phenomenon brought about by discussions of many variables that may affect a person during their career and lifetime. The resident utilizes information obtained during these sessions to develop written expectations and goals for initial and future positions that they will target upon completion of the residency. Table 6 provides data from UW Master s of Pharmacy program alumni regarding the advising/mentoring they received. Using information obtained in answering the pre residency survey, rotational experiences, and career counseling sessions the resident develops structured plans for the first and second year of their residency, highlighted in Appendices 7 (p. A4 40) and 8 (p. A4 42), respectively. These first and second year plans are reviewed with their program advisor on an ongoing basis. Table 4 6. Responses from the 2009 Alumni Survey Regarding Advising (N=18) Question: How would you rate each of the following aspects of your experience in the M.S. in Health System Pharmacy Administration residency program? Excellent Good Neutral Fair Poor Academic advising you received 33.3% (6) 44.4% 22.2% 0.0% 0.0% (8) (4) (0) (0) Clarity of academic expectations 27.8% (5) 38.9% 27.8% 5.6% 0.0% (7) (5) (1) (0) Mentoring 55.6% (10) 33.3% 11.1% 0.0% 0.0% Accessibility of program faculty 55.6% (10) (6) 44.4% (8) (2) 0.0% (0) (0) 0.0% (0) (0) 0.0% (0) Pharmacy MS Graduate Program 4 18

19 Upon completion of residency rotations, the resident is responsible for filling out a rotation evaluation. This evaluation is reviewed with the rotation preceptor and resident advisor, and is then sent to the Director of Pharmacy. Appendix 9 (p. A4 45) is a sample experiential rotation evaluation. Degree Committees On the fourth Thursday of every month a Residency Advisory Committee convenes that includes rotation preceptors (including School of Pharmacy faculty), advisors, and residents. This meeting is utilized to provide oversight of the activities of the pharmacy residency programs, track the progress of residents throughout the experience, provide information to the Resident Advisory Committee members, review and approve resident project proposals, and to advise the overall residency program. The first half of the meeting is used to discuss issues that are pertinent to all committee members and the residents. Each resident provides a brief report at these committee meetings. Residents are excused for the second half of the meeting. During this time, preceptors discuss each resident s progress, and assess strengths and opportunities for improvement. This helps preceptors be attune to what areas they can help the resident with during future rotations. Feedback from the meeting is given to the resident by their advisor during regularly scheduled resident/advisor meetings. Resident Master s Project proposals are prepared by the residents for the Resident Advisory Committee during the residents first year (see the Curriculum section for further detail regarding the proposal review and degree conferral process). Residents complete and distribute their proposal to the committee in advance of the meeting to give committee members time to review the proposal. Residents present their project proposals to the committee and field questions about the rationale for, methods of, and projected results of their project. The Resident: Rotation and Preceptor: Overall performance in the program: Skills to work on from previous rotation: Practice and management skill strengths: Practice and management skill weaknesses: Status of rotation reports: Status of Project: Follow up required: Figure 4 2. Resident Report Template Pharmacy MS Graduate Program 4 19

20 committee also reviews the breadth, difficulty, and rigor of the project to ensure the project is appropriate for a Master s Project. The Resident Advisory Committee members discuss the project and grant or withhold approval to begin the project. Once a resident s Master s Project is complete the committee has input into whether the resident is ready for conferral of the Master s degree, but the primary decision is made between the project advisor and the Master s program director. Residency Advisory Committee Members Administrative Staff/Residency Program Directors Carrie Boeckelman Manager, Ambulatory Pharmacy Services Pat Cory Manager, Managed Care Pharmacy Programs Director, Unity Health Plans Caitlin Curtis Clinical Pharmacist; Program Director, Clinical Nutrition Residency Jeff Fish Sr. Clinical Pharmacist; Program Director, Critical Care Residency Sean Gehrke Senior Clinical Pharmacist Brad Ludwig Assistant Director, Technology and Inpatient Pharmacy Operations Jessica Mahoney Manager, Patient Care Services and Operations Rebecca Marnocha Director, Pharmaceutical Research Center Director of Clinical Research (UW School of Medicine & Public Health) Dave Musa Manager, Pharmacy Asset Management and Budget Connie Peterson Assistant Director, Ambulatory Pharmacy Services Steve Rough Director of Pharmacy Bill Tanke Manager, Acute Care and Emergency Services & Medication Safety Sylvia Thomley Manager, Medication Informatics Hannet Tibagwa Manager, Ambulatory Pharmacy Services Philip Trapskin Manager, Acute Care Services Lee Vermeulen Director, Center for Drug Policy Clinical Staff Sheila Aton Sr. Clinical Pharmacist Jill Bennett Clinical Pharmacist Claude Taylor Clinical Pharmacist Lisa Gryttenholm Clinical Pharmacist Dave Hager Clinical Pharmacist Ben Johnson Clinical Pharmacist Glynis Kinney Clinical Pharmacist Brian LaRowe Sr. Clinical Pharmacist Tricia Ludwig Clinical Pharmacist Julie Pawola Clinical Pharmacist Heidi Ress Clinical Pharmacist Jennifer Sandra Clinical Pharmacist MaryAnn Steiner Sr. Clinical Pharmacist Aaron Steffenhagen Sr. Clinical Pharmacist Pharmacy MS Graduate Program 4 20