Relating the CAPE 2013 Outcomes, PPCP, and EPAs All Together Dr. Melissa S. Medina University of Oklahoma College of Pharmacy AACP Preceptor Webinar Series June 20, 2019 Center for Advancement of Pharmacy Educational (CAPE) 2013 Outcomes At the completion of this webinar, the participant will be able to: Describe the purpose of the CAPE 2013 Outcomes. Explain the domains and subdomains of the CAPE 2013 Outcomes. Interpret the role of the CAPE 2013 Outcomes in the curriculum of colleges and schools of pharmacy.   Pharmacists’ Patient Care Process (PPCP) Identify the purpose of Pharmacists’ Patient Care Process for the pharmacy profession and pharmacy education. Execute the elements of the Pharmacists’ Patient Care Process. Test strategies to implement the Pharmacists’ Patient Care Process into the curriculum, including experiential education. Entrustable Professional Activities (EPAs) for New Pharmacy Graduates Explain the purpose of the EPAs for New Pharmacy Graduates. Describe the domains of the EPAs for New Pharmacy Graduates. Test strategies to integrate the EPAs for New Pharmacy Graduates into pharmacy school curriculum, including experiential education.

Conflict of Interest Disclosure Statement Dr. Medina has no conflicts of interest to disclose.

Webinar Overview Center for Advancement of Pharmacy Educational (CAPE) 2013 Outcomes Pharmacists’ Patient Care Process (PPCP) Entrustable Professional Activities (EPAs) for New Pharmacy Graduates Mapping EPA to CAPE to PPCP The series will provide  broad overview of concepts and likely be an introduction for many preceptors and others to the constructs of the CAPE Outcomes, the Pharmacist Patient Care Process, the Entrustable activities and how they all  weave together for practice.

Overall Webinar Objectives Analyze the relationship between the CAPE 2013 Outcomes, PPCP, and EPAs for New Pharmacy Graduates. Relate the mapping of the CAPE 2013 Outcomes, PPCP, and EPAs for New Pharmacy Graduates developed by the 2017 AACP Academic Affairs Standing Committee. Outline considerations for faculty and preceptors to incorporate the EPAs for New Pharmacy Graduates as an evaluation tool into pharmacy school curricula and pharmacy practice experiences.

Center for Advancement of Pharmacy Educational (CAPE) 2013 Outcomes

CAPE Objectives Center for Advancement of Pharmacy Educational (CAPE) 2013 Outcomes Describe the purpose of the CAPE 2013 Outcomes Interpret the role of the CAPE 2013 Outcomes in the curriculum of colleges and schools of pharmacy Explain the domains and subdomains of the CAPE 2013 Outcomes

CAPE Purpose Designed to capture what students should be capable of upon graduation from a Doctor of Pharmacy program Defines the curricular priorities of Doctor of Pharmacy programs Informs other health professions of those priorities Obj #1

CAPE’s Role in S/COPs CAPE is a guide, but ACPE adopted the outcomes as standards Some S/COPs adopted CAPE as their program outcomes Inspires and guides curricular revision and innovation Serves as target for curriculum mapping Functions as core component of comprehensive assessment plan to assure achievement of outcomes by end of professional program Obj #2

Audience Question Poll Has your S/COP adopted the CAPE outcomes as their program outcomes? Yes, use CAPE as written Yes, use CAPE but modified them No, but similar to CAPE No, different but tag to CAPE Other I am not sure

CAPE 2013 Domains & Subdomains Obj #3 CAPE 2013 Domains & Subdomains 1. Foundational knowledge 1.1 Learner (Learner) 2. Essentials for practice & care 2.1 Patient-centered care (Caregiver) 2.2 Medication use systems management (Manager) 2.3 Health and wellness (Promoter) 2.4 Population-based care (Provider) Approach to practice 3.1 Problem solving (Problem-solver) 3.2 Educator (Educator) 3.3 Patient advocacy (Advocate) 3.4 Interprofessional collaboration (Collaborator) 3.5 Cultural sensitivity (Includer) 3.6 Communication (Communicator) 4. Personal & professional development 4.1 Self-awareness (Self-assessor) 4.2 Leadership (Leader) 4.3 Innovation and Entrepreneurship (Innovator) 4.4 Professionalism (Professional) A one word descriptor in parenthesis is provided for each subdomain that illustrates the main construct and can be used to concisely articulate the outcome.

Pharmacists’ Patient Care Process 2. PPCP Pharmacists’ Patient Care Process

PPCP Objectives Pharmacists’ Patient Care Process (PPCP) Identify the purpose of Pharmacists’ Patient Care Process for the pharmacy profession and pharmacy education. Execute the elements of the Pharmacists’ Patient Care Process. Test strategies to implement the Pharmacists’ Patient Care Process into the curriculum, including experiential education.

Obj #1 PPCP Purpose Provides a consistent process in delivery of patient care across the profession Developed by Joint Commission of Pharmacy Practitioners (JCPP)  Applicable to any practice setting where pharmacists provide patient care and for any patient care service provided by pharmacists https://jcpp.net/patient-care-process/

Pharmacists’ Patient Care Process Obj #2

Implementing PPCP Use in didactic setting Obj #3 Implementing PPCP Use in didactic setting Train students on steps, discuss process, practice with patient cases, document using SOAP notes – SOAP vs. PPCP confuses Can use a PPCP rubric to evaluate students and provide feedback Use in I/APPEs Have students practice steps with actual patients

Audience Question Poll How have you implemented PPCP with your students? Have not implemented it yet Only use explicit PPCP language with students Use PPCP language AND PPCP rubrics Use PPCP language & rubrics & feedback Other

Entrustable Professional Activities (EPAs) for New Pharmacy Graduates

EPA Objectives Entrustable Professional Activities (EPAs) for New Pharmacy Graduates Explain the purpose of the EPAs for New Pharmacy Graduates. Describe the 6 domains of the EPAs for New Pharmacy Graduates. Test strategies to integrate the EPAs for New Pharmacy Graduates into pharmacy school curriculum, including experiential education.

Purpose of EPAs EPA statements communicate core skills that are part of entry-level pharmacist identity EPAs expand view from product-tied dispensing to a medication-focused, cognitive skills provider Helps the academy train for “Practice-Ready” Informs future and current students Engages current pharmacists Identifies pharmacists’ role in healthcare team Enlightens the public of what pharmacists can do Informs policy makers of pharmacists’ skills so pharmacy laws & regulations can be modified Obj #1

EPAs – 6 Domains Self-developer Pt Provider Interprofess-ional Team Member Population Health Promoter Information Master Practice Manager Self-developer Obj #2

Example Core EPAs Published in AJPE Issue 1 for 2017 along with a commentary

EPA Assessment Tool

Strategy for Implementing EPAs Identify the team Map curriculum to EPAs Identify Milestones Use existing curricular assessment activities Leveling and Calibrating Each EPA Core Statement Determine adequate progress Pilot assessment with Students Faculty training Preceptor training Student training Obj #3

Audience Question Poll How have you implemented EPAs with your students? Have not implemented it yet Use EPA domains and supporting tasks only Use EPA domains & tasks AND EPA rubrics Other

4.Mapping EPA-CAPE-PPCP Mapping EPAs to CAPE outcomes and Pharmacists’ Patient Care Process

AJPE, 2017, 81(5):article s4

Domain 1: Patient Provider EPA Collect info on pt. related problems & health needs Collect D2 Caregiver, Manager, Promoter, D3 Problem-solver, Includer, Communicator Analyze Info Assess D1 Learner, D2 Caregiver, D3 Problem-solver, Includer Est. pt. goals & create care plan Plan D1 Learner, D2 Caregiver, Manager, D3 Problem-solver, Includer Implement pt. care plan Implement D2 Caregiver, Manager, D3 Collaborator, Communicator Follow-up & monitor care plan Follow-up: monitor & eval Domain 1: Patient Provider C=EPA subdomain; circle = PPCP Overall all 6 core statements address a PPCP and the first 3 of CAPE domains are present – including #1

Domain 2: Inter Prof Team Member EPA Collaborate as interprofess-ional team member Collect, Assess Plan, Implement, Follow-up: (Monitor & Eval) D1 Learner, D3 Problem-solver, Advocate, Collaborator, Communicator, D4 Self-assessor, Leader, Professional Domain 2: Inter Prof Team Member C=EPA subdomain; circle = PPCP Overall all 6 core statements address a PPCP and the first 3 of CAPE domains are present – including #1

Domain 3: Pop. Health Promoter EPA Identify at-risk pts. for prevalent disease Collect D2 Promoter, Provider, D3 Educator, Collaborator, Includer, Communicator Minimize ADE & med errors D2 Manager, Promoter, Provider, D3 Educator, Advocate, Collaborator, Includer, Communicator Maximize use of meds in population D2 Caregiver, Manager, Promoter, Provider, D3 Educator, Advocate, Collaborator, Includer, Communicator Ensure immunizations Domain 3: Pop. Health Promoter For 3 of the cores, all PPCP area addressed. For CAPE domains 2 and 3 are addressed

Domain 4: Information Master EPA Educate pt & provider on medication use Assess, Plan, Implement, Follow-up: M/E D1 Learner, D3 Educator, Advocate, Includer, Communicator, D4 Leader, Professional Use evidence-based info to advance pt care D1 Learner, D3 Includer, Communicator Domain 4: Information Master Learner addressed here for CAPE, this step does not address CAPE #4

Domain 5: Practice Manager EPA Oversee pharmacy operations at work Assess, Plan, Implement, Follow-up: M/E D2 Educator, D3 Problem-solver, Communicator, D4 Self-assessor, Leader, Innovator, Professional Fulfill medication order D2 Manager, D3 Problem-solver, Communicator Domain 5: Practice Manager 2, 3, 4 CAPE Addressed

Domain 6: Self-developer EPA Create written CPD plan D4 Self-assessor, Professional Domain 6: Self-developer Makes sense from the name that this step emphasizes CPAE #4

Summary CAPE 2013 Outcomes, PPCP, and EPAs have areas of overlap and portions can be evaluated at the same time. Map out the relationship among the EPAs, CAPE outcomes and the PPCP with your program to ensure that goals and assessments are aligned among all preceptors. Explore training options within your college or AACP to increase reliability when evaluating students on rotation.

Relating the CAPE 2013 Outcomes, PPCP, and EPAs All Together Dr. Melissa S. Medina University of Oklahoma College of Pharmacy AACP Preceptor Webinar Series June 20, 2019 Center for Advancement of Pharmacy Educational (CAPE) 2013 Outcomes At the completion of this webinar, the participant will be able to: Describe the purpose of the CAPE 2013 Outcomes. Explain the domains and subdomains of the CAPE 2013 Outcomes. Interpret the role of the CAPE 2013 Outcomes in the curriculum of colleges and schools of pharmacy.   Pharmacists’ Patient Care Process (PPCP) Identify the purpose of Pharmacists’ Patient Care Process for the pharmacy profession and pharmacy education. Execute the elements of the Pharmacists’ Patient Care Process. Test strategies to implement the Pharmacists’ Patient Care Process into the curriculum, including experiential education. Entrustable Professional Activities (EPAs) for New Pharmacy Graduates Explain the purpose of the EPAs for New Pharmacy Graduates. Describe the domains of the EPAs for New Pharmacy Graduates. Test strategies to integrate the EPAs for New Pharmacy Graduates into pharmacy school curriculum, including experiential education.