This study examined the attitudes of pharmacy faculty toward student evaluation of classroom teaching and the effects of student evaluations on classroom instructional practices. A questionnaire was mailed to a random sample of 1,600 pharmacy faculty, and 43.6 percent responded. Nineteen statements measured attitude on a five-point scale (1=strongly disagree). After item analyses, the statements were combined to produce a mean attitude of 3.07, indicating the faculty tend to not commit themselves on the issue of student evaluation of classroom teaching. For each of 22 instructional activities, faculty indicated changes, i.e., increases in the activity, decreases, or no change, attributable to student evaluations. Over half the faculty (52.4 percent) reported making changes in eight or more of the activities and 96.6 percent reported making at least one change. Relationships between academic and demographic characteristics of the faculty and attitudes and instructional changes were examined. Where statistical significance was found, the authors felt the differences were too small to be of practical consequence. Despite a noncommittal attitude on the part of faculty toward student evaluation of classroom teaching, these evaluations do contribute to instructional change.

An investigation of current procedures used to evaluate teaching in schools of pharmacy was conducted. A questionnaire was mailed to deans of 79 schools of pharmacy. Responses numbered 72 (91.1 percent). Information on evaluation methods, procedures, instruments and use of evaluation results was collected. Data were compared to a similar study conducted 20 years previously. All 72 schools utilize students to evaluate classroom teaching, and 69 (95.8 percent) use students for evaluation of experiential/rotational teaching. Use of students to evaluate teaching has increased by 60 percent in twenty years. Student evaluations of teaching occur primarily for each offering of a course or rotation and are administered primaryly at the conclusion of the course. Instruments employed to review experiential/rotational teaching have in most instances been developed by the schools of pharmacy. Instruments for evaluation of classroom teaching have been developed by the pharmacy schools or are university-wide instruments. Results of teaching evaluations are used most frequently in promotion and tenure decisions, selfimprovement/development activities, and determination of merit salary increases. Peers review classroom teaching in 36 (50.0 percent) of schools and experiential/rotational teaching in nine (12.5 percent). Use of peers to evaluate teaching has increased by 53.8 percent in twenty years. Other methods of evaluation (self-appraisal, evaluation by alumni, portfolio development, interviewing samples of students, and review by teaching experts) are rarely used. Student evaluation remains the most common method used to evaluate teaching in schools of pharmacy; however, innovations in frequency and timing of student evaluations have not been implemented.

Schools and colleges of pharmacy were recently called on to evaluate students based on portfolios that document progressive achievement of competencies. Student buy-in is recognized as an important consideration related to implementation, and in order to better communicate the relevance of maintaining a portfolio, a Practitionersʼ Roundtable Discussion was initiated in one college of pharmacy. To assess studentsʼ attitudes towards portfolio-based learning and determine the effect of a Practitionersʼ Roundtable Discussion on student perceptions of portfolio-based learning, a survey was administered to 146 P1 pharmacy students before and after the discussion. The pre-and post-discussion response rates were 95% and 85%, respectively. Students maintained a neutral attitude towards the impact, value, and practical application of maintaining a Professional Development Portfolio (PDP). Pre-and post-intervention analyses of P1 student results suggest that the intervention of the Practitionersʼ Roundtable Discussion positively affected student attitudes, but in a limited capacity.

To test a new prescription counseling method termed "patient-guided counseling" (PGC) in community pharmacies. Design: Post-test experimental design in which subjects were randomized to three groups. Setting: Six community pharmacies [three chain and three independent). Patients: Patients presenting new prescriptions. Interventions: Patients were randomly a ssigned to one of three comparison groups. The PGC group was given a written prompt instructing them to write any questions they wished to ask about their prescription or their medical condition. The pharmacist then incorporated these questions into the subse-I quent verbal counseling. A second group wa~ given a written prompt encouraging them to ask the pharmacist questions. This was fol-[lowed by customary verbal counseling. A third group served as the control. No prompts were provided, but the pharmacist did pro-(vide customary verbal counseling. Main Outcome Measures: Patients' demographics, recall of medication information, and isatisfaction with counseling. Patients were contacted by telephone 5 days after the start of drug therapy to measure compliance. Phar-(macists rated their satisfaction with the information communicated and with their interactions with patients. Results: Compared with lcustomary verbal counseling, the PGC method was associated with more supplemental questions asked by the patient. Compared with the other two methods, PGC was associated with greater pharmacist satisfaction with the information communicated and slightly l onger counseling sessions. No significant differences were found for patients' overall satisfaction with counseling, recall of informa-,60n, and compliance. Conclusion: In the community pharmacy setting, PGC fosters patient participation in medication counseling, a necessary element for the provision of pharmaceutical care.

Objective. To document teaching evaluation practices in colleges and schools of pharmacy. Methods. A 51-item questionnaire was developed based on the instrument used in a previous study with modifications made to address changes in pharmacy education. An online survey service was used to distribute the electronic questionnaire to the deans of 98 colleges and schools of pharmacy in the United States. Results. Completed surveys were received from 89 colleges and schools of pharmacy. All colleges/ schools administered student evaluations of classroom and experiential teaching. Faculty peer evaluation of classroom teaching was used by 66% of colleges/schools. Use of other evaluation methods had increased over the previous decade, including use of formalized self-appraisal of teaching, review of teaching portfolios, interviews with samples of students, and review by teaching experts. While the majority (55%) of colleges/schools administered classroom teaching evaluations at or near the conclusion of a course, 38% administered them at the midpoint and/or conclusion of a faculty member's teaching within a team-taught course. Completion of an online evaluation form was the most common method used for evaluation of classroom (54%) and experiential teaching (72%). Conclusion. Teaching evaluation methods used in colleges and schools of pharmacy expanded from 1996 to 2007 to include more evaluation of experiential teaching, review by peers, formalized selfappraisal of teaching, review of teaching portfolios, interviews with samples of students, review by teaching experts, and evaluation by alumni. Procedures for conducting student evaluations of teaching have adapted to address changes in curriculum delivery and technology.

Objectives. This study compared the results of traditional student evaluations of classroom teaching with those of faculty self-evaluations and with the results of evaluations by smaller, representative subsets of students. Methods. Students enrolled in required courses completed teaching evaluations, and 31 faculty members self-evaluated their instruction using the same 12 evaluation items given to the students. Students used a 5-point, ordinal response scale, and faculty used a visual analog scale. Within each professional year, representative subsets of 24 students were selected. Results. There were no overall differences between the scores for faculty members' self-evaluations and the scores for evaluations by the whole class of students, with one exception: responses to the evaluation item "the pace of presentation." At the level of individual instruction, there was no significant difference between responses given by faculty members on self-evaluations and those given by whole-class ratings for a mean of 7.31 items. There were no differences between the overall ratings given by the whole class and those given by a subset of students from that class for 91.7% of the instruction sessions. Conclusion. Faculty self-evaluations and evaluation by representative subsets of students can enhance the evaluation of faculty teaching.

Objective: To determine whether consumers are using nonprescription ibuprofen more predominantly to treat acute or chronic conditions, incidence of adverse effects, and whether a healthcare professional is providing patient information. Design: A questionnaire was developed and placed in 15 randomly selected community pharmacies in a major metropolitan area. Adult consumers who were purchasing an ibuprofen over-the-counter product or who had previously used an ibuprofen product were asked to complete a written questionnaire (n=190). The information collected included age, gender, prescription, and other over-the-counter drugs presently used, quantity, duration, present illnesses or conditions, both intended and past use of ibuprofen, and incidence of adverse reactions. Results: Most subjects who self-treated with ibuprofen were female (70.8 percent) with a mean age of 37 years. Consumers generally used ibuprofen for stress/tension headache (38.9 percent), menstrual cramps (34.2 perc...

In the last ten years, the practice of nuclear pharmacy has changed from academic hospital-based to that of private community centralized service centers (1 ,2). There is some indication that growth of these chain pharmacies has had a positive effect on nuclear pharmacists' working conditions, including higher salaries and greater medical and non-medical benefits (I ,2). However, employment conditions and levels of satisfaction among chain nuclear pharmacists have never been published. In 1982, the Section of Nuclear Pharmacy, Academy of Pharmacy Practice, (APhA), conducted a membership survey (2). Respondents who were commercial nuclear pharmacists numbered 28. The survey included a few measures of satisfaction: to the statement, "Nuclear pharmacy excites me," the chain nuclear pharmacists responded with a mean score of 4.5 on a 5-point scale indicating agreement. They felt neutral about their salaries (3.3). In a recent study (3), Board Certified Nuclear Pharmacists ...

Objective. To document teaching evaluation practices in colleges and schools of pharmacy. Methods. A 51-item questionnaire was developed based on the instrument used in a previous study with modifications made to address changes in pharmacy education. An online survey service was used to distribute the electronic questionnaire to the deans of 98 colleges and schools of pharmacy in the United States. Results. Completed surveys were received from 89 colleges and schools of pharmacy. All colleges/ schools administered student evaluations of classroom and experiential teaching. Faculty peer evaluation of classroom teaching was used by 66% of colleges/schools. Use of other evaluation methods had increased over the previous decade, including use of formalized self-appraisal of teaching, review of teaching portfolios, interviews with samples of students, and review by teaching experts. While the majority (55%) of colleges/schools administered classroom teaching evaluations at or near the conclusion of a course, 38% administered them at the midpoint and/or conclusion of a faculty member's teaching within a team-taught course. Completion of an online evaluation form was the most common method used for evaluation of classroom (54%) and experiential teaching (72%). Conclusion. Teaching evaluation methods used in colleges and schools of pharmacy expanded from 1996 to 2007 to include more evaluation of experiential teaching, review by peers, formalized selfappraisal of teaching, review of teaching portfolios, interviews with samples of students, review by teaching experts, and evaluation by alumni. Procedures for conducting student evaluations of teaching have adapted to address changes in curriculum delivery and technology.

Persons diagnosed with HIV were enrolled from eight centers receiving Ryan White Title lIIbfunds. Inclusion in thestudy was based onenrollment in centers within the 12defined Public Health Service regions intheUSandPuerto Rico. access to themedical records, andavailability of themedication profiles. Information was collected bythecenter nurse, pharmacist, or physician through review of the medical records at the cations, homehealth care, and nursing homecare, in 1992 for persons with HIV infection was $10 000,2,3 The average annual cost of treatment in the sameyearfor a person with AIDS was $38000, with a lifetime cost of care estimated to be $119000. Hellinger-' reportedfrom data of the AIDS Cost and Service Utilization Survey that during a 3-monthperiodpeoplewith AIDS had, on the average, 7.8 outpatient prescriptions, at an estimated annual average costof $4060. Bjornson et al.' reported thatin 1989 outpatient drug costs were $270 per month ($3240/y) with an annual extrapolated cost of nearly $500000 for 190HIVinfected patients at Walter Reed Army Medical Center. Kotzan et al. 5 reported the costof treatment for a patient in Georgia withAIDS receiving Medicaid benefits was$850 per monthin 1992and predicted an increase to $8500by January 2000. Currently, treatment of persons infected with HIV consistsprimarily of therapies designed to delaythe progression of the disease and minimize opportunistic infections and malignancies associatedwith HIV. The cost of drug treatment is a significant factor thatcontributes to the total cost of treatment." The first antiretroviral agent, zidovudine, became commercially available in 1987. Sincethen, a number of othercostly antiretroviral agents havebeenintroduced: didanosine, zalcitabine, stavudine, and lamivudine. In addition to antiretroviral therapy, drug treatment and prophylaxis for the opportunistic infections' associated withAIDS are significant costs in treatment of patients infected withHIV.8 Theprimary objective of thisstudy wasto determine the cost of prescription medications used among ambulatory HIV-infected persons at centersreceiving funds from the PublicHealthService, specifically, Ryan WhiteTitleIIIb sites. Additional datawerecollected on use of prescription medications and extentof use of over-the-counter (OTe) drug therapies andnontraditional therapies in this population.

To test a new prescription counseling method termed "patient-guided counseling" (PGC) in community pharmacies. Design: Post-test experimental design in which subjects were randomized to three groups. Setting: Six community pharmacies [three chain and three independent). Patients: Patients presenting new prescriptions. Interventions: Patients were randomly a ssigned to one of three comparison groups. The PGC group was given a written prompt instructing them to write any questions they wished to ask about their prescription or their medical condition. The pharmacist then incorporated these questions into the subse-I quent verbal counseling. A second group wa~ given a written prompt encouraging them to ask the pharmacist questions. This was fol-[lowed by customary verbal counseling. A third group served as the control. No prompts were provided, but the pharmacist did pro-(vide customary verbal counseling. Main Outcome Measures: Patients' demographics, recall of medication information, and isatisfaction with counseling. Patients were contacted by telephone 5 days after the start of drug therapy to measure compliance. Phar-(macists rated their satisfaction with the information communicated and with their interactions with patients. Results: Compared with lcustomary verbal counseling, the PGC method was associated with more supplemental questions asked by the patient. Compared with the other two methods, PGC was associated with greater pharmacist satisfaction with the information communicated and slightly l onger counseling sessions. No significant differences were found for patients' overall satisfaction with counseling, recall of informa-,60n, and compliance. Conclusion: In the community pharmacy setting, PGC fosters patient participation in medication counseling, a necessary element for the provision of pharmaceutical care.

The development and validation of a survey questionnaire measuring pharmacists' satisfaction with their jobs and careers is outlined. The instrument was part of a 1983 study which surveyed pharmacists licensed and residing in Florida. The use of the pilot survey to arrive at a final survey instrument is outlined. Reliability of the instrument is assessed with tests of internal consistency reliability. Validity is judged through a test of concurrent validity utilizing the Job Descriptive Index, a standardized measure of job satisfaction. The delineation of this process is intended to aid other researchers in the development and validation of their surveys of job satisfaction and similar attitudinal measures.

Schools and colleges of pharmacy were recently called on to evaluate students based on portfolios that document progressive achievement of competencies. Student buy-in is recognized as an important consideration related to implementation, and in order to better communicate the relevance of maintaining a portfolio, a Practitionersʼ Roundtable Discussion was initiated in one college of pharmacy. To assess studentsʼ attitudes towards portfolio-based learning and determine the effect of a Practitionersʼ Roundtable Discussion on student perceptions of portfolio-based learning, a survey was administered to 146 P1 pharmacy students before and after the discussion. The pre-and post-discussion response rates were 95% and 85%, respectively. Students maintained a neutral attitude towards the impact, value, and practical application of maintaining a Professional Development Portfolio (PDP). Pre-and post-intervention analyses of P1 student results suggest that the intervention of the Practitionersʼ Roundtable Discussion positively affected student attitudes, but in a limited capacity.

Objective: To determine whether community pharmacist-provided foodallergy education and auto-injectable epinephrine training is needed. Design: Cross-sectional assessment. Setting: United States. Participants:1,887 recently joined members of the Food Allergy & Anaphylaxis Network. Intervention: Electronic survey. Main Outcome Measures: 35 items covering past education and training associated with food allergy and use of auto-injectable epinephrine, demographics, attitudes toward pharmacist-provided education about food allergy, training in the use of auto-injectable epinephrine, confidence in managing food allergies on a daily basis and in emergency situations, and the necessity for pharmacists to provide education and training about food allergy and autoinjectable epinephrine use. Results: Prescriber-provided food-allergy education and auto-injectable epinephrine training is incomplete (60.7%) or absent (16.3%) at the time autoinjectable epinephrine is first prescribed. These initial prescriptions are being dispensed from community pharmacies (94%), and written information is commonly provided with the medication (73.6%); however, oral counseling is largely absent (86.6%), and training in administration of auto-injectable epinephrine occurs infrequently (13.3%). Food-allergic patients and their caregivers are receptive to the idea of pharmacist-provided education and training. The majority (63.6% or more) feel confident about managing their food allergies. They are not requesting counseling when refill prescriptions are dispensed (81.4%); however, they would like to see routine review at refill time of the signs of allergic reaction (54.5%) and use of the epinephrine auto-injector (79.3%). Conclusion: Community pharmacists have an opportunity to assist newly diagnosed food-allergic patients by working collaboratively with their pediatricians and allergists. Community pharmacists can provide ongoing assistance at refill time by retraining patients in the use of the epinephrine auto-injector and reviewing the signs of allergic reaction.

Pegylated liposomal doxorubicin (PLD) has a unique pharmacokinetic profile and is widely used to treat a variety of malignancies, alone or in combination with other agents. A 57-year-old female patient with metastatic breast cancer developed dural metastases to the brain and underwent craniotomy and whole-brain radiation. She continued to receive chemotherapy with carboplatin without any serious complications. Four months later, there was evidence of progression leading to the institution of PLD. During the first course of PLD, there was evidence of acute encephalopathy which resolved after 18 h with discontinuation of this agent. Interestingly, she did well when she was rechallenged with conventional doxorubicin in the following cycles. We hereby report, to the best of our knowledge, the first case of acute transient encephalopathy induced by PLD. We postulate that partial disruption of the blood-brain barrier may have been responsible for PLD-induced encephalopathy.

Background: Cyclophosphamide is an alkylating agent widely used in antineoplastic and immunosuppressive therapies. Symptomatic hyponatremia can be a rare but life-threatening complication in patients treated with cyclophosphamide. Case Presentations: We report 2 patients who presented with severe acute hyponatremic encephalopathy after receiving their first cycles of a low-dose cyclophosphamide-containing regimen for breast cancer. In case 1, a 58-year-old female received the combination of docetaxel and cyclophosphamide, and in case 2, a 56-year-old female received the combination of doxorubicin and cyclophosphamide. Both patients recovered after correction of their serum sodium concentration without neurological deficits. Future cycles of chemotherapy were well tolerated without recurrence of hyponatremia after cyclophosphamide was discontinued from the respective regimens. Conclusion: Clinicians must always keep in mind that acute hyponatremic encephalopathy can be induced by low...