16
Available online at www.sciencedirect.com Currents in Pharmacy Teaching and Learning 6 (2014) 210225 Research Evaluation of pharmacy faculty knowledge and perceptions of the patient-centered medical home within pharmacy education Anisha B. Grover, PharmD, BCACP a,*,1 , Bella H. Mehta, PharmD, FAPhA b , Jennifer L. Rodis, PharmD, BCPS b , Kristin A. Casper, PharmD b , Randy K. Wexler, MD, MPH c a Department of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy at the University of the Sciences, Philadelphia, PA b Division of Pharmacy Practice and Administration, The Ohio State University College of Pharmacy, Columbus, OH c Department of Family Medicine, The Ohio State University, Columbus, OH Abstract Purpose: To assess pharmacy faculty knowledge about key patient-centered medical home (PCMH) principles and evaluate pharmacy faculty perception of inclusion of PCMH information in didactic and/or experiential pharmacy education. Methods: E-mail addresses of 6433 pharmacy faculty members were obtained from the 20112012 American Association of Colleges of Pharmacy (AACP) roster. In an online survey, faculty rated their familiarity with key PCMH principles, indicated whether PCMH concepts are currently included and/or should be included in pharmacy education, and where and how this information should be taught. Results: Responses are included from 781 faculty members (12.1%). Among them, 641 (82%) respondents reported being aware of PCMH. A total of 207 (27%) respondents report PCMH is taught didactically and 203 (28%) report inclusion in experiential education. Faculty members were most likely to indicate that PCMH should be incorporated into required lectures and workshops in the rst, second, and third professional didactic years, and into experiential education in the third and fourth years. Conclusion: Many faculty members agree that it is important to teach about the PCMH health care model, but there is a low level of faculty familiarity with the standards and principles that guide this health care paradigm. Future pharmacists have an important opportunity to advance practice by participating in PCMH team care, and pharmacy education has a central responsibility in incorporating these concepts into the didactic and experiential curriculum in order to prepare pharmacists to effectively contribute in this setting. r 2014 Elsevier Inc. All rights reserved. Keywords: Pharmacy education; Patient-centered medical home; Curriculum; Faculty perceptions Introduction The Patient Protection and Affordable Care Act of 2010 recognizes the need for enhanced coordination among health care professionals including improvements in the use of medications. 1 This legislation supports the involve- ment of pharmacists in addressing these needs and includes provisions that increase opportunities for patients to access clinical pharmacy services in order to receive comprehen- sive health care. 1 To catalyze the process of health care reform, this act emphasizes the need for a reorganized http://www.pharmacyteaching.com 1877-1297/14/$ see front matter r 2014 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.cptl.2013.11.018 * Corresponding author: Bella H. Mehta, PharmD, FAPhA, Division of Pharmacy Practice and Administration, The Ohio State University College of Pharmacy, 500 West 12th Ave, Columbus, OH 43210-1291. E-mail: [email protected] 1 Study completed during Post-Graduate-Year-One (PGY1) Com- munity/Ambulatory Care, Pharmacy Practice Residency at The Ohio State University, College of Pharmacy, 500 West 12th Ave, Columbus, OH 43210-1291.

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Page 1: Evaluation of pharmacy faculty knowledge and perceptions of the patient-centered medical home within pharmacy education

Available online at www.sciencedirect.com

1877-1297/14/$http://dx.doi.org

* CorrespondiDivision of PharUniversity ColleOH 43210-1291

E-mail: meh1Study compl

munity/AmbulatOhio State UnivColumbus, OH

Currents in Pharmacy Teaching and Learning 6 (2014) 210–225

Research

Evaluation of pharmacy faculty knowledge and perceptions of thepatient-centered medical home within pharmacy educationAnisha B. Grover, PharmD, BCACPa,*,1, Bella H. Mehta, PharmD, FAPhAb,

Jennifer L. Rodis, PharmD, BCPSb, Kristin A. Casper, PharmDb,Randy K. Wexler, MD, MPHc

a Department of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy at theUniversity of the Sciences, Philadelphia, PA

b Division of Pharmacy Practice and Administration, The Ohio State University College of Pharmacy, Columbus, OHc Department of Family Medicine, The Ohio State University, Columbus, OH

http://www.pharmacyteaching.com

Abstract

Purpose: To assess pharmacy faculty knowledge about key patient-centered medical home (PCMH) principles and evaluatepharmacy faculty perception of inclusion of PCMH information in didactic and/or experiential pharmacy education.Methods: E-mail addresses of 6433 pharmacy faculty members were obtained from the 2011–2012 American Association ofColleges of Pharmacy (AACP) roster. In an online survey, faculty rated their familiarity with key PCMH principles, indicatedwhether PCMH concepts are currently included and/or should be included in pharmacy education, and where and how thisinformation should be taught.Results: Responses are included from 781 faculty members (12.1%). Among them, 641 (82%) respondents reported being awareof PCMH. A total of 207 (27%) respondents report PCMH is taught didactically and 203 (28%) report inclusion in experientialeducation. Faculty members were most likely to indicate that PCMH should be incorporated into required lectures and workshopsin the first, second, and third professional didactic years, and into experiential education in the third and fourth years.Conclusion: Many faculty members agree that it is important to teach about the PCMH health care model, but there is a lowlevel of faculty familiarity with the standards and principles that guide this health care paradigm. Future pharmacists have animportant opportunity to advance practice by participating in PCMH team care, and pharmacy education has a centralresponsibility in incorporating these concepts into the didactic and experiential curriculum in order to prepare pharmacists toeffectively contribute in this setting.r 2014 Elsevier Inc. All rights reserved.

Keywords: Pharmacy education; Patient-centered medical home; Curriculum; Faculty perceptions

– see front matter r 2014 Elsevier Inc. All rights reserv/10.1016/j.cptl.2013.11.018

ng author: Bella H. Mehta, PharmD, FAPhA,macy Practice and Administration, The Ohio Statege of Pharmacy, 500 West 12th Ave, Columbus,[email protected] during Post-Graduate-Year-One (PGY1) Com-ory Care, Pharmacy Practice Residency at Theersity, College of Pharmacy, 500 West 12th Ave,43210-1291.

Introduction

The Patient Protection and Affordable Care Act of 2010recognizes the need for enhanced coordination amonghealth care professionals including improvements in theuse of medications.1 This legislation supports the involve-ment of pharmacists in addressing these needs and includesprovisions that increase opportunities for patients to accessclinical pharmacy services in order to receive comprehen-sive health care.1 To catalyze the process of health carereform, this act emphasizes the need for a reorganized

ed.

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A.B. Grover et al. / Currents in Pharmacy Teaching and Learning 6 (2014) 210–225 211

primary care system and supports the patient-centeredmedical home (PCMH) model of care as a primary careinitiative. The increased need for primary care services isdictated by an aging population, health care reform thatinvolves a transfer of focus from acute to preventative care,and a workforce capacity that does not meet the highdemand for primary care providers.2 The PCMH model ofcare provides structured, individualized, team-based careinvolving long-term partnerships between patients, families,and the health care team. In this setting, health care isprovided with the assistance of information technology tocoordinate and track care over time. Patient centeredness isa focus within this model, and there is an emphasis onintegrating behavioral health care and care management,implementing patient surveys to help drive quality improve-ment, and involving patients and their families in decision-making and quality improvement.3 To support PCMH as afocal point of primary care redesign, this act specificallymentions the establishment of community health teams,which may include pharmacists, and the provision of patientaccess to pharmacist-delivered medication managementservices. The interdisciplinary primary care team serves asa point of entry into the complex health care system andfacilitates the provision of continuous, coordinated, andcomprehensive care.

The National Committee for Quality Assurance (NCQA)is one of several not-for-profit organizations that hasdeveloped quality standards and performance measures forthe accreditation of PCMHs.3 NCQA defines the PCMHmodel of care as a redesigned primary health care settingthat “facilitates partnerships between individual patients,and their personal physicians, and when appropriate, thepatient’s family. Care is facilitated by registries, informationtechnology, health information exchange, and other meansto assure that patients get the indicated care when and wherethey need and want it in a culturally and linguisticallyappropriate manner.”3 The Joint Principles of the PCMHcharacterize the key components of the PCMH model ofcare and provide a national set of standards.4 They weredeveloped collectively in 2007 by the American Academyof Family Physicians (AAFP), American Academy ofPediatrics (AAP), American College of Physicians (ACP),and American Osteopathic Association (AOA). Theseprinciples include a personal physician, a physician-directed medical team that is responsible for ongoing patientcare, whole-person orientation, coordinated and integratedcare, quality and safety, enhanced access, and payment thatrecognizes the added value of PCMH.4 With the predicteddecline and shortage of primary care physicians, theAmerican Association of Medical Colleges suggests anincrease in the utilization of other health professionals, suchas clinical pharmacists, as the demands for primary careservices cannot continue to be met by one profession.2

Pharmacists can have an important role within a PCMH,both in providing direct patient care and in optimizing useof medications.5–8

Incorporation of the PCMH model of care into pharmacyeducation is an important component in the preparation ofstudent pharmacists to deliver health care as part of aninterdisciplinary team in this type of health care setting.Various studies have investigated the exposure of studentphysicians and resident physicians to PCMH, and a set ofJoint Principles relating specifically to medical educationwas prepared by the same four physician organizations, inan effort to prepare student physicians to practice within thissetting.9–11 These Joint Principles for the Medical Educa-tion of Physicians as Preparation for Practice in thePatient-Centered Medical Home provide a set of compe-tencies needed to address the national standards and a set ofcorresponding educational sub-principles that supports eachof the seven Joint Principles of PCMH.11 This documentguides the education of student physicians with regards todelivering care within this model of health care, and its useis encouraged with students of other health professions.This document demonstrates the efforts to incorporateelements of health care reform into medical school curric-ula; however, this level of widespread adaptability to matchthe evolving health care climate has not been seen withinpharmacy education, as standards relating specifically tostudent pharmacists have not yet been developed.

The 2004 American Association of Colleges of Phar-macy (AACP) Center for the Advancement of Pharmaceut-ical Education (CAPE) Educational Outcomes state thatpatient-centered pharmaceutical care should be provided incooperation with patients, prescribers, and other members ofan interprofessional health care team.12 They also state thatstudent pharmacists should be prepared to work as part ofan interprofessional health care team to manage and useresources of the health care system in order to promotehealth and improve the therapeutic outcomes of medicationuse.12 In 2006, AACP released a supplemental educationaloutcomes document, which serves as an additional resourcefor faculty in developing, improving, and assessing curric-ula and learning experiences that aim to accomplish the2004 CAPE Educational Outcomes.13 This section of thedocument provides more detail related to patient-centeredpharmaceutical care plans developed in collaboration withother health care professionals, as well as the establishmentof interprofessional relationships involving effective com-munication and collaboration with various members of thehealth care team.13 The Accreditation Council for PharmacyEducation (ACPE) also released an updated version ofAccreditation Standards and Guidelines for the ProfessionalProgram in Pharmacy Leading to the Doctor of PharmacyDegree in January 2011.14 Although the standards remainunchanged, the guidelines relating to methods of achievingthe standards have been clarified and updated. Among theupdates was an increased emphasis on interprofessionaleducation and a specification that this multidisciplinaryapproach to learning and collaborative practice should bepromoted both in didactic and experiential education. Inaddition, a guideline was added that encouraged the

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A.B. Grover et al. / Currents in Pharmacy Teaching and Learning 6 (2014) 210–225212

development of students as leaders and agents of change,with the ability to affect positive change in pharmacypractice and health care delivery. Along with the CAPEeducational outcomes, the updated ACPE standards andguidelines have fueled the advancement of experientialeducation, resulting in the expansion and enhancement ofprograms. Several of these programs include learningexperiences in health care settings that provide opportunitiesfor students to work with academic pharmacists andcollaborate with other health care providers to providepatient-centered health care.5

An important preliminary step in identifying opportuni-ties for student pharmacist education is to assess facultyawareness of PCMH. Through a systematic literature reviewand a Call for Successful Practices, the 2009–2010 Pro-fessional Affairs Committee (PAC) of the American Asso-ciation of Colleges of Pharmacy (AACP) describedrelationships between academia and patient-centered care.15

The report identified 69 sites, including ambulatory care orclinic settings, community pharmacies, integrated models,and others, in which a pharmacy faculty member providedpatient-centered care and 46 sites that reported incorpora-tion of residency or experiential training.15 The report didnot specify whether these practice sites incorporated PCMHmodels of care. Although this report identified primary caresites at which pharmacy faculty members are leadingresidency and experiential patient-centered training, thePCMH knowledge and perception of pharmacy facultyacross the country has not been assessed. Consequently, astudy was conducted to identify pharmacy faculty members’familiarity with key PCMH definitions and principles,current inclusion of PCMH in didactic and experientialpharmacy education, and faculty perception of where andhow this information should be included.

The primary objectives of this study were to (1) assesspharmacy faculty knowledge about key PCMH principles,(2) evaluate pharmacy faculty perceptions of inclusion ofPCMH information in didactic and/or experiential pharmacycurriculum, and (3) evaluate pharmacy faculty perceptionsof where and how information about PCMH should betaught. Results from this study provide insight into oppor-tunities for incorporating PCMH into pharmacy curricula, inorder to prepare student pharmacists to provide clinicalpharmacy services in this type of health care setting.

Methods

The study was submitted to The Ohio State UniversityInstitutional Review Board and was approved as exemptresearch. A 2011–2012 pharmacy faculty member rostercontaining 6433 valid e-mail addresses was obtainedfrom AACP.

An original survey instrument (Appendix 1) was devel-oped to collect the data necessary to meet the statedobjectives, and survey questions were predominantly multi-ple-choice, yes/no, and Likert-scale format. A skip–logic

format was utilized and faculty members either completedthe entire survey or portions of the survey based on theirprovided responses. Faculty respondents had the opportu-nity to specify if they were unsure of an answer or declineto answer any specific questions while taking the survey.The survey was pilot tested by non-AACP membersinvolved with teaching at The Ohio State University.Feedback provided by the pilot test participants on thereadability, clarity of questions, and time required forsurvey completion was used to refine the survey instrument.The survey content was loaded into Qualtrics™ (www.qualtrics.com; Qualtrics, Inc., Provo, Utah), an onlinesurvey tool, and an invitation to participate in the surveywas sent via e-mail to all 6433 AACP members listed on theroster. The invitation included a brief explanation of theresearch project and a hyperlink to the survey instrument.Faculty members were informed that survey completion wasvoluntary and that they could withdraw at any time. Noquestions on the survey were mandatory. Faculty memberswere also informed that responses would be kept confiden-tial and that data would only be reported in aggregate.Completion of the survey instrument served as consent toparticipate in the study. The online survey was conductedusing the Dillman Tailored Design Method, which recom-mends multiple contacts to increase response rate.16 Therecruitment e-mail was sent in February 2012, and thesurvey remained open for four weeks. One reminder e-mailwas sent at midpoint, on day 15, and the second reminder e-mail was sent on day 22, when there was one weekremaining before the survey closed.

Survey content related to the three study objectives

Faculty knowledge was assessed with questions relatingto PCMH definitions and principles. Participants were askedto rate their familiarity with the PCMH definition presentedby NCQA and provided in the survey.3 Respondents werealso asked to rate their familiarity with the Joint Principlesfor the Medical Education of Physicians as Preparation forPractice in the Patient-Centered Medical Home.11 Currentinclusion of PCMH in pharmacy education was assessedwith questions relating both to didactic and experientialeducation. Respondents indicated whether or not theseconcepts were currently taught at their respective univer-sities, and if so, in which professional year. Responseoptions included pre-professional years and first throughfourth professional years so that six-year programs wereable to appropriately specify where in the curriculum thisinformation was included. Respondents also indicatedwhether these concepts were included in required or electiveclasses, in which courses, in what format, and how muchtime was dedicated to teaching. Participants then answeredthe same set of questions related to where and how theythought the information should be incorporated in both thedidactic and experiential curriculum. Survey content alsoincluded faculty and university demographics.

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Table 1Survey demographics

Variable n (%)

Age (years) 685 (100)18–26 18 (3)27–35 214 (31)36–45 192 (28)46–55 134 (20)56–65 110 (16)465 17 (2)

Gender 685 (100)Male 267 (39)Female 418 (61)

Registered pharmacist 688 (100)Yes 599 (87)No 89 (13)

Time practicing as pharmacist (years) 596 (100)o1 2 (1)1–2 29 (5)3–6 133 (22)7–10 79 (13)11–20 142 (24)420 211 (35)

Primary practice setting 600 (100)Academia 399 (67)Ambulatory care 116 (19)Hospital (clinical pharmacist) 53 (9)Othera 32 (5)

Currently practice in patient-centered medical home(PCMH)

590 (100)

Yes 66 (11)No 430 (73)Unsure 94 (16)

Time as faculty member (years) 683 (100)o1 51 (7)1–2 69 (10)3–6 209 (31)7–10 101 (15)11–20 145 (21)420 109 (16)

Post-graduate training 683 (100)Did not complete 76 (11)One year of residency 246 (36)Two years of residency 122 (18)Fellowship 58 (8)PhD 143 (21)Masters 38 (6)

Academic area 684 (100)Pharmacy practice 517 (75)Social administrative sciences 93 (14)Otherb 74 (11)

Faculty track 685 (100)Clinical track 332 (48)Tenure track 258 (38)Research track 12 (2)Adjunct/auxiliary track 18 (3)Administrativec 12 (2)Non-tenure trackc 25 (4)Tenuredc 9 (1)Otherd 19 (3)

Table 1Continued

Variable n (%)

Number of professional years (years) 686 (100)Three 51 (7)Four 591 (86)Six 31 (5)Othere 13 (2)

University description 680 (100)Private 276 (41)Public 404 (59)

Pharmacy school founded (years ago) 675 (100)o10 148 (22)Z10 527 (78)

Academic medical center affiliation 682 (100)Yes 307 (45)No 375 (55)

a Other includes: community (chain and independent), consultant, govern-

ment, hospital (staff pharmacist), managed care, research, management, and

call center.b Other includes: biologic sciences, chemistry, continuing professional

education, pharmaceutics, and libraries/educational resources.c Response option did not appear on original survey; due to high

frequency of these responses in “Other” category, these responses were re-

categorized and are listed separately.d Other includes: professional, contract (non-specified duration, two year,

and four year), instructor, education track, public service track, and

experiential.e Other includes: one year, two years, and five years.

A.B. Grover et al. / Currents in Pharmacy Teaching and Learning 6 (2014) 210–225 213

Descriptive statistics were generated for all survey items,with responses expressed using frequencies and percen-tages. Descriptive results were analyzed by the university’sCenter for Biostatistics and are reported overall and as two-way tables, cross-tabulating knowledge and curriculumresponses with demographic information. Chi-square testswere used to compare two categorical variables andKruskal–Wallis tests were used to compare categoricaland ordinal variables. Due to the number of tests that wereconducted and the impact that this has on the type I errorrate, p-values are considered to be significant if they are lessthan 0.0001.

Results

Baseline demographics are listed in Table 1. Overall,781 (12.1%) of the 6433 AACP members initially identifiedcompleted the survey instrument between February 17,2012, and March 16, 2012. Due to the skip–logic formatof the survey and because respondents could decline toanswer any specific questions while taking the survey, thenumber of respondents varied for each survey question. Themajority of respondents were females (n ¼ 418; 61%) andbetween 27 and 65 years of age (n ¼ 650; 95%). Themajority of respondents (n ¼ 517; 75%) taught within the

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A.B. Grover et al. / Currents in Pharmacy Teaching and Learning 6 (2014) 210–225214

pharmacy practice department, with 399 (67%) listing theirprimary practice setting as academia and 116 (19%) listingambulatory care. A total of 66 (11%) respondents indicatedthat their practice setting was an NCQA-accredited PCMHand 94 (16%) were unsure whether or not they werepracticing in a PCMH. The majority of the colleges orschools of pharmacy were founded at least ten years ago (n¼ 527; 78%) and almost half were affiliated with anacademic medical center (n ¼ 307; 45%). Respondentsrepresented schools or colleges of pharmacy from 46 of the50 states within the United States of America. The statesthat were not represented include Alaska, Delaware, NewHampshire, and Vermont and are the only four states withinthe country that do not contain a school or college ofpharmacy. Additional faculty and university demographiccharacteristics can be found in Table 1.

Results regarding faculty perspectives on where PCMHconcepts are and should be taught can be found in Table 2.The beginning of the survey addressed faculty familiaritywith PCMH, and 641 (82%) respondents were aware of thismodel of care. When presented with the NCQA definitionof PCMH and asked to rate their familiarity, 341 (44%)respondents indicated that they were either not at all orslightly familiar. When presented with a brief description ofthe Joint Principles for the Medical Education of Physiciansas Preparation for Practice in PCMH, there was a similartrend, and 395 (58%) faculty members indicated that theywere either not at all or only slightly familiar with theseconcepts. Overall, 20% of respondents (n ¼ 136) werefamiliar or very familiar with the principles. When askedabout the implications of such principles for pharmacyeducation, about half of respondents indicated that theseprinciples should be adapted and then applied to pharmacyeducation (n ¼ 350; 52%).

The next set of questions related to the inclusion ofPCMH concepts in the didactic curriculum at the respond-ents’ respective universities. Of the 356 faculty membersthat were familiar with the curriculum, 207 (58%) indicatedthat PCMH concepts were currently taught didactically, andthis subset of respondents was then asked to respond toadditional survey questions in order to provide more specificinformation regarding when and where these concepts aretaught. All respondents were then asked to report theirpersonal opinions regarding the didactic teaching of thePCMH model of care. A total of 582 (76%) respondentseither agreed or strongly agreed that PCMH concepts shouldbe included in the didactic curriculum at their respectiveuniversities. Graph 1 depicts where in the didactic curricu-lum PCMH concepts are currently included as comparedwith where faculty perceive that they should be included.

The third set of questions related to the inclusion ofPCMH concepts in experiential education at the respond-ents’ respective universities. Of the 353 faculty membersthat were familiar with the curriculum, 203 (58%) indicatedthat PCMH concepts were currently taught experientially,and this subset of respondents continued to provide more

detail. All respondents then indicated their personal opin-ions regarding the experiential teaching of the PCMH modelof care. A total of 538 (75%) respondents either agreed orstrongly agreed that PCMH concepts should be included inexperiential education at their respective universities. Graph2 depicts where in the experiential curriculum PCMHconcepts are currently included as compared with wherefaculty perceive that they should be included. Additionalresults can be found in Table 2.

The secondary objectives of this study were to comparefaculty and university demographics for respondents who didand did not report being aware of the PCMH model of careand for respondents who did or did not think PCMH conceptsshould be taught in didactic and experiential settings. Amongsurvey respondents, a significantly higher proportion ofregistered pharmacists (n ¼ 525; 88%) had heard of thePCMH model of care compared to those who were notregistered pharmacists (n ¼ 54; 61%; p o 0.0001). Inaddition, there was a significant difference in the proportionof those who had heard of the PCMH model of care based onthe types of post-graduate education pursued by the respond-ents (p o 0.0001) and based on academic area (p o 0.0001)(Graph 3). There is also evidence to suggest a significantdifference in how strongly participants agreed or disagreedwith the inclusion of PCMH concepts in the didacticpharmacy curriculum (po 0.0001) and experiential pharmacyeducation (p o 0.0001) at their respective universities amongthe different academic areas reported by faculty respondents.Of the 93 respondents working in social administration, 90%(n ¼ 84) reported either agreeing or strongly agreeing with thestatement “PCMH concepts should be included in the didacticpharmacy curriculum at my university.” Of the 517 respond-ents working in pharmacy practice, 79% (n ¼ 410) agreed orstrongly agreed with this statement. With regards to experi-ential education, of the 92 respondents working in socialadministration, 80% (n ¼ 74) reported either agreeing orstrongly agreeing with the statement “PCMH concepts shouldbe included in experiential pharmacy education at myuniversity,” whereas 78% (n ¼ 399) of the 511 respondentsworking in pharmacy practice agreed or strongly agreed.

Discussion

Our findings show that a majority of surveyed facultymembers have heard of the PCMH model of care, butrespondents were less familiar with the presented standardsand principles that define and structure this health careframework. Despite a general awareness of the existence ofthis model, the low level of respondent familiarity with theNCQA definition of PCMH and the medical education JointPrinciples may be a result of the variability that exists in boththe implementation of PCMH standards in emerging practicesand the methods of achieving recognition as a medicalhome.17 This range of approaches has translated to asubstantial variability in curricular methodologies, both inmedical and pharmacy education.15,17–19 In order to

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Table 2Faculty perceptions regarding the inclusion of patient-centered medical home (PCMH) in pharmacy education

Current inclusion, n (%) Faculty preference, n (%)

Didactic curriculumWhen are PCMH concepts taught?a

Pre-professional pharmacy years 2 (1) 33 (5)First professional year 93 (47) 330 (49)Second professional year 77 (39) 398 (59)Third professional year 107 (54) 456 (68)Otherb 23 (12) 81 (12)Unsure 37 (19) –

How is PCMH information incorporated?Required classes 103 (52) 262 (39)Elective classes 10 (5) 52 (8)Both required and elective classes 69 (35) 361 (53)Unsure 17 (8) –

In which courses is PCMH information incorporated?a

Pharmacy practice courses 127 (64) 566 (83)Therapeutics courses 41 (21) 210 (31)Career planning courses 12 (6) 173 (26)Management courses 93 (47) 438 (65)Otherc 38 (19) 66 (10)Unsure 25 (13) –

In what format is PCMH information delivered?Lecture 111 (57) 95 (14)Workshop 5 (3) 58 (9)Both lecture and workshop 48 (24) 517 (77)Unsure 32 (16) –

Experiential educationWhen are PCMH concepts taught?a

First professional year introductory pharmacy practice experience (IPPE) 31 (16) 176 (27)Second professional year IPPE 33 (17) 228 (35)Third professional year IPPE 55 (28) 330 (51)Fourth professional year advanced pharmacy practice experience (APPE) 178 (90) 547 (84)Otherd 6 (3) 19 (3)Unsure 16 (8) –

How is PCMH information incorporated?a

Required IPPEs 49 (25) 319 (49)Elective IPPEs 26 (13) 198 (31)Required APPEs 128 (65) 412 (64)Elective APPEs 112 (57) 343 (53)Unsure 28 (14) –

How much IPPE time is dedicated to PCMH experiences?One IPPE rotation 20 (10) 366 (58)Two IPPE rotations 8 (4) 70 (11)Three or more IPPE rotations 5 (3) 36 (6)No IPPE time 73 (37) 155 (25)Unsure 89 (46) –

How much APPE time is dedicated to PCMH experiences?One APPE rotation 62 (32) 430 (68)Two APPE rotations 15 (8) 92 (14)Three or more APPE rotations 10 (5) 56 (9)No APPE time 25 (13) 58 (9)Unsure 83 (42) –

PCMH ¼ patient-centered medical home; IPPE ¼ introductory pharmacy practice experience; APPE ¼ advanced pharmacy practice experience.a Respondents could select more than one response.b Other includes: fourth professional year APPE rotations.c Other includes: pharmacy administration, quality improvement class, health systems course, health policy initiatives, research courses, introduction to

pharmacy course, public health course, interprofessional education introduction, hospital pharmacy elective, managed care pharmacy elective, ethics course,

pharmaceutical care skills course, health care delivery, pharmacogenomics, advanced patient care course, medication therapy management elective, pharmacy

practice lab, and capstone course.d Other includes: service learning at free care clinic, third professional year APPE, summer between second and third professional years, interprofessional health

screening clinics.

A.B. Grover et al. / Currents in Pharmacy Teaching and Learning 6 (2014) 210–225 215

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Graph 1. PCMH inclusion in didactic curriculum.

A.B. Grover et al. / Currents in Pharmacy Teaching and Learning 6 (2014) 210–225216

effectively examine this diversity of educational approachesand move forward in standardizing the teaching of PCMHconcepts, it is important to first evaluate the knowledge andperceptions currently possessed by student health care pro-fessionals. This type of needs assessment has not yet beenconducted with student pharmacists, but a survey of first-through fourth-year student physicians conducted by Jooet al.20 revealed that 41% of student respondents hadencountered a PCMH topic, despite the lack of formal PCMHinclusion in the curriculum. Exposure occurred most com-monly in primary care or family medicine clerkships, small-group discussions, and clinical practice settings. Although themajority of students reported a general lack of understandingabout the overall PCMH model, students did have someunderstanding of six of the seven Joint Principles of PCMH,with the least understood principle being “value-based pay-ment.” Although these results indicate that some PCMHconcepts may already be interlaced into existing curriculartopics, one-third of respondents incorrectly identified the roleof primary care physicians within a PCMH as gatekeepers ofpatient access to specialist care. This highlights a need forthese topics to be presented more formally within the frame-work of PCMH, in order to appropriately convey the basicprinciples of this model of care.

Although there is a scarcity of literature related tostudent pharmacist knowledge and perceptions of PCMH,

a recent survey of community pharmacists evaluated train-ing and confidence related to this model of care.21 Amajority of respondents agreed that pharmacists are suffi-ciently trained (79.8%) and have the skills required (93.8%)to participate within the PCMH. Despite the confidence ofthese community pharmacists in their ability to contribute inthis setting, only 32.6% were familiar with PCMH beforethe survey. When made aware of this model of care, 74.4%indicated that they were willing to assume more responsi-bility in order to be included in a PCMH team. The studydid not elaborate on the definition of increased responsi-bility. These results demonstrate the eagerness of pharma-cists to take an active role within this health care model.With the growth of opportunities for pharmacists toparticipate in these settings, schools and colleges ofpharmacy should prepare students and provide them withthe knowledge and training necessary to offer direct patientcare in this health care setting. The introduction of studentpharmacists to the PCMH model of care within the didacticcurriculum and the integration of students into these healthcare settings through experiential education would foster thetraining of student leaders and change agents who areparticipating in the expanded role of clinical pharmacistsand who are prepared to deliver collaborative, patient-centered health care as an integral part of interprofessionalhealth care teams.

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Graph 2. PCMH inclusion in experiential curriculum.

Graph 3. Proportions of faculty members having heard of patient-centered medical home (PCMH) based on demographic characteristics.

A.B. Grover et al. / Currents in Pharmacy Teaching and Learning 6 (2014) 210–225 217

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As previously mentioned, there is a high degree ofvariability in the curricular approaches across differenthealth care disciplines. In 2010, Barnhart et al.22 developedan electronic communication curriculum that was deliveredduring a required six-week third-year family medicineclerkship. This curriculum involved didactic sessionsaddressing patient and physician expectations, e-mail lim-itations, system issues, and confidentiality protection duringthe first week. Students then responded to four weekly“standardized” patient e-mails that presented various clin-ical challenges and received clerkship faculty feedback inthe form of a rubric that was created based on predictederrors in communication, clinical judgment, and non-cognitive areas. In the final week of the clerkship, studentscompleted an e-mail objective structured clinical exam(OSCE) that re-introduced the challenges initially presentedin the four weekly e-mails. Although this curriculum targetsonly a specific topic within one PCMH principle, itdemonstrates the feasibility of incorporating electroniceducation modules into experiential education settings.These modules could be utilized to introduce PCMHconcepts and provide students with the hands-on opportu-nity to apply their knowledge and practice their skills. In2011, Lausen et al.23 described the contents of a recentlyimplemented Department of Family and Community Med-icine Clerkship Curriculum and the relationship of eachcurricular element to a specific PCMH concept. Deliverymethods included didactic lecture and self-directed assign-ments. Following the implementation of this new curriculum,student clerkship ratings increased significantly, showing thepositive impact of the introduction of these concepts into thiseducational setting. The White Paper recently published bythe Pennsylvania Pharmacist Association describes an inno-vative PCMH longitudinal curriculum at the Penn StateCollege of Medicine that provides third- and fourth-yearstudent physicians with the opportunity to learn aboutmedication management and drug utilization concepts frompatient care teams that include a pharmacist.24 These threecurricula offer suggestions that may be easily translatable toexperiential pharmacy education, particularly in the ambula-tory care setting. They include approaches that incorporatedidactic elements and self-directed activities that introduceand reinforce key principles related to the PCMH model ofcare. The PCMH Education Advisory Group (EAG) and thePatient-Centered Medical Home Education Pilot Programwere created by Ohio’s medical home statute (Ohio HouseBill 198 of the 128th Ohio General Assembly) and focus onadvancing medical and nursing education as it relatesspecifically to care delivery within the PCMH model ofcare.25 Objectives of the pilot program include revisingstudent physician, resident physician, and student nursecurricula to incorporate PCMH principles. In a reportpublished in 2011, the EAG Curriculum Design task forcedescribed goals, objectives, and integrated learning strategiesthat comprise a PCMH curriculum.25 Although these elementswere designed for medical and nursing curricula, the

integrated learning strategies described in this document relatestrongly with pharmacy education and may be applicable tothe training of student pharmacists.

Current literature indicates that the PCMH model of careis being incorporated into pharmacy education at severalinstitutions. AACP describes many of these successful,innovative practices in academic pharmacy in reportspublished in 2010 and 2011.18,19 Although PCMH conceptsare taught at some schools and colleges of pharmacy, themajority of surveyed faculty members were not sure if thiswas being done at their respective universities. For respond-ents that were aware of this information being taught, manywere not sure where and how this information wasconveyed. In order to gain a more clear understanding ofhow this information is currently being taught, futureresearch may target a different respondent demographic. Arecent survey to identify communication topics included inpharmacy curricula across the country was sent to deans,department chairs, and curriculum chairpersons, and theinformation obtained in this study suggests a clearerestimation of current curricular inclusions.26

When asked for their personal opinions regarding theteaching of PCMH concepts, nearly half of faculty respondentsindicated that these concepts should be incorporated in the firstprofessional year of the didactic curriculum, and the majorityfelt that these concepts should be included in the second andthird professional years. Faculty felt that these concepts couldbe included in a variety of courses including introduction topharmacy, pharmacy practice, management, health systems orhealth care delivery, interprofessional education, and anassortment of electives. The majority of respondents alsoindicated that this information should be incorporated intoexperiential education during the third and fourth professionalyears. Our results showed that faculty respondents are awareof this model of care and are strongly in favor of teaching thisinformation in both didactic and experiential settings.

When presented with a brief description of the JointPrinciples for the Medical Education of Physicians asPreparation for Practice in PCMH and asked about theimplications of such principles for pharmacy education,about half of respondents indicated that these principlesshould be adapted and then applied to pharmacy education.The development of learning objectives and correspondingcompetencies that align with the Joint Principles of thePCMH and relate specifically to the education of studentpharmacists may represent a starting point in the effort tocreate a more systematic, consistent approach to teachingthese concepts. A doctor of pharmacy curriculum can bereasonably expected to provide a strong foundationalawareness and understanding of the basic principles andstructures of different care models, including the PCMH.Pharmacy curricula can also teach student pharmacists todeliver comprehensive medication management serviceswithin a variety of settings; however, as with any clinicalspecialty, advanced training is essential in complementingand extending the learning that occurs within the doctor of

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pharmacy program, in order to prepare pharmacists tooptimize medication management and effectively contributeto team-based care within a collaborative PCMH setting.27

Limitations

Limitations of this study include the utilization of a non-validated survey tool. Although a small population ofpharmacy faculty members was included, this was likely arepresentative sample of practicing faculty members, asdemographics show diversity in age, number of yearsteaching, and number of years practicing pharmacy. Theuniversities that are represented are also diverse in terms ofgeographic location, public or private status, affiliation withmedical center, and age of pharmacy program. The AACProster was obtained in an effort to gain a broad scope ofviews, but these responses may not be representative of allpharmacy faculty members. The majority of respondentsheld positions within pharmacy practice departments, whichmay introduce a level of bias when considering surveyresponses; however, this is representative of the member-ship of AACP, which was the targeted population for thisstudy. In addition, the AACP roster may have included non-faculty members, so the response rate may be lower than itwould have been if invitations were sent only to faculty.Respondent bias may exist because the survey invitationincluded the purpose and topic of the research project, andfaculty members who were more interested in or moreaware of PCMH may have been more likely to take thesurvey. Respondents were allowed to skip questions in thesurvey, so numbers of respondents vary among questions.There were a few single-select demographic questions forwhich faculty members may have preferred the option toselect multiple responses. These included post-graduateeducation, academic area, and practice setting. Finally, thequestion assessing the amount of time spent teaching aboutthe PCMH model of care in experiential education includedresponse options that listed numbers of APPE rotations.Since there are a variety of ways to quantify this informa-tion, the listing of response options in terms of hours may

Appendix 1. Survey questions

1. Have you heard of the Patient-Centered Medical Homa. Yesb. No

2. The National Committee for Quality Assurance (NCQquality standards, performance measures, and accreddefines PCMH as a redesigned primary health care spatients, and their personal physicians, and when apregistries, information technology, health informationthe indicated care when and where they need and wmanner.”

have provided a different perspective, as the length ofrotations can vary among schools and colleges of pharmacy.

Although we were able to engage faculty members with abroad variety of experience and from every state in theUnited States of America that contained a pharmacy school,our study was limited to the knowledge and perceptions offaculty members of AACP. Our results helped identifyopportunities for pharmacy education in both didactic andexperiential settings and may be used by schools and collegesof pharmacy that may be seeking to increase opportunities forinterprofessional education in collaborative settings. Futureresearch is needed to examine the current inclusion of PCMHconcepts in pharmacy education, to assess the knowledge andperceptions of students and preceptors regarding PCMH, andto evaluate the efforts across the country to implement someversion of the PCMH model of care.

Conclusion

Many faculty members agree that it is important to teachabout the PCMH health care model, but there is a low levelof faculty familiarity with the standards and principles thatguide this health care paradigm. To work toward achieve-ment of ACPE standards and principles and CAPE educa-tional outcomes, schools and colleges of pharmacy shouldintroduce opportunities for interprofessional education byincorporating concepts of the PCMH into both the didacticand experiential curriculum. Approaches for inclusion of thisinformation may include teaching these concepts in didacticclasses related to the introduction of pharmacy practice,career opportunities, and health care systems. Electivecourses can also be offered for those students who maywant to obtain more detailed information about this model ofhealth care. IPPE and APPE rotations that offer opportunitiesto collaborate as a part of multidisciplinary teams to deliverpatient-centered health care should also be offered. Futurepharmacists have an important opportunity to advancepractice by participating in PCMH team care, and pharmacyeducation has a central responsibility in preparing pharma-cists to effectively contribute in this setting.

e (PCMH) primary care initiative?

A) is a not-for-profit organization that has developeditation processes for health care organizations. NCQAetting that “facilitates partnerships between individualpropriate, the patient’s family. Care is facilitated byexchange and other means to assure that patients getant it in a culturally and linguistically appropriate

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How would you rate your familiarity with this definition?a. Not at all familiar (I have not heard of this definition)b. Slightly familiar (I have heard of this definition but do not know much about it)c. Somewhat familiar (I have heard of this definition and I know a little bit about it)d. Familiare. Very familiar

3. Are PCMH concepts included in the didactic pharmacy curriculum at your university?a. Yes, they are currently included in didactic pharmacy education at my college.b. No, they are NOT currently included in didactic pharmacy education at my college. If no, skip to questionno. 8.

c. I am unsure. If unsure, skip to question no. 84. At your university, where in the didactic curriculum are PCMH concepts incorporated? Please select all that

apply.***a. Pre-professional pharmacy yearsb. First professional pharmacy yearc. Second professional pharmacy yeard. Third professional pharmacy yeare. Other Please specify…:::::::::::::::::::::::::::::::::::f. I am unsure

5. At your university, how is PCMH information incorporated into the didactic curriculum?a. In required classesb. In elective classesc. In both required and elective classesd. I am unsure

6. At your university, in which didactic courses is PCMH information incorporated? Please select all thatapply.***

a. Pharmacy practice coursesb. Therapeutics coursesc. Career planning coursesd. Management coursese. Other Please specify…:::::::::::::::::::::::::::::::::::f. I am unsure

7. At your university, in what format is PCMH information delivered in the didactic curriculum?a. Lectureb. Workshopc. Both lectures and workshopsd. I am unsure

8. Please identify how strongly you agree or disagree with the following statement: “PCMH concepts should beincluded in the didactic pharmacy curriculum at my university.” (If A or B, skip to question no. 13)

a. Strongly disagreeb. Disagreec. Neither agree nor disagreed. Agreee. Strongly agree

9. Where in the didactic curriculum do YOU think PCMH concepts should ideally be incorporated? Please selectall that apply.***

a. Pre-professional pharmacy yearsb. First professional pharmacy yearc. Second professional pharmacy yeard. Third professional pharmacy yeare. OtherPlease specify…:::::::::::::::::::::::::::::::::::

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10. How do YOU think PCMH information should ideally be incorporated into the didactic curriculum?a. In required classesb. In elective classesc. In both required and elective classes

11. In which didactic courses do YOU think PCMH information should ideally be incorporated? Please select allthat apply.***

a. Pharmacy practice coursesb. Therapeutics coursesc. Career planning coursesd. Management coursese. OtherPlease specify…:::::::::::::::::::::::::::::::::::

12. In what format do YOU think PCMH information should ideally be delivered in the didactic curriculum?a. Lectureb. Workshopc. Both lectures and workshops

13. Are PCMH experiences included in experiential pharmacy education at your university?a. Yes, they are currently included in experiential pharmacy education at my college.b. No, they are NOT currently included in experiential pharmacy education at my college. If no, skip toquestion no. 18.

c. I am unsure. If unsure, skip to question no. 18.14. At your university, where in experiential education are PCMH experiences incorporated? Please select all that

apply.***a. First professional pharmacy year [introductory pharmacy practice experience (IPPE)]b. Second professional pharmacy year (IPPE)c. Third professional pharmacy year (IPPE)d. Fourth professional pharmacy year [advanced pharmacy practice experience (APPE)]e. OtherPlease specify…:::::::::::::::::::::::::::::::::::f. I am unsure

15. At your university, how are PCMH experiences incorporated into experiential pharmacy education? Pleaseselect all that apply.***

a. In required IPPEsb. In elective IPPEsc. In required APPEsd. In elective APPEse. I am unsure

16. At your university, how much time is dedicated to PCMH experiences in IPPE experiential education?a. One IPPE rotationb. Two IPPE rotationsc. Three or more IPPE rotationsd. No time is dedicated to PCMH experiences in IPPE experiential educatione. I am unsure

17. At your university, how much time is dedicated to PCMH experiences in APPE experiential education?a. One APPE rotationb. Two APPE rotationsc. Three or more APPE rotationsd. No time is dedicated to PCMH experiences in APPE experiential educatione. I am unsure

18. Please identify how strongly you agree or disagree with the following statement: “PCMH concepts should beincluded in experiential pharmacy education at my university.” (If A or B, skip to question no. 23)

a. Strongly disagreeb. Disagree

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c. Neither agree or disagreed. Agreee. Strongly agree

19. Where in experiential education do YOU think PCMH experiences should ideally be incorporated? Pleaseselect all that apply.***

a. First professional pharmacy year [introductory pharmacy practice experience (IPPE)]b. Second professional pharmacy year (IPPE)c. Third professional pharmacy year (IPPE)d. Fourth professional pharmacy year [advanced pharmacy practice experience (APPE)]e. OtherPlease specify…:::::::::::::::::::::::::::::::::::

20. How do YOU think PCMH experiences should ideally be incorporated into experiential pharmacy education?Please select all that apply.***

a. In required IPPEsb. In elective IPPEsc. In required APPEsd. In elective APPEs

21. How much time do YOU think should ideally be dedicated to PCMH experiences in IPPE experientialeducation?

a. One IPPE rotationb. Two IPPE rotationsc. Three or more IPPE rotationsd. No time should be dedicated to PCMH experiences in IPPE experiential education

22. How much time do YOU think should ideally be dedicated to PCMH experiences in APPE experientialeducation?

a. One APPE rotationb. Two APPE rotationsc. Three or more APPE rotationsd. No time should be dedicated to PCMH experiences in APPE experiential education

23. The Joint Principles for the Medical Education of Physicians as Preparation for Practice in PCMH weredeveloped collectively in February 2007 by the American Academy of Family Physicians (AAFP),American Academy of Pediatrics (AAP), American College of Physicians (ACP), and AmericanOsteopathic Association (AOA). They characterize the components of PCMH and provide a correspondingset of competencies to be achieved by medical students throughout the medical education process:

These principles indicate that medical students should be able to demonstrate the following:1. Personal physician: communicating effectively and demonstrating caring and respectful behaviors wheninteracting with patients, families, and fellow professionals

2. Physician-directed medical practice: working effectively as a member of a health care team and definingthe roles of other team members

3. Whole-person orientation: practicing motivational interviewing, promoting health behavior change,promoting self-efficacy, and understanding the importance of health literacy and cultural competency

4. Coordinated and integrated care: working effectively with electronic health records (EHRs), learning thebasics of medical informatics and technologies, understanding population health, knowing and applying theprinciples of patient safety, and understanding the economics of payment models, including reimbursement

5. Quality and safety: understanding evidence-based medicine as the standard of care, participating in teamswithin practices to improve the care process and patient experience, and participating in multi-disciplinarypatient safety training experiences

6. Enhanced access: experiencing a variety of different encounter types, including face-to-face, telephone andelectronic messaging, and group visits

7. Payment recognizes value of PCMH: knowing about different payment models, assisting patients in dealingwith system complexities via advocacy

How would you rate your familiarity with the PCMH Joint Principles for Medical Education?

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a. Not at all familiar (I have not heard of these concepts)b. Slightly familiar (I have heard of these concepts but do not know much about them)c. Somewhat familiar (I have heard of these concepts and I know a little bit about them)d. Familiare. Very familiar

24. What implications do you think that these PCMH Joint Principles for Medical Education should have forpharmacy education?

a. These principles should be directly applied to pharmacy educationb. These principles should be adapted and then applied to pharmacy educationc. New Joint Principles should be created specifically for pharmacy educationd. I think PCMH information should be taught in pharmacy education, but a set of national standards is notnecessary

e. I do not think PCMH information should be incorporated into pharmacy education

Demographic Information25. What is your age?

a. 18–26 yearsb. 27–35 yearsc. 36–45 yearsd. 46–55 yearse. 56–65 yearsf. Older than 65 years

26. What is your gendera. Maleb. Female

27. Are you a registered pharmacist?a. Yesb. No; if no, skip to question no. 31

28. For how many years have you been practicing as a registered pharmacist?a. Less than 1 yearb. 1–2 yearsc. 3–6 yearsd. 7–10 yearse. 11–20 yearsf. More than 20 years

29. How would you describe your primary practice setting?a. Academiab. Ambulatory carec. Community (chain)d. Community (independent)e. Consultantf. Governmentg. Hospital (staff pharmacist)h. Hospital (clinical pharmacist)i. Industryj. Managed carek. Militaryl. Nuclearm. Researchn. OtherPlease specify…:::::::::::::::::::::::::::::::::::o. Not currently practicing pharmacy

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30. Is your current practice setting an NCQA-accredited PCMH?a. Yesb. Noc. I am unsure

31. For how many years have you been a faculty member?a. Less than 1 yearb. 1–2 yearsc. 3–6 yearsd. 7–10 yearse. 11–20 yearsf. More than 20 years

32. What type of post-graduate training did you pursue?a. Did not complete post-graduate trainingb. One year of residencyc. Two years of residencyd. Fellowshipe. PhDf. Masters

33. What academic area, according to the AACP categories, best describes your current faculty position?a. Biologic sciencesb. Chemistryc. Continuing professional educationd. Pharmaceuticse. Libraries/educational resourcesf. Pharmacy practiceg. Social administrative sciences

34. How would you describe your employment as a faculty member?a. Tenure trackb. Clinical trackc. Research trackd. Adjunct/auxiliarye. Other Please specify…:::::::::::::::::::::::::::::::::::

35. How many professional years are there in your school of pharmacy?a. One yearb. Two yearsc. Three yearsd. Four yearse. Five yearsf. Six years

36. Where is your university located?a. Drop down menu containing all U.S. states

37. How would you describe your university?a. Privateb. Public

38. When was your school of pharmacy founded?a. Less than ten years agob. Ten or more years ago

39. Does your university have an academic medical center?a. Yesb. No

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References

1. H.R. 3590—111th Congress: The Patient Protection andAffordable Care Act. Introduced September 17, 2009.Approved March 23, 2010. Public Law 111-148. 124 Stat. 119.

2. American Association of Medical Colleges Center for WorkforceStudies. The complexities of physician supply and demand:projections through 2025. ⟨http://www.innovationlabs.com/pa_future/1/background_docs/AAMC%20Complexities%20of%20physician%20demand,%202008.pdf⟩; Accessed January 2, 2014.

3. National Committee for Quality Assurance. Patient-centeredmedical home. ⟨www.ncqa.org⟩; Accessed January 2, 2014.

4. American Academy of Family Physicians, American Academy ofPediatrics, American College of Physicians, and American Osteo-pathic Association. Joint principles of the patient-centered medicalhome. ⟨http://www.aafp.org/dam/AAFP/documents/practice_management/pcmh/initiatives/PCMHJoint.pdf⟩; 2007 January 2, 2014.

5. Haines SL, DeHard RM, Flynn AA, et al. Academic pharmacyand patient-centered health care: a model to prepare the nextgeneration of pharmacists. J Am Pharm Assoc. 2011;51(2):194–202.

6. Smith M, Bates DW, Bodenheimer T, Cleary PD. Whypharmacists belong in the medical home. Health Affairs.2010;29(5):906–913.

7. Scott MA, Hitch B, Ray L, Colvin G. Integration of pharma-cists into a patient-centered medical home. J Am Pharm Assoc.2011;51(2):161–166.

8. Academy of Managed Care Pharmacy, American Associationof Colleges of Pharmacy, American College of ClinicalPharmacy, American Pharmacists Association, American Soci-ety of Consultant Pharmacists, American Society of Health-System Pharmacists, College of Psychiatric and NeurologicPharmacists, National Association of Chain Drug Stores,National Community Pharmacists Association. Integration ofpharmacists’ clinical services in the patient-centered primarycare medical home. ⟨http://www.accp.com/docs/positions/misc/IntegrationPharmacistClinicalServicesPCMHModel3-09.pdf⟩;2009 Accessed January 2, 2014.

9. Saultz JW, O’Neill P, Gill JM, et al. Medical student exposureto components of the patient centered medical home duringrequired ambulatory clerkship rotations: implications for edu-cation. Acad Med. 2010;85(6):965–973.

10. David A, Baxley L. Education of students and residents inpatient centered medical home (PCMH): preparing the way.Ann Fam Med. 2011;9(3):274–275.

11. American Academy of Family Physicians, American Academyof Pediatrics, American College of Physicians, and AmericanOsteopathic Association. Joint principles for the medicaleducation of physicians as preparation for practice in thepatient-centered medical home. ⟨http://www.acponline.org/running_practice/pcmh/understanding/educ-joint-principles.pdf⟩;2010 Accessed January 2, 2014.

12. American Association of Colleges of Pharmacy. Center for theadvancement of pharmaceutical education (CAPE) educationaloutcomes. ⟨http://aacp.org/resources/education/Documents/CAPE2004.pdf⟩; 2004 Accessed January 2, 2014.

13. American Association of Colleges of Pharmacy. Center for theadvancement of pharmaceutical education (CAPE) pharmacypractice supplemental educational outcomes. ⟨http://www.aacp.

org/resources/education/Documents/PharmacyPracticeDEC006.pdf⟩; 2007 Accessed January 2, 2014.

14. Accreditation Council for Pharmacy Education. Accreditationstandards and guidelines for the professional program inpharmacy leading to the Doctor of Pharmacy Degree. Version2.0. ⟨https://www.acpe-accredit.org/pdf/FinalS2007Guidelines2.0.pdf⟩; 2011 Accessed January 2, 2014.

15. Haines SL, DeHart RM, Hess KM, et al. Report of the 2009–2010 professional affairs committee: pharmacist integration inprimary care and the role of academic pharmacy. Am J PharmEduc. 2010;74(10):S5.

16. Dillman DA. Mail and Internet Surveys: The Tailored DesignMethod, 2nd ed., New York: John Wiley & Sons, Inc.; 2000.

17. Rogers J, Juliao TR. Innovation and creativity in educationcurricula for the medical home. Fam Med. 2011;43(10):693–695.

18. American Association of Colleges of Pharmacy. Successfulpractices in college/school involvement with pharmacists’integration in primary care practice. ⟨http://www.aacp.org/resources/education/Documents/Primary%20Care%20Final.pdf⟩;2010 Accessed January 2, 2014.

19. American Association of Colleges of Pharmacy. Successfulpractices in college/school involvement with partnerships con-tributing to the implementation of pharmacists’ services forteam based, patient centered care. ⟨http://www.aacp.org/resources/education/Documents/Teams.pdf⟩; January 2, 2014.

20. Joo P, Younge R, Jones D, Hove J, Lin S, Burton W. Medicalstudent awareness of the patient-centered medical home. FamMed. 2011;43(10):696–701.

21. Hohmeier KC, Mangan MN, Powers MF, Lengel AJ. Thepatient-centered medical home and community pharmacists’perceptions. J Pharm Technol. 2012;28(4):151–155.

22. Barnhart A, Lausen H, Smith T, Lopp L. Electronic healthcommunication: an educational application for this principle ofthe patient-centered medical home. Fam Med. 2010;42(5):322–326.

23. Lausen H, Kruse JE, Barnhart AJ, Smith TJ. The patient-centered medical home: a new perspective for the familymedicine clerkship. Fam Med. 2011;43(10):718–720.

24. Berdine H, Dougherty T, Ference J, et al. The pharmacists’ rolein the patient-centered medical home (PCMH): a white papercreated by the health policy committee of the Pennsylvaniapharmacists association (PPA). Ann Pharmacother. 2012;46(5):723–750.

25. Ecklar GP, Wymyslo T, Milstead J, Snow R Ohio HB. 198:Patient-centered medical home education pilot project, finalwork product report. The Patient Centered Medical HomeEducation Advisory Group. ⟨http://www.ohioafp.org/wp-content/uploads/Ohio_HB198_PCMH_Education_Pilot_Project_Final_Work_Product_Report.pdf⟩; 2011 Accessed January 2,2014.

26. Rickles NM, MacLean LG, Hess K, et al. Teaching medicationadherence in US colleges and schools of pharmacy. Am JPharm Educ. 2012;76(5):Article 79.

27. Patient-Centered Primary Care Collaborative. The patient-centered medical home: integrating comprehensive medicationmanagement to optimize patient outcomes. 2nd ed. ⟨http://www.accp.com/docs/positions/misc/CMM%20Resource%20Guide.pdf⟩; 2012 Accessed January 2, 2014.