Pharmacy Practice in Focus: Health Systems
Incorporating AI into pharmacy education is crucial to training on its appropriate use.
Pharmacy residency programs have evolved significantly since their inception. The official establishment of pharmacy residency programs in 1962 by the American Society of Health-System Pharmacists (ASHP) standardized residency requirements and improved pharmacy training. Initially, these programs focused primarily on hospital pharmacy practice, but over time, they expanded to include specialized areas of practice.1
Residency programs are essential for preparing pharmacists to meet the complex demands of modern health care and deliver high-quality patient care. As the pharmacist’s role expands and technology is integrated into health care, it is essential to evaluate and implement innovative methods to guide the next generation of pharmacists.
Taking PGY-1 Residency Goal 2.2 to the Next Level
The competency goal R2.2 for ASHP-accredited PGY-1 pharmacy residency programs requires the resident to “demonstrate ability to evaluate and investigate practice, review data, and assimilate scientific evidence to improve patient care and the medication-use system.”2 ASHP advises that a quality improvement or research project can accomplish this and further outlines the objectives that include identifying, implementing, and assessing changes needed to improve patient care or medication use systems.
One effective way to approach this goal is to engage pharmacy residents in projects or evaluations that will help expand pharmacy services or incorporate patient safety initiatives, thereby advancing the pharmacy and the facility’s goals. Numerous examples exist of engaging residents in the expansion of clinical pharmacy services and initiatives for quality improvement and patient safety.
Al-Diery et al described competency development in residency programs.3 In their literature summary, they noted numerous ways that residents expanded services, including the following:
Hill et al also described how one institution developed a resident learning experience that enabled the expansion of decentralized pharmacy services.4
Residents can also play a key role in quality improvement (QI) and patient safety initiatives. For example, resident projects can help implement Institute for Safe Medication Practices recommendations (eg, developing a policy and procedure to ensure complete administration of intravenous small-volume infusions, as one author’s institution did). Another critical role for residents is in initiatives that incorporate hospital quality measures from the Overall Hospital Quality Star Rating, as described by McDonald et al.5 Finally, residents may contribute to medication use evaluations that result in protocol development and implementation or electronic medical record improvements. Another helpful resource is the 2023 American College of Clinical Pharmacy commentary addressing best practices of pharmacy resident research and QI projects.6 Allowing residents to evaluate a problem and develop a solution systematically should give them a sense of satisfaction at leaving an impact on the organization while helping the hospital address an important practice issue.
Incorporating Artificial Intelligence in Pharmacy Education
ASHP standards require that “the use of information technology and automation is consistent with established best practices to optimize medication safety and efficiency in the medication-use process.”7 Pharmacy is an integral part of the health care system, and artificial intelligence (AI) will be essential in pharmacy practice. Unlike the automation processes and robotics already available in pharmacy settings, AI refers to “the exhibition of human-like behaviors or intelligence by any computer or machine.”8
Innovative pharmacy residency projects could involve evaluating and implementing a new AI tool. However, caution is warranted to ensure critical thinking is still at the heart of quality patient care.
Fundamental teachings when educating pharmacy residents on AI include the following8-10:
Examples of AI models in pharmacy include predicting and detecting adverse drug events, assisting clinical decision support systems with medication-related decisions, optimizing medication dosages, and detecting drug-drug interactions. The implementation of rapid diagnostic testing (RDT) in bloodstream infections paired with antimicrobial stewardship programs has been shown to have a significant reduction in mortality vs RDT alone11; pharmacy residents should be thoroughly trained on RDT while understanding that RDT alone will not improve patient outcomes.
Diandra Ruidera, PharmD, BCPS, BCIDP, is a medical science liaison in anti-infectives for GSK.
Patricia Saunders-Hao, PharmD, BCPS, BCIDP, is a clinical pharmacy specialist in infectious diseases at North Shore University Hospital in Manhasset, New York.
Lastly, with the boom in generative AI tools such as ChatGPT, pharmacy educators must be well-versed in these powerful language-generation models to teach residents about their appropriate use. These models can summarize data from medical research papers and clinical trials, create discharge summaries and patient education materials, and help answer medical-related questions. However, reminding residents of the potential for bias, misinformation, privacy, and other ethical concerns is necessary.12,13 For instance, depending on the data sets used to power an AI algorithm, implicit bias against racial groups or genders can result, leading to poor care and health care outcomes.14,15
For each class of new trainee pharmacists, teaching methods should be current and innovative to keep them engaged in their training and the profession. Hopefully, by incorporating residents into meaningful projects, they will be inspired to give back as they embark on their careers.
REFERENCES
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