Abstract
An initiative of the Center for the Advancement of Pharmacy Education (formerly the Center for the Advancement of Pharmaceutical Education) (CAPE), the CAPE Educational Outcomes are intended to be the target toward which the evolving pharmacy curriculum should be aimed. Their development was guided by an advisory panel composed of educators and practitioners nominated for participation by practitioner organizations. CAPE 2013 represents the fourth iteration of the Educational Outcomes, preceded by CAPE 1992, CAPE 1998 and CAPE 2004 respectively. The CAPE 2013 Educational Outcomes were released at the AACP July 2013 Annual meeting and have been revised to include 4 broad domains, 15 subdomains, and example learning objectives.
CAPE BACKGROUND AND 2013 REVISION PROCESS
CAPE 2013 represents the fourth version (preceded by panels in 1992, 1998 and 2004) of educational outcomes created to guide curricular discussions of faculty and preceptors within the academy and curriculum planning, delivery, and assessment within colleges and schools of pharmacy.1,2 CAPE will be established as an active Center within the Association, in recognition of the key role the CAPE Educational Outcomes continue to play in the evolution of pharmacy education. Revision of the CAPE 2004 Educational Outcomes was recommended by the 2010-2011 AACP Academic Affairs Standing Committee and the AACP Board of Directors commissioned the CAPE 2013 panel in the spring of 2012.3 The CAPE 2013 panel was charged to review and revise the CAPE Educational Outcomes to ensure that the outcomes are relevant and consistent with emerging scientific and clinical developments and practitioner roles. Melissa S. Medina, EdD (University of Oklahoma) was selected to chair the panel and Cecilia M. Plaza, PharmD, PhD, served as AACP staff liaison. The Panel was comprised of representation from 8 Joint Commission Pharmacy Practitioners member organizations and 7 AACP appointees listed in Table 1.
CAPE 2013 Panel Members
To guide their work, the CAPE 2013 panel used literature from pharmacy and other health professions to provide evidence-based revisions. The panel gained additional perspectives from other health professions when they met representatives from the Interprofessional Education Collaborative (IPEC) organizations including Association of American Medical Colleges (AAMC), American Association of Colleges of Osteopathic Medicine (AACOM), American Association of Colleges of Nursing (AACN), and American Dental Education Association (ADEA), American Association of Colleges of Pharmacy (AACP), as well as a patient care advocate. The panel also sought input regarding the revision from the pharmacy academy through focus groups at the AACP 2012 Annual and 2013 Interim meetings. The detailed methodology used in the development of CAPE 2013 can be found in the 2012-13 Academic Affairs Standing Committee report.4 Through these meetings, general themes and suggestions emerged that have helped shape the revision process. Specifically, the majority of feedback called for:
• Continued commitment to a firm grounding in the science of the profession,
• Inclusion of an affective domain that would address personal and professional skills, attitudes and attributes required for the delivery of patient-centered care,
• Emphasis on what is unique to pharmacists and their role in healthcare,
• Enhanced clarity of terminology that aligns with the core content and language of other health professions,
• Outcomes that are forward thinking and aspirational, yet achievable and measurable,
• Creation of example learning objectives for each subdomain to guide programs in curricular revision and assessment
• Minimization of redundancy in outcomes within the document.
Preamble
The CAPE 2013 Educational Outcomes were created by focusing on the end of the Doctor of Pharmacy program and the knowledge, skills, and attitudes entry-level graduates should possess. They are designed to define for the academy and other health professions the curricular priorities of the Doctor of Pharmacy programs. The CAPE 2013 Educational Outcomes provide a structured framework for promoting and guiding curricular change, inspiring innovation, meeting challenges facing pharmacy education, and mapping and measuring programmatic outcomes. They are aspirational and emphasize increased program expectations; motivating educators and students alike to strive for the highest level of professional preparation. They are also intended to be achievable by the end of the professional program and measurable within academic and practice environments that are evolving to meet a changing healthcare system.
CAPE 2013 was intentionally expanded beyond knowledge and skills to include the affective domain, in recognition of the importance of professional skills and personal attributes to the practice of pharmacy. The change emphasizes the mindset of self-awareness, innovation, leadership, and professionalism needed for pharmacy practice. The affective domain bridges foundational scientific knowledge with essential skills and approaches to practice and care. It also highlights that a concentration in any singular domain alone is insufficient for graduates to practice at the highest level of the profession. Instead, this expanded scope is essential for pharmacists to be able to transform their knowledge and skills into positive outcomes in all professional settings. Reexamination of programmatic educational outcomes in context of this revision should include attention to admissions as this examination is critical to assure candidates are prepared to advance in all essential domains of the professional program. Attention should also be paid to integrated assessments to ensure that students are retaining, integrating, and applying the knowledge, skills, and attitudes.
The outcomes were purposefully constructed around 4 broad domains to guide the academy in educating pharmacists who possess: 1) foundational knowledge that is integrated throughout pharmacy curricula, 2) essentials for practicing pharmacy and delivering patient-centered care, 3) effective approaches to practice and care, and 4) the ability to develop personally and professionally.
The 4 broad domains of CAPE 2013 are divided into 15 specific subdomains. The subdomain outcome statements are designed to capture what students should be capable of upon graduation from a Doctor of Pharmacy program. A one word descriptor in parenthesis is provided for each subdomain that illustrates the main construct and can be used to concisely articulate the outcome. In addition to the 15 subdomain outcome statements, example student learning objectives for each subdomain have been developed to guide programs in curricular revision and assessment. The domains, subdomains, and example learning objectives are coded with a numbering system to increase clarity. The depth and delineation of the example learning objectives allows for mission specific needs of individual institutions to be met at the programmatic level. Colleges or schools are encouraged to expand or edit these example learning objectives to meet local needs, as these are not designed to be prescriptive. To illustrate this flexibility, an example of expanded learning objectives has been provided in Table 2. To provide clarity of terms used in the outcome statements and learning objectives a glossary was created, see Table 3. The terms defined in the glossary are bolded and italicized in the CAPE 2013 document.
Example of Expanded Learning Objectives Within a Subdomain
Glossary
Overall, an essential premise of CAPE 2013 is that pharmacists now and of the future must be capable of functioning collaboratively as members of an interprofessional team, advocating for patients and demonstrating leadership, providing care for diverse patient populations, contributing to the health and wellness of individuals and communities, educating a broad range of constituents, and effectively managing a highly technical workplace. CAPE 2013 is designed to represent all areas of pharmacy and guide the academy’s efforts to educate Doctor of Pharmacy students.
EDUCATIONAL OUTCOMES
Domain 1 – Foundational Knowledge
1.1. Learner (Learner) - Develop, integrate, and apply knowledge from the foundational sciences (i.e., pharmaceutical, social/behavioral/administrative, and clinical sciences) to evaluate the scientific literature, explain drug action, solve therapeutic problems, and advance population health and patient-centered care.
Examples of Learning Objectives (colleges or schools are encouraged to expand or edit these example learning objectives to meet local needs, as these are not designed to be prescriptive):*
1.1.1. Develop and demonstrate depth and breadth of knowledge in pharmaceutical, social/behavioral/administrative, and clinical sciences.
1.1.2. Articulate how knowledge in foundational sciences is integral to clinical reasoning; evaluation of future advances in medicine; supporting health and wellness initiatives; and delivery of contemporary pharmacy services.
1.1.3. Integrate knowledge from foundational sciences to explain how specific drugs or drug classes work and evaluate their potential value in individuals and populations.
1.1.4. Apply knowledge in foundational sciences to solve therapeutic problems and advance patient-centered care.
1.1.5. Critically analyze scientific literature related to drugs and disease to enhance clinical decision making.
1.1.6. Identify and critically analyze emerging theories, information, and technologies that may impact patient-centered and population based care.
Domain 2 – Essentials for Practice and Care
2.1. Patient-centered care (Caregiver) - Provide patient-centered care as the medication expert (collect and interpret evidence, prioritize, formulate assessments and recommendations, implement, monitor and adjust plans, and document activities).
Examples of Learning Objectives:*
2.1.1. Collect subjective and objective evidence related to patient, medications, allergies/adverse reactions, and disease, by performing patient assessment (including physical assessment) from chart/electronic health records, pharmacist records and patient/family interviews.
2.1.2. Interpret evidence and patient data.
2.1.3. Prioritize patient needs.
2.1.4. Formulate evidence based care plans, assessments, and recommendations.
2.1.5. Implement patient care plans.
2.1.6. Monitor the patient and adjust care plan as needed.
2.1.7. Document patient care related activities.
2.2. Medication use systems management (Manager) - Manage patient healthcare needs using human, financial, technological, and physical resources to optimize the safety and efficacy of medication use systems.
Examples of Learning Objectives:*
2.2.1. Compare and contrast the components of typical medication use systems in different pharmacy practice settings.
2.2.2. Describe the role of the pharmacist in impacting the safety and efficacy of each component of a typical medication use system (i.e., procurement, storage, prescribing, transcription, dispensing, administration, monitoring, and documentation).
2.2.3. Utilize technology to optimize the medication use system.
2.2.4. Identify and utilize human, financial, and physical resources to optimize the medication use system.
2.2.5. Manage healthcare needs of patients during transitions of care.
2.2.6. Apply standards, guidelines, best practices, and established processes related to safe and effective medication use.
2.2.7. Utilize continuous quality improvement techniques in the medication use process.
2.3. Health and wellness (Promoter) - Design prevention, intervention, and educational strategies for individuals and communities to manage chronic disease and improve health and wellness.
Examples of Learning Objectives:*
2.3.1. Describe systematic preventive care, using risk assessment, risk reduction, screening, education, and immunizations.
2.3.2. Provide prevention, intervention, and educational strategies for individuals and communities to improve health and wellness.
2.3.3. Participate with interprofessional healthcare team members in the management of, and health promotion for, all patients.
2.3.4. Evaluate personal, social, economic, and environmental conditions to maximize health and wellness.
2.4. Population-based care (Provider) - Describe how population-based care influences patient-centered care and influences the development of practice guidelines and evidence-based best practices.
Examples of Learning Objectives:*
2.4.1. Assess the healthcare status and needs of a targeted patient population.
2.4.2. Develop and provide an evidence-based approach that considers the cost, care, access, and satisfaction needs of a targeted patient population.
2.4.3. Participate in population health management by evaluating and adjusting interventions to maximize health.
Domain 3 - Approach to Practice and Care
3.1. Problem Solving (Problem Solver) – Identify problems; explore and prioritize potential strategies; and design, implement, and evaluate a viable solution.
Examples of Learning Objectives:*
3.1.1. Identify and define the primary problem.
3.1.2. Define goals and alternative goals.
3.1.3. Explore multiple solutions by organizing, prioritizing, and defending each possible solution.
3.1.4. Anticipate positive and negative outcomes by reviewing assumptions, inconsistencies, and unintended consequences.
3.1.5. Implement the most viable solution, including monitoring parameters, to measure intended and unintended consequences.
3.1.6. Reflect on the solution implemented and its effects to improve future performance.
3.2. Educator (Educator) – Educate all audiences by determining the most effective and enduring ways to impart information and assess understanding.
Examples of Learning Objectives:*
3.2.1. Conduct a learning needs assessment of constituents who would benefit from pharmacist-delivered education (e.g., patients/caregivers, technicians and interns, pharmacy students, fellow pharmacists, other healthcare providers, legislators).
3.2.2. Select the most effective techniques/strategies to achieve learning objectives.
3.2.3. Demonstrate the ability to coordinate educational efforts with other healthcare providers, when appropriate, to ensure a consistent, comprehensive, and team-based encounter.
3.2.4. Ensure instructional content contains the most current information relevant for the intended audience.
3.2.5. Adapt instruction and deliver to the intended audience.
3.2.6. Assess audience comprehension.
3.3. Patient Advocacy (Advocate) - Assure that patients’ best interests are represented.
Examples of Learning Objectives:*
3.3.1. Empower patients to take responsibility for, and control of, their health.
3.3.2. Assist patients in navigating the complex healthcare system.
3.3.3. Ensure patients obtain the resources and care required in an efficient and cost-effective manner (e.g., triage to social and/or other healthcare services).
3.4. Interprofessional collaboration (Collaborator) – Actively participate and engage as a healthcare team member by demonstrating mutual respect, understanding, and values to meet patient care needs.
Examples of Learning Objectives:*
3.4.1. Establish a climate of shared values and mutual respect necessary to meet patient care needs.
3.4.2. Define clear roles and responsibilities for team members to optimize outcomes for specific patient care encounters.
3.4.3. Communicate in a manner that values team-based decision making and shows respect for contributions from other areas of expertise.
3.4.4. Foster accountability and leverage expertise to form a highly functioning team (one that includes the patient, family, and community) and promote shared patient-centered problem solving.
3.5. Cultural sensitivity (Includer) - Recognize social determinants of health to diminish disparities and inequities in access to quality care.
Examples of Learning Objectives:*
3.5.1. Recognize the collective identity and norms of different cultures without overgeneralizing (i.e., recognize and avoid biases and stereotyping).
3.5.2. Demonstrate an attitude that is respectful of different cultures.
3.5.3. Assess a patient’s health literacy and modify communication strategies to meet the patient’s needs.
3.5.4. Safely and appropriately incorporate patients’ cultural beliefs and practices into health and wellness care plans.
3.6. Communication (Communicator) – Effectively communicate verbally and nonverbally when interacting with an individual, group, or organization.
Examples of Learning Objectives:*
3.6.1. Interview patients using an organized structure, specific questioning techniques (e.g., motivational interviewing), and medical terminology adapted for the audience.
3.6.2. Actively listen and ask appropriate open and closed-ended questions to gather information.
3.6.3. Use available technology and other media to assist with communication as appropriate.
3.6.4. Use effective interpersonal skills to establish rapport and build trusting relationships.
3.6.5. Communicate assertively, persuasively, confidently, and clearly.
3.6.6. Demonstrate empathy when interacting with others.
3.6.7. Deliver and obtain feedback to assess learning and promote goal setting and goal attainment.
3.6.8. Develop professional documents pertinent to organizational needs (e.g., monographs, policy documents).
3.6.9. Document patient care activities clearly, concisely, and accurately using appropriate medical terminology.
Domain 4 – Personal and Professional Development
4.1. Self-awareness (Self-aware) – Examine and reflect on personal knowledge, skills, abilities, beliefs, biases, motivation, and emotions that could enhance or limit personal and professional growth.
Examples of Learning Objectives:*
4.1.1. Use metacognition to regulate one’s own thinking and learning.
4.1.2. Maintain motivation, attention, and interest (e.g., habits of mind) during learning and work-related activities.
4.1.3. Identify, create, implement, evaluate and modify plans for personal and professional development for the purpose of individual growth.
4.1.4. Approach tasks with a desire to learn.
4.1.5. Demonstrate persistence and flexibility in all situations; engaging in help seeking behavior when appropriate.
4.1.6. Strive for accuracy and precision by displaying a willingness to recognize, correct, and learn from errors.
4.1.7. Use constructive coping strategies to manage stress.
4.1.8. Seek personal, professional, or academic support to address personal limitations.
4.1.9. Display positive self-esteem and confidence when working with others.
4.2. Leadership (Leader) - Demonstrate responsibility for creating and achieving shared goals, regardless of position.
Examples of Learning Objectives:*
4.2.1. Identify characteristics that reflect leadership versus management.
4.2.2. Identify the history (e.g., successes and challenges) of a team before implementing changes.
4.2.3. Develop relationships, value diverse opinions, and understand individual strengths and weaknesses to promote teamwork.
4.2.4. Persuasively communicate goals to the team to help build consensus.
4.2.5. Empower team members by actively listening, gathering input or feedback, and fostering collaboration.
4.3. Innovation and Entrepreneurship (Innovator) - Engage in innovative activities by using creative thinking to envision better ways of accomplishing professional goals.
Examples of Learning Objectives:*
4.3.1. Demonstrate initiative when confronted with challenges.
4.3.2. Develop new ideas and approaches to improve quality or overcome barriers to advance the profession.
4.3.3. Demonstrate creative decision making when confronted with novel problems or challenges.
4.3.4. Assess personal strengths and weaknesses in entrepreneurial skills
4.3.5. Apply entrepreneurial skills within a simulated entrepreneurial activity.
4.3.6. Conduct a risk-benefit analysis for implementation of an innovative idea or simulated entrepreneurial activity.
4.4. Professionalism (Professional) - Exhibit behaviors and values that are consistent with the trust given to the profession by patients, other healthcare providers, and society.
Examples of Learning Objectives:*
4.4.1. Demonstrate altruism, integrity, trustworthiness, flexibility, and respect in all interactions.
4.4.2. Display preparation, initiative, and accountability consistent with a commitment to excellence.
4.4.3. Deliver patient-centered care in a manner that is legal, ethical, and compassionate.
4.4.4. Recognize that one’s professionalism is constantly evaluated by others.
4.4.5. Engage in the profession of pharmacy by demonstrating a commitment to its continual improvement.
ACKNOWLEDGEMENTS
This report is the product of the 2013 CAPE Panel and is intended to serve as a resource. It is not an adopted policy of AACP or other supporting organizations.
Footnotes
↵* Committee chair.
- © 2013 American Association of Colleges of Pharmacy
REFERENCES
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