Anaphylactic reactions in schools, although not frequent, are not uncommon events. A systematic review of anaphylactic events that required epinephrine administration identified opportunities for improvement in the treatment of students with life-threatening allergies.

During the past decade, prevalence of food allergies among children increased. Caring for children with life-threatening food allergies has become a major challenge for school personnel. Prior to 2002, Massachusetts did not provide clear guidelines to assist schools in providing a safe environment for these children and preparing for an emergency response to unintended allergic reactions. In 2001, the Asthma and Allergy Foundation of America/New England Chapter, Massachusetts Department of Education, Massachusetts Department of Public Health, Massachusetts School Nurse Organization, parents, and other professional organizations forged a successful collaboration to develop guidelines for managing life- threatening food allergies in schools. The guidelines assist schools by providing information on food allergies and anaphylaxis, emphasizing the need for team planning and development of an individualized health care plan, giving guidance on strategies to prevent accidental exposure to specific allergens in school settings, and offering information on emergency responses should unintended exposures occur. The collaborative process for developing the guidelines, which continued during the distribution and implementation phases, set a tone for successful multidisciplinary teamwork in local schools.

School nurses, in collaboration with primary care providers (PCPs), can work to better manage asthma by using the Asthma Action Plan (AAP) with peak flow monitoring. The aim of this pilot study was to determine the effectiveness of an intervention to increase the number of AAPs in schools for students with asthma by having school nurses provide the students' peak flow measurements to their PCPs with a request for an AAP. The study found a significant increase in AAPs when school nurses provided PCPs with accurate peak flow data and requested an AAP from the PCP than when school nurses requested an AAP via the students' parents and did not provide peak flow data to the PCP. This study provided data on the importance of collaboration with PCPs in order to affect better care for children with asthma.

School nurses, in collaboration with primary care providers (PCPs), can work to better manage asthma by using the Asthma Action Plan (AAP) with peak flow monitoring. The aim of this pilot study was to determine the effectiveness of an intervention to increase the number of AAPs in schools for students with asthma by having school nurses provide the students' peak flow measurements to their PCPs with a request for an AAP. The study found a significant increase in AAPs when school nurses provided PCPs with accurate peak flow data and requested an AAP from the PCP than when school nurses requested an AAP via the students' parents and did not provide peak flow data to the PCP. This study provided data on the importance of collaboration with PCPs in order to affect better care for children with asthma.

Adolescents with life-threatening allergies are at a greater risk for a fatal anaphylactic event since only about half of them carry unexpired epinephrine available for emergency use. The aim of this study was to test the effectiveness of school nurse interventions that consisted of either routine or periodic checks during the school year for the availability of unexpired auto-injectable epinephrine. Seventy-seven students from 11 Massachusetts high schools participated in this study. Descriptive and chi-square (χ²) statistics as well as the Fisher's exact test were used to analyze data. Findings suggest that while periodic checks for the availability of epinephrine throughout the school year do not increase the likelihood that students will have epinephrine available, those students who do carry their epinephrine are more likely to have unexpired medication with periodic reminders during the school year.

Objective. To describe students' experiences and perceptions of non-traditional student-preceptor learning models and evaluate the effectiveness of these models on students' learning experience. Methods. Pharmacy students who had completed at least one experiential rotation with a nontraditional learning model participated in semi-structured interviews. Models included peer-assisted learning (PAL; two or more students of same educational level), near-peer teaching (NPT; one or more junior students with one or more senior students), and co-preceptorship (CoP; two or more preceptors). Interviews were transcribed, coded, and analyzed for themes. Themes were mapped according to the Kirkpatrick model for evaluating educational training. Results. Twenty semi-structured interviews were conducted. Forty-three experiences (19 CoP, 14 PAL, 10 NPT) from 14 institutions were described. Many themes overlapped between the three models. In CoP, learners described increased preceptor availability and exposure to different patient care approaches. Challenges arose when preceptors had different expectations. Students overwhelmingly endorsed a multi-learner environment. Both PAL and NPT learners felt supported as collaboration with other learners was readily fostered. Potential challenges in PAL and NPT were difficulties when personalities conflicted and when there was a significant knowledge gap between the learners. All three models allowed for the development of skills, including communication and collaboration. Learners reported an enhanced approach to patient care and professional practice, including approaches to teaching as new preceptors. Conclusion. Pharmacy students and graduates valued their experiences in non-traditional studentpreceptor models. Institutions may find support for using these precepting models to increase placement capacity.

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