Objectives. To characterize the use of high-fidelity mannequins and standardized patients in US pharmacy colleges and schools. Methods. A survey instrument was sent to 105 doctor of pharmacy (PharmD) programs to collect data on the use of simulation and to identify barriers to using simulation-based teaching methods. Results. Eighty-eight colleges and schools completed the survey instrument (response rate 84%). Of these, 14 did not use high-fidelity mannequins or standardized patients within the curriculum. Top barriers were logistical constraints and high resource cost. Twenty-three colleges and schools used simulation for introductory pharmacy practice experiences (IPPEs), 34 for interprofessional education, and 68 for evaluation of at least 1 core competency prior to advanced pharmacy practice experiences (APPEs). Conclusions. Although the majority of US colleges and schools of pharmacy use simulation-based teaching methodologies to some extent in the pharmacy curricula, the role of simulation in IPPEs, interprofessional education, and assessment of competency-based skills could be expanded.
Recent studies suggest that plerixafor mobilization and apheresis in patients with sickle cell disease (SCD) is safe and can allow collection of sufficient CD34+ hematopoietic stem cell (HSC) collection for clinical gene therapy applications. However, the quantities of plerixafor-mobilized CD34+ cells vary between different SCD patients for unknown reasons. Twenty-three participants with SCD underwent plerixafor mobilization followed by apheresis, processing, and HSC enrichment under a phase 1 safety and efficacy study conducted at 2 institutions. Linear regression or Spearman's correlation test was used to assess the relationships between various hematologic and clinical parameters with total CD34+ cells/kg collected. Median CD34+ cells/kg after 2 or fewer mobilization and apheresis cycles was 4.0 × 106 (range, 1.5-12.0). Similar to what is observed generally, CD34+ yield correlated negatively with age (P < .001) and positively with baseline (P = .003) and preapheresis blood CD34+ cells/µL (P < .001), and baseline white blood cell (P = .01) and platelet counts (P = .03). Uniquely for SCD, CD34+ cell yields correlated positively with the number of days hydroxyurea was held (for up to 5 weeks, P = .01) and negatively with markers of disease severity, including hospitalization frequency within the preceding year (P = .01) and the number of medications taken for chronic pain (P = .002). Unique SCD-specific technical challenges in apheresis were also associated with reduced CD34+ cell collection efficiency and purification. Here, we describe factors that impact plerixafor mobilization success in patients with SCD, confirming known factors as described in other populations in addition to reporting previously unknown disease specific factors in patients with SCD. This trial was registered at www.clinicaltrials.gov as #NCT03226691.
Recent environmental changes have demonstrated that the Earth has entered the Anthropocene. In this new age, complex interactions between human and natural systems exacerbate “wicked problems” that challenge researchers to engage both deep disciplinary expertise and broad integrative knowledge to address these societally relevant problems. Researchers and practitioners are making an increased effort to bridge the divide between human and natural systems research by facilitating multi-, inter-, and transdisciplinary collaborations. Despite 21st century changes to the research environment, the structure of a typical graduate education remains largely unchanged over the past several decades. Wicked problems necessitate communication and collaboration expertise; innovative transdisciplinary training and research opportunities can equip graduate students with these necessary skills. Oregon State University has offered such an opportunity through an NSF-funded Research Traineeship Program (NRT) for students focusing on Risk and Uncertainty Quantification and Communication in Marine Science. Herein, we reflect on the experience of graduate students who successfully completed the NRT and assert that support for transdisciplinary training and research at the graduate stage is urgently needed. We present five lessons learned from our year-long transdisciplinary project focused on the development of an approach for integrating diverse data sets within a social-ecological systems framework to reach a broader understanding of the interconnections between a marine reserve system, people, and the environment. Finally, we present current challenges and paths forward to enhance the success of early career transdisciplinary research.
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