In light of the COVID-19 pandemic, pharmacy education has shifted from in-person teaching and assessments to the virtual environment. Many education programs had previously adopted objective structured clinical examinations (OSCEs) to assess communication abilities in-person with standardized patients (SPs). However, comparative student outcome data between virtual and in-person methods as well as guidance on how to conduct communication-based OSCEs in the virtual environment is lacking. The University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences (SSPPS) describes its methods of conducting two types of communication-based OSCEs (patient counseling and gathering a medical history). Student performance data from the two virtual OSCEs in 2020 was compared to results from two 2019 in-person OSCEs using Mann Whitney U Tests. The 2020 cohort scored significantly higher than the 2019 cohort in all variables (i.e., using effective verbal and non-verbal communication, using patient friendly education, organizing the encounter, demonstrating empathy, establishing trust, professionalism) and in overall score. However, the effect size for these findings indicate the differences between performances are generally small and more likely due to changes in grading patterns due to the pandemic.

Patient: Male, 64 Final Diagnosis: Pseudomonas mendocina bacteremia Symptoms: Encephalopathy • fever • hypotension • rigors • tachypnea Medication: — Clinical Procedure: — Specialty: Infectious Diseases Objective: Rare disease Background: Pseudomonas mendocina is a Gram-negative, aerobic, rod-shaped bacterium belonging to the family Pseudomonadaceae. In nature, P. mendocina has been isolated from water and soil samples. The species rarely causes disease in humans though severe infections resulting in hospitalization and intensive care have been documented. This case is perhaps the second reported case in the United States of a P. mendocina related infection. In this case report, we analyze the clinical and laboratory features of P. mendocina infection in a severely immunocompromised acquired immunodeficiency syndrome (AIDS) patient and review the available literature. Case Report: A 64-year-old white male with past medical history significant for human immunodeficiency virus (HIV)/AIDS (CD 4 count on admission <10 cells/mm 3 ) diagnosed in 1988 and on antiretroviral therapy since 1992, was admitted to our facility for acute management of a suspected invasive mold infection. On hospital day 20 the patient developed a fever of 39.9°C, had an elevated lactate of 2.6 mmol/L and absolute neutrophil count greater than 1000 cells/mm 3 . On hospital day 22, both blood culture sets were positive for Pseudomonas mendocina . Antibiotic therapy was de-escalated to ceftazidime and after a total treatment course of 10 days the was successfully discharged. Conclusions: There have been 14 reported cases of P. mendocina in the world. Four cases presented with meningitis and 5 with endocarditis. Beyond typical anti-pseudomonal agents, 2 of the reported cases show susceptibility of P. mendocina antibiotics such as sulfamethoxazole/trimethoprim and ceftriaxone. All documented case reports of P. mendocina infection resulted in successful treatment with antibiotics and survival of the patient.

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Background: Klebsiella pneumoniae has gained recognition for its association with invasive liver abscess syndrome (ILAS). ILAS is associated with a hypervirulent strain of K pneumoniae and can impact immunocompetent as well as immunocompromised patients. Case Report: A 42-year-old Hispanic male with no significant past medical history was admitted with complaints of subjective fevers and worsening fatigue. The patient was found to have multiple septic pulmonary emboli, a prostate abscess, a seminal vesicle abscess, bilateral frontoparietal and left temporal infarcts thought to be due to septic emboli, pyelonephritis, endophthalmitis, and hepatic abscesses. Cultures grew K pneumoniae that was determined to be the hypervirulent strain associated with ILAS. The patient was treated for a total of 71 days, including ceftriaxone and multiple intravitreal injections with ceftazidime. Conclusion: Notably, this case report details a disease state new to Colorado. Pharmacists are able to assist in the care of ILAS with antibiotic selection, considering sites of infection and encouraging appropriate consultation of specialized care teams.