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Dear
Colleague Letter
Preface
This publication was produced by the U.S. Department
of Health and Human Services (HHS), Health Resources
and Services Administration (HRSA), Office of Women's
Health (OWH), with the American Association of Colleges
of Pharmacy under contract #02-0339P with support
from HHS Office on Women’s Health, HHS National
Institutes of Health, HHS Food and Drug Administration,
and HHS Agency for Healthcare Research and Quality.
TABLE
OF CONTENTS
Executive
Summary
Introduction
Curricular
Resource Center
Web-based
Review of Existing Curricula
Development
of a Curriculum Framework for Women’s Health
Instruction
Compiled
Lists of Instructional Resources
Dissemination
Efforts
Summary
and Conclusions
References
Appendix
I: Participating Organizations
Appendix
II: Women’s Health Project Steering Committee
Appendix
III: Women’s Health Content Expert Panel
Appendix
IV: U.S. Colleges and Schools of Pharmacy Recognized
by the Accreditation
Council for Pharmacy Education (August 2004)
Appendix
V: Women’s Health Courses and Content at U.S.
Pharmacy Colleges and
Schools
Appendix
VI: Gender and Sex-Related Health Care Pharmacy Curriculum
Guide
Appendix
VII: Compiled List of Instructional Resources Available
from Federal
Co-Sponsors
Appendix
VIII: Sample Letter Sent to Program Directors and
Principal Investigators
Associated with Key Federally-funded Women’s
Health Initiatives
EXECUTIVE SUMMARY
There
has been a growing recognition of similarities and
differences by sex and gender in disease rates, symptoms,
and the outcomes of therapeutic interventions. In
this context, the term sex refers to “the classification
of living things, generally as male or female, according
to their reproductive organs and functions assigned
by their biological make-up. Gender refers to a person’s
self-representation as male or female, or how society
responds to that person based on the individual’s
gender presentation.”1 There has also been increased
recognition that the field of women’s health
extends beyond reproductive years and that sex and
gender issues are relevant across the lifespan and
across many diseases and conditions. While research
continues to document these differences and uncover
the bases for such differences, health professions
education programs have been slow to incorporate these
new understandings into the curriculum.
In
May 2004, the American Association of Colleges of
Pharmacy (AACP) reviewed and revised its Center for
the Advancement of Pharmaceutical Education (CAPE)
Educational Outcomes.2 The 2004 CAPE Educational Outcomes
describe the desired terminal outcomes of a pharmacy
curriculum. Educational Outcomes 2004 is an organizing
framework to facilitate the integration of general
abilities; legal, ethical, social, economic, and professional
issues; emerging technologies; and evolving pharmaceutical,
biomedical, sociobehavioral, and clinical sciences
across the major practice functions of patient-centered
and population-based pharmaceutical care; systems
management; and health promotion, disease prevention,
and public health. The framework provides structure
and guidance for curriculum development by including
emerging components of contemporary pharmacy practice
and setting expectations for interprofessional collaboration,
scientific grounding, evidence-based practice, appropriate
use of technology, and integration of fundamental
general abilities in thinking, communication, ethics,
social and contextual awareness, social responsibility,
social interaction, professionalism, and life-long
learning into professional contexts.
Women’s
health issues provide an important and relevant context
and imperative for the development of pharmacists’
abilities across the CAPE Educational Outcomes. The
expanding research agenda and understanding of women’s
health issues, such as differences between males and
females in disease manifestation, drug response, and
the clinical, social and other factors impacting health
across female lifespan stages, when incorporated into
the education and training of pharmacists, strengthens
the scientific and clinical knowledge base that underpins
their clinical decision making. In contemporary health
care settings, especially in the community, pharmacists
are increasingly engaged in health promotion, disease
prevention, and public health initiatives. To prepare
future pharmacy practitioners capable of meeting the
needs of society and female patients, the pharmacy
curriculum must reflect a lifespan approach to women’s
health, integrated across the entirety of the curriculum.
This
project was built on the analyses and recommendations
relative to the inclusion of women’s health-related
content and outcomes in the medical, dental, and nursing
education programs.3,4,5 It involved the analysis
of the current status of women’s health issues
within the professional degree program in pharmacy,
including content and instructional delivery format,
and was intended to serve the Health Resources and
Services Administration, along with the National Institutes
of Health (NIH) Office of Research on Women’s
Health, the Agency for Healthcare Research and Quality
(AHRQ), the Food and Drug Administration (FDA), and
the U.S. Department of Health and Human Services (HHS)
Office on Women’s Health in their efforts to
document women’s health content in educational
programs across the health professions. Using the
results of a Web-based review of current curricular
offerings at U.S. colleges and schools of pharmacy
and input from content experts, a framework for a
curriculum in women’s health was outlined to
guide the incorporation of instruction into and throughout
the pharmacy degree program.
Project
Approach and Methods
At initiation of the project, an explicit decision
was made to not duplicate the methods used in the
previous studies of women’s health instruction
in health professions education programs. It was agreed
that a detailed survey of U.S. colleges and schools
of pharmacy regarding the extent to which women’s
health related content was included within the pharmacy
curriculum would not yield information not already
generally known. It was decided to conduct a more
simple analysis of course and curriculum descriptions
available on the Web sites of the colleges and schools
of pharmacy, learn from the recommendations included
in the medicine, dentistry, and nursing reports, and
focus the project efforts and resources on the development
of materials that would facilitate the expansion and
enhancement of women’s health instruction within
pharmacy education.
Beginning
in 1999 and prior to the beginning of the funding
period for the project, representatives of the American
Association of Colleges of Pharmacy (AACP), the American
Pharmacists Association (APhA), the American College
of Clinical Pharmacy (ACCP), the University of Illinois
at Chicago (UIC) and the UIC/U.S. Department of Health
and Human Services (HHS) Center of Excellence in Women’s
Health, and the University of Arizona Center for Education
and Research on Therapeutics (Arizona CERT) participated
in planning discussions and completed preliminary
steps toward achieving the project outcomes. The project
participants, with primary input from faculty members
in the University of Illinois College of Pharmacy
and those associated with the UIC/HHS Center for Excellence
in Women’s Health, prepared a draft outline
of content areas that may serve as a core curriculum
in women’s health in pharmacy education. Feedback
for the project was obtained from participants at
the AACP Women Faculty Special Interest Group (SIG)
luncheon and meeting in July 2001. Participants were
asked to review the draft curriculum outline and provide
information on the current status of women’s
health instruction at their own institutions. An online
review of the draft curriculum framework was activated
in August 2002.
Findings
The principal finding of the analysis of Web-based
information and curricular descriptions was that women’s
health instruction was specifically mentioned (in
fall 2004) by just under 40 percent (n=34) of the
89 U.S. colleges and schools of pharmacy. At those
institutions, some of which have multiple courses
with women’s health content, 48 courses were
identified: 21 didactic elective courses dedicated
to women’s health issues, two elective experiential
courses dedicated to women’s health; 3 didactic
electives in which women’s health was one of
a broad array of component content areas; and 22 required
courses in which women’s health content was
incorporated. Among those 22 required courses, 18
were courses in pharmacotherapeutics;
two were pharmacokinetics/dose optimization courses;
one was a pharmacy practice course, and one was a
first-year orientation course on practice trends.
Given the variability across colleges and schools
in how course descriptions are worded and the level
of detail provided, it is likely that women’s
health issues are included, at the very least, in
the pharmacotherapeutics courses in more colleges
and schools than identified in this review.
Input
from interested faculty members, the project Steering
Committee, and Content Expert Panel led to the following
guiding principles for the development of the project
resources:
•
The curriculum framework should be comprehensive,
organized across and by lifespan stages, and be outcome-based.
• Resource materials and other guidance documents
should be as flexible in design as possible to allow
use by multiple institutions and to facilitate integration
of the content into existing courses to the greatest
extent possible, rather than suggesting the addition
of new focused required or elective courses.
• Materials should be Web-accessible.
Resources
To facilitate the expansion and enhancement of women’s
health instruction within pharmacy education, the
following resources were developed as components of
this project:
•
Overall design/concept for a Web-based Curricular
Resource Center (CRC). Many pharmacy educators, as
well as others (e.g., practitioners, consultants,
corporations) who provide professional education/development
materials, currently use the Internet, university,
and/or personal Web sites for hosting and delivering
courses and the related resources to enhance their
teaching. The AACP CRC provides a single point of
access for curricular materials available on a variety
of topics and from various sources.
•
Curriculum Framework. A framework for a curriculum
in women’s health was outlined to guide the
integration of women’s health issues into the
pharmacy curriculum. The framework includes an overview
section on sex and gender factors, and outlines content
areas and desired student outcomes organized by lifespan
stages, including infancy through reproductive years;
reproductive age (including pregnancy and lactation);
and climacteric, menopause, and post-menopausal women.
The curriculum guide is included as Appendix VI.
•
List of Instructional Resources Available from Federal
Co-sponsors of the Women’s Health Project. For
each Federal office, information is organized as follows:
• Name of Agency;
• Office of Women’s Health (Yes/No);
• One to two sentence description of vision,
mission, and or focus of the agency/office;
• Web site URL for office of women’s health
(if applicable);
• Key programs and initiatives related to women’s
health (includes URLs if information is available
on the Web);
• Grant programs available through the agency/office
related to women’s health research and/or instruction
(includes URLs if information is available on the
Web);
• Fact sheets or other information summaries
related to women’s health (includes URLs if
information is available on the Web);
• List of publications (examples of recent publications
available to the public); and
• Additional information (telephone number or
URL to access additional publications, information).
INTRODUCTION
In
recent years, there has been a growing recognition
of similarities and differences by sex and gender
in disease rates, symptoms, and the outcomes of therapeutic
interventions. In this context, the term sex refers
to “the classification of living things, generally
as male or female, according to their reproductive
organs and functions assigned by their biological
make-up. Gender refers to a person’s self-representation
as male or female or how society responds to that
person based on the individual’s gender presentation.”1
There has also been increased recognition that the
field of women’s health extends beyond reproductive
years and that sex and gender issues are relevant
across the lifespan and across many diseases and conditions.
While research continues to document these differences
and uncover the bases for such differences, health
professions education programs have been slow to incorporate
these new understandings into the curriculum.
Three
projects were completed in the late 1990s and early
2000s to document the extent to which women’s
health issues are addressed in the education and training
of physicians, dentists, and nurses. The first of
these reports, Women’s Health in the Medical
School Curriculum: Report of a Survey and Recommendations,
was issued in 1996. The report documented the then
current state of women’s health instruction
in the medical curriculum (allopathic and osteopathic),
recommended core components that a women’s health
curriculum in medicine should comprise, presented
several strategies for implementing a women’s
health curriculum in medical education, and recommended
a model women’s health curriculum with 11 core
content areas.3
The
report specific to the education and training of dentists,
Women’s Health in the Dental School Curriculum:
Report of a Survey and Recommendations, was issued
in 1999. The report reviewed the results of a survey
conducted to determine the status of women’s
health and oral health issues in the dental school
curriculum, as well as the format (required or elective;
instructional strategies; and assessment methods)
of such instruction. Additionally, the report included
12 recommendations for the integration of women’s
health issues into the dental curriculum.4
Issued
in 2001, Women’s Health in the Baccalaureate
Nursing School Curriculum: Report of a Survey and
Recommendations, duplicated the processes used in
medicine and dentistry and applied them to the baccalaureate
nursing curriculum. The report noted that “despite
a heavy emphasis on women’s health issues in
the baccalaureate nursing curriculum, there are areas
for improvement.” Fifteen recommendations were
forwarded toward advancing women’s health in
nursing education.5
Pharmacists
represent the third largest group of health professionals
in the United States, with approximately 223,000 active
pharmacists in 2004.6 Any effort to increase the use
of preventive services and improve women’s health
status must be interprofessional in nature and include
pharmacy as one of the targeted health professions.
The time is appropriate to examine the extent to which
women’s health issues are included in the pharmacy
curriculum, facilitate the expansion and enhancement
of women’s health instruction in pharmacy education
with a curriculum framework that organizes recommended
required and elective content into modules, and facilitate
the expansion and enhancement of women’s health
instruction in health professions education.
This
project involved the analysis of the current status
of women’s health issues within the professional
degree program in pharmacy, including content and
instructional delivery format, and was intended to
serve the Health Resources and Services Administration
(HRSA), along with the National Institutes of Health
(NIH) Office of Research on Women’s Health,
the Agency for Healthcare Research and Quality (AHRQ),
the Food and Drug Administration (FDA), and the U.S.
Department of Health and Human Services (HHS) Office
on Women’s Health in their efforts to document
women’s health content in educational programs
across the health professions. Using the results of
the analysis, a framework for a curriculum in women’s
health was outlined to guide the integration of women’s
health issues into the pharmacy curriculum.
Beginning
in 1999, representatives of the American Association
of Colleges of Pharmacy (AACP), the American Pharmacists
Association (APhA), the American College of Clinical
Pharmacy (ACCP), and the University of Illinois at
Chicago and the UIC/U.S. Department of Health and
Human Services (HHS) Center of Excellence in Women’s
Health, and the University of Arizona Center for Education
and Research on Therapeutics (Arizona CERT) participated
in planning discussions and completed preliminary
steps toward achieving the project outcomes. Detailed
information about each of the participating organizations
is included in Appendix I.
Representatives
from the participating organizations (AACP, APhA,
ACCP, University of Illinois at Chicago, Arizona CERT)
and key staff from the American Association of Medical
Colleges (AAMC), the American Dental Education Association
(ADEA), and the American Association of Colleges of
Nursing (AACN) involved in the conduct of the similar
projects in those professions were invited to serve
on the project Steering Committee formed to provide
input into the conduct of the project and consider
broader project implications for and implementation
with other health care professions. Members of the
project Steering Committee and their organizational
affiliations are listed in Appendix II.
A
Content Expert Panel consisting of content experts
from pharmacy education (identified through AACP and
the ACCP Women’s Health Practice Research Network)
and staff from the various Federal co-sponsors of
the project with content expertise was convened to
guide the analysis of the information gathered regarding
the current status of instruction in women’s
health in the pharmacy curriculum and to revise the
draft curriculum framework. Members of the Content
Expert Panel and their organizational affiliations
are listed in Appendix III. Over the course of the
project, the Content Expert Panel was tasked to:
• Review the draft curriculum framework; suggest
needed modifications to the content and/or organization
of the framework; and comment on the extent to which
the abilities and content in the framework are included
within the curriculum at their institutions.
• Review the list of information sources and
resources; indicate which, if any, they have used
to provide instruction for professional degree students;
and identify additional sources and instructional
materials not listed that they use or that are used
at their institutions to provide instruction in women’s
health for professional degree students.
CURRICULAR RESOURCE CENTER
Knowledge
and information related to pharmacy practice, patient
care, and the biomedical sciences is expanding rapidly.
Not only are new areas of science and practice emerging,
but the depth of specialization required to effectively
teach and conduct research across the breadth of subjects
touching the contemporary practice of pharmacy challenges
the resources of the typical college or school of
pharmacy. AACP has developed a Curricular Resource
Center (CRC) as a solution to expand educators’
access to evidence-based materials on timely and relevant
topics. Such materials are appropriate for incorporation
into required and elective coursework in professional
doctoral degree programs, as well as in postgraduate
programs for pharmacists and other health professionals.
The
accessibility and versatility of Web-based information
lends itself to this resource center. Many pharmacy
educators, as well as others (e.g., practitioners,
consultants, corporations) who provide professional
education and development materials, currently use
the Internet, university, and personal Web sites for
hosting and delivering courses and related resources
to enhance their teaching. The AACP CRC provides a
single point of access for curricular materials available
on a variety of topics and from various sources. Each
electronic folder is devoted to a particular topic
(e.g., women’s health, pharmacogenomics, patient
safety, managed care, geriatrics, social and administrative
sciences). The materials associated with any given
topic vary in design and delivery medium and may include
sets of lecture outlines and notes, video and audio
clips, case studies, laboratory exercises, simulations,
and assessment strategies and instruments.
Technology
Consultant Mark Hollander of MH+CO was engaged to
provide input into platform decision making and to
outline a framework for the development of instructional
resources. Through a series of telephone conferences
and on-site meetings with the project staff, the technology
consultant identified various technology and organization
solutions to produce and deliver the curriculum framework
and instructional resources. After comparing 11 possible
platforms and vendors, Mr. Hollander recommended a
delivery and distribution platform for the developed
instructional resources, because of the relatively
low initial costs, a simple fee structure, the strength
of the company; the number of universities already
using
a platform, and the ease of use for course developers.
AACP staff user accounts were established for further
study and testing.
Project
staff registered with this vendor to establish a prototype
module. Resources were drawn from existing sites and
courses at colleges and schools of pharmacy to develop
an example of how such materials might be integrated
into a Web-based system organized within the platform
format.
The
analysis of available delivery technologies and formats
was valuable in informing the subsequent development
of the instructional resources in women’s health
as part of this project. However, the estimated costs
of maintaining a client-vendor relationship could
be prohibitive. AACP had recently completed a Web
site upgrade and redesign and the decision was made
to build the Curricular Resource Center within the
infrastructure and capabilities of the AACP Web site.
Christopher
Cullander, Assistant Dean, School of Pharmacy, University
of California-San Francisco, was engaged to provide
AACP staff with the perspectives of a faculty member
and potential user of Web-based instructional resources
and to assist AACP staff in:
• Defining the larger infrastructure of a curricular
resources center under which the Women’s Health
curricular resources would fall; and
• Describing conceptually how access to newly
developed resources, existing faculty-developed resources,
and resources available from other organizations (Federal
agencies, professional organizations, commercial vendors)
may be integrated and provided.
Dr.
Cullander confirmed that there was an increasing use
of digital media (e.g., video clips, animations, audio
files, images, diagrams, graphics, as well as text
resources such as case studies, laboratory exercises,
and classroom demonstrations) by faculty in the design
and delivery of instruction; use of online course
management systems; and publication and deposition
of instructional materials online. He identified the
following problems with the current status of Web-based
instructional materials:
• Quality is inconsistent across resources;
• Resources are available in varying formats
and delivery vehicles;
• Electronic links to resources change over
time; and
• There is much duplication of effort in resource
development and duplicative resources available in
some content areas (e.g., histology resources).
Potential
advantages in the curricular resource center approach
for shared resources were identified as:
• Reduction in overall instructional costs;
• Savings in faculty time spent in designing
instruction; and
• Improvement in quality of instructional materials
and education provided.
Goals
for the Curricular Resource Center were suggested:
• Provide access to instructional resources
online;
• Promote sharing of resources; including mechanisms
to encourage faculty to create and use such resources;
• Maintain standards for interoperability and
efficient access to resources; and
• Build a scaleable, sustainable infrastructure.
The
Curricular Resource Center (accessed May 15, 2005).
WEB-BASED REVIEW OF EXISTING CURRICULA
An
initial review of Web-based information from colleges
and schools of pharmacy relative to instruction and/or
research in women’s health was completed in
November/December 2002. Descriptions of elective courses
focused exclusively on women’s health were obtained
from 21 colleges and schools of pharmacy. Specific
mention of women’s health issues within descriptions
of required courses were found for six programs, most
frequently within the pathophysiology and/or pharmacotherapeutics
sequence. One college of pharmacy (University of Kentucky)
was involved in an extensive women’s health
curriculum development project across several health
professions funded by the U.S. Department of Education
Fund for the Improvement of Postsecondary Education.
Descriptions of two continuing education conferences
for health care professionals in which a college or
school of pharmacy functioned as a convener or co-convener
were identified. Several colleges and schools of pharmacy
have faculty members that list women’s health
as an area of research activity and interest. In 2002,
of the 13 National Centers of Excellence in Women’s
Health (a program in the U.S. Department of Health
and Human Services, Office on Women’s Health),
six were on campuses that have colleges or schools
of pharmacy.
In
August 2004, a second Web-based review of each college
and school of pharmacy’s curriculum was conducted
in order to determine any change in the extent of
coverage of gender-related health topics. The 89 colleges
and schools of pharmacy recognized by the Accreditation
Council for Pharmacy Education (ACPE) in August 2004
are listed in Appendix IV. The method used involved
browsing the college or school home page first, followed
by a search for course catalog descriptions or course
schedules, and scan for stand-alone courses on women’s
health and specific mentions of women’s health
issues/topics within broader courses. The principal
finding of the analysis of Web-based information and
curricular descriptions was that women’s health
instruction was specifically mentioned by just under
40 percent (n=34) of the 89 U.S. colleges and schools
of pharmacy. At those institutions, some of which
have multiple courses with women’s health content,
48 courses were identified: 21 didactic elective courses
dedicated to women’s health issues, two elective
experiential courses dedicated to women’s health;
3 didactic electives in which women’s health
was one of a broad array of component content areas;
and 22 required courses in which women’s health
content was incorporated. Among those 22 required
courses, 18 were courses in pharmacotherapeutics;
two were pharmacokinetics/dose optimization courses;
one was a pharmacy practice course; and one was a
first-year orientation course on practice trends.
Appendix V lists the courses and content identified
in the Web-based review of curricula. Given the variability
across colleges and schools in how course descriptions
are worded and the level of detail provided, it is
likely that women’s health issues are included,
at the very least, in the pharmacotherapeutics courses
in more colleges and schools than identified in this
review.
DEVELOPMENT
OF A CURRICULUM FRAMEWORK FOR WOMEN’S HEALTH
INSTRUCTION
The
project participants, with primary input from faculty
members in the University of Illinois College of Pharmacy
and those associated with the UIC/HHS Center for Excellence
in Women’s Health, prepared a draft outline
of content areas that might serve as a core curriculum
in women’s health in pharmacy education. Feedback
for the project was obtained from participants at
the AACP Women Faculty Special Interest Group (SIG)
luncheon and meeting in July 2001. Participants were
asked to review the draft curriculum outline and provide
information on the current status of women’s
health instruction at their own institutions. An online
review of the draft curriculum framework was activated
in August 2002.
Two
responses were received as a result of an online review
of the draft curriculum framework in August 2002.
Feedback on the curriculum framework from representatives
of the Federal sponsors of the project was obtained
through personal interviews conducted by Michiyo Yamazaki,
FDA Office of Women’s Health Intern. A reformatted
curriculum framework that included the Federal partner
suggestions was prepared for review by the project
Steering Committee and Content Expert Panel for finalization.
During
the second quarter of the project, project staff continued
to welcome and seek individual and group (Steering
Committee and Content Expert Panel) review and input
into the evolving curriculum framework. Dr. Shareen
El-Ibiary, Clinical Assistant Professor, School of
Pharmacy, University of California, San Francisco,
expressed interest in the project and agreed to review
the draft curriculum framework and provide feedback
on its content and structure.
A
framework for a curriculum in women’s health
was outlined to guide the integration of women’s
health issues into the pharmacy curriculum. The framework
includes a section on sex and gender factors, and
outlines content areas and desired student outcome
abilities organized by lifespan stages. The complete
curriculum framework is included as Appendix VI.
COMPILED
LISTS OF INSTRUCTIONAL RESOURCES
Project
staff conducted an initial review the Web sites of
project sponsors (HRSA, NIH, FDA, AHRQ) and professional
organizations and societies (American Pharmacists
Association, American College of Clinical Pharmacy,
Society for Women’s Health Research, etc.) to
identify and list existing resources to support instruction
in women’s health. In early October 2003, project
staff met with Federal co-sponsors to discuss revision
of the draft list of existing resources. The goals
of the meeting were to develop a resource list that
better serves pharmacy faculty and informs them of
women's health-related publications available from
the Federal agencies. From the meeting, an organizing
format for resource descriptions was developed and
included the following components:
• Name of Agency;
• Office of Women’s Health (Yes/No);
• One to two sentence description of vision,
mission, and or focus of the agency/office;
• Web site URL for office of women’s health
(if applicable);
• Key programs and initiatives related to women’s
health (includes URLs if information is available
on the Web);
• Grant programs available through the agency/office
related to women’s health research and/or instruction
(includes URLs if information is available on the
Web);
• Fact sheets or other information summaries
related to women’s health (includes URLs if
information is available on the Web);
• List of publications (examples of recent publications
available to the public); and
• Additional information (telephone number or
URL to access additional publications and information).
Following
development of an organized format for the resource
descriptions, staff at the various Federal offices
and agencies finalized their materials accordingly.
The list of women’s health-related publications,
initiatives, contact information, and grant and funding
opportunities available from the Federal women’s
health offices was compiled. The Compiled List of
Instructional Materials Available from Federal Co-Sponsors,
updated in August 2005, is available online in the
AACP
Curricular Resource Center (accessed August 15,
2005) and is included as Appendix VII.
DISSEMINATION
EFFORTS
On June 18, 2004, a conference call was held among
AACP staff (Susan Meyer, Erin McSherry, Norida Torriente)
and Federal partners for the project to introduce
a new director of communications at AACP, Norida Torriente,
who would be participating in the project as it related
to AACP’s larger communications strategies and
goals, to provide a project update, and to begin a
discussion on planning the public release of materials
at the project’s completion. The call was also
intended to gather guidelines for the release of a
federally-funded project, in terms of any specific
language and procedure required. As a result of the
discussion, it was decided to focus dissemination
efforts on the intended users of the developed curriculum
framework and compiled resources, primarily faculty
at colleges and schools of pharmacy. A variety of
strategies and formats have been used to disseminate
the work of the project, including:
• Lucinda L. Maine, Ph.D., AACP Executive Vice
President, presented an update on the Health Professions
Training, Education, and Competency: Women’s
Health in the Pharmacy School Curriculum project at
the FIP (International Pharmaceutical Federation)
Academic symposium on “Incorporating Gender
Analysis of Medications into Pharmacy Education,”
September 8, 2003, in Sydney, Australia.
•
Following posting of completed materials to the Web
site, a description of the project and an announcement
to the AACP membership of the availability of the
curriculum framework and the resource list was included
in the April 2004 issue of the AACP News.
•
A project description, along with descriptions of
and links to the curriculum framework and resource
list, was sent to members of the following groups:
• Principal Investigators/Program Directors:
Building Interdisciplinary Research Careers in Women’s
Health (BIRCWH; BIRCWH II);
• Program Directors: National Centers of Excellence
in Women’s Health;
• Program Directors: National Community Centers
of Excellence in Women’s Health; and
• Principal Investigators/Program Directors:
Specialized Centers of Research (ORWH SCOR).
A sample letter is included as Appendix VIII.
•
A 90-minute special session on the Women’s Health
project was presented on Tuesday, July 13, 2004, during
AACP’s Annual Meeting in Salt Lake City, Utah,
to share the results of the analysis of the extent
to which women’s health issues are included
within the pharmacy curriculum; raise awareness of
women’s health issues and the need for pharmacists
to be educated about those issues; promote the integration
of women’s health in pharmacy education; and
promote the use of the curriculum framework and Federal
resources. The session description read as follows:
A
curricular framework for the inclusion of sex- and
gender-related health issues in pharmacy and other
health professions education programs will be introduced.
This Federally-funded program (through HRSA) has also
supported the development of a curricular resources
sharing system as part of www.aacp.org that will be
expanded to include resources in a wide array of content
areas in support of faculty in their education roles.
Presenters will share the results of an analysis of
the extent to which women’s health issues are
included within the pharmacy curriculum; discuss opportunities
to integrate women’s health issues into pharmacy
education, clinical services, community outreach,
and research; and promote the use of the curriculum
framework and Federal resources to facilitate instruction
in women’s health.
Susan
Meyer (project director) gave an introduction and
overview of the project, followed by a presentation
by Erin McSherry (project staff) on the process for
accessing the curriculum framework and resource list.
Janet McCombs, Pharm.D., of the Content Expert Panel
and the University of Georgia, spoke about her experience
with women’s health as part of the pharmacy
curriculum at her institution. Rosalie Sagraves, Pharm.D.,
a member of the project Steering Committee and Dean
of the College of Pharmacy at the University of Illinois-Chicago,
contributed a presentation on interprofessional research,
clinical service, community outreach and education,
and professional development initiatives at UIC within
the National Center of Excellence in Women’s
Health.
•
A 90-minute special session was held during the AACP
annual meeting in July 2005, in which the results
of the Women’s Health in the Pharmacy Curriculum
Project were presented. The session description is
as follows:
A
curricular framework for the inclusion of sex- and
gender-related health issues in pharmacy and other
health professions education programs will be introduced.
This Federally-funded project (through HRSA) has also
supported the development of a curricular resources
sharing system on the AACP Web site that has been
expanded to include resources in a wide array of content
areas in support of faculty in their education roles.
Speakers
included project director Susan M. Meyer, Ph.D. and
Content Expert Panel members Damary Castanheira Torres,
Pharm.D. (St. John’s), Shareen Y. El-Ibiary,
Pharm.D. (University of California at San Francisco),
and Laura Hansen, Pharm.D. (University of Colorado).
SUMMARY AND CONCLUSIONS
Following
the completion of the previous work on women’s
health curricular content in medical, dental, and
nursing programs, this pharmacy-specific project was
designed to examine the extent to which women’s
health issues are included in the pharmacy curriculum,
facilitate the expansion and enhancement of women’s
health instruction in pharmacy education with a curriculum
framework that organizes recommended required and
elective content into modules, and facilitate the
expansion and enhancement of women’s health
instruction in health professions education. The examination
of the extent to which women’s health issues
are included in the curriculum was a similar aim across
each of the profession-specific projects, although
the methods for gathering the information and conducting
the analysis differed across projects. A review of
Web-based curricular information and course descriptions
at the U.S. colleges and schools of pharmacy found
that at least 34 colleges and schools (40 percent
of the 89 U.S. colleges and schools of pharmacy) include
instruction specific to women’s health issues
within the curriculum. It is possible that the methods
used to identify women’s health content at colleges
and schools of pharmacy failed to identify the true
extent to which the content is included because of
the variability in the level of detail and presentation
format for Web-based course content descriptions across
colleges and schools of pharmacy.
The
project in pharmacy was also similar in nature to
the other projects in that a recommended content outline
for colleges and schools to use in designing and implementing
instruction in women’s health was developed.
The pharmacy project however, expanded this resource
so that it might serve as framework or guide for curriculum
development (content; instructional process and strategies;
and assessment methods) through the inclusion of not
only content areas organized across the life span,
but also desired student outcome abilities within
each of the content areas.
The
project in pharmacy differed significantly from the
other projects in that a process for developing recommendations
for the advancement of women’s health in the
profession of pharmacy, for follow-up activities by
academic pharmacy, or for future activities of Federal
agencies was not included. Rather, the intent of the
project was to expand and enhance women’s health
instruction across pharmacy programs by facilitating
awareness of and access to resources available from
the Federal co-sponsors of the project. Based on input
from interested faculty members, the project Steering
Committee, and members of the Content Expert Panel
participating in the project, the following principles
were developed to guide the development of the instructional
materials and resources:
• The curriculum framework should be comprehensive,
organized across and by lifespan stages, and be “outcome-based.”
• Resource materials and other guidance documents
should be a flexible in design as possible to allow
use by multiple institutions and to facilitate integration
of the content into existing courses to greatest extent
possible, rather than suggesting the addition of new
focused required or elective courses.
• Materials should be Web-accessible.
The
Web-based AACP Curricular Resource Center is structured
to provide access to the resources, including the
curriculum guide and the lists of resources available
from Federal agencies. Located at on the AACP
Web site, the Curricular Resource Center also
houses, or provides links to, instructional resources
in clinical prevention and population health, pharmacogenomics,
managed care, Medicare/medication therapy management
services, patient safety, geriatrics, reaching underserved
populations, and social and administrative sciences.
REFERENCES
1.
U.S. Department of Health and Human Services, Public
Health Service, National Institutes of Health. Agenda
for Research on Women’s Health for the 21st
Century, Volume 7. New Frontiers in Women’s
Health. Bethesda, MD. NIH Publication No. 01-4391.
2. CAPE
Educational Outcomes, American Association of Colleges
of Pharmacy. Accessed August 17, 2005.
3. U.S. Department of Health and Human Services, Health
Resources and Services Administration, and the National
Institutes of Health. Women’s Health in the
Medical School Curriculum: Report of a Survey and
Recommendations. Bethesda, MD. HRSA-A-OEA-96-1.
4. U.S. Department of Health and Human Services, Health
Resources and Services Administration, and the National
Institutes of Health. Women’s Health in the
Dental School Curriculum: Report of a Survey and Recommendations.
Bethesda, MD. NIH publication No. 994399.
5. U.S. Department of Health and Human Services, Health
Resources and Services Administration, and the National
Institutes of Health. Women’s Health in the
Baccalaureate Nursing School Curriculum: Report of
a Survey and Recommendations. Bethesda, MD.
6. U.S. Department of Labor, Bureau of Labor Statistics.
Occupational Employment and Wages, May 2004. 29-1051
Pharmacists. Accessed August 18, 2005.
APPENDIX I: PARTICIPATING ORGANIZATIONS
Founded
in 1900, the American Association of Colleges of Pharmacy
(AACP) is the national organization representing pharmacy
education in the United States. The organization serves
member colleges and schools and their respective faculties
by acting as their advocate at the national level,
by providing forums for interaction and exchange of
information among members, by recognizing outstanding
performance among its member educators, and by assisting
member colleges and schools in meeting their mission
of educating and training pharmacists and pharmaceutical
scientists. The Association recognizes a special responsibility
to provide leadership in advancing and enhancing the
quality of education and training in its member colleges
and schools while respecting the diversity inherent
among them. The pharmacy education community in fall
2004 included 89 colleges and schools with pharmacy
degree programs accredited by the Accreditation Council
for Pharmacy Education, over 43,000 professional degree
students, 2,900 students enrolled in graduate studies
and more than 3,600 full-time faculty.
The
American Pharmacists Association (APhA) is the national
professional society of pharmacists and represents
practitioners from all pharmacy practice settings,
scientists and pharmacists in training. With more
than 50,000 members, it maintains affiliation with
all State pharmacy associations and has a student
chapter at each college and school of pharmacy.
The
American College of Clinical Pharmacy (ACCP) is a
professional and scientific society that provides
leadership, education, advocacy, and resources enabling
clinical pharmacists to achieve excellence in practice
and research. ACCP’s membership comprises practitioners,
scientists, educators, administrators, students, residents,
fellows, and others committed to excellence in clinical
pharmacy and patient pharmacotherapy. ACCP functions
to foster the growth of clinical pharmacy services
and promote their value in all health care settings;
facilitate the performance, dissemination, and application
of pharmaceutical and biomedical research; and promote
excellence in all facets of clinical pharmacy education.
The
University of Illinois at Chicago College of Pharmacy
is a regular institutional member of AACP with a long-standing
focus and expertise in women’s health research
and education. The UIC/HHS National Center of Excellence
in Women’s Health emphasizes partnership across
disciplines and professions, involving collaborative
efforts across six health professional colleges at
the University of Illinois at Chicago (pharmacy, nursing,
medicine, public health, dentistry, and health and
human development services); partnerships between
academia and the community, and partnerships between
health care provider and patient. UIC’s Center
of Excellence focuses on four core areas: provision
of comprehensive health services; community-based
awareness, involvement, and education; research to
advance knowledge across the life span; and curriculum
development and leadership for women.
The
focus of the Arizona Center for Education and Research
on Therapeutics (Arizona CERT) is to improve therapeutic
outcomes and reduce adverse events caused by drug
interactions, especially those affecting women. The
CERT is also focused on identifying and understanding
mechanisms for drug-induced arrhythmias. These goals
are accomplished by basic and clinical research programs
and a variety of educational efforts.
APPENDIX II: WOMEN’S HEALTH PROJECT
STEERING COMMITTEE
Susan M. Meyer, Ph.D., project director
Senior Vice President
American Association of Colleges of Pharmacy
Lucinda
L. Maine, Ph.D.
Executive Vice President
American Association of Colleges of Pharmacy
Peggy
Kuehl, Pharm.D.
Former Director of Education and Member Services
American College of Clinical Pharmacy
Rosalie
Sagraves, Pharm.D.
Dean, College of Pharmacy
University of Illinois at Chicago
Marietta
Anthony, Ph.D.
Associate Vice President for Women's Health Research
University of Arizona Center for Education and Research
on Therapeutics
Joan
Stanley, Ph.D., Director of Education Policy
American Association of Colleges of Nursing
M.
Brownell Anderson, M.S.
Senior Associate Vice President
Division of Medical Education
Association of American Medical Colleges
Sabrina Matoff-Stepp, M.A.
Director
U.S. Department of Health
and Human Services
Health Resources and Services
Administration
Maternal and Child Health
Bureau Office of Women’s Health
Rosaly
Correa-de-Araujo, M.D., M.Sc., Ph.D.
Director
U.S. Department of Health
and Human Services
Agency for Healthcare Research and Quality
Office of Women’s Health
and Gender-Based Research
Wanda
K. Jones, Dr.P.H.
Deputy Assistant Secretary for Women’s Health
U.S. Department of Health and Human Services
Office on Women’s Health
Vivian
W. Pinn, M.D.
Associate Director for Research on
Women’s Health
Director
U.S. Department of Health
and Human Services
National Institutes of Health
Office of Research on Women’s Health
Susan
F. Wood, Ph.D.
Director
U.S. Department of Health and Human Services
Food and Drug Administration
Office of Women’s Health
APPENDIX III: WOMEN’S HEALTH CONTENT EXPERT
PANEL
Mary Berg, Ph.D. (deceased)
University of Iowa
College of Pharmacy
Richard
J. Bertin, Ph.D.
Board of Pharmaceutical Specialties
Candace
S. Brown, Pharm.D.
University of Tennessee
College of Pharmacy
Damary
C. Castanheira Torres, Pharm.D.
St. Johns University
College of Pharmacy and Allied Health Professions
Stuart
T. Haines, Pharm.D.
University of Maryland
School of Pharmacy
Laura
B. Hansen, Pharm.D.
University of Colorado Health Sciences Center
School of Pharmacy
Karim
A. Calis, Pharm.D., M.P.H.
U.S. Department of Health
and Human Services
National Institutes of Health
Leisa L. Marshall, Pharm.D.
Mercer University
Southern School of Pharmacy
H.
Anthony McBride, Ph.D.
Samford University
McWhorter School of Pharmacy
Janet
McCombs, Pharm.D.
University of Georgia
College of Pharmacy
Mary
G. Mihalyo, Pharm.D.
Duquesne University
Mylan School of Pharmacy
Louise
S. Parent-Stevens, Pharm.D.
University of Illinois at Chicago
College of Pharmacy
Charles
D. Ponte, Pharm.D.
West Virginia University
School of Pharmacy
Ronald
J. Ruggiero, Pharm.D.
University of California-San Francisco
School of Pharmacy
APPENDIX IV: U.S. COLLEGES AND SCHOOLS OF PHARMACY
RECOGNIZED BY THE ACCREDITATION
COUNCIL FOR PHARMACY EDUCATION (AUGUST 2004)
Alabama
Auburn University
Harrison School of Pharmacy
Auburn University, AL
Samford
University
McWhorter School of Pharmacy
Birmingham, AL
Arizona
Midwestern University, Glendale
College of Pharmacy
Glendale, AZ
University
of Arizona
College of Pharmacy
Tucson, AZ
Arkansas
University of Arkansas for Medical Sciences
College of Pharmacy
Little Rock, AR
California
Loma Linda University
School of Pharmacy
Loma Linda, CA
University
of California, San Diego
College of Pharmacy
La Jolla, CA
University
of California, San Francisco
College of Pharmacy
San Francisco, CA 94143
University
of the Pacific
Thomas J. Long School of Pharmacy and Health Sciences
Stockton, CA
University of Southern California
School of Pharmacy
Los Angeles, CA
Western
University of Health Sciences
College of Pharmacy
Pomona, CA
Colorado
University of Colorado
School of Pharmacy
Denver, CO
Connecticut
University of Connecticut
School of Pharmacy
Storrs, CT
District
of Columbia
Howard University
College of Pharmacy, Nursing and Allied Health Sciences
Washington, DC
Florida
Florida Agricultural and Mechanical University
College of Pharmacy & Pharmaceutical Sciences
Tallahassee, FL
Nova
Southeastern University
College of Pharmacy
Fort Lauderdale, FL
Palm
Beach Atlantic University
School of Pharmacy
West Palm Beach, FL
University
of Florida
College of Pharmacy
Gainesville, FL
Georgia
Mercer University
Southern School of Pharmacy
Atlanta, GA
South
University
School of Pharmacy
Savannah, GA
University
of Georgia
College of Pharmacy
Athens, GA
Idaho
Idaho State University
College of Pharmacy
Pocatello, ID
Illinois
Midwestern University
Chicago College of Pharmacy
Downers Grove, IL
University
of Illinois, Chicago
College of Pharmacy
Chicago, IL
Indiana
Butler University
College of Pharmacy and Health Sciences
Indianapolis, IN
Purdue
University
School of Pharmacy and Pharmacal Sciences
West Lafayette, IN
Iowa
Drake University
College of Pharmacy and Health Sciences
Des Moines, IA
University of Iowa
College of Pharmacy
Iowa City, IA
Kansas
University of Kansas
School of Pharmacy
Lawrence, KS
Kentucky
University of Kentucky
College of Pharmacy
Lexington, KY
Louisiana
University of Louisiana at Monroe
College of Pharmacy
Monroe, LA
Xavier
University of Louisiana
College of Pharmacy
New Orleans, LA
Maryland
University of Maryland
School of Pharmacy
Baltimore, MD
Massachusetts
Massachusetts College of Pharmacy and Allied Health
Sciences – Boston
Boston, MA
Massachusetts
College of Pharmacy and Allied Health Sciences –
Worcester
Worcester, MA
Northeastern
University
Bouvé College of Pharmacy and Health Sciences
Boston, MA
Michigan
Ferris State University
College of Pharmacy
Big Rapids, MI
University
of Michigan
College of Pharmacy
Ann Arbor, MI
Wayne
State University
Eugene Applebaum College of Pharmacy and Health Sciences
Detroit, MI
Minnesota
University of Minnesota
College of Pharmacy
Minneapolis, MN
Mississippi
University of Mississippi
School of Pharmacy
University, MS
Missouri
St. Louis College of Pharmacy
St. Louis, MO
University
of Missouri, Kansas City
School of Pharmacy
Kansas City, MO
Montana
University of Montana
School of Pharmacy & Allied Health Sciences
Missoula, MT
Nebraska
Creighton University
School of Pharmacy and Health Professions
Omaha, NE
University
of Nebraska
College of Pharmacy
Omaha, NE
Nevada
University of Southern Nevada
Nevada College of Pharmacy
Henderson, NV
New
Jersey
Rutgers, the State University of New Jersey
Ernest Mario School of Pharmacy
Piscataway, NJ
New
Mexico
University of New Mexico
College of Pharmacy
Albuquerque, NM
New
York
Long Island University
Arnold & Marie Schwartz College of Pharmacy and
Health Sciences
Brooklyn, NY
St.
John's University
College of Pharmacy and Allied Health Professions
Jamaica, NY
University
of Buffalo, State University of New York
School of Pharmacy and Pharmaceutical Sciences
Buffalo, NY
Union
University
Albany College of Pharmacy, Albany, NY
North Carolina
Campbell University
School of Pharmacy
Buies Creek, NC
University
of North Carolina, Chapel Hill
School of Pharmacy
Chapel Hill, NC
Wingate
University
School of Pharmacy
Wingate, NC
North
Dakota
North Dakota State University
College of Pharmacy
Fargo, ND
Ohio
Ohio Northern University
College of Pharmacy
Ada, OH
Ohio
State University
College of Pharmacy
Columbus, OH
University
of Cincinnati Medical Center
College of Pharmacy
Cincinnati, OH
University
of Toledo
College of Pharmacy
Toledo, OH
Oklahoma
Southwestern Oklahoma State University
School of Pharmacy
Weatherford, OK
University of Oklahoma
College of Pharmacy
Oklahoma City, OK
Oregon
Oregon State University
College of Pharmacy
Corvallis, OR
Pennsylvania
Duquesne University
Mylan School of Pharmacy
Pittsburgh, PA
Lake
Erie College of Osteopathic Medicine
School of Pharmacy
Erie, PA
University
of the Sciences in Philadelphia
Philadelphia College of Pharmacy
Philadelphia, PA
Temple
University
School of Pharmacy
Philadelphia, PA
University
of Pittsburgh
School of Pharmacy
Pittsburgh, PAWilkes
University
Nesbitt School of Pharmacy
Wilkes-Barre, PA
Puerto
Rico
University of Puerto Rico
School of Pharmacy
San Juan, PR
Rhode Island
University of Rhode Island
College of Pharmacy
Kingston, RI
South
Carolina
Medical University of South Carolina
College of Pharmacy
Charleston, SC
University
of South Carolina
College of Pharmacy
Columbia, SC
South
Dakota
South Dakota State University
College of Pharmacy
Brookings, SD
Tennessee
University of Tennessee
College of Pharmacy
Memphis, TN
Texas
Texas Southern University
College of Pharmacy & Health Sciences
Houston, TX
Texas
Tech University
School of Pharmacy
Amarillo, TX
University
of Houston
College of Pharmacy
Houston, TX
University
of Texas, Austin
College of Pharmacy
Austin, TX
Utah
University of Utah
College of Pharmacy
Salt Lake City, UT
Virginia
Hampton University
School of Pharmacy
Hampton, VA
Shenandoah
University
Bernard J. Dunn School of Pharmacy
Winchester, VA
Virginia
Commonwealth University
School of Pharmacy
Richmond, VA
Washington
University of Washington
School of Pharmacy
Seattle, WA
Washington
State University
College of Pharmacy
Pullman, WA
West
Virginia
West Virginia University
School of Pharmacy
Morgantown, WV
Wisconsin
University of Wisconsin, Madison
School of Pharmacy
Madison, WI
Wyoming
University of Wyoming
School of Pharmacy
Laramie, WY
APPENDIX V: WOMEN’S HEALTH COURSES AND
CONTENT AT U.S. PHARMACY COLLEGES AND
SCHOOLS
Conducted
in August 2004, th | 
