By Maureen Thielemans
Women make up just over half of the United States population, according to 2012 estimated figures from the U.S. Census Bureau, and oftentimes are the ones responsible for their families’ healthcare and well-being. So it only makes sense that women’s health issues be a priority for teaching in today’s health professions education curriculum.
For more than a decade, AACP members and staff have been dedicated to ensuring that women’s health is a vital part of student pharmacist training. Earlier this year, a key group of individuals revised and released the Women’s Health Curriculum. Developed in collaboration with the FDA Office of Women’s Health, the curricular framework outlines core competencies and performance-based learning objectives for use in either dedicated courses on women’s health or in conjunction with other pharmacy courses. Academic Pharmacy Now takes a look at how the curriculum, while years in the making, is already demonstrating immediate value to pharmacy schools across the country.
In 2003, Dr. Rosalie Sagraves, dean and professor emerita at the University of Illinois at Chicago College of Pharmacy, was actively involved in the National Institutes of Health Office of Research and Women’s Health Advisory Committee, a collection of federal agencies including the Health Resources and Services Administration (HRSA), the Department of Health and Human Services and the Agency for Healthcare Research and Quality. The group was tasked with assessing the degree to which women’s health issues were incorporated into medical and dentistry school curriculums and Sagraves felt the same analysis should also be performed in pharmacy programs.
Later that year, AACP developed the Web-based “Gender and Sex-Related Health Care Pharmacy Curriculum Guide,” which was housed in the Curricular Resource Center and included a pharmacy curricular framework for defining women’s health, general health concerns for sex and gender differences, socioeconomics of women’s health, and other topics. It did not, however, provide detailed content-specific information. In 2005, AACP, in collaboration with the same federal partners, produced a report through HRSA titled “Health Professions Training, Education and Competency: Women’s Health in the Pharmacy School Curriculum.” The project sought to assess the extent to which women’s health is addressed in required and elective courses in the Pharm.D. curriculum; learn from the recommendations included in the medicine, dentistry, and nursing reports on women’s health in their curricula; and compile resources to promote women’s health instruction within pharmacy education.
Dr. Susan M. Meyer, senior vice president at AACP from 1998 to 2006, led an effort to conduct a brief survey of pharmacy schools with the goal of determining how many had women’s health components within their curriculum. Of the 89 schools, about 40 percent explicitly mentioned women’s health. “That 40 percent was a wake-up call,” Sagraves said. “We knew there was a need to develop a curriculum guide that would help schools teach women’s health that weren’t already doing so.”
With women’s health issues continuously changing, AACP staff was challenged with maintaining the curriculum guide’s informational accuracy. That task fell upon Dr. Robert A. (Buzz) Kerr, AACP vice president for academic affairs from 2009 to 2012, who determined that a revision of the curriculum was necessary and recommended removing the outdated guide from the Curricular Resource Center. Next, Kerr submitted a grant proposal to the FDA Office of Women’s Health requesting and being granted funds to form a working group that would be responsible for an overhaul of the current guide or the creation of a new one.
Eight individuals representing various clinical and academic pharmacy backgrounds comprised the Women’s Health Task Force in 2010. From the beginning, it was apparent to the group that updating the outdated content wasn’t achievable—a new curriculum structure was needed.
“As a group we decided to focus on the skills students needed and the approach that was necessary to care for women, rather than concentrate on detailed content,” said Dr. Elena M. Umland, associate dean for academic affairs at the Thomas Jefferson University School of Pharmacy and member of the task force.
From there, the task force determined that a set of resources would be helpful to schools. “Not every pharmacy program is able to develop a required course in women’s health,” said Dr. Annie Y. Lin, dean of the Notre Dame of Maryland University School of Pharmacy and task force member. “Some offer a women’s health elective, while others embed women’s health elements in required classes. Every school will approach it differently and so we wanted to include resources that were going to be flexible enough to allow schools to adapt them to their own curriculum.”
The task force began the content overhaul by looking at women’s health across a lifespan, identifying the key issues in each segment of their lives, and determining an approach to each scenario. For example, an adolescent female requires a different care approach than a woman of reproductive age, Umland said, and the group paid special attention to ensuring these types of scenarios were included in the curriculum.
“Students need to know the right questions to ask and to feel comfortable asking them, depending on where the woman is in her lifespan,” she added. “We also wanted to make the curriculum more interactive and useful to faculty.”
The FDA Office of Women’s Health echoed the importance of including women’s health issues in today’s student pharmacist training. “We are very excited that this FDA-AACP collaboration resulted in a nimble curriculum and resource toolbox for pharmacy educators and students, giving student pharmacists the opportunity to master core competencies in critical areas of women’s health, such as the inclusion of women in clinical trials, sex differences in response to FDA-regulated medical products, and the differing health needs of a woman across her lifespan,” said Marsha Henderson, assistant commissioner for women’s health at FDA. “These students can then, as practitioners, play a vital role in advancing the health of women and their families, and recognize women not only as patients but also as caregivers and healthcare decision makers in our society.”
To avoid creating another curriculum guide that would soon become outdated, the task force knew that fixing broken links and continuously researching expired guidelines was beyond their scope of work. “Rather than include current guidelines, the curriculum leads educators to where they can find that information online, as well as other useful resources,” Lin said.
Keeping the future practitioner in mind was another way the team managed content accuracy. With the expanding roles pharmacists play as key members of the healthcare team, the task force designed the curriculum to incorporate the demands of the on-the-ground community pharmacist, who is often the first person a patient sees. “We’re not trying to make students experts because they need to know when to refer a patient to a physician or to another pharmacist,” Lin noted. “There are some basic things a general practitioner should know, but the goal was not to make them specialists.”
The revised Women’s Health Curriculum will continue to play a vital role in ensuring that women’s health issues remain a significant part of pharmacy education and skill development. Its flexibility guarantees that pharmacy schools can keep up with the ever-changing knowledge about women’s unique health issues, which is paramount to a student’s success as a future practitioner.
“We have issues that are unique, but are very common to all women,” Umland said. “They will be the ones coming in to the pharmacy and so students need to know how to take care of them, and we need to give them those skills.”
Maureen Thielemans is Communications Manager at AACP and editor of Academic Pharmacy Now; firstname.lastname@example.org.