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Current Status of Immunology Education in US Schools And

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Current Status of Immunology Education in US Schools And American Journal of Pharmaceutical Education 2019; 83 (7) Article 6994. RESEARCH Current Status of Immunology Education in US Schools and Colleges of Pharmacy Yuan Zhao, PhD,a Dana Ho, PharmD,a Benjamin Oldham, PharmD,a Bonnie Dong, PharmD,a Daniel Malcom, PharmDa,b a Sullivan University College of Pharmacy, Louisville, Kentucky b Associate Editor, American Journal of Pharmaceutical Education, Arlington, Virginia Submitted February 2, 2018; accepted June 17, 2018; published September 2019. Objective. To determine the extent of immunology education in US Doctor of Pharmacy (PharmD) programs. Methods. Curricular information on immunology education was collected from the web pages of US PharmD programs (N5142). The data were sorted, comparisons were made, and trends were identified. Results. Of 142 PharmD programs studied, 100% posted curriculum information on their websites. Among them, 73 programs (51.4%) had a dedicated immunology course in their curriculum, either as an independent course or a course combined with another subject. Most immunology education was offered in the first professional year (72.5%). Of the programs that offered immunology as an in- dependent course, the number of semester hours dedicated to the course varied from 1.5 to 3.5 (median53, mode53, mean52.7). More three-year programs offered immunology as a core compo- nent in the didactic curriculum than did four-year programs (64.7% vs 49.6%). Similarly, more private programs offered immunology than did public programs (64% vs 37.3%). Conclusion. Immunology education in US schools and colleges of pharmacy lacks consensus. Not all PharmD programs indicated they offered specific, focused immunology education in their curricula. There were also variations in the placement of immunology content within the curriculum among programs offering specific immunology course(s). Lastly, there was discrepancy in the allocation of credit hours to the immunology courses. Continued discussion on standardization of immunology education across US pharmacy schools is recommended. Keywords: immunology, pharmacy education, curriculum by guest on September 28, 2021. © 2019 American Association of Colleges Pharmacy INTRODUCTION ing). Examples of the contributions of immunology to the Immunology is a fundamental discipline of medicine medical field include development and use of vaccina- that studies the mechanisms of how the body defends tions and the growing number of monoclonal antibodies itself against foreign entities at a cellular and molecular used to treat a variety of disease states such as cancer and http://www.ajpe.org level, as well as involvement of the immune system in the inflammatory disorders.3-8 Pharmacists pursuing training pathophysiology of various disease states.1 Through ad- in or practicing in highly specialized areas such as oncol- vancements in technology, imaging, and drug develop- ogy require an even deeper understanding of immuno- ment, immunology is used in medical specialty fields therapy to provide the highest level of patient care. For such as oncology, transplantation, rheumatology, neurol- example, a recent advancement in immunotherapy is chi- 2-8 Downloaded from ogy, infectious disease, and others. An understanding meric antigen receptor (CAR) T therapy, in which the of the core concepts of immunology is increasing in im- patient’s own T lymphocytes are collected and geneti- portance, and it is also used in the diagnosis of several cally modified before transfusing them back into the pa- diseases (eg, tuberculin skin testing, rapid diagnostic test- tient in order to fight off malignant tumors.6 No matter the area of practice, an understanding of the immune system Corresponding Author: Yuan Zhao, Sam Houston State University, Proposed College of Osteopathic Medicine, Box is critical to fully appreciate the purpose and the mecha- 2303, Huntsville, TX 77341. Tel: 9362942392. E-mail: nism of these drugs and therapies. [email protected] Given the large and increasingly important role of Note: At the time of the study, Yuan Zhao was affiliated with immunology in medical and pharmacy practice, immu- Sullivan University College of Pharmacy. nology is among the topics required to be taught in 1578 American Journal of Pharmaceutical Education 2019; 83 (7) Article 6994. pharmacy curricula. The Accreditation Council for Phar- The website of each pharmacy school and college was macy Education(ACPE) Standards 2016mandate (through examined in October 2017 to determine the presence of Appendix 1) that pharmacy programs should ensure stu- curriculum information. If applicable, the student handbook dents are able to fully understand human immunity and containing the curriculum was explored. To account for vari- immune response, principles of antigen-antibody rela- able terminology, key words such as “immunology,” “im- tionships, the molecular aspects of immune response, as munity,” “immune,” and “immune-” were searched for on well as the genetic basis for antibody synthesis, develop- the curriculum website or document posted. The following ment, function, and immunopathology.9 Notably, Appen- information was gathered: the nature of the immunology dix 1 is silent as to the weight (often reflected in time course (independent course or combined with another sub- allocated) that should be devoted to each topic on the list, ject) offered as a core (required) component in the curricu- and only states that the topics are viewed as “central” to a lum, the length of the program (three years or four years), high-quality pharmacy education.9 whether the program was private or public, the timing of the The Pharmacy Curriculum Outcomes Assessment immunology course in the curriculum (first, second, or third (PCOA), which is conducted by the National Association professional year), and the number of credit hours dedicated of Boards of Pharmacy (NABP), is designed to provide an to immunology. Of the 142 programs analyzed, the majority external and objective measure of student performance in (n5123; 86.7%) operated under the semester system; thus, US pharmacy curricula. The PCOA lists immunology as a we used the semester credit hour measurement for this study. subtopic of the basic medical sciences domain in which For programs operating in a quarter system, credit hours pharmacy students are expected to show proficiency.10 were converted to semester hours using the following for- The current PCOA content areas and subtopics are largely mula: 1.5 quarter credit hours equaled one semester credit based on the results from the 2015 NABP US Schools and hour. For programs operating in a trimester system, credit Colleges of Pharmacy Curricular Survey, which ranked hours were converted using the following formula: 1.2 tri- immunology 20 out of 30 topics in order of overall im- mester credit hour equaled one semester credit hour. Data portance to the curriculum.11 Of the 200 questions on the were recorded and analyzed in Microsoft Excel 2016 (Red- PCOA, only four are mapped to immunology.12 This mond, WA). As this project involved only review of course equates to roughly 2% of the total PCOA content. information from college or school websites and did not Despite its required nature in pharmacy curricula, no qualify as human subjects research, it did not require insti- review to date has explored the manner in which immu- tutional review board evaluation. nological concepts are integrated within pharmacy edu- The AACP’s 2017-2018 Pharmacy Prerequisite In- cation. While immunology has been evaluated (as a part formation was used to determine how many pharmacy of a larger review) in terms of its importance as a pre- programs either required or conditionally required immu- by guest on September 28, 2021. © 2019 American Association of Colleges Pharmacy requisite prior to entering pharmacy school,13 no study nology as a prerequisite.16 Conditional requirement was has been published detailing how pharmacy programs defined as a prerequisite that could be substituted by an- allocate didactic curricular time to immunology. Thus, other course to fulfill a specific requirement. Which the goal of this study was to summarize available infor- courses can substitute for immunology and in what cir- mation on the manner and degree to which immunology is cumstances is decided on a program-by-program basis. http://www.ajpe.org included in curricula of US Doctor of Pharmacy Two programs that were included in AACP’s list of US (PharmD) programs. schools and colleges of pharmacy at the time of data col- lection had not been included on AACP’s 2017-2018 METHODS Pharmacy Prerequisite Information and were therefore One hundred forty-one US schools and colleges of not included in this study. These were the University of pharmacy recognized as regular or associate members of Texas at El Paso and the Medical College of Wisconsin, Downloaded from the American Association of Colleges of Pharmacy both of which were AACP associate institutes and in pre- (AACP) were included in the study.14 All of these insti- candidate status at the time of the study. Lebanese Amer- tutions offered a PharmD in their professional pharmacy ican University was included in the AACP’s prerequisite programs and were either fully accredited, a candidate for list; however, it was not included in our study because it is accreditation, or had pre-candidate status from ACPE.15 located outside of the United States. For analysis purposes, Lake Erie College of Osteopathic Medicine (LECOM) was counted twice as it had both a RESULTS three-year and a four-year
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