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Keywords: Background and purpose: Medication therapy management (MTM) is a comprehensive, patient-
Medication therapy management centered approach to improving medication use, reducing the risk of adverse events and im-
Communication proving medication adherence. Given the service delivery model and required outputs of MTM
Advanced pharmacy practice experience services, communication skills are of utmost importance. The objectives of this study were to
identify and describe communication principles and instructional practices to enhance MTM
training.
Educational activity and setting: Drawing on formative assessment data from interviews of both
pharmacy educators and alumni, this article identifies and describes communication principles
and instructional practices that pharmacy educators can use to enhance MTM training initiatives
to develop student communication strategies.
Findings: Analysis revealed five key communication challenges of MTM service delivery, two
communication principles that pharmacy teachers and learners can use to address those chal-
lenges, and a range of specific strategies, derived from communication principles, that students
can use when challenges emerge. Implications of the analysis for pharmacy educators and re-
searchers are described.
Summary: Proactive communication training provided during MTM advanced pharmacy practice
experiences enabled students to apply the principles and instructional strategies to specific pa-
tient interactions during the advanced pharmacy practice experiences and in their post-gradua-
tion practice settings.
The Medicare Modernization Act of 2003 included a mandate for the provision of medication therapy management (MTM)
services to high-risk Medicare beneficiaries with Part D prescription drug coverage.1 MTM is a patient-centric and comprehensive
approach to improve medication use, reduce the risk of adverse events and improve medication adherence.1,2 The cornerstone of
MTM is the comprehensive medication review (CMR), defined as an interactive, person-to-person or telehealth medication review
(including prescriptions, over-the-counter medications, herbal therapies, and dietary supplements) performed in real-time by a
pharmacist or other qualified provider.2,3 A written summary of the medication review is provided to the patient in the form of a
personal medication list and a medication action plan (MAP). Following the CMR, pertinent findings are communicated to
⁎
Corresponding author.
E-mail addresses: paul.denvir@acphs.edu (P.M. Denvir), Katie.cardone@acphs.edu (K.E. Cardone), Wendy.parker@acphs.edu (W.M. Parker),
cerullij@gmail.com (J. Cerulli).
https://doi.org/10.1016/j.cptl.2017.10.014
The MyMedZ Medication Management Service at Albany College of Pharmacy and Health Sciences began in April 2011 when
opportunities for provision of MTM services began to emerge in the region. At that time, students, preceptors, and faculty were not
routinely providing MTM, leading to MTM payers having unmet needs for providers in the region. Thus, the MyMedZ Service
emerged to meet both the unmet provider need and unmet training need, serving as an on campus “laboratory” for the training of
future practitioners. In the clinic, students shadowed the preceptors for several encounters (recruitment, comprehensive medication
reviews CMR), then engaged in provision of MTM services with direct pharmacist supervision. Patients were referred by third party
payers via electronic MTM platforms that were used to provide, document and bill for services. Patients were not familiar with the
college service at the outset. Approximately 95% of services were provided telephonically. From 2011 to 2015, the service grew from
providing 120 CMRs and 170 targeted medication reviews (TMRs) to almost 200 CMRs and 324 TMRs annually, with a patient CMR
acceptance rate of over 30%.
The MyMedZ service promotes MTM services through patient care, teaching, service, and scholarship. A goal of the practice is to
provide quality MTM services while educating student pharmacists to deliver patient care using the MTM framework. Two years after
establishing MTM-focused advanced pharmacy practice experiences (APPEs) within the service, two pharmacy practice faculty
sought to conduct a formative assessment of the MTM training experience. Whereas summative assessment emphasizes measurement
of learning outcomes to determine the effectiveness of an educational intervention, formative assessment is typically used to explore
teachers’ and learners’ emerging understandings and perspectives and to inform future interventions.6
In standard course evaluations of our MTM experiences, students’ Likert scale and open-ended responses indicated that the APPEs
were seen as valuable and professionally satisfying (data available upon request). Open-ended comments specifically highlighted the
value of communication skills training, with particular emphasis on opportunities for patient interaction. The pharmacy practice
faculty preceptors believed that the standard APPE evaluation tools did not adequately address oral and written communication-
based competencies that were present in eleven of the experience's sixteen educational objectives (Table 1) and wished to further
explore the teaching and learning of MTM communication skills. Previous literature of MTM service delivery during APPEs has not
specifically focused on communication skills and used student survey methods to assess their perceived achievement of educational
outcomes.7,8 This pilot study assesses communication skill development in a different way. An interdisciplinary collaboration
emerged between the pharmacy practice faculty, a health communication scholar, and a medical sociologist to complete this for-
mative assessment. Institutional review board approval was obtained.
The primary purpose of this article is to identify and describe communication concepts and instructional approaches that may be
used to enhance MTM training initiatives. The specific objectives of this article are to draw on both faculty and student perspectives
to describe the following: (1) communication challenges encountered during MTM service delivery; (2) communication principles
Table 1
Medication therapy management (MTM) APPE communication-focused course objectives.
1. Identify and describe the components of a comprehensive medication review (CMR) as defined by Centers for Medicare and Medicaid Services (CMS) and the
Core Elements of MTM Version 2.0. (Rememberinga)
2. Describe the features and benefits of MTM services to various stakeholders (e.g., patients, prescribers). (Understanding)
3. Prepare for a CMR with a patient by conducting a preliminary review of prescription medication claims and diagnoses to identify potential medication-related
problems. (Applying)
4. Collect patient specific information during a CMR with a patient (either live or telephonically) including identifying the patient chief compliant, conducting a
medical history and gathering medication information. (Understanding)
5. Assess medication therapies to identify and prioritize medication related problems (MRPs) utilizing primary literature and print/electronic references.
(Analyzing)
6. Improve patients’ knowledge of their prescriptions, over-the-counter medications, herbal therapies and dietary supplements, identify and address problems or
concerns that patients may have, and empower patients to self-manage their medications and their health condition. (Understanding)
7. Effectively verbally communicate the potential MRPs and recommendations to the patient. (Applying)
8. Create a personal medication record for the patient using either the web-based MTM platforms. (Applying)
9. Effectively communicate in writing to the patient via a Medication Action Plan a plan to resolve MRPs and address patient concerns using patient friendly
language. (Applying)
10. Verbally communicate potential MRP and recommendations to the physician office as needed. (Applying)
11. Prioritize and communicate the potential MRPs and recommendations to the physician via a written SOAP note. (Evaluating, Creating)
CMR (comprehensive medication review); CMS (Centers for Medicare & Medicaid Services); MTM (Medication Therapy Management); MRP (medication-related
problem); SOAP (subjective, objective, assessment, plan).
a
Bloom's taxonomy level.
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that are central to MTM service delivery; (3) ways of adapting established instructional practices in APPEs to develop students’ MTM
communication skills; and (4) examples of communication strategies, derived from broader communication principles, that students
used to address the unique communication challenges of MTM service delivery. Our overall intent with this article is to provide an
accessible and empirically-grounded educational resource that pharmacy educators can use to develop the novice MTM practitioner.
Setting
The educational objectives of the MTM-focused APPEs expose students to various aspects of MTM service delivery, including
therapeutics, compensation mechanisms, practice management, literature evaluation and professional certificate training (Table 1).
These six-week APPEs occurred in both a campus-based, stand-alone MTM clinic and in an ambulatory dialysis setting. The ex-
periences began with an orientation to MTM, including payer requirements, plan service descriptions, overview of MTM platforms,
overview of patient recruitment process, and CMR provision and documentation. Students prepared for CMRs by conducting a pre-
review using a preliminary medication list (from claims data, prescriber records, patient-provided medication lists, and/or previous
medication reviews) to identify potential medication-related problems. The patient population included MTM-eligible Part D ben-
eficiaries, including a cohort of patients receiving dialysis. The practice received compensation for the services provided.
Throughout the experiences, faculty utilized several commonly used instructional practices, including group discussion, role-
modeling, shadowing, and collaborative editing of written documentation to meet the educational objectives in a two-to-one student-
to-faculty ratio. Faculty preceptors modeled the patient recruitment process and demonstrated how to conduct a CMR. After sha-
dowing the faculty member, APPE students led CMRs under faculty supervision via telephone or in person. Discussions with pre-
ceptors and peers before and following encounters encouraged dialogue regarding how to gather needed information from patients
and to review anticipated or encountered challenges. Students were provided with sample scripts and templates for patient re-
cruitment, completing the pre-review and conducting the CMR.9 Faculty and students collaboratively wrote, shared, and critiqued
written communication to be sent to patients and their physicians.
A health communication scholar and qualitative researcher conducted a joint interview with the two MTM faculty preceptors. An
interview guide was developed to explore the underlying communication challenges and principles at work in MTM as well as the
instructional strategies used to develop students’ communication skills (see Appendix for sample questions). While the interview
guide provided an overarching framework for discussion, qualitative approaches to in-depth interviewing also require active listening
and improvisation, pursuing novel or unanticipated topics that emerge from interviewees’ responses. The interview was conducted
over two sessions, each about two hours in duration, with the interviewer taking notes. While the interviews provided a teaching
perspective on MTM communication skills, we also sought to include learners’ perspectives. We did so by contacting alumni.
For the alumni interviews, we solicited all former MTM service APPE students by email (n=36). A total of five alumni responded
to the solicitation, all of whom completed an informed consent process. This sample includes representation from two preceptors’
experiences and from two different academic years (2011–2012 and 2012–2013). Among the five alumni, three were currently
providing MTM services in their places of employment (and had played a role in its adoption by the employer), one had been
advocating for the current employer to adopt MTM services, and one was not currently providing MTM services. The development of
the alumni interview guide (see Appendix for sample questions) was informed by the previous faculty interviews. For example,
because faculty preceptors had indicated that students often struggled communicatively with patients when addressing potentially
sensitive topics (e.g., adherence difficulties or lifestyle modifications), the alumni interview guide included open-ended questions
about those matters. The alumni interviews sought primarily to explore their views of the communication challenges they experi-
enced and to identify the specific strategies they used to navigate these challenges. This provided a way to assess the extent to which
students could apply communication principles and instructional strategies to concrete moments of patient interaction. All interviews
were audio-recorded and transcribed verbatim by an outside contractor, with identifying information replaced by pseudonyms. The
mean length of the interviews was 86 min, yielding a total of approximately 150 pages of single-spaced interview text.
Data analysis
Faculty and alumni interview data were analyzed inductively using thematic analysis,10 an approach that builds on the core
methodological strength of Grounded Theory,11 the constant comparative method. The overall approach was to develop various
thematic collections of data that share common features (e.g., “language that could offend patients” or “definitions of MTM”), but to
remain flexible about the name, meaning, or analytic value of the collection until all data have been considered. That is, each new
piece of data considered for a provisional collection is constantly compared to previous entries in that collection, as well as other
collections. As new data are added, the analyst may re-conceptualize the collection, combine it with other collections that initially
seemed dissimilar, decompose the collection into more suitable sub-collections, or develop a new collection. Throughout this process,
the “fit” between the data and the emerging analytic themes is refined, with the goal of giving authentic voice to the participants,
rather than imposing pre-existing concepts on the data.
Four waves of qualitative coding were used to analyze the interviews. First, NVivo (qualitative analysis software) was used to
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complete initial coding of all transcriptions, breaking the data into broad topical collections (e.g., “oral communication”). Second,
focused coding of these initial collections was completed, resulting in additional sub-collections (e.g., “oral communication” was
decomposed into more useful sub-collections, such as “conversations about adherence” and “conversations about patient lifestyle”).
Third, analytic memoing (sometimes called “open coding”) of each sub-collection was completed. Analytic memoing is a process of
writing emerging ideas, concepts, connections, or reactions in the margins of the collection. For example, analytic memoing of the
sub-collection “conversations about adherence” yielded a number of specific language strategies for avoiding offense when exploring
reasons for non-adherence, which also revealed connections with other themes that addressed patient-centered communication. This
wave yielded a wide range of themes and sub-themes that were shared with the research team, along with examples of data from each
theme. For the fourth and final wave of coding, the research team discussed the current themes and data together, sought out
negative cases, and resolved differing interpretations. As a pilot study with a relatively small sample size (two preceptors and five
alumni), it is difficult to confidently assess saturation; additional interviews may have yielded a more exhaustive and diverse set of
responses.
Findings
Describe the unique communication challenges encountered during MTM service delivery
Pharmacists encounter unique communication challenges when learning to provide MTM services. The service delivery model
requires a degree of interpersonal and interprofessional competence that may not be called upon in other pharmacy settings. These
challenges informed the communication-based teaching/learning practices developed within this MTM service. Five key challenges
that emerged in faculty and student interviews are summarized below (though not exhaustive, these do represent recurrent issues for
MTM learners).
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Describe communication principles (adaptation to audience and adaptation to medium) that are central to MTM service delivery
Analysis of faculty and student interviews revealed the salience of two key principles, both well-established in the discipline of
communication, that could be used as a framework for future MTM training. They serve as reflective tools when students understand
the therapeutic content to be communicated, but wonder, “How do I say that?”
Adaptation to audience
Consistent with the audience-adapted theme embedded within the CAPE outcomes, health communication research has amply
demonstrated that health-related messages are more effective when they take their intended audiences into consideration.15 MTM
service delivery requires students to develop sensitivity to the needs of two primary audiences, patients, and physicians, and to
develop a repertoire of communication strategies for adapting their messages to these audiences. The experiences offered by this
MTM service emphasized both sensitivity to the knowledge-base of the recipient and to tonal issues. With respect to knowledge-base,
students were trained to adapt their communication to the different kinds of knowledge that patients and physicians bring to
healthcare encounters. For example, while patients may prefer detailed, accessible, jargon-free explanations for recommended
medication changes, prescribers may prefer crisp, evidence-based, terminologically well-informed explanations of those same
changes. With respect to tonal issues, faculty encouraged students to adopt oral and written language strategies that conveyed
warmth, patient-centeredness. and collegiality, while avoiding language that could inadvertently cause offense or distress.
Describe how established instructional practices in advanced pharmacy practice experiences can be adapted to develop students’ MTM
communication skills
Faculty utilized a variety of instructional practices to enhance students’ MTM-based communication skills, all of which involve
personalized, collaborative contact among faculty and students. Although the basic practices are well-establish in pharmacy edu-
cation, they were delivered in ways that emphasized application of the two communication principles (adaptation to audience and
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Table 2
Summary of communication challenges and instructional practices.
Instructional Practice Strategy COM Challenge(s) Addressed COM Principle(s) Example of use of instructional practice in MTM service
Implemented delivery
Collaborative Discussion Balancing quality and quantity Adaptation to Development of patient question formats, discussing
of patient interaction Audience question phrasing (i.e., How do I say…?)
Minimizing judgment when “Why aren’t you filling your prescriptions on time?” vs.
addressing patient problems “What barriers are you having to taking your medications?”
Role Modeling during patient Persuading stakeholders of the Adaptation to Students observe preceptors’ techniques for gently steering
recruitment and medication value of MTM Audience conversation back to focal topics
reviews CMR) Balancing quality and quantity
of patient interaction
Minimizing judgment when
addressing patient problems
Student-led Patient Interaction with Balancing quality and quantity Adaptation to Sensing the patient does not understand, preceptor “jumps
Preceptor “Jump In” of patient interaction Audience in” to translate student's medical jargon
Minimizing judgment when Preceptor “jumps in” to collect more information which the
addressing patient problems student omitted
Peer-to-Peer Feedback Writing a patient-centered Adaptation to Students proofread one another's documentation and make
medication action plan Audience textual suggestions to soften recommendations that sound
Collaborating with other Adaptation to Medium like commands
providers through written
documentation
Faculty-Student Collaborative Writing a patient-centered Adaptation to Preceptor uses track changes to show which words/phrases
Documentation medication action plan Audience can be trimmed from an unnecessarily detailed note or
Collaborating with other Adaptation to Medium modify wording choice such as removal of “should” from a
providers through written physician correspondence
documentation
COM (communication); MTM (medication therapy management); CMR (comprehensive medication review).
medium) to overcome the five unique communication challenges encountered in MTM service delivery. For example, role-modeling is
a fairly standard instructional practice, and the faculty would model both recruitment and CMR activities, but this was followed by
group discussion about any communication challenges or strategies the students observed (e.g., techniques for gently steering the
conversation, thus balancing quality and quantity of patient interaction). Across the spectrum of instructional activities, faculty
encouraged a focus on communication, and collaborative reflection before and after oral and written communication experiences (see
Table 2). This approach allowed students to think critically and adaptively about patient-centered communication, and arrive at their
own solutions in a less didactic fashion, rather than seeking to mimic particular scripts.
Describe examples of communication strategies, derived from broader communication principles, students used to address the unique MTM
communication challenges
One of the aims of the alumni interviews was to identify and evaluate the specific communication strategies former students
developed to address the unique communication challenges of MTM service delivery. While it is useful to be aware of the challenges,
the critical next step in learning is for the student to develop a repertoire of communication strategies to draw on when these
challenges emerge. The strategies that emerged in the alumni interviews confirm that adaptation to audience and medium can serve
as a concise and accessible MTM communication framework, while also providing an initial practical toolbox of communication
strategies for MTM learners. We organize and present these strategies as responses to the five communication challenges described
earlier in the article.
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when working as a professional. The student captures many of the aforementioned features of MTM, while also clearly illustrating the
principle of audience adaptation:
“It depends on who I'm targeting…. If I'm looking at my definition for a patient, I would say it's a basic review of your medication, reviewing
basic things like side effects, drug interactions, but also looking at things like your cough and your priorities that will help you manage your
medications and achieve your health goals. And then my description for pharmacists will be a little bit different, trying to encourage them to
take up MTM more and encourage them that it's just your basic activities that you've been doing every single day since you graduated from
pharmacy school. You know, taking that knowledge that you had about each individual medication and actually applying it to a patient
and addressing them holistically, so you have a more encompassing intervention which looks at the patient more holistically rather than just
individual medications.”
“I was involved with at least one managed care organization that was requesting more information about MTM services. For them, I found
out that it's all about the dollars. You need them to buy the fact that MTM decreases costs, but you need to provide concrete examples…. I
found that the most impactful way to describe MTM to a managed care organization is to basically give them specific examples of a patient
where you change their medication to something less expensive, so say this amount of dollars over this many years.”
This quote shows the ability to adapt the message to a managed care audience. It was the alumnus's perception that the managed
care organization with which s/he was working was concerned with the financial implications of offering an MTM program. Although
MTM services are mandated by Medicare Part D, they are not reimbursed separately by Medicare. Thus, the managed care organi-
zation must provide the service within the confines of the existing payment from Medicare part D plan. Therefore, generating an
“efficient” MTM program is important to the prescription drug plan, as they must be able to achieve the quality outcomes sought by
the program with judicious use of resources.
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always interesting for me to see how the professors are able to take that information on the fly, roll with it, and still work it into
leading to the medication question (laughs). Taking a little detour if they had to but always bringing it back in a gentle way. Never
being like, ‘Okay enough of that; let's get back to this,’ but leading the patient back: ‘Okay, well are you on any medications for this?
And what do you take and how do you take it?’ Bringing it back that way.”
Student strategies for collaborating with other providers through written documentation
Although there were few opportunities for face-to-face collaboration with physicians on these experiences, students reported that
learning the style and tone of the physician documentation helped them understand some of the dynamics of interprofessional
collaboration. In terms of adapting written communication for the physician audience, students emphasized many of the same issues
as with the patient MAP, but with very different implications. They emphasized the balance between conciseness and completeness,
as well as the importance of communicating recommendations with credibility and respect.
In terms of balancing conciseness and completeness, students indicated that they initially tended to err on the side of com-
pleteness, providing far more information than the physician needed (or would have time to read). Through intensive, one-on-one
editing of documentation with their preceptors, students developed a sense of physicians’ practical needs, as well as their working
knowledge of pharmacotherapy. In their zeal to demonstrate competence to another medical professional, students tended to over
explain things that physicians would either already know or would not need to know. For example, one student recounted an editing
session in which her preceptor pointed out that, while she had provided an accurate description of the pharmacokinetics of a
medication, the level of detail was not necessary for the physician's management of the patient. Students indicated that their pre-
ceptors emphasized conciseness even in grammar and format, favoring crisp sentence fragments over long paragraphs. The emphasis
on conciseness was clearly audience-sensitive, rooted in a realistic understanding of the time constraints under which physicians are
typically operating.
Students were well-versed in the nuances of phrasing their recommendations to physicians. Previous research has indicated that
pharmacists’ recommendations to physicians can be difficult interprofessional terrain, especially because recommendations may
come across as tacit criticisms of the physician's past or current treatment decisions.18 Students reported a wide range of commu-
nication strategies for managing these issues with a physician audience. One strategy that every student reported was appropriate use
of published clinical evidence. Students indicated that evidence bolstered the credibility of their recommendations and allowed
physicians to investigate and come to their own conclusions: “If you're going to make a recommendation, you need to have it very
thoroughly supported by literature. Even if it seems like common knowledge, everything needs to be in accordance with current
consensus guidelines X, Y, and Z to make sure everything is supported. Because, as much as you're building a relationship with the
patient, you're also building a relationship with the prescriber. They need to trust you because their thought is, and I've heard this
feedback a lot, there are concerns about taking the recommendations of a practitioner who has not actually seen the patient.”
As with patient MAPs, students used language that sounded collaborative rather than dictatorial. In addition to specific mitigated
phrases (e.g., “consider…” and “…might be appropriate”), students indicated that their overall approach was to present their
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recommendations as “options” for the physician, rather than clear-cut, obvious next steps. One student reported a particularly
respectful and audience-sensitive strategy for framing recommendations. The key principle is to write with the assumption that the
physician may have already considered the recommended action, thereby giving credit to the physician: “So there was a patient who
is probably a candidate for an oral diabetes medication, but they have poor renal function. So in your comment you want to address
any potential oversight. You might phrase it, I'm not going verbatim here, but basically ‘The patient may not be a candidate for
Metformin due to impaired renal function.’ So you're showing them that you acknowledge the fact that they've probably already
considered that and they're aware of it but you’re bringing that up as well, pointing out that you understand that there are reasons
why this would not be appropriate and acknowledging the fact that the doctor is probably already aware of this.”
Discussion
This pilot study fills an important gap in the literature by identifying specific communication principles and instructional ap-
proaches that pharmacy educators can use to enhance MTM training. Formative assessment of the APPE activities from both in-
structor and student perspectives revealed five unique communication challenges in MTM service delivery, two communication
principles that can be productively applied to those challenges, and a range of student-reported strategies that draw on these
principles to address the challenges. The article also shows how established instructional practices in APPEs can be modified to
promote reflective thinking and strategic communication in a collaborative learning environment with a small faculty-to-student
ratio. As the title suggests, even when students understand the content of what is to be communicated from a medical or therapeutic
perspective, the question, “How do I say that?” remains a potent issue for students, one that highlights the interpersonal and in-
terprofessional sensitivity required in MTM. It underscores that how something is communicated can be as important as what is
communicated.
This work has several implications for MTM training. First, it reveals specific, empirically derived communication concepts that
can be used to supplement standard course evaluations in MTM-focused APPEs. For example, students could be asked how well the
experience prepared them to navigate each of the five challenges. This would provide valuable feedback for instructors, who can
adapt pedagogical materials to address areas where students seem to struggle. Second, these materials could be used to assess
individual student progress in the experience. For example, students could be quizzed to provide audience-adapted strategies for
navigating a particular challenge (e.g., “Describe some non-judgmental ways to ask patients about their difficulties with adherence”).
Finally, this work reveals that when preceptors make time in APPEs for collaborative reflection about communication choices,
students prove resourceful. This kind of reflection and group feedback can be incorporated into familiar instructional practices in
APPEs to emphasize the importance of communication choices in MTM service delivery. It also engages critical thinking about
audience, a key feature of empathy. Rather than memorizing scripted actions and reactions, this approach encourages students to
apply principles in situationally sensitive ways.
A limitation of the current study is its relatively small sample size; however, the detailed qualitative analysis reveals important
themes and concepts to enhance future curricular innovations and self-assessment methods. Based on this formative pilot study,
future work will aim to apply and test this framework in a more structured and summative way, building in pre- and post-experience
measures for MTM communication skill development. We would be cautious in generalizing from a relatively small sample size, but
we are confident that these data provided rich, detailed informant perspectives on a wide range of topics, including communication
challenges encountered, oral and written communication strategies utilized, commonly encountered communication principles
central to MTM service delivery, instructional practices to teach MTM communication skills and examples of communication stra-
tegies. An additional limitation is that we did not assess, from the student perspective, which instructional practices were most useful.
This was assessed from a faculty perspective only.
Summary
MTM provides significant opportunities for pharmacists to expand their roles in patient care and interprofessional healthcare
teamwork, but this role requires excellent communication skills training. Faculty and preceptors working with students to develop
their MTM communication skills can use the instructional practices such as collaborative writing and critical reflection to aid student
development. When armed with knowledge of the unique communication challenges in MTM service delivery and communication
principles that can be productively applied to those challenges, pharmacists will be better able to mobilize stakeholders and deliver
high quality MTM services.
Disclosures/Conflicts
None to report.
Supplementary data associated with this article can be found in the online version at http://dx.doi.org/10.1016/j.cptl.2017.10.
014.
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