Evolution and Validation 0f Practice Standards, Training, and Professional Development

although many of the alternative pathways available to

gaining experience, knowledge, and skills in critical care

pharmacy have been successful, these are not considered

preferred pathways, given the high degree of variability

and inconsistency of resources to support them, there-

fore options A, B and D are non-preferred alternative

pathways and are incorrect.

Answer: C

Even though the principles of team-based health care

are all interdependent, effective communication is most

tightly linked to mutual trust. Open and frank commu-

nication and the willingness to state your beliefs and

challenge those of your teammates require a high level

of mutual trust to keep the relationship and conversa-

tion professional and nonpersonal. Without mutual trust,

communication can be more guarded, ineffective, and

political. Options A, B and D are relevant principles of

team-based healthcare, but not as tightly linked to effec-

tive communication, and are incorrect.

Answer: B

Although structured mentor-mentee programs can be

successful, there is a greater probability of success with

relationships that are voluntary and that evolve from

mutual interests and a perceived opportunity to have a

mutually beneficial relationship. Mentors must be will-

ing to serve in this role, which can require a great deal

of time and effort; they wish to work with mentees who

are highly motivated with a track record of accept-

ing challenges. Moreover, mentees must be responsive

to feedback and teaching. Mentees seek out mentors

with shared interests, a record of sharing their time and

expertise, and the necessary prestige and position in the

organization to promote and create opportunities for

them. In an arranged relationship, it is less likely that

all of these factors will come together to lead to a highly

productive relationship. Mentoring relationships can

exist both within and outside formal training programs

like residencies and fellowships so option A is incorrect,

and clinical pharmacists will often have several mentors

through the different stages of their career to address dif-

ferent and evolving needs as they mature in their practice

and scholarly activities so option D is incorrect. Finally,

although mentored training programs are a viable option

for the nonconventional training of critical care pharma-

cists, they are not an exclusive pathway so option C is

incorrect.

Continuing pharmacy education should be included

as an important strategy in a CPD PDP, and therefore

options A and B are incorrect. The self-directed learner

should select CPE programs that are relevant to their

PDP, incorporate active learning strategies, are prefer-

ably curricular based, and are free of commercial or

other bias. Continuing professional development is not

an alternative to CPE; rather, it is an individualized, self-

directed, continuous, and iterative process intended to

address specific learning objectives developed over time

by the pharmacist-learner. Continuing pharmacy educa-

tion is an important component of this process, but it

should not be the only learning strategy. Both CPD and

CPE can include multiple learning strategies, so option

C is incorrect.

The recently published Standards of Practice for

Clinical Pharmacy, which includes a standardized pro-

cess of care endorsed by all major pharmacy practitioner

organizations, is intended to be applicable to any prac-

tice environment, regardless of acuity or complexity.

Like other professions (e.g., medicine, nursing, physi-

cal therapy), clinical pharmacy must define and apply

standards of care to create consistent expectations by all

stakeholders. It is often argued that clinical pharmacists

in different complex or unique practice environments

cannot possibly conform to a standard of care; how-

ever, a thoughtful review of the Standards of Practice

for Clinical Pharmacy reveals that it can be easily incor-

porated into any practice environment, and therefore

options A, B and D are incorrect.

Clinical pharmacists practicing in the ICU have long

had a broad educational role that includes students and

residents in their own profession, residents and students

in other professions, and colleagues on the critical care

team, as well as coworkers in the pharmacy department,

among the target audiences. Clinical pharmacists have

used many different strategies and techniques to teach

these diverse audiences across different learning envi-

ronments. Although there are exceptions, the frequent or

regular inclusion of patients and families in their edu-

cational activities is a more recent development. Many

factors have led to this change, including a greater focus

on patient- and family-centered care, greater inclusion of