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Biotechnology in the Pharmacy Curriculum: A Progress Report1 Marilyn K. Speedie,2,a, Robert D. Sindelar,b, Gary C. Yee,c Joseph A. Tami,d and Curtis D. Black,e

a

School of Pharmacy, University of Maryland Baltimore MD 21201; bSchool of Pharmacy, University of Mississippi University MS 38677; c University of Florida College of Pharmacy, Gainesville, FL 32610; dUniversity of Texas Health Science Center, San Antonio, TX 78284; e College of Pharmacy, University of Toledo Toledo, OH 43606 PROLOGUE

Many schools of pharmacy have made progress in incorporating biotechnology material into their curricula either through individual courses or integration throughout the curriculum. Several specific examples are presented, including a biotechnology elective course, an example of an integrated curriculum, and an immunology course which addresses many biotechnology issues. In addition, a survey conducted by the Biotechnology Education Committee illustrates that progress has been made across many schools of pharmacy, although the faculty perception is that students’ preparation in this area is poor. Perceived barriers are identified as well. INTRODUCTION

Biotechnology-derived products are entering the pharmaceutical marketplace at an increasing rate. Major areas of impact of biotechnology on pharmacy practice and, therefore, on pharmaceutical education can be identified as: (i) proteins and proteinaceous drug products are on the market, leading to new drug delivery systems, new problems with storage, reconstitution, stability, new issues of antigenicity, and home health care (most of the agents are administered parenterally); (ii) new drug classes are emerging, especially in the area of immunotherapy; (iii) many new diagnostic tools based upon monoclonal antibodies or hybridization technology are available; and (iv) There are new economic and ethical considerations concerning limited supply and/or increased costs of therapy, the appropriate use of diagnostics, and the role of pharmacy in the distribution and use of biotechnology derived products. In 1990, the Academic Sections Coordinating Committee of the American Association of Colleges of Pharmacy prepared a series of papers on the impact of biotechnology on the pharmacy curriculum(1-5). In these papers each discipline was analyzed for new or expanded curricular material in response to developments in biotechnology. A summary of the changes one might anticipate in each of the disciplines is seen in Table I. Since 1990 many schools have made some progress in incorporating biotechnology-related materials into the curriculum to meet these goals. A Biotechnology Education Committee of faculty members interested in assisting other faculty in developing biotechnology-related courses and course materials was formed in 1992 by the Philadelphia College of Pharmacy and Science through the sponsorship of Amgen.4 This Committee has developed a bibliographic resource(6) and has discussed additional ways of assisting

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faculty and schools. This report is an attempt to share the approaches some of the committee faculty have taken in incorporating biotechnology-related material into their curricula in the hope that others will find the examples stimulating and useful. The Committee also conducted a survey concerning progress made in schools across the country and perceived barriers to further progress, the results of the survey are also presented in this report. The models presented below include an example of biotechnology material integrated throughout an entrylevel PharmD curriculum, a separate biotechnology course, and a course focused on immunotherapeutics which addresses biotechnology issues in that context. Biotechnology-related material can be incorporated in many configurations in addition to these three examples, but it is our hope that these will provide useful ideas for schools to adapt to their particular circumstances. *** The University of Mississippi: Integrating Biotechnology into the Basic Pharmaceutical Sciences (presented by Robert

Sindelar) The University of Mississippi School of Pharmacy has addressed the impact of biotechnology upon pharmacy practice, education and research at the discipline level with wide interaction among faculty. Biotechnology is a multidisciplinary topic embracing aspects of medicinal chemistry, pharmaceutics, pharmacognosy, pharmacology, pharmacy administration and pharmacy practice. Therefore, the School provides biotechnology education in a multidisciplinary manner. The basic pharmaceutical science and product aspects of biotechnology are incorporated into numerous courses throughout the curriculum taught by 1

The material contained in this report was presented to the American Association of Colleges of Pharmacy at its 1994 Annual Meeting, Albuquerque, New Mexico, and to the American College of Clinical Pharmacy at its 1994 Annual Meeting, St. Louis, Missouri. 2 The authors are all members of the Biotechnology Education Committee sponsored by Amgen through the Philadelphia College of Pharmacy and Science. 3 A listing of these materials (and in some cases the materials themselves) are available by contacting Dr. Stephanie Zarus at the Philadelphia College of Pharmacy and Science. 4 Members of the Biotechnology Education Committee include, in addition to the authors, W. Sandy Zito, PhD (St. John’s University), Peggy Piascik, PhD (University of Kentucky), Stan Louie, PharmD (University of Southern California). Stephanie Zarus, PharmD, Philadelphia College of Pharmacy and Science, is the coordinator and Carol Giltner, PharmD serves as the Amgen liaison

American Journal of Pharmaceutical Education Vol. 58, Winter 1994

Table I. Discipline specific content needed to address biotechnology developments Discipline

Material

Biochemistry

Expanded information in protein chemistry, gene expression, molecular control mechanisms, biotechnology/molecular biology terminology, hybridization technology. Stability, solubility and metabolism related to protein chemistry; chemical differences between related products (e.g., glycosylation variants) and new types of therapeutic agents (antisense oligonucleotides. peptidomimetics, gene therapy): students need a 3-D view of molecules and their interactions with target molecules. A basic understanding of immunology sufficient to understand antigenicjty. immunologically based diseases, immunomodulators and the roles of monoclonal antibodies. Biotechnology-derived products need to be integrated with other drugs of a given pharmacological class. Some new classes need to be added (e.g., thrombolytics. immunomodulators). A knowledge of molecular mechanisms of drug action is essential

Medicinal Chemistry

Immunology Pharmacology Pharmaceutics Clinical Therapeutics Pharmacy Administration

Liposomal drug delivery, drug delivery of proteins across membranes, targeted dosage forms, crystallization of proteins, other novel drug delivery systems (e.g., pumps, implants) New drug classes, particularly immunotherapeutics. Other topics include use of new routes of administration, increased use of patient-administered diagnostics, formulary selection among related products and pharmacokinetic considerations of proteinaceous drugs. Ethical (do we do everything we are capable of doing?), economic (what is the impact of expensive drugs or delivery systems?), political (public acceptance of biotechnology-derived products), and professional issues

faculty representing all departments. The material stresses relationships, including the relationship of a small molecule drug to a biopharmaceutical, up to the relationship of biotechnology-derived Pharmaceuticals to each pharmaceutical care practice setting. Initially, biotechnology topics were included on various courses based on faculty interest and perceived topical importance to that faculty member’s discipline. The incorporation of biotechnology topics across the curriculum has been facilitated by the curricular change the school has undertaken to offer the entry-level PharmD degree. The process of curricular change, formally begun in Fall, 1989, initially involved a three-year commitment by each departmental representative and curriculum committee member. While biotechnology education was not the goal of the Curriculum Committee, the environment facilitated discussions of such topics across the disciplines and a consensus of what material was needed and where it would best be taught was developed. As the school moved toward implementation of the entry-level Doctor of Pharmacy degree, individual course instructors began incorporating more biotechnology topics into their courses. Board approval and legislative funding of the entry-level PharmD curriculum in Spring, 1994, has resulted in an additional factor influencing biotechnology curricular matters. New faculty hiring in each department has provided an opportunity to recruit pharmaceutical educators that are interested in biotechnology education and research. The biotechnology curriculum as described below with course names and credit hours as it will evolve with the full implementation of the Doctor of Pharmacy curriculum in 1995-96. However, the biotechnologyrelated materials are currently taught under the corresponding courses and in the same departments with any exceptions noted. The first professional year builds upon the basic science education our students received as part of their prepharmacy curriculum. Entering students have been exposed to biotechnology in a very general way through high school courses

(biology), college courses (biology and chemistry) and the popular press. The key professional course entitled “Biochemical Foundation of Therapeutics (three credit hours, PHCL 343) provides the students with the prerequisite biochemical foundations for a much needed understanding of amino acids, polypeptides, and proteins including their structure and function. While gene expression and protein synthesis is presented in the current class, these topics will be detailed in the new “Pharmacogenetics and Pharmacoimmunology” course. “Principles of Medicinal Chemistry” (four credit hours including a three hour laboratory, MEDC 314) topics include the physicochemical properties of pharmaceuticals: the relationship of chemical structure to product stability and reactivity, absorption, drug distribution, and metabolism to drug action. A detailed discussion of the similarities and differences between small molecule drugs and biopharmaceuticals is an integral part of the course. Three 50-minute lectures are devoted entirely to biotechnologyproduced pharmaceuticals. Emphasis is placed upon the differences and similarities between biopharmaceuticals and small molecule drugs in pharmaceutical care and the role of pharmacists in this care. In addition, various educational materials provided by biotechnology companies are distributed to the students. The laboratory currently includes studies of monoclonal antibody-based home diagnostics. It is presently being adapted to include several experiments on protein chemistry and biopharmaceutical stability and handling. To provide our students with the needed competencies in genetics and immunology that serve as one aspect of a foundation necessary to support modern pharmaceutical care, the faculty decided to create a completely new course. The course was designed by volunteer faculty from five of our six departments. Since the course will be taught across disciplines, and will bring together basic knowledge required in some courses offered in each department, a multidisciplinary team-taught approach will be used. This


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Table II. Course outline for Pharmacogenetics and Pharmacoimmunology (PHCY 304) 1. Pharmacogenetics (approximately 35-40 percent of 1. antibody (Ab) synthesis and structure (including material) monoclonal Abs) A. Introduction 2. Ab function B. DNA in detail 3. Ab diversity 1. the structures of DNA 4. Ab specificity 2. the replication of DNA D. Complement 3. recombination at the molecular level E. T-cell 4. the mutability and repair of DNA 1. T-cell types C. Steps in protein synthesis 2. HC 1. synthesis of RNA and DNA templates 3. receptors 2. involvement of RNA in protein synthesis F. Immune cell cooperation and interactions 3. the genetic code 1 cytokines 4. posttranslational modification 2. immunoregulation/modification D. Prokaryotic genetics 3. other 1. regulation of protein synthesis G. Hypersensitivity reactions (including associated 2. replication of bacterial viruses inflammation) E. Eukaryotic genetics H. autoimmune diseases (including autoimmune inflam1. yeast as the E. coli of eukaryotic cells matory diseases) 2. structures of eukaryotic genomes I. Transplantation rejection 3. functioning and regulation of higher eukaryotic J. Immune deficiency states genes 1. congenital 4. transposable genes and rearrangements 2. acquired 5. genetic basis of disease states a. disease induced 6. effects of genetics on drug therapy b. drug-induced F. Genetic biotechnology c. physically-induced 1. gene mapping K. Immune therapy (a rapidly evolving area that will 2. genetic engineering emphasize at least the following) 3. gene therapy 1. biotherapeutics (biological response modifiers) 2. immune stimulants II. Pharmacoimmunology (approximately 60-65 percent of 3. immune suppressants material) 4. monoclonal antibodies A. Introduction III Current topics illustrating the interrelationship of B. Cellular basis of immunity pharmacogenetic factors and pharmacoimmunologic factors C. B-cell in disease states and drug therapy

course (three credit hours, PHCY 304) will be presented for the first time in the Spring semester, 1996. The course topical outline is found in Table II. Other first professional year courses include some biotechnology-related topics. “Human Physiology and Pathophysiology” (10 credit hours over two semesters, PHCL 341-342) covers sections on cellular functions, hormonal action including insulin and human growth hormone, pregnancy (a lead-in to home diagnostics) and blood chemistries with an introduction to hematopoiesis. Dosage forms and delivery systems are covered along with product stability, packaging and storage of biologies in the course “Basic Pharmaceutics II” (four credit hours with a three-hour lab, PHAR 332). Also, the Pharmacy Administration faculty provide a section on technological communication including home test kits and communicating new technologies to patients in their course “Professional Communication in Pharmacy” (three credit hours, PHAD 380). The second professional year courses build on the first year basic pharmaceutical sciences foundation. Three lectures on the pharmaceutical products of biotechnology are presented by a medicinal chemist in the first semester pharmaceutics course. A newly designed required course for the Doctor of Pharmacy curriculum offered by the Department of Pharmacognosy will be “Pharmacomicrobiology” (three credit hours, PHCG 421). Several aspects of biotechnology including vaccine production and the difference among the various methods to prepare a vaccine will be presented. During the second professional year, Pharmacy 460

Administration (“Management”, four credit hours, PHAD 483) has included a student project using an economic model for G-CSF usage in a hospital. As the entry-level PharmD curriculum was being developed, the Chairs of the Departments of Medicinal Chemistry, Pharmacognosy, and Pharmacology met to coordinate the topical material for each of those courses. The topics are organized by therapeutic class with biotechnology-produced Pharmaceuticals presented in their logical class. Medicinal Chemistry (‘“Medicinal Chemistry of Therapeutic Agents I”, three credit hours, MEDC 411) presents the chemical factors influencing the therapeutic response of a class of Pharmaceuticals as Pharmacology (“Introductory Pharmacology I”, four credit hours, PHCL 443) covers the pharmacological aspects of the same therapeutic class. During the second semester of the second professional year the courses diverge slightly to cover adequately all the necessary topics. Pharmacognosy (“Natural Product-Derived Pharmaceuticals”, four credit hours, PHCG 422) emphasizes the antibiotics. Some divergence also occurs between Medicinal Chemistry and Pharmacology (“Introductory Pharmacology II”, four credit hours, PHCL 444). “Medicinal Chemistry of Therapeutic Agents II” (three credit hours, MEDC 412) presents a six-lecture session on biotherapy, immune modulation and the role of biotechnology in oncology. Biotechnology education does not end with the second professional year courses. Biotechnology-derived pharmaceuticals are naturally a component of the infectious disease and hematology/oncology sections of Pharmacotherapeutics


Table Ill Biotechnology course—University of Florida I. Introduction (1 lecture) II. Scientific Foundations (4 lectures) A. Overview of the immune system B. Cytokines C. Hematopoiesis III Biotechnology Processes (4 lectures) A. Recombinant DNA technology B. Molecular biology techniques C. Molecular antibody technology IV Biotechnology Products (14 lectures) A. OKT-3 B. Immunotoxins and fusion toxins C. Interleukin-1 receptor antagonist and other cytokine antagonists D. Radioimmunoconjugates E. Tissue plasminogen activator F. Monoclonal antibodies and cytokine antagonists in sepsis G. Interferons Ff. Interferons and vaccines in hepatitis I. Interleukin-2 J. Erythropoietin K. Hcmatopoietic growth factors L. DNase V. Pharmaceutical Issues (2 lectures) A. Storage and stability of drugs B. Pharmacoeconomics of biotechnology drugs VI Biotechnology and Medicine (2 lectures) A. Human Gene Therapy B. Human Genome Project

I and II (12 credit hours over two semesters, CLPH 555, 556), “Clinical Case Conferences I, II” (four credit hours over two semesters, CLPH 568) and “Patient Assessment and Therapeutic Monitoring” (three credit hours, CLPH 571) courses. Also it may be discussed during ‘‘Biomedical Ethics:’ (one credit hour, CLPH 575). A multimedia biotechnology resource is being developed by faculty in the Department of Medicinal Chemistry. Envisioned as becoming a continually updated reference source with multidisciplinary contributions, the resource could serve as a basis of an elective course in the Doctor of Pharmacy curriculum. *** The University of Florida: A Model Biotechnology Course

(Presented by Gary Yee) The University of Florida College of Pharmacy recognized the need for increased emphasis on biotechnology in the pharmacy curriculum. While the ideal approach might be to integrate biotechnology-related material into the core course in the curriculum, there were difficulties encountered because of limited control over basic science courses, lack of faculty with background in biotechnology, and unwillingness of the faculty to allocate lectures to biotechnology topics. Also, revision of core courses to include such material might involve several years of curriculum recision. Therefore, a stand-alone biotechnology course was developed for the entry-level PharmD curriculum with the goal of providing pharmacy students with an understanding of the clinical and economic impact of biotechnology on pharmacy practice. It is an elective course offered during the last semester of the third year after completion of core courses. It was initially offered as a one credit course and later was

expanded to two credits. The course uses lecture handouts, review articles, and information obtained from companies as resource materials. The course objectives are as follows: (i) To define biotechnology and review the milestones of biotechnology; (ii) to describe monoclonal antibody and recombinant DNA technology; (iii) to describe the role of cytokines in immunology and specific diseases; (iv) to describe the biology and clinical use of selected biotechnology products; and (v) to describe the economic impact of biotechnology on pharmacy practice. The course is organized as shown in Table III. The course was evaluated by surveying student knowledge before and after the course. The results of the baseline survey indicated that three of the 20 students completing the survey could correctly define a biotechnology drug and six of 20 students were able to list five or more biotechnology drugs. All students commented that very little information is devoted to biotechnology in the required curricular core. After the course, 20 of the 22 students correctly defined a biotechnology drug and all students were able to list five or more biotechnology drugs. Student interest in biotechnology was very high, scoring an average of 1.3 on a 1 to 5 Likert scale. *.*.* The University of Texas: Specialized Coursework in Immu-

nology (Presented by Joseph Tami) The immune system is involved in a number of diseases including AIDS, diabetes, and leukemia. A basic knowledge of the immune system is required for understanding manyissues in pediatric, adult and geriatric patients. Without a basic comprehension of the immune system, it is difficult to fully comprehend such topics as vaccination, autoimmune diseases and cancer. Also, a large percentage of the biotechnology-derived products are related to the immune system, either as immunomodulators, vaccines, or monoclonal antibodies, and many of the diseases being targeted by biotherapies involve the immune system, so a basic knowledge of immunology is directly linked to an understanding of biotechnology drugs. Between 1987 and 1990 many of the students in the University of Texas PharmD program stated that they felt they had an inadequate understanding of the immune system and immunology. This issue was raised several times at the PharmD retreats that are held annually with the. students. Perhaps much of this feeling was due to the increased scientific knowledge about the effects of HIV on the immune system. Many of the patients encountered by the students had questions about HIV and AIDS. While some of the students stated that they had received coursework in immunology in their undergraduate programs, many did not. Thus, during these years many of the students voiced a concern that they would like to receive additional coursework in the area of immunology. In 1990, an elective course was begun for the PharmD students to increase their knowledge about the immune system. The students had the option to attend fourteen hours of lecture which covered basic and applied immunology taught by two faculty, one from the Department of Microbiology who was already involved in teaching immunology to medical, dental and nursing students at the University of Texas Health Science Center at San Antonio and the other having had a three year basic research fellowship in immunology/oncology. After discussing the students re-


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quest for more immunology with the administration of the School, the elective course on immunology was put together. This elective course was received very well the first year and the following year the immunology course became required for students. During our discussions on how to make the course better for the next year, it was decided to have the PharmD students take the course along with medical students. The medical students were taught immunology in the medical microbiology section of their coursework. PharmD students had already taken other pathophysiology lectures with the medical students, and were familiar with the medical students and the lecture halls. Thus, the course “Pathophysiology: Medical Immunology” was instituted for the PharmD students. By taking this course the students were now receiving additional lectures, totalling 27 hours of lecture on the immune system. The medical immunology section of the course is team taught primarily by four immunologists. Much of the information is basic immunology. The medical students receive more applied immunology later in their studies. We felt it best to teach the PharmD students the applied immunology intertwined with the basic immunology. Therefore, for some of the lectures, the PharmD class met without the medical students to learn about the clinical applications of what they had just learned in the Medical Immunology section. We felt that perhaps by attending these lectures in association with the basic immunology lectures, students could more fully understand the clinical importance of what was being discussed in regards to basic immunology. The 1994 PharmD course “Pathophysiology III: Medical Immunology’” is thirty hours in length and begins with a two-hour session on an overview of host defenses. This lecture is geared to introduce the students to the cells of the immune system and the cytokines which mediate it. The basic functions of the immune system are described, with more detail to follow later in the course. Non-specific and specific immunity are discussed, focusing on the differences between these two arms of the immune system. The next four hours of lecture are on antigen recognition by the immune system. During these lectures much of the focus is how the immune system uses antibodies to protect itself from pathogens. Students learn how the body uses the various genes encoding portions of an immunoglobulin molecule to put together an intact immunoglobulin capable of binding to a specific antigen. For some of the students, understanding the diversity of the immunoglobulin repertoire is difficult since a majority of this information involves molecular biology. The (re)introduction to molecular biology at this point may be difficult. These lectures do have clinical relevance, however, since researchers are now utilizing this knowledge to isolate human immunoglobulin genes, insert them into bacteria and have the bacteria such as E. coli produce human antibodies or antibody fragments for potential clinical uses. A one hour lecture on therapeutic uses of monoclonal antibodies follows these lectures to apply some of the information gained. The use of muromonab-CD3 in transplantation is discussed, with the introduction of terms such as human anti-murine antibody (HAMA) response. Monoclonal antibody conjugates are described including radiolabeled antibody conjugates for imaging purposes. The students are also taught about the various different home testing kits that utilize monoclonal antibody based technol 462

ogy, such as the pregnancy and ovulation kits. A one-hour lecture discussing antigen/antibody interactions is meant to introduce the student to the various immunological assays that have been developed to identify antigens. These assays include enzyme-linked immunosorbent assays (ELISA), radioimmunoassays (RIA), flow cytometry, and Western blots. As an increasing number of articles in the medical and pharmacy literature discuss results based on these assays, it is important that the students understand the ways in which these assays are performed and their limitations. The students then receive a one hour lecture on the major histocompatibility system where they learn the differences been HLA-A, HLA-B, HLA-C, and the HLA-D antigens. The importance of HLA matching in organ transplantation is discussed, as well as the serological and molecular methods for detection of the HLA genes and antigens. The following five hours of lecture describe the cellular basis of immunity. These lectures primarily focus on T cells and the T cell receptors, however other cells such as macrophages and neutrophils are discussed as well. Furthermore, the cytokines (including up to interleukin-15) are described as to their various functions in moderating the immune system. A two hour lecture on vaccines describes the basics of what makes a good vaccine and the various forms of vaccines (attenuated, killed, subunit, etc.). The specifics of the different types of vaccines and when they should be administered is taught later in the pediatrics course. This lecture is devoted to a basic understanding of vaccines and the advantages and disadvantages to the different forms. Four hours of lecture are devoted to the hypersensitivities, immediate and delayed. The basic mechanisms and forms of hypersensitivity are discussed. Drug sensitivities and allergies are important areas of discussion in these lectures with the pharmacy students. The following five hours of lecture describe a wide variety of issues including autoimmunity, immunodeficiency disease, transplantation and tumor immunology. While these lectures also describe basic immunology issues, these lectures lend themselves to focusing on the clinical issues. The immunodeficiency disease lecture concentrates primarily on congenital forms of immunodeficiency disease, as the students receive a specific lecture on HIV and AIDS later in their other coursework. The last four to five hours of the course are devoted to what many of the students have described as the best part of the course. These hours are the immunology grand rounds in which the students are given approximately 8-10 different case reports in which a patient is described and laboratory values given. Numerous questions are asked in regards to the patient and the lab values. For some of these cases the PharmD students are in class with the medical students. The lecturer discusses the case with the entire class, calling on students to discuss what they feel are the appropriate answers. Of some of these case discussions, the PharmD students meet without the medical students, sitting at a table with 4-5 students discussing the case amongst themselves to come up with the answers. Many of the students have stated that they prefer this latter format. A multiple choice and essay exam concludes the course. The pharmacy and medical students receive the same multiple choice questions, however, only the pharmacy students


Fig. 2. Average contact hours allocated to fundamental courses. Clear bars represent lecture hours; shaded bars represent laboratory or other hours.

Fig. 1. Location in the curriculum where biotechnology is specifically discussed. Others listed include Nuclear Pharmacy, Immunology, Pharmacy Biotechnology and Lab, Pharmacy Administration in Pharmacoeconomics, Natural Products, Microbiology.

receive the essay questions. Most of the essay questions involve clinical topics from lectures which the pharmacy students received by themselves. Overall, most of the students rank the course as very worthwhile. Some comments have focused on the students’ concerns about the intensity of the basic immunology and molecular biology which is taught. However, this seems to be less of an issue with more recent classes who appear to have received more molecular biology as undergraduate students. For many of the students, their favorite part of the course is the immunology grand rounds in which they get to discuss patient cases with their peers. This requires that they use many of ideas that they have learned in the earlier immunology lectures. Many of the students also enjoy the active demonstrations, in which students (and teachers) act out the different cells or antibodies of the immune system. While many Schools of Pharmacy are undergoing rapid changes in their curriculums these days, it is important to remember the inclusion of lectures on immunology while making these changes. A firm understanding of immunology is necessary in many different areas of patient care and is critical for understanding many of the biotechnology products available today or emerging in the near future. ***

A Needs-Assessment Report (Analyzed and Presented by Curtis Black) The Biotechnology Education Committee initiated its activities at the AACP meeting in Washington two years ago. At that time we were motivated by the Academic Sections “White Paper on Biotechnology in the Pharmacy Curriculum,” and were seeking ways to facilitate the efforts/ recommendations of that consortia effort; i.e., of integrating biotechnology instruction into our professional programs.

We looked at a number of approaches—including the “ideal” curricular plan—but soon found we could collectively consume the curriculum with biotechnology related topics if we tried. In fact we literally covered the walls of the room with “flip-chart” paper of all the topics to include. Perhaps best telling of that effort was the observation that it illustrated through the array of coursework identified that the impact of biotechnology permeated all aspects of the development process of our students. So we reconsidered our role and elected first: •

•

to survey and complete information and instructional resources available on biotechnology-related topics , which resulted in the “Biotechnology Resource Catalog”(6); to survey pharmacy faculty about what is currently being done to include biotechnology in the curriculum and to identify barriers and needs.

In April 1993, the Biotechnology Education Committee assembled the elements of a “needs assessment,” which was subsequently refined and in October 1993, mailed to all faculty listed in the AACP director. A follow-up FAX bulletin was sent to all pharmacy deans with particular attention given to the curriculum committee chair to respond to the survey. The Response: Surveys representing 72 colleges/schools of pharmacy were received, with 136 responses overall. Reviewing the returns, it was obvious that in many cases completion of the needs assessment for any one program required more than one faculty member to respond to the questions regarding curricular content. Questions regarding resource desires and perceived barriers and the adequate preparation of our current graduates were individually tabulated however. The Results: The first question we were interested in pursuing was “what areas of the curriculum are specific biotechnology-related products discussed?” Figure 1 illustrates the broad range of courses in which biotechnology-related products are brought to the students attention: from biochemistry to pharmaceutics to pharmacology and applied therapeutics. The pattern of the graph also indicates that there is fairly consistent “mention” of biotechnology-related products throughout the curriculum. This led to the next inquiry which asked the specific number of contact hours, in lecture


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Fig. 3. Average hours allocated to application courses. Clear bars represent lecture hours; shaded bars represent laboratory or other-hours.

and laboratory settings, devoted to biotechnology and biotechnology-related products. To facilitate the completion of the survey at this point, the courses that make up at a typical entry-level plan of study in pharmacy were divided into the “Foundation/Fundamental” courses and the “Application” courses. Figure 2 illustrates the distribution of contact hours provided to students averages for the 72 colleges/schools of pharmacy responding to the survey. The x-axis on the graph is the “mean number of contact hours” for the subject course/areas that are on the y-axis. Although some may argue specific placement of any given subject in this “fundamental” course compilation, it is nonetheless apparent that microbiology, immunology and biochemistry topics provide a bulk of the instructional effort. Microbiology defines the x-axis limit of 18 hours. Altogether, the “foundation/fundamental” courses provide an average of approximately 75 lecture hours and 15 laboratory hours of instruction, or the equivalent of nine quarter hours or six semester hours of coursework on biotechnology principles and products. Figure 3, compiles the results of instruction in the “Application” courses. Again, the x-axis is the mean number of hours devoted to biotechnology principles and products for each of the topic areas on the y-axis. In this graph, it is evident that laboratory or recitation sessions play a larger role as the venue for the instruction, especially in courses on patient monitoring and clinical assessment. More fundamentally however, while “therapeutics” defines the graph’s borders for contact hours, look closely at the x-axis; the range is from 0-2 contact hours (versus 0-18 hours for the foundation courses). In all, the application courses provide on average, nine hours of instruction plus approximately three hours in the laboratory or recitation or practice setting. Is this disparity desired or problematic? Our committee does not have an opinion on that issue specifically; although, given the opportunity, I think we would all like to take the approach of integrating the topic throughout the curriculum. An indication, however, was received from the people who responded to the survey about the current curricular allocation—at least in terms of its effectiveness. The survey asked, “on a scale of 1 to 5, with 1 being “very poor” and 5 being the “best possible,” how would you rate your curriculum’s current preparation of students to understand the role and potential impact of biotechnology-related products in pharmacy practice?” The response: an average of 1.6— between the poorest and next poorest indicators. So 464

Fig. 4. Barriers to implementing information about biotechnology into coursework.

Fig. 5. Needed resources to overcome barriers to implementing biotechnology. Others mentioned include videos and clinical studies.

obviously, there is a definite sense that we need to strengthen our efforts—perhaps by more efficient and effective methods of presenting the material. In fact, the survey sought to identify the common barriers to implementing biotechnology coursework in the curriculum. Figure 4 depicts the response. As might be guessed, “competition with other topics” was the biggest barrier rating a 3.75/5 (with the scale graduated from 0=no obstacle, 5=major obstacle). The “lack of teaching tools” and the


“lack of information resources” were the next most problematic areas, with the lack of personnel and administrative support a tertiary concern. Parenthetically, few thought the “lack of faculty expertise was the issue,” which is positive and may reflect faith in our colleagues. For the skeptic however, it may better reflect an inherent flaw in critical self-assessment. As a committee, we realized we were unable to address the “competition” issue since certainly it affects us all. That answer lies within the faculty at any given institution; being a matter of prioritizing the wealth of knowledge/competencies we wish our students to achieve and the instructional program with which we deliver that instruction. The committee however, can seek to address the barriers related to information resources and teaching tools; and perhaps with that, also diminish the impact of personnel needs, and maybe even the competition issue, by highlighting efficient and effective collaboration instructional strategies such as that at the University of Mississippi. In fact, when asked about the resources needed to overcome the barriers identified, the survey respondents identified “reference materials” and “lecture materials” as shown in Figure 5. “Educational grants” were identified as another useful “barrier-breaker” and of course, we are all seeking that! The committee responded to the survey with forums at the 1994 annual meetings of the American Association of

Colleges of Pharmacy and the American College of Clinical Pharmacy in which ideas for specific courses and approaches to biotechnology in the curriculum were presented. A number of resources for previewing were assembled: reference materials, course study materials (including stand alone and supplemental materials), AV materials (with accompanying text), computer-guided instructional/tutorial materials. Through this survey, a number of individuals have also submitted course syllabi and materials and we are planning to establish a type of clearinghouse for this information and for a slide bank that would provide ready access to these instructional materials for your use. Am. J. Pharm. Educ., 58, 458-465(1994); received 10/17/94. References (1) Speedie, M.K., “The impact of biotechnology upon pharmaceutical education,” Amer. J. Pharm. Educ., 54, 55-60(1990). (2) Henkel, J.G., Mangold, J.B., Zito, S.W. and Speedie, M.K.,” The impact of biotechnology upon chemistry in pharmacy schools,” ibid., 54, 65-68(1990). (3) Block, L.H., “The impact of biotechnology on pharmaceutics,” ibid., 54, 69-70(1990). (4) Hudson, R.A., “The new biotechnology and biological science-related instruction in colleges of pharmacy.” ibid., 54, 61-64(1990). (5) Black, CD., Hicks, C.I., and Koelier, J.M., “Impact of biotechnology on pharmacy practice,” ibid., 54, 73-74(1990). (6) Biotechnology Education Committee. “Biotechnology Resource Catalog,” Amgen, Inc., Thousand Oaks CA (1993). .


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