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Ian McGrane, PharmD, BCPS, BCPP
Assistant Professor, Skaggs School of Pharmacy, College of Health Professions & Biomedical Sciences The University of Montana
Missoula, MT

“I saw the article your student recently published on researchgate.net—how would I go about writing a case report?” –University of Montana pharmacy student

A goal for many pharmacy school students is to obtain a post-graduate year one (PGY1) residency. While American Society of Health-System Pharmacists (ASHP) accredited residency positions have increased by 42% over the last five years, with 4,777 matched positions in 2018,1 students are still faced with the challenge of “standing-out” amongst their peers during this competitive process. Demonstration of scholarship is clearly an opportunity to do this. It would appear that scholarly activity by pharmacy students is also popular, as 2,117 student posters were presented at the 2018 ASHP midyear meeting.2

The importance of scholarly activity in pharmacy training has recently been described by the American College of Clinical Pharmacy research affairs committee.3 While their commentary offers relevant and practical considerations related to the benefits of trainee research and overcoming barriers, it does not comprehensively discuss scholarly activity outside the context of original research.3 Clearly, well-designed studies are of high importance to the field of medicine, but therapeutic case reports also add value to the literature and spark important research questions. Examples of this would be the repurposing of older medications for new indications (e.g., prazosin for posttraumatic stress disorder-related nightmares), describing rare adverse drug events, and drug-drug interactions.

Given that pharmacy student advanced pharmacy practice experience (APPE) rotations are generally four to six-week blocks for clinical specialties, time limitations pose challenges in developing a research question and study design, obtaining institutional research board approval, collecting and analyzing data, and drafting and submitting a manuscript. As such, composing a therapeutic case report is an attractive alternative for students interested in scholarly activity under such time restraints.

There are several considerations for preceptors to make prior to drafting a case report with a student. Foremost, is understanding the importance of the case report and what it will add to the literature. It is uncommon to encounter a patient case that is clear and interesting enough to be accepted by a journal. Therefore, preceptors may identify these cases prior to the student starting rotation. Next, educational and professional goals of the student should be assessed prior to asking if they are interested in collaboration. Future residency applicants or students who have demonstrated excellence in academics may be more suitable for collaboration. After collaboration is established and the patient case is determined to be clear and interesting through performing a chart and literature review, a logical next step is to select a specific journal target. Not all journals publish case reports and authorship guidelines vary regarding maximum word and reference count. Finally, the preceptor should coach the student through the manuscript drafting process and critically review their work. During this time, students should review case reports published in the target journal, recommendations for how to write a case report,4 tools to evaluate drug-drug interactions,5 and/or scales to calculate the probability of adverse drug events,6 as applicable.

While the importance of research and scholarly activity in pharmacy training is described more comprehensively elsewhere,3 academic publishing in the form of therapeutic case reports is achievable during short APPE pharmacy rotations. The process reinforces skills related to academic writing, literature analysis, and the tenacity required to see a manuscript reach journal acceptance. Students will gain confidence in identifying journals suitable for their submission, navigating journal authorship guidelines, and the submission process.

Pharmacy students who demonstrate scholarly accomplishments may be more likely to undergo further training where additional scholarly development occurs. The students with whom I have collaborated on therapeutic case reports continue to express gratitude for their involvement in this process and its contribution to their professional success.

References

  1. ASHP’s pharmacy residency match shows steady growth in postgraduate training. American Society of Health-System Pharmacists Web site. Retrieved August 4, 2019 from https://www.ashp.org/news/2018/04/12/ashps-pharmacy-residency-match-shows-steady-growth-in-postgraduate-training.
  2. 2018 midyear clinical meeting poster information. American Society of Health-System Pharmacists Web site. Retrieved August 4, 2019 from https://www.ashp.org/Meetings-and-Events/Get-Involved-in-a-Meeting/Midyear-Clinical-Meeting-and-Exhibition/MCM18-Poster-Information.
  3. Deal E, Stranges P, Maxwell W, et al. The importance of research and scholarly activity in pharmacy training. Pharmacotherapy 2016;36:e200-e205.
  4. Cohen H. How to write a patient case report. Am J Health-Syst Pharm 2006;63:1888-1892.
  5. Horn J, Hansten P, Chan L. Proposal for a new tool to evaluate drug interaction cases. Ann Pharmacother 2007;41:674-680.
  6. Naranjo C, Busto U, Sellers E, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981;30:239-245.
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