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Integrating structural analysis in the pre-APPE curriculum: Experiences from three institutions.

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Τίτλος: Integrating structural analysis in the pre-APPE curriculum: Experiences from three institutions.
Συγγραφείς: Ko J; School of Pharmacy, Chapman University, 9401 Jeronimo Rd, Irvine, CA 92618, USA. Electronic address: jeko@chapman.edu., Connor SE; School of Pharmacy, University of Pittsburgh, 3501 Terrace St, Pittsburgh, PA 15261, USA. Electronic address: sconnor@pitt.edu., Frederick EK; College of Pharmacy & Health Sciences, Sullivan University, 2100 Gardiner Ln, Louisville, KY 40205, USA. Electronic address: efrederick@sullivan.edu., Foley K; School of Pharmacy, University of Pittsburgh, 3501 Terrace St, Pittsburgh, PA 15261, USA. Electronic address: kef111@pitt.edu., Snook E; School of Pharmacy, University of Pittsburgh, 3501 Terrace St, Pittsburgh, PA 15261, USA. Electronic address: ejs153@pitt.edu., Romah A; School of Pharmacy, University of Pittsburgh, 3501 Terrace St, Pittsburgh, PA 15261, USA. Electronic address: alr266@pitt.edu., Leslie KF; College of Pharmacy & Health Sciences, Sullivan University, 2100 Gardiner Ln, Louisville, KY 40205, USA. Electronic address: kleslie@sullivan.edu.
Πηγή: Currents in pharmacy teaching & learning [Curr Pharm Teach Learn] 2026 Oct; Vol. 18 (10), pp. 102694. Date of Electronic Publication: 2026 Jun 12.
Τύπος έκδοσης: Case Reports; Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier Country of Publication: United States NLM ID: 101560815 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1877-1300 (Electronic) Linking ISSN: 18771297 NLM ISO Abbreviation: Curr Pharm Teach Learn Subsets: MEDLINE
Imprint Name(s): Original Publication: New York : Elsevier
Ιατρικοί όροι (MeSH): Curriculum*/trends , Curriculum*/standards, Education, Pharmacy/methods ; Problem-Based Learning/methods ; Students, Pharmacy/statistics & numerical data ; Humans ; Social Determinants of Health
Περίληψη: Background: Pharmacy graduates must be prepared to address health disparities and the structural and social drivers of health (SSDH) that shape patient outcomes. These skills require intentional introduction, practice, and scaffolding. One approach to operationalizing this within case-based instruction is the Structural Analysis (SA) framework.
Educational Activity: Three Doctor of Pharmacy programs piloted the SA framework as a structured method for integrating SSDH into patient case discussions. Each institution implemented the SA framework within distinct curricular contexts, offering insight into feasibility, learner progression, and instructional challenges.
Evaluation Findings: The SA framework was successfully integrated into required pre-APPE coursework. Although implementation varied by learner level and course structure, students readily identified social determinants of health and contextual influences within patient cases. Steps requiring structural prioritization and multilevel intervention development required more advanced reasoning. At one institution, with repetition and increasing curricular exposure, students demonstrated greater sophistication in addressing upstream structural factors.
Analysis of Educational Activity: These pilots demonstrated that SSDH can move from conceptual aspiration to observable clinical reasoning within required coursework. Across varied institutional contexts, students were able to incorporate structural considerations into case-based decision-making, suggesting that these skills are teachable and developmentally attainable. Continued refinement of teaching and assessment strategies and intentional alignment within experiential learning are important next steps in advancing SSDH from awareness to sustained practice.
(Copyright © 2024. Published by Elsevier Inc.)
Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose.
Contributed Indexing: Keywords: Case-based education; Education, pharmacy; Health equity; Social determinants of health; Structural competency
Entry Date(s): Date Created: 20260612 Date Completed: 20260817 Latest Revision: 20260817
Update Code: 20260818
DOI: 10.1016/j.cptl.2026.102694
PMID: 42284870
Βάση Δεδομένων: MEDLINE
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  Data: Integrating structural analysis in the pre-APPE curriculum: Experiences from three institutions.
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  Data: <searchLink fieldCode="AU" term="%22Ko+J%22">Ko J</searchLink>; School of Pharmacy, Chapman University, 9401 Jeronimo Rd, Irvine, CA 92618, USA. Electronic address: jeko@chapman.edu.<br /><searchLink fieldCode="AU" term="%22Connor+SE%22">Connor SE</searchLink>; School of Pharmacy, University of Pittsburgh, 3501 Terrace St, Pittsburgh, PA 15261, USA. Electronic address: sconnor@pitt.edu.<br /><searchLink fieldCode="AU" term="%22Frederick+EK%22">Frederick EK</searchLink>; College of Pharmacy & Health Sciences, Sullivan University, 2100 Gardiner Ln, Louisville, KY 40205, USA. Electronic address: efrederick@sullivan.edu.<br /><searchLink fieldCode="AU" term="%22Foley+K%22">Foley K</searchLink>; School of Pharmacy, University of Pittsburgh, 3501 Terrace St, Pittsburgh, PA 15261, USA. Electronic address: kef111@pitt.edu.<br /><searchLink fieldCode="AU" term="%22Snook+E%22">Snook E</searchLink>; School of Pharmacy, University of Pittsburgh, 3501 Terrace St, Pittsburgh, PA 15261, USA. Electronic address: ejs153@pitt.edu.<br /><searchLink fieldCode="AU" term="%22Romah+A%22">Romah A</searchLink>; School of Pharmacy, University of Pittsburgh, 3501 Terrace St, Pittsburgh, PA 15261, USA. Electronic address: alr266@pitt.edu.<br /><searchLink fieldCode="AU" term="%22Leslie+KF%22">Leslie KF</searchLink>; College of Pharmacy & Health Sciences, Sullivan University, 2100 Gardiner Ln, Louisville, KY 40205, USA. Electronic address: kleslie@sullivan.edu.
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  Data: <searchLink fieldCode="JN" term="%22101560815%22">Currents in pharmacy teaching & learning</searchLink> [Curr Pharm Teach Learn] 2026 Oct; Vol. 18 (10), pp. 102694. <i>Date of Electronic Publication: </i>2026 Jun 12.
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  Data: Background: Pharmacy graduates must be prepared to address health disparities and the structural and social drivers of health (SSDH) that shape patient outcomes. These skills require intentional introduction, practice, and scaffolding. One approach to operationalizing this within case-based instruction is the Structural Analysis (SA) framework.<br />Educational Activity: Three Doctor of Pharmacy programs piloted the SA framework as a structured method for integrating SSDH into patient case discussions. Each institution implemented the SA framework within distinct curricular contexts, offering insight into feasibility, learner progression, and instructional challenges.<br />Evaluation Findings: The SA framework was successfully integrated into required pre-APPE coursework. Although implementation varied by learner level and course structure, students readily identified social determinants of health and contextual influences within patient cases. Steps requiring structural prioritization and multilevel intervention development required more advanced reasoning. At one institution, with repetition and increasing curricular exposure, students demonstrated greater sophistication in addressing upstream structural factors.<br />Analysis of Educational Activity: These pilots demonstrated that SSDH can move from conceptual aspiration to observable clinical reasoning within required coursework. Across varied institutional contexts, students were able to incorporate structural considerations into case-based decision-making, suggesting that these skills are teachable and developmentally attainable. Continued refinement of teaching and assessment strategies and intentional alignment within experiential learning are important next steps in advancing SSDH from awareness to sustained practice.<br /> (Copyright © 2024. Published by Elsevier Inc.)
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  Data: Declaration of competing interest The authors have no conflicts of interest to disclose.
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