Teaching and Assessing Pharmacy Students in Medication-Use Process Stewardship

The medication use system is a complex process of medication prescribing, order processing, dispensing, administration, and effects monitoring. The objectives of this review are to describe the available literature and identify resources for educating and assessing pharmacy students in COEPA (Curriculum Outcomes and Entrustable Professional Activities) 2.6 Medication-use Process Stewardship.

In 2013, the Center for the Advancement of Pharmacy Education (CAPE) published educational outcomes, which included Medication Use Systems Management (CAPE 2.2, Manager). In 2022, the educational outcomes for pharmacy education were updated and integrated with entrustable professional activities as COEPA. During this evolution, the revised Medication-use Process Stewardship (COEPA 2.6, Steward) de-emphasized process management while focusing more on stewardship of the Pharmacists' Patient Care Process, person-centered care, optimizing patient outcomes, and the environmental impact of medication-use systems. A literature review identified 41 articles relevant to pharmacy education and assessment of medication-use concepts. Most available literature is aligned with CAPE 2013 domain 2.2 Manager, not COEPA 2.6 Steward. Many articles reported innovations in teaching and assessment, such as simulation in prescription verification and objective structured clinical examinations. Few articles reported on prescription verification and dispensing in noncommunity settings.

The change from management to stewardship in COEPA 2.6 has significant curricular implications, with the emphasis moving from process- to person-centered care. However, continued integration of process-centered activities throughout the curriculum is essential to fully prepare graduates for entry-level practice. Future research is needed to identify approaches for teaching and assessing stewardship and the environmental impact of medication use systems.