(1082) Assessing Demographic and Disease State Diversities Across University of Pittsburgh School of Pharmacy Experiential Sites: A Quality Control Study

Objectives: The primary research objective is to describe the differences in 2020 Census diversity indices and demographic data between each active experiential learning site in the University of Pittsburgh School of Pharmacy database. The secondary objective is to analyze the student-reported patient data collected during experiential rotations from in the 2020-2021 and 2021-2022 academic years. The purpose of this project is to determine the disease state and demographic diversity of patients seen by Pitt Pharmacy students on IPPE and APPE rotations. This data is important to ensure students have adequate opportunities to care for diverse patient populations in order to reduce implicit biases. Strong cultural humility results in more equitable care for patients and helps to mitigate health disparities for marginalized and historically minoritized populations. Additionally, accreditation standards require pharmacy schools to expose students to diverse patient populations, but there are currently no methods to collect this data reported in the literature.

Methods: In this retrospective data analysis quality improvement study, we utilized experiential learning site addresses pulled from the pharmacy school’s rotation management system. Site addresses were compared to 2020 US Census demographic data, three Census diversity indices (Social Vulnerability Index (SVI), Area Deprivation Index (ADI), and Census Diversity Index (CDI), and available state-level Department of Health disease state prevalence. Pitt Pharmacy students document patient encounters on IPPE and APPE rotations in a de-identified manner. These aggregated, subjective data were compared to the objective government-collected data to obtain a more well-rounded perspective of the diversity of patients that students are seeing at IPPE and APPE rotation sites. Descriptive statistics and regression analyses were used to assess the differences in patient disease states and demographics across Pitt’s geographically-diverse IPPE and APPE sites.

Results: 1784 active experiential learning sites met inclusion criteria and were analyzed. Approximately one-third (32.2%, n=566) of these sites were located in census tracts with ADI scores of 8-10 (most deprived areas). 10.4% of sites (n=180) were located in counties where the CDI was >/= 65%, indicative of 'very diverse' racial/ethnic areas. 16.5% (n=293) of sites were located in census tracts that are in the top 25% of SVI ratings, the areas with the highest social vulnerability. Subjective, student-reported data from over 50,000 unique patient encounters recorded from APPEs in the classes of 2021 and 2022 paralleled these objective findings. These data demonstrated that students were exposed to a variety of patients with different ages, race/ethnicities, genders, disease states, and drug therapy problems.

Conclusions: In this quality control study at a single institution, using publicly available census data proved to be an accurate representation of the diversity of patient populations that students saw on rotation. Based on the results obtained, Pitt Pharmacy students were exposed to sociodemographic and disease state diversities in their IPPE and APPE rotations. Other schools of pharmacy looking to quantify the types of patients students see on experiential rotations may find value in this approach. These data may also be beneficial for further research to determine if this exposure helps to mitigate implicit bias. Using these results, curricular changes can be implemented to expand the diverse rotation options to build pharmacy students’ cultural humility and improve the care that patients receive.