Development of a critical care pharmacist career coaching and professional development program at an academic medical center

Continuing professional development is a lifelong process that is multifaceted, holistic, self‐directed, and is not a replacement for continuing education. Through ongoing professional development, pharmacists can improve their skill set in a broad range of clinical, educational, research, and administrative activities. Not only does development of this growth benefit the individual pharmacist, but also the institution and pharmacy profession. In 2020, the American College of Clinical Pharmacy, the Society of Critical Care Medicine, and the American Society of Health‐System Pharmacists published an updated position paper on critical care pharmacy services. A new recommendation in the update was to create mechanisms for critical care pharmacists to develop their career and professional development. Herein, we describe our experience with the development and implementation of a critical care pharmacy career professional development program using peer‐to‐peer coaching within a large academic medical center. Professional development is not a one size fits all and should be individualized. We initially focused on developing research skills based on initial surveys. Afterwards professional development was varied we created new resources such as journal referee “how‐to” and teaching in a flipped classroom.


| INTRODUCTION
Beginning in the 1940s and 1950s with the development of artificial respiration, medical critical care was born and modern intensive care units (ICUs) were developed. 1 It was during this era when hospital pharmacists began to assume clinical responsibility in addition to traditional medication dispensing. 2 The Society of Critical Care Medicine (SCCM) recommends that current best practice in the ICU occurs with a high-performing intensivist-led interprofessional team which includes pharmacists. 1 Clinical pharmacists providing proactive, patient-centered care have been shown to improve outcomes in the ICU setting including decreasing adverse drug events, length of stay, medication cost, morbidity, and mortality. [3][4][5][6][7][8][9] Dedicated clinical pharmacy ICU services started in the 1970s and have proliferated since the turn of the century. In 1981, the first critical care pharmacy residency training program was established, and The American Society of Health-System Pharmacists (ASHP) published standards for critical care pharmacy practice in 1990. 10 Representative of the expansion of critical care pharmacy services, ASHP-accredited critical care pharmacy residency programs grew from 8 in 2001 to 150 programs by 2019. 10 The first position paper on critical care pharmacy services was published in 2000 by the SCCM and the American College of Clinical Pharmacy (ACCP), addressing both clinical and nonclinical activities with the designation of which activities are deemed fundamental, desirable, or optimal. 11 An update on critical care pharmacy services was published in 2020 by SCCM, ACCP, and ASHP, expanding on previous recommendations.
Activities were deemed either foundational or desirable. 12

| PROFESSIONAL COACHING
Continuing professional development is a lifelong process that is multifaceted, holistic, self-directed, and is not a replacement for continuing education. 10,13 It should center on an outcomes-focused approach that evolves over time rather than a static approach throughout a career. There are many forms of coaching and areas for professional development. Coaching can be either internal or external, and it can be individualized or conducted at the group level. 14 Areas for professional development may include performance, leadership, business, career, research, and health and/or wellness.  year two (PGY2) critical care pharmacy residents before the pandemic, which grew to 17 during the pandemic. These specialists range in experience from a few years post-residency training to over 20 years of practice. The pharmacists participate in a broad range of clinical, educational, research, and administrative activities. The critical care pharmacy team delivers educational activities to many disciplines, including pharmacists, physicians, nurses, dieticians, respiratory therapists, and advanced practice providers. 15 Members of the team also routinely serve as clinical preceptors not only for pharmacy residents and students, but advance practice providers in the critical care fel-

| DO
During this phase, the committee developed a survey to assess the needs of the critical care pharmacy team and to identify who wanted mentoring and who was willing to serve as a mentor. The survey was purposely created so an individual could indicate if they wanted to serve as a coach in one area but also desired coaching in another area. The committee also discussed what coaching models would be best for the group. It was felt that it would be beneficial to include both group mentoring for areas multiple team members identified as desiring coaching and one-on-one coaching models for individualized mentoring needs.

| STUDY
In the study phase, the survey was sent via Survey Monkey by the committee lead to 13 critical care pharmacists in April 2019.
A follow-up email was sent to ensure all pharmacists completed the survey. Table 1

| ACT
During the Act phase, the committee met regularly to implement professional development activities to address the interests identified through the survey. These mentoring initiatives included communicating existing pharmacy department and university resources to critical care pharmacy team members, some of which required revision, as well as developing added resources in identified areas. Table 2 summarizes professional development activities examined by the committee during the Act phase.
Research was a primary focus for professional development activities. As the department had many research resources available to educate our pharmacy residents, we were able to modify these

| REPEAT PLAN-DO-STUDY-ACT
After taking a hiatus in 2020 due to demands of the COVID-19 pandemic, the committee began a second round using the Plan-Do-Study-Act model in early 2021. For this round, the survey was expanded to include options to indicate interest in leadership, how to become a journal referee, or consulting. As there was growth in the critical care pharmacy team, the survey was sent to 17 critical care pharmacists and the response rate was 100%. A total of 10 (59%) pharmacists indicated they would like coaching and 9 (53%) were willing to serve as a coach, including 24% who wanted both to be coached and to serve as a coach (Table 1). Those who wanted coaching had a mean of 5.9 years of practice since the end of residency vs 12.6 years for those willing to serve as a coach. Those that wanted coaching and were willing to serve as a coach were out of residency for a mean of 12.3 years. Areas for coaching were more diverse with the top areas being leadership (60%), research (40%), and professional society involvement (30%). Based on more diverse results after review by the committee, a one-on-one coaching model was used to address the top three areas identified on the individual level, in addition to activities targeting the entire team. Matching of coach and pharmacist was conducted by the committee lead and administration based on professional qualifications and/or personality-based criteria. As there was no one to serve as a coach for consulting activities on the critical care pharmacy team, the committee worked with pharmacy administration to find a coach for this area. The one-on-one activities and cadence of meetings were determined by the coach-pharmacist pair.

| CONCLUSION
In conclusion, development and implementation of a critical care pharmacist professional development model with team-based and one-onone coaching is feasible. These programs should be designed to include a continuous improvement process so that coaching activities can evolve as the needs within an institution or a particular team T A B L E 2 Professional development activities Existing Revised Newly developed member change. Future research is needed to assess both individual and groups outcomes following implementation of such programs.

FUNDING INFORMATION
There was no external funding for this research.