Teaching Implicit Bias and its Management in the Pain Care of Sickle Cell Anemia Patients in a Hyflex Pre-Professional Classroom During COVID-19

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Clinical pharmacists partner with prescribers to manage pain, including sickle cell pain crises [1–3]. For example, the Department of Veterans Affairs has added clinical pharmacists to its primary care teams to support pain management and patient safety [1, 2]. For patients with sickle cell anemia, the addition of clinical pharmacists to an outpatient care team was shown to improve dose escalation of hydroxyurea, which can both improve outcomes and reduce the need for opioids [3].

During the coronavirus disease 2019 (COVID-19) global pandemic, New York State mandated mask-wearing, 6-foot distancing, and reduced classroom occupancy beginning in March 2020. Our Doctor of Pharmacy (PharmD) degree program chose a hybrid flexible (“hyflex”) model and randomized half of each pre-professional class to attend in the classroom or simultaneously over Zoom in alternating weeks. As planned prior to the pandemic, students applied knowledge gained in the first semester (Table 1) to a second semester capstone workshop featuring the National Institutes of Health (NIH) Pain Consortium online sickle cell anemia patient case, Devon. Activities were integrated into the Fall 2020 and Spring 2021 semesters culminating in the patient with sickle cell anemia case as presented in a 3-hour workshop in February 2021. A combination of live lectures, online patient and health system cases, and online-self-assessments were used during live class sessions. Outcomes were assessed through written assignments, take-home quizzes, and exams. To assess the effects of hyflex on student learning outcomes, student exam, and assignment performance were compared for students randomized to attend in-person or over Zoom during academic year 2020–2021.



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