Objective. To introduce a high-fidelity simulation series into a 5-year doctor of pharmacy (PharmD) curriculum to demonstrate a hybrid model for introductory pharmacy practice experience (IPPE) delivery. Design. Fourth-year pharmacy students at a satellite campus participated in a 6-week high-fidelity patient simulation series in which small groups of students worked with members of a patient care team to care for patients in the following scenarios: asthma exacerbation, acute decompensated heart failure, and infective endocarditis with a subsequent anaphylactic reaction to the antibiotic. Fourth-year pharmacy students at the main campus who did not participate in the simulation served as a comparator group. Assessment. Students' scores on a knowledge-based post-simulation quiz were significantly higher than scores on the presimulation quiz ( p , 0.05). Knowledge retention was significantly higher among the simulation participants than students in the comparator group ( p 5 0.004). The majority (76%) of students felt more confident ''making clinical recommendations to a healthcare provider'' after completing the simulation series ( p 5 0.01). Conclusion. High-fidelity patient simulation is an effective active-learning strategy to augment IPPEs that allows students to apply clinical skills in a realistic but low-risk patient care setting.

In 2014, the United States has experienced an increase in measles activity, the most since the elimination of the virus in 2000. The measles infection occurs in unvaccinated individuals. Communities and individuals choose to not vaccinate for a number of reasons, primarily citing religious and philosophical motives. Objections based upon religion most often center on the use of aborted human fetus tissue used in the rubella component of the combined vaccine products, and animal derived gelatins used in vaccine production. Objections among religious communities may also not be faith based, rather in some cases concerns related to lack of safety and efficacy of the vaccination result in refusal.

BACKGROUND Hospital Onset Clostridioides difficile infection (HO-CDI) is a costly problem leading to readmissions, morbidity and mortality. We evaluated the effect of a single probiotic strain, Saccharomyces boulardii, at a standardized dose on the risk of HO-CDI within hospitalized patients administered antibiotics frequently associated with HO-CDI. METHODS This retrospective cohort study merged hospital prescribing data with HO-CDI case data. The study assessed patients hospitalized from January 2016 through March 2017 that were administered at least one dose of an antibiotic frequently associated with HO-CDI during hospitalization. Associations between S. boulardii administration, including timing, and HO-CDI incidence were evaluated by multivariable logistic regression. RESULTS The study included 8,763 patients. HO-CDI incidence was 0.66% in the overall cohort. HO-CDI incidence was 0.56% and 0.82% among patients co-administered S. boulardii with antibiotics and not co-administered S. boulardii, respectively. In adjusted analysis, patients co-administered S. boulardii had a reduced risk of HO-CDI (OR=0.57, 95% CI 0.33–0.96, p=0.04) compared to patients not co-administered S. boulardii. Patients co-administered S. boulardii within 24-hours of antibiotic start demonstrated a reduced risk of HO-CDI (OR=0.47, 95% CI 0.23–0.97, p=0.04) compared to those co-administered S. boulardii after 24-hours of antibiotic start. CONCLUSIONS S. boulardii administered to hospitalized patients prescribed antibiotics frequently linked with HO-CDI was associated with a reduced risk of HO-CDI.