Development of new problem-based learning to promote problem-solving ability in therapeutics at Meijo University

Pharmacy students in the six-year education system are expected to combine their knowledge obtained from many lectures and to develop problem-solving abilities in therapeutics. These two expectations are considered to be difficult in the conventional education system. Therefore we introduced a new problem-based learning (PBL) method in the class on "pharmacotherapeutics," which was held in the first semester of the fourth year. In the PBL modules, students studied the etiology, pathology, and appropriate drug therapeutics of a given disease and obtained the knowledge and skills necessary for monitoring patients during treatment. We conducted 12 PBL modules, and students studied one case per module, each lasting a week. To encourage constructive group work and to generate original input formats to provide students with a problem-solving road map, we developed new systems including a class review and portfolio. The new PBL method also included lectures on the overview of each disease and the therapeutic agents (action mechanism, physical properties, pharmacokinetics, and monitoring of the efficacy and adverse reactions). By integrating their knowledge and skills, we hope that the students will be able to acquire problem-solving abilities in therapeutics when they become pharmacists.     

The influence of learning environment on trainee pharmacy technicians' education and training experiences

Background

In Great Britain (GB), pharmacy technicians (PTs) are registered professionals, with their education and training regulated; little is known about this or the learning environment in which it takes place.

以问题为基础的教学法在冠心病监护病房护理继续教育中的应用

目的探讨以问题为基础的学习方法（PBL教学法）提高冠心病监护病房（CCU）护理继续教育中的应用效果。方法选择哈尔滨医科大学附属第二医院心内科CCU护士22名,采用随机抽样原则,按照1：1的比例对其进行随机分组,分为试验组和对照组,各11名。对照组采用传统讲授法;试验组采用PBL教学法。比较2组的成绩。结果试验组和对照组的理论成绩相似,差异无统计学意义（P〉0．05）;试验组的病案分析及护理技能成绩比对照组高,差异有统计学意义[（85±7）分比（82±7）分、（87±8）分比（84±7）分]（P〈0．05）;试验组的日常工作表现（特殊疾病护理能力,突发事件处理能力及临床医生配合能力）及总分评价优于对照组,差异有统计学意义[（22±1）分比（18±1）分、（21±1）分比（20±2）分、（22±1）分比（21±1）分、（87±4）分比（80±3）分]（P〈0．05）。结论采用PBL教学法可提高CCU护士的临床思维。     

Interprofessional education in introductory pharmacy practice experiences at US colleges and schools of pharmacy

Objective. To assess the extent to which US colleges and schools of pharmacy are incorporating interprofessional education into their introductory pharmacy practice experiences (IPPEs), and to identify barriers to implementation; characterize the format, structure, and assessment; and identify factors associated with incorporating interprofessional education in IPPEs.Methods. An electronic survey of 116 US colleges and schools of pharmacy was conducted from March 2011 through May 2011.Results. Interprofessional education is a stated curricular goal in 78% of colleges and schools and consistently occurred in IPPEs in 55%. Most colleges and schools that included interprofessional education in IPPEs (70%) used subjective measures to assess competencies, while 17.5% used standardized outcomes assessment instruments. Barriers cited by respondents from colleges and schools that had not implemented interprofessional education in IPPEs included a lack of access to sufficient healthcare facilities with interprofessional education opportunities (57%) and a lack of required personnel resources (52%).Conclusions. Many US colleges and schools of pharmacy have incorporated interprofessional education into their IPPEs, but there is a need for further expansion of interprofessional education and better assessment related to achievement of interprofessional education competencies in IPPEs.     

中国临床药学研究生教育的现状分析与展望

目的 探讨和分析我国临床药学研究生教育现状,促进提高临床药学研究生教育水平和质量。 方法 通过网络检索文献,调查我国临床药学教育现状,分析评价临床药学教育模式和发展趋势。 结果 纳入分析的文献136篇,涉及现状分析、模式探讨、国内外比较和课程优化的文献70篇(51.47%)。分析表明目前临床药学研究生教育主要有专业学位和科学学位2种培养模式,但在课程设置和教学方法方面尚未形成较为成熟的教育模式。主要问题是:课程设置不合理、临床实践学时不足、教学内容与临床需求脱节。 结论 我国现行临床药学研究生教育尚不能达到研究生培养目标,也难以满足临床药学对研究生人才的需要。建议在临床药学研究生的培养过程中要注重理论联系实际,突出医药融会贯通,优化教学内容和方法,规范教学质量标准。     

我院门诊药房规范化培训医院药师的教学实践和体会

目的对医院药师教学工作系统化规范化,保证医院药学教学水平达到新形势医院药学服务工作的更高要求。方法我院门诊药房按照《培训细则》的要求,制订了门诊药房医院药师培训计划书,按照计划书中的安排,系统、规范地实施对医院药师的教学实践活动,为审核处方做好专业业务知识的储备。结果医院药师在门诊药房的8个月的系统规范的培训,基本掌握了药品管理相关制度,各大类常用药品相关基础知识,药师对处方进行规范的审核、调配、核对、发放药品以及向患者交代用法用量和注意事项的方法。结论执行教学责任老师全程带教方法,按照计划全程负责,收到了很好的效果。为下一步制定规范标准的医院药学实习教学模式打下了基础,提供了宝贵的实践经验。     

Development and acceptability of structured work based learning in a community pharmacy vacation training programme

The development of structured work based learning (WBL) for use by pharmacy students in a standardised summer vacation work placement is outlined. Assessment methods were developed for measuring the acceptability of the WBL activities and work placement from both the students' and employers' viewpoint. Overall, both were acceptable, and students suggested that the WBL activities should become an integral part of the undergraduate degree course.     

Development and evaluation of effective learning system for patient interview training as a part of pre-education clinical pharmacy practice

The aim of this study was to develop an effective learning system for patient interview training as a part of a pre-education clinical pharmacy. We devised a learning system for performing pharmaceutical care training and then investigated its usefulness. The learning content was a first interview with a simulated patient (SP). All students were divided into 8 groups of 5. Each student practiced interviewing an SP while 2 other students checked the performance of the interviewer, with roles rotated within each group. Additionally, the teachers also rotated among the groups to check the students. We evaluated the results contained in 55 check sheets used by teachers to evaluate the learning system, 223 check sheets used by students, and 110 check sheets used by the SPs. We found that there was a significantly greater number of students rated as unable to perform by the teachers as compared to those rated by the other students. In addition, the ratings for the items, "other symptom is confirmed" and "the severity and properties of the symptom are confirmed" were similar to the above result. Furthermore, there was a significantly greater number of students rated as unable to perform by the teachers as compared to those rated by the SPs in regard to the item "interviewed using open-ended questions." After the students had performed their first attempt at a first interview, 28.6% were rated as unable to perform by the teachers, which was significantly reduced to 15.8% after the fourth attempt and 10.4% after the fifth attempt. Our results indicate that students must practice the first interview at least 4 times before reaching a level of competency. In addition, our findings suggest that both teachers and SPs should undertake pre-education training in clinical pharmacy practice, as the evaluations were significantly different among the teachers, students, and SPs in the present study.     

北京大学第一医院临床药师学员培训现状及启发

目的:通过剖析北京大学第一医院临床药师学员培训现状,分析原因,并提出改进建议。方法:收集北京大学第一医院药剂科2014―2015年不同地区来自不同医院申请进入临床药师培训基地进行培训的所有学员信息,统计并记录学员们性别、年龄、学历、在职医院、临床实践及文章、培训专业需求等信息。结果:上交申请表的学员中男女比例差异较大,女性占77.8%(63/81),男性占20.9%(17/81),未知性别占1.2%(1/81)。所有学员的学历平均得分为54.59,其中学历在其他专业硕士或临床药学本科最多,为66人,占81.5%。临床实践及文章平均得分为48.29,其中得分在临床实践≥1年或者发表1篇文章最多,为33人,占40.7%。所在医院平均得分为53.02,普通城市三级甲等医院最多,占48.2%。     

Concentration-time profile for perhexiline and hydroxyperhexiline in patients at steady state

AIM: To define inter- and intraday variability in plasma perhexiline concentrations, time-to-maximum plasma perhexiline concentration and variability in the ratio of hydroxyperhexiline to parent perhexiline concentrations over the course of the day in patients at steady state. METHODS: Eight blood samples were taken over a 24-h period from 12 adult patients already taking perhexiline for the treatment of angina pectoris. These patients were assumed to be at steady state, having taken the same dose of perhexiline for more than 4 weeks and having no changes made to other drug therapy that might have affected plasma perhexiline concentrations (especially drugs that interfere with CYP2D6). Perhexiline was assayed by HPLC/FL. The percentage increase over baseline concentration was determined for each patient for both perhexiline and hydroxyperhexiline. RESULTS: Trough plasma perhexiline concentrations from two patients were below the limit of quantification of the assay (0.05 mg l-1) and thus were excluded from the analysis. The greatest mean percentage increase in plasma perhexiline concentration over the day was 21% (95%CI 9%, 33%, range -19% to 45%) which occurred 6 h postdose. The greatest mean percentage increase in plasma hydroxyperhexiline concentration was 10.8% (95%CI -5.3%, 26.9%, range -13% to 60%) which occurred 4 h postdose. However individual patients demonstrated > 60% intraday variability in perhexiline concentrations which was not related to the concomitant use of drugs that affect CYP2D6 activity. Changes in random plasma perhexiline concentration which are attributed to changes in concomitant drug therapy should be supported by additional kinetic data. Inter-day variability in plasma perhexiline concentration as determined by the ratio of C24 : C0 was small (mean 0.90, 95%CI 0.77, 1.03) which supports C0 as the best sampling time for perhexiline concentration monitoring. The variability in C24 : C0 for hydroxyperhexiline concentrations was smaller (mean 0.96, 95%CI 0.81, 1.11). Variability in the ratio of plasma concentrations of hydroxyperhexiline to perhexiline over the day was also small. The ratio of plasma hydroxyperhexiline to perhexiline concentration over the day fell within a narrow range for all subjects with 95% confidence intervals being < 15% for eight patients and < 25% for the remaining patient. This suggests that formation of the metabolite occurs rapidly and may be presystemic. It also supports the calculation of the hydroxyperhexiline : perhexiline ratio (in patients at steady state) on blood samples taken at any time during the dosing interval. CONCLUSIONS: The within-day variability in plasma perhexiline concentrations was small. While C0 is probably the best time for therapeutic drug monitoring purposes, it is not unreasonable to use samples drawn at any time during the dosing interval. The therapeutic range used in this hospital (0.15-0.6 mg l-1) was devised from earlier work using 4 h postdose blood sampling which is close to the 'peak' concentration and a mean of 16% higher than C0 in this study. This increase is probably clinically insignificant and a different C0 range is therefore not warranted.     

Historical study of clinical pharmacy education in Japan (part 1). The founding and history of the one-year graduate course of clinical pharmacy practice (yakugaku senkouka) at the Meijo University

Since there was an increasing demand for highly educated pharmacists with clinical experience, a one-year graduate course in clinical pharmacy practice (Yakugaku Senkouka) was established at Meijo University in 1975. This was aimed to provide pharmacists a training program for clinical skills and hospital settings. The course became a leading school in clinical pharmacy education in Japan. The present study describes what it was like and how it contributed to the development of clinical pharmacy in the country. In this article, the history is divided into five terms ranging from 1975 to 2002. The first term (1975-1979): To introduce the educational system, a system that was modeled on those in USA was introduced. The curriculum of clinical clerkship and the methods for evaluating training process were devised. The second term (1980-1984): Clinical clerkships were systematized and modified to fit to society. A manual textbook for training in clinical pharmacy was edited. The third term (1985-1989): The activities in the course were recognized as a new professional practice of pharmacists in Japan under The New Medical Law and The Law of Healthcare Insurance. The fourth term (1990-1995): Clinical pharmacy became popular nationwide. In Meijo University, a new challenge was made to merge clinical pharmacy skills with scientific backgrounds. The fifth term (1996-2002): To cope with the trends of extending undergraduate pharmacy education to six years, it has been decided that the course will be reorganized into a 2-year master's course in clinical pharmacy and accepted as a graduate course in 2003. The history of the course, a forerunner of clinical pharmacy education in Japan, ended in 2002.     

肿瘤患者门诊化疗的焦虑状况与健康教育需求

目的分析肿瘤患者门诊化疗的焦虑状态及焦虑相关因素,了解患者健康教育的需求,采取相应护理措施提高护理质量和治疗效果。方法对在门诊化疗的120例肿瘤患者进行焦虑量表和自行设计问卷调查。结果在门诊化疗的肿瘤患者焦虑患病率为74．2％,其中轻度焦虑占46．7％,中度焦虑的占19．2％,重度焦虑的占8．3％;其中疾病程度、疾病复发、经济状况、治疗效果、个人意志力、影响生活和食欲及治疗硬件条件等等为肿瘤患者的主要焦虑影响因素;大部分患者需要化疗前、化疗中、化疗后的健康教育。结论在门诊化疗的肿瘤患者有着不同程度的焦虑状况并需要医护工作者的适当健康宣教支持。     

Historical study of clinical pharmacy education in Japan (part 2) retrospective evaluation of the roles of the one-year graduate course of clinical pharmacy practice (Yakugaku Senkouka) at Meijo University

Clinical pharmacy practice education started 30 years ago in Japan. Since 1975, a one-year graduate course, clinical pharmacy practice (Yakugaku Senkouka), has been offered at Meijo University, making it a leading school to raise pharmacists with sufficient experience in hospital settings. This article describes the scope of the course, the development of educational systems to meet public demand for new pharmaceutical skills, and the influences on reforming the Japanese health-care system. The content consists of the following: (1) The process of building up the first curricula of clerkship, (2) requirements for admission, namely including an essay, an interview, school records and an aptitude test, (3) establishing the teaching discipline, (4) achievement goals, (5) learning process modeled on methods used in the United States, (6) establishing the concept of medical ethics, (7) professional status of course graduates, and (8) nationwide influence on the social health-care of the country. The one-year graduate course of clinical pharmacy practice was terminated in 2002 and is to be reintroduced as a two-year graduate school course to cope with the present and future trends in health-care systems.