Electronic Reflective Student Portfolios to Demonstrate Achievement of Ability-based Outcomes During Advanced Pharmacy Practice Experiences

Objectives

To demonstrate achievement of ability-based outcomes through a structured review of electronic student portfolios in an advanced pharmacy practice experience (APPE) program.

Design

One hundred thirty-eight students produced electronic portfolios containing select work products from APPEs, including a self-assessment reflective essay that demonstrated achievement of course manual-specified ability-based outcomes.

Assessment

Through portfolio submissions, all students demonstrated the achievement of ability-based outcomes for providing pharmaceutical care, evaluating the literature, and managing the medication use system with patient case reports most frequently submitted. The rubric review of self-reflective essays addressed student learning through APPEs and continuing professional development plans.

Conclusion

The electronic portfolio with reflective essay proved to be a useful vehicle to demonstrate achievement of ability-based outcomes.     

A Service-Learning Course for First-Year Pharmacy Students

Objectives

To describe the design of a required service-learning course offered to first- year (P1) pharmacy students, and to assess student learning and the relevance of this learning in the pharmacy curriculum.

Design

A 14-week service-learning course was designed and community organizations were recruited to participate. All first-year students enrolled in the School completed the course. A post-course survey was administered to the students, inquiring about what they had learned from the course; supervisors at the students'' service sites also completed a short survey.

Assessment

The course and the student survey instrument were completed by 195 students, and of these 190 gave permission for the information they provided to be used in the study. Notable learning outcomes were identified, especially in the areas of communication and the social and behavioral aspects of pharmacy.

Conclusion

The survey administered at the conclusion of the course described in this article demonstrated that students in the course had achieved the desired learning outcomes. This shows that service-learning is a pedagogy that educators can employ to effect relevant learning in the pharmacy curriculum.     

Redesign and Evaluation of a Patient Assessment Course

Objectives

To redesign a patient assessment course using a structured instructional design process and evaluate student learning.

Design

Course coordinators collaborated with an instructional design and development expert to incorporate new pedagogical approaches (eg, Web-based self-tests), create new learning activities (eg, peer collaboration on worksheets, SOAP note writing), and develop grading rubrics.

Assessment

Formative and summative surveys were administered for student self-assessment and course evaluation. Seventy-six students (78%) completed the summative survey. The mean course grade was 91.8% ± 3.6%, with more than 75% of students reporting achievement of primary course learning objectives. All of the additional learning activities helped students meet the learning objectives with the exception of the written drug information response.

Conclusion

The use of a structured instructional design process to redesign a patient assessment course was successful in creating a curriculum that succeeded in teaching students the specified learning objectives. Other colleges and schools are encouraged to collaborate with an instructional design and development expert to improve the pharmacy curriculum.     

Pharmacy students' preferences for various types of simulated patients

Objective

To evaluate pharmacy students'' preferences for various types of simulated patients.

Methods

Second-professional year (P2) pharmacy students participated in 7 learning activities that used simulated patients including community volunteers, College administrative staff, course instructors, and student peers. Students ranked each simulated patient type according to believability, skill development, and preference using a 5-point Likert scale.

Results

One-hundred seven of 155 students (69%) completed the survey instrument. Students preferred community volunteers as simulated patients (mean rank 1.39), followed by peers (2.22), instructors (2.63), and staff members (2.81) (p < 0.001). Greater than 89% agreed or strongly agreed that their work with simulated patients prepared them for actual patients, with community volunteers receiving the highest ratings (p < 0.03).

Conclusions

Although pharmacy students found value in interactions will all types of simulated patients, they preferred community volunteers over staff members and their peers. Future scholarship should explore the relationship among simulated patient types and student learning outcomes.Key words: simulated patient, survey, practice laboratory     

A Simulated Interprofessional Rounding Experience in a Clinical Assessment Course

Objective

To implement a simulated interprofessional rounding experience using human patient simulators as a required activity for third-year pharmacy students in a clinical assessment course.

Design

Interprofessional student teams consisting of pharmacy, medical, and physician assistant students participated in a simulated interprofessional rounding experience in which they provided comprehensive medical care for a simulated patient in an inpatient setting.

Assessment

Students completed a survey instrument to assess interprofessional attitudes and satisfaction before and after participation in the simulated interprofessional rounding experience. Overall student attitudes regarding interprofessional teamwork and communication significantly improved; student satisfaction with the experience was high and students’ self-perceived clinical confidence improved after participation. The mean team clinical performance scores were 65% and 75% for each simulated interprofessional rounding experience.

Conclusion

Incorporating a simulated interprofessional rounding experience into a required clinical assessment course improved student attitudes regarding interprofessional teamwork and was associated with high student satisfaction.     

A shared assignment to integrate pharmaceutics and pharmacy practice course concepts

Objective

To demonstrate for first-year pharmacy students the relevance of pharmaceutics course content to pharmacy practice by implementing a joint, integrated assignment in both courses and assessing its impact.

Design

Medication errors and patient safety issues relevant to ophthalmic and otic formulations were selected as the assignment topic. A homework assignment based on a mock court case involving a patient who was given an inappropriate formulation because of a pharmacist''s medication error was given to students. The scenario was followed by essay and calculation questions linking physical pharmacy concepts with patient safety recommendations.

Assessment

Students’ average score on the crossover assignment was 88.7%. Minute papers completed before and after the assignment showed improvement in student learning. Students’ scores on examination questions related to the assignment topic were significantly higher than the previous year''s students’ performance on similar questions. In a survey conducted at the end of the semester, 91% of students indicated that the assignment helped them relate the covered topics to future practice, and 98% agreed that the assignment emphasized the importance of the pharmaceutics in professional practice.

Conclusion

A crossover assignment was an effective means of demonstrating the connection between specific pharmaceutics concepts and practice applications to pharmacy students.     

Heart of Pharmacy: A Course Exploring the Psychosocial Issues of Patient Care

Objective

To implement and assess the impact of a course utilizing reflective learning to explore the complex, psychosocial human issues encountered in pharmacy practice.

Design

A 1-credit-hour elective course, The Heart of Pharmacy, was offered to all pharmacy students. The course utilized both content and reflective techniques to produce a mutual exploratory learning experience for students, staff, and faculty members. Faculty and staff facilitators observed competencies and used a single group posttest design to assess students’ attitudes. In year four, students’ written reflections for each session were added and reviewed on a continuous basis throughout the course.

Assessment

Faculty and staff observations indicated that educational outcomes were achieved and student perceptions and evaluations of the course were highly positive. Three major themes were identified in the students’ qualitative responses: a recognition of communal support among student and faculty colleagues; a grounding for personal growth and professional formation; a deeper insight into and experience with the role of the pharmacist as compassionate listener and caregiver.

Conclusion

Faculty observations of student competencies and students’ perceptions of this course point to the need for pharmacy education to provide organized, structured reflective learning opportunities for students and faculty members to explore the deeper human issues of pharmacy practice and patient care.     

A capstone advanced pharmacy practice experience in research

Objective

To implement a required capstone experience in research for pharmacy students, assess course outcomes, and solicit mentors'' and students'' opinions regarding the structure and efficacy of the course.

Design

Fourth-year pharmacy students chose a research project, selected a mentor, and completed a 5-week capstone advanced pharmacy practice experience (APPE), during which they wrote a research paper and presented their research at a poster session.

Assessment

Eighty students completed the capstone experience in 2008-2009 and 56 faculty and non-faculty pharmacists served as mentors. Based on their responses on a course evaluation, the students'' experience with their mentor and course instructor were positive. Thirty-one mentors completed a survey on which they indicated their overall support of the capstone project, but wanted their role to be better defined and felt the students needed to have additional training in statistics, survey question design, and the IRB process before completing the APPE.

Conclusion

The capstone APPE was perceived by students and mentors as a positive learning experience that allowed the student to take information from the curriculum and apply it to a real-world situation. Additional research is needed to determine whether pharmacy students will use the research skills acquired in their future careers.     

A mental health elective to improve pharmacy students' perspectives on mental illness

Objective

To evaluate the impact of a mental health elective on pharmacy students'' perceptions and stigmatizing views of mental illness.

Design

An elective was designed that featured an advanced overview of psychopharmacology; student training in motivational interviewing; a presentation by the National Alliance on Mental Illness (NAMI) local chapter; introduction to pharmacy collaborations with peer support specialists, social workers, and psychiatrists; mock patient counseling sessions; and a required psychiatric patient interview at a local community mental health center.

Assessment

A survey instrument with 17 Likert-scale items was constructed to measure 2 distinct areas: social distance and stigmatizing views. The survey instrument was administered at the beginning and end of the spring 2010 semester to pharmacy students enrolled in the mental health elective course and to a control group of pharmacy students enrolled in an unrelated clinical elective. The course had a positive impact on pharmacy students'' perceptions of mental illnesses. Students'' social distance and stigmatizing views of mental illnesses improved, while no significant change in views occurred among students in the control group.

Conclusion

Advanced training in psychiatric medicine and exposure to mental health care are vital to prepare pharmacy students to provide unbiased, patient-centered care to this population.     

Multiple rubric-based assessments of student case presentations

Objectives

To evaluate a rubric-based method of assessing pharmacy students'' case presentations in the recitation component of a therapeutics course.

Methods

A rubric was developed to assess knowledge, skills, and professional behavior. The rubric was used for instructor, student peer, and student self-assessment of case presentations. Rubric-based composite scores were compared to the previous dichotomous checklist-based scores.

Results

Rubric-based instructor scores were significantly lower and had a broader score distribution than those resulting from the checklist method. Spring 2007 rubric-based composite scores from instructors and peers were significantly lower than those from the pilot study results, but self-assessment composite scores were not significantly different.

Conclusions

Successful development and implementation of a grading rubric facilitated evaluation of knowledge, skills, and professional behavior from the viewpoints of instructor, peer, and self in a didactic course.Key words: rubric, pharmacy, peer assessment, self-assessment, assessment     

Social Constructivist Learning Environment in an Online Professional Practice Course

Objective

To assess the online social constructivist learning environment (SCLE) and student perceptions of the outcomes of the online introductory module of pharmacy professional practice that was designed based on social constructivism theory.

Design

The online introductory module of pharmacy professional practice in pharmaceutical marketing and business was carefully designed by organizing various activities, which were intended to encourage social interaction among students. The Constructivist Online Learning Environment Survey (COLLES) was applied to assess the SCLE. Course evaluation questionnaires were administered to assess student perceptions of this online module.

Assessment

The result from the COLLES illustrated the development of SCLE in the course. The students reported positive perceptions of the course.

Conclusion

An online introductory module of pharmacy professional practice in pharmaceutical marketing and business was effective in promoting SCLE.     

Improvisational Exercises to Improve Pharmacy Students' Professional Communication Skills

Objective

To create and implement improvisational exercises to improve first-year pharmacy students'' communication skills.

Design

Twelve 1-hour improvisational sessions were developed and added to an existing/established patient communication course to improve 3 basic skills: listening, observing and responding. Standardized patient examinations were used to evaluate student communication skills, and course evaluations and reflective journaling were used to evaluate students'' perceptions of the improvisational exercises.

Assessment

The improvisational exercises markedly improved the students'' performance in several aspects of standardized patient examination. Additionally, course evaluations and student comments reflected their perception that the improvisational exercises significantly improved their communication skills.

Summary

Improvisational exercises are an effective way to teach communication skills to pharmacy students.     

Using human patient simulation to prepare student pharmacists to manage medical emergencies in an ambulatory setting

Objective

To implement a simulation-based educational experience focused on medical emergencies in an ambulatory pharmacy setting.

Design

Second-year student pharmacists were assigned randomly to groups and played the role of pharmacists in a community pharmacy setting in which a simulated patient experienced 1 of 5 emergency scenarios: medication-related allergic reaction, acute asthma attack, hypoglycemia, myocardial infarction, and stroke. The students were expected to use patient assessment techniques to determine which emergency the simulated patient was experiencing and the appropriate intervention. Following each simulation, a debriefing session was conducted.

Assessment

Eighty-two student pharmacists completed the simulation activity. Ninety-three percent of student groups correctly identified the emergency. A post-activity survey instrument was administered, and 83% of responders indicated this activity was effective or very effective.

Conclusion

Simulation of emergencies seen in an ambulatory pharmacy setting allowed students to assert knowledge, practice communication skills, apply assessment techniques, and work as a team in a low-risk environment.     

Plaintiff or Defendant: Using Legal Cases to Teach Students Pharmacy Law

Objective

To demonstrate the value of students using actual legal cases during collaborative “breakout” sessions in a pharmacy law class.

Design

Students were broken into smaller groups and randomly assigned a legal case to arbitrate or defend. One week prior to the groups'' presentation, all students were given the facts of a case that was reflective of issues covered during the lecture component of the course. Formative assessments were utilized in addition to an overall breakout satisfaction survey administered at the end of the course.

Assessment

Overall, students felt the breakout sessions enhanced their learning environment and reinforced material covered during the didactic portion of the course. Students also recommended the breakout sessions for future pharmacy law courses.

Conclusion

Dividing a large pharmacy law class into 2 sections of 12 groups each and conducting mock trials resulted in increased student participation and interaction and deeper understanding of the course content.     

Current Events Project in a Pharmacotherapy Course

Objective

To implement and assess a current events project added to the curriculum of a pharmacotherapy course in a doctor of pharmacy (PharmD) program.

Design

Third-year PharmD students researched a current event topic related to infectious diseases and prepared a written and verbal summary that was presented to their classmates.

Assessment

Scores on course examinations and quizzes to assess students'' knowledge of current events material were equal to or better than non-current events material. Based upon a student self-assessment survey, this active-learning activity increased students'' awareness of current events related to pharmacy practice, and their understanding of the process to prepare and present information to a group in a statistically significant manner. There was a positive but not significant improvement in students'' desire to prepare and present information to a group; ability to evaluate, organize, and present information in a written report; and ability to verbally present material to a group.

Conclusion

The addition of a current events presentation as an active-learning activity significantly increased students'' awareness of current events related to pharmacy practice and their understanding of the process to prepare and present information to a group.     

Pharmacy Student Knowledge and Communication of Medication Errors

Objectives

To describe and evaluate pharmacy students'' knowledge of and comfort in communicating, managing, and preventing medication errors.

Methods

Using a cross-sectional design, a survey instrument was administered to fifth-year pharmacy students. The survey instrument included both open- and close-ended questions to describe and examine factors associated with knowledge and comfort in communication of medication errors.

Results

Survey instruments were completed by 93 students (90% response rate). Nearly 80% reported not having received training in communicating medication errors. The perception of having more adequate training was related to greater knowledge in the communication of medication errors (p ≤ 0.001). Knowledge was also associated with students having greater comfort in communicating medication errors (p ≤ 0.05).

Conclusions

The need and value of additional training for pharmacy students in communicating medication errors was demonstrated. Educational interventions should be developed to provide consistent instruction on these communication issues.     

Factors Influencing Pharmacy Students' Attendance Decisions in Large Lectures

Objectives

To identify reasons for pharmacy student attendance and absenteeism in large lectures and to determine whether certain student characteristics affect student absenteeism.

Methods

Pharmacy students'' reasons to attend and not attend 3 large lecture courses were identified. Using a Web-based survey instrument, second-year pharmacy students were asked to rate to what degree various reasons affected their decision to attend or not attend classes for 3 courses. Bivariate analyses were used to assess the relationships between student characteristics and degree of absenteeism.

Results

Ninety-eight students (75%) completed the survey instrument. The degree of student absenteeism differed among the 3 courses. Most student demographic characteristics examined were not related to the degree of absenteeism. Different reasons to attend and not to attend class were identified for each of the 3 courses, suggesting that attendance decisions were complex.

Conclusions

Respondents wanted to take their own notes and the instructor highlighted what was important to know were the top 2 common reasons for pharmacy students to attend classes. Better understanding of factors influencing student absenteeism may help pharmacy educators design effective interventions to facilitate student attendance.     

An Elective Course in Adult Acute Care Medicine Using a Hybrid Delivery System

Objective

To develop and assess the effectiveness of an elective course modeled after activities students encounter on internal medicine advanced pharmacy practice experiences (APPEs).

Design

This hybrid elective course used a Web-based course management system linking pre-class lectures and assignments, classroom discussions, and projects to promote active student learning.

Assessment

Assessment of student performance was based on assignments, quizzes, and participation in classroom discussions. Students were surveyed to ascertain their opinion of the elective.

Conclusion

This elective in adult acute care medicine increased student exposure to inpatient settings and provided students additional opportunities to communicate effectively, evaluate medical literature, and think critically.     

Evaluating the accuracy of pharmacy students' self-assessment skills

Objectives

To evaluate the accuracy of self-assessment skills of senior-level bachelor of science pharmacy students.

Methods

A method proposed by Kruger and Dunning involving comparisons of pharmacy students'' self-assessment with weighted average assessments of peers, standardized patients, and pharmacist-instructors was used.

Results

Eighty students participated in the study. Differences between self-assessment and external assessments were found across all performance quartiles. These differences were particularly large and significant in the third and fourth (lowest) quartiles and particularly marked in the areas of empathy, and logic/focus/coherence of interviewing.

Conclusions

The quality and accuracy of pharmacy students'' self-assessment skills were not as strong as expected, particularly given recent efforts to include self-assessment in the curriculum. Further work is necessary to ensure this important practice competency and life skill is at the level expected for professional practice and continuous professional development.