An elective course on lifestyle modifications in pharmacotherapy

Objectives

Develop and implement a pharmacy course explaining basic lifestyle modification components and assess changes in student knowledge, skills, beliefs, and confidence after completing the course.

Design

A 2-credit hour elective course was offered to pharmacy students in which basic lifestyle modification components were applied to case-based patients with hypertension, dyslipidemia, diabetes mellitus, obesity, and metabolic syndrome in the pharmacy practice setting through comprehensive wellness programs. Knowledge, skills, beliefs, and confidence assessments were embedded into the course.

Assessment

There were significant improvements in students'' skills and confidence, and in most knowledge areas, but not in their beliefs regarding health behaviors.

Conclusion

Implementing an elective course on lifestyle modifications is an effective means of teaching students about wellness and disease prevention.     

A Diabetes Camp as the Service-Learning Capstone Experience in a Diabetes Concentration

Objectives

To assess the effectiveness of a service-learning advanced pharmacy practice experience (APPE) in a diabetes camp to improve student confidence in diabetes knowledge and related skills

Design

Pharmacy students assisted medical staff during a week-long diabetes camp for children. Students participated in all aspects of diabetes care, as well as wrote pre- and post-camp reflection papers, completed online quizzes, presented an educational training session, and completed pre- and post-camp survey instruments.

Assessment

Students'' confidence in their diabetes knowledge and patient care skills increased as a result of participating in the camp.

Conclusion

A diabetes camp APPE improved students'' confidence in their knowledge and ability to manage diabetes, and allowed them to gain experience working with an interdisciplinary team in a unique real-world environment.     

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 Electronic Medical Records to Teach Patient-Centered Care

Objective

To develop, implement, and evaluate the use of electronic medical records (EMRs) in disease state management activities to teach pharmacy students patient-centered care skills.

Design

Faculty created 12 patient cases and an EMR for each simulated patient. Students used the information in the EMR to confirm the presence of a disease in their patient; to design and monitor an evidence-based patient-centered care plan, and document their assessment, medication, and monitoring recommendations; and to follow up in a SOAP (subjective, objective, assessment, plan) note format within the EMR.

Assessment

A precourse and postcourse survey instrument was administered to assess students'' perceived gains in knowledge and attitudes regarding the use of EMRs for learning patient-centered care skills. A grading rubric was used to evaluate each SOAP note.

Conclusion

Implementation of disease state management activities involving EMRs improved pharmacy students'' patient care skills.     

Comparison of attitudes, beliefs, and resource-seeking behavior for CAM among first- and third-year Czech pharmacy students

Objectives

To assess and compare first- and third-year Czech pharmacy students'' attitudes toward CAM, CAM use, CAM evidence, recommending CAM to patients, and including CAM in the pharmacy curricula.

Methods

The CAM Health Belief Questionnaire (CHBQ) was translated from English to Czech and administered to 250 first-year and 187 third-year students.

Results

The students'' mean CHBQ score was 48.5, affirming positive attitudes toward CAM. Vitamins, herbs, massage, and relaxation were the most commonly used therapies among students. Czech students reported significantly low use of evidence-based resources on CAM. Ninety percent of the pharmacy students surveyed would recommend CAM and 89% believed pharmacists should be knowledgeable of CAM. Ninety-one percent of first-year vs 78% of third-year students supported CAM education (p = 0.01).

Conclusions

Czech students have positive attitudes about CAM, but are less likely to access evidence-based information. They agree pharmacists should be educated about CAM.     

An elective course in information mastery

Objective

To design and implement an elective course in information mastery and assess its impact on students'' ability to identify information needs and formulate clinically relevant, evidence-based answers.

Design

A semester-long (15-week) elective course was offered to third-year (P3) doctor of pharmacy (PharmD) students that outlined the necessary knowledge and skills for using information mastery in evidence-based practice.

Assessment

Results of a pre- and postcourse survey instrument demonstrated an increase in students'' knowledge of information mastery and confidence in and familiarity with the practice of evidence-based medicine in pharmacy. Students who had completed the elective were able to provide higher quality search strategies and evidence-based answers to a clinical question than other P3 students, and P4 students who did not participate in the elective.

Conclusion

An elective course in information mastery improved students'' knowledge and understanding of information mastery as it pertains to practicing evidence-based medicine.     

Nine constructs of cultural competence for curriculum development

Objective

To examine the self-administered Clinical Cultural Competency Questionnaire (CCCQ) and assess the perceived level of cultural competence of students in Xavier University of Louisiana College of Pharmacy to guide curriculum development within the 4-year academic program.

Methods

The CCCQ was administrated to each class of pharmacy students during spring 2009. Exploratory factor analysis with principal components and varimax rotation was conducted to build the constructs explaining the factors measuring students'' self-assessment of cultural competence.

Results

Nine factors, including 46 items extracted from the CCCQ and explaining 79% of the total variance, were found as the best fit to measure students'' self-assessment of cultural competence.

Conclusions

The CCCQ was found to be a practical, valid, and reliable self-assessment instrument to measure the perceived level of pharmacy students'' knowledge, skills, attitudes, and encounters in cross-cultural environments. The questionnaire allowed the identification of students'' needs for training in cultural competence and the development of a curriculum tailored to satisfy those needs.     

A Pharmacy Course on Leadership and Leading Change

Objective

To develop and implement a course that develops pharmacy students'' leadership skills and encourages them to become leaders within the profession.

Design

A leadership course series was offered to pharmacy students on 2 campuses. The series incorporated didactic, experiential, and self-directed learning activities, and focused on developing core leadership skills, self-awareness, and awareness of the process for leading change.

Assessment

Students reported increased knowledge and confidence in their ability to initiate and lead efforts for change. The learning activities students'' valued most were the StrengthsFinder assessment (67% of students rated “very useful”) and a Leadership Networking Partners (LNP) program (83% of students rated “very useful”).

Conclusion

Teaching leadership skills poses a significant challenge in curriculum development and requires multifaceted course design elements that resonate with students and engage the practice community. Addressing these requirements results in a high level of student engagement and a desire to continue the development of leadership skills.     

An Evidence-based Elective on Dietary Supplements

Objective

To implement and evaluate the effectiveness of a pharmacy elective on dietary supplements that emphasized evidence-based care.

Design

A 3-credit elective that employed both traditional lectures and a variety of active-learning exercises was implemented. The course introduction provided a background in dietary supplement use and evidence-based medicine principles before addressing dietary supplements by primary indication.

Assessment

Student learning was assessed through quizzes, case assignments, discussion board participation, and completion of a longitudinal group project. Precourse and postcourse surveys were conducted to assess students'' opinions, knowledge, and skills related to course objectives.

Conclusion

The course was an effective way to increase students'' knowledge of dietary supplements and skills and confidence in providing patient care in this area.     

A Motivational Interviewing Course for Pharmacy Students

Objective

To create, implement, and evaluate a pharmacy course on motivational interviewing.

Design

A 3-hour elective course was created to train doctor of pharmacy (PharmD) students in brief patient-centered motivational interviewing counseling strategies that have proven effective with the types of health issues most commonly addressed in pharmacy settings. Students were assisted in developing their skills through required readings, interactive lectures, in-class demonstrations and practice sessions, out of class skills practice, one-on-one supervision provided by doctoral level clinical health psychology students, and written reflections on each class session.

Assessment

Students demonstrated significant improvement in motivational interviewing skills and a high level of motivation for and confidence in using these skills in their future practice. Students overall assessment of the course and supervision process was highly positive.

Conclusion

This patient-centered counseling skills course was feasible and produced improvements in PharmD students'' counseling skills and increased their motivation and confidence to use motivational interviewing skills in their future communications with patients.     

An Elective Course on Landmark Trials to Improve Pharmacy Students' Literature Evaluation and Therapeutic Application Skills

Objectives

To determine the impact of a landmark trials elective course on pharmacy students'' attitudes toward evidence-based medicine, students'' comfort with technical concepts used in drug literature, and students'' perceptions of accessibility of PubMed from home computers.

Design

An elective course which gave third-year pharmacy students the opportunity to discuss landmark trials in primary care and reinforced skills in applying evidence from the primary literature to support therapeutic recommendations was design and implemented. The impact of the course was evaluated via a pre- and postcourse questionnaire administered during 3 consecutive course offerings.

Assessment

Overall, students had positive attitudes toward evidence-based medicine before taking the course (97.5% positive or somewhat positive) and these attitudes were unchanged postcourse (p = 0.74). Though 97.6% (n = 40) of students had Internet access at home, only 68.3% (n = 28) indicated having PubMed access at home. The course increased self-assessed comfort with technical concepts used in literature evaluation including random assignment (p < 0.01), placebo-controlled (p < 0.01), and intention-to-treat (p = 0.02).

Conclusion

An elective course on landmark trials allowed third-year pharmacy students to increase their comfort level with literature evaluation and reinforced their positive attitudes toward the use of evidence-based medicine in pharmacy practice.     

Active-learning strategies to develop health literacy knowledge and skills

Objective

To implement active-learning exercises in a required pharmacy course and assess their impact on students'' knowledge and confidence in identifying and communicating with patients with low health literacy, as part of a required course in cultural competency, health literacy, and health beliefs.

Design

Active-learning activities including administering health literacy assessments, identifying informal signs of low health literacy, conducting mock patient counseling sessions, rating the readability of drug information, analyzing information in drug advertisements, and writing patient education materials were incorporated into the 6-sesssion health literacy portion of the course.

Assessment

A pretest and posttest showed that students'' knowledge of health literacy increased, and a retrospective pretest found improvement in students'' confidence in their ability to care for patients with low health literacy. In-class discussions provided informal evidence that students gained new knowledge from the active-learning activities.

Conclusion

The addition of active-learning activities was effective in teaching health literacy concepts to pharmacy students.     

Physician Acceptance of Pharmacotherapy Recommendations Made by Pharmacy Students in a Rural Pharmacy-based Diabetes Care and Education Clinic

Objective

To assess outcomes from a rural, community pharmacy-based diabetes care and education program involving collaboration between local pharmacists and physicians, fourth-year pharmacy students, and University of Colorado Denver School of Pharmacy faculty members.

Design

Fourth-year pharmacy students provided education and testing (hemoglobin A1c, blood glucose, blood pressure, and lipid profiles) to diabetes patients, once a month for 6 months. Clinical notes with medication recommendations were faxed to each patient''s physician following each visit.

Assessment

Twelve pharmacy students made 533 recommendations to 29 physicians for 52 patients over 18 months. Overall, 32% of the recommendations were accepted based on subsequent medication orders and patient reports. Three of the physicians accepted 50%-60% of the recommendations they received while 4 did not accept any recommendations.

Conclusions

Physician acceptance of pharmacy students'' medication recommendations for patients attending a rural community pharmacy-based diabetes management clinic varied. Further study is needed to determine the reasons for this.     

Cultural competence knowledge and confidence after classroom activities

Objectives

To determine change in cultural competency knowledge and perceived confidence of second-year pharmacy students to deliver culturally competent care after completing a required cultural competency curriculum.

Design

Cultural competence material was covered in the second-year PharmD curriculum through lectures, laboratories, and an experiential/out-of-class assignment.

Assessment

Eighty-five second-year (P2) pharmacy students completed a survey which assessed influence of classroom activities related to cultural competence. Mean values for knowledge and perceived confidence were significantly higher for posttest compared to pretest (p < 0.01), after cultural competency activities. Focus groups were used to solicit students'' opinions on instructional effectiveness, relevance of activities, and areas for enhancement.

Conclusion

The cultural competency curriculum increased pharmacy students'' awareness of and confidence in addressing cultural diversity issues that affect pharmaceutical care delivery.     

Impact of a diabetes certificate program on PharmD students' knowledge and skills

Objectives

To determine the impact of a pregraduation diabetes certificate program on PharmD students'' knowledge and skills.

Methods

A comprehensive elective in diabetes was created and implemented in the third-professional year of the PharmD curriculum. A nonrandomized, single-blinded, controlled, 2-year study was conducted to determine the impact of the elective. Written and oral examinations were administered to the participants and students in a control group.

Results

The certificate students'' (N = 25) and control students'' (N = 12) average oral examination grades were 88.5% ± 13.4% and 89.5% ± 15.8%, respectively (p = 0.58). The certificate students'' average grade on the counseling section of the oral examination was 9% higher than that of the students in the control group (p = 0.01). The certificate students'' and control students'' grades on the written examination were 80.9 ± 11.1% and 61.1 ± 17.4% (p = 0.0062), respectively.

Conclusions

A diabetes certificate program improved students'' knowledge of diabetes disease state management and patient education skills compared to students who did not take the elective.     

Pharmacy Students' Attitudes Toward a Required Public Health Course and Developing a Public Health Program

Objective

To determine pharmacy students'' attitudes towards a required public health course and developing a public health program.

Method

Two hundred ten first-year pharmacy students enrolled in a public health course at a large private pharmacy school were surveyed. A 24-item adjective rating scale and a 10-item scale were used to measure students'' attitudes towards the course and developing a public health program.

Results

Of 198 respondents, two-thirds found the course to be extremely or very appealing, of practical value, and only slightly demanding and difficult. The majority of the students indicated that establishing a public health program would be an opportunity to help the community and make a difference. Few students indicated that it would be a poor use of time or an example of busy work.

Conclusion

Pharmacy students had positive attitudes towards a required public health course and developing a public health program. Strategies to mold positive attitudes into actual behaviors of engaging in public health activities are needed.     

Factors Associated With Reflection Among Students After an Advanced Pharmacy Practice Experience (APPE) in Sweden

Objective

To identify individual and social factors associated with pharmacy students'' level of reflection in an advanced pharmacy practice experience (APPE).

Methods

A postal questionnaire, including a reflective assignment, was sent to all pharmacy interns (n=262) at Uppsala University, Sweden, for 4 semesters in 2005-2007.

Results

In a univariate analysis, 7 factors were found to be associated with students'' level of reflection. After controlling for covariates, 3 social factors were found to be independently associated with reflection: having a formal preceptor (OR=5.3), being at a small pharmacy (OR=19.8), and students'' perception of the importance of discussing critical thinking with the preceptor (OR=1.2). No correlation could be observed between level of reflection and critical thinking, nor learning style.

Conclusion

Social components seem to be of higher importance than individual components in students'' reflective levels after pharmacy internship experience. Trained preceptors are important to foster reflection skills.     

Active-Learning Laboratory Session to Teach the Four M's of Diabetes Care

Objective

To implement an active-learning methodology for teaching diabetes care to pharmacy students and evaluate its effectiveness.

Design

Laboratory instruction was divided into 4 primary areas of diabetes care, referred to by the mnemonic, the 4 M''s: meal planning, motion, medication, and monitoring. Students participated in skill-based learning laboratory stations and in simulated patient experiences. A pretest, retrospective pretest, and posttest were administered to measure improvements in students'' knowledge about diabetes and confidence in providing care to diabetes patients.

Assessment

Students knowledge of and confidence in each area assessed improved. Students enjoyed the laboratory session and felt it contributed to their learning.

Conclusion

An active-learning approach to teaching diabetes care allowed students to experience aspects of the disease from the patient''s perspective. This approach will be incorporated in other content areas.