Long-term evaluation of a train-the-trainer workshop for pharmacy faculty using the RE-AIM framework

BackgroundAlthough two thirds of tobacco users express interest in quitting, few pharmacists address tobacco use as part of routine practice. Historically, pharmacy schools provided inadequate tobacco cessation training for students. To address this educational gap, train-the-trainer workshops were conducted between 2003 and 2005 to train pharmacy faculty (n = 191) to teach a shared, national tobacco cessation curriculum at their academic institutions.ObjectiveTo characterize faculty perceptions of the train-the-trainer workshops and estimate the long-term reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) of the shared curriculum at pharmacy schools.MethodsThis study is the second phase of a sequential mixed methods study. Results from Phase 1, a qualitative study, informed the development of survey items for Phase 2. Applying the RE-AIM framework, a web-based survey was developed and administered to train-the-trainer participants.ResultsOf 191 trainees, 137 were locatable; of these, 111 completed a survey (81.0%). Most (n = 87; 78.4%) reported current employment in academia. The most highly rated reason for attending a workshop was to improve teaching of tobacco cessation content, and 98.1% reported moderate or high confidence for teaching tobacco cessation. Among those who practice in a clinical setting, 70.6% reported asking their patients about tobacco use all or almost all the time. Just over three fourths of faculty respondents who work in academia believe that shared curricula should be more broadly considered for use in pharmacy schools, and 79.0% agreed that shared curricula are a cost-effective approach to teaching.ConclusionEvidence is provided for long-term reach, effectiveness, adoption, implementation, and maintenance of the Rx for Change shared tobacco cessation training program. Participants perceived that the workshop resulted in long-term, positive effects on their careers as well as their teaching and clinical practice.     

Evaluation of a Train-the-Trainer Program for Tobacco Cessation

Objectives

To assess pharmacy faculty members'' perceptions of the Rx for Change tobacco cessation program materials and train-the-trainer program.

Methods

Pharmacy faculty members attended a 14.5 hour train-the-trainer program conducted over 3 days. Posttraining survey instruments assessed participants'' (n = 188) characteristics and factors hypothesized to be associated with program adoption.

Results

Prior to the training, 49.5% of the faculty members had received no formal training for treating tobacco use and dependence, and 46.3% had never taught students how to treat tobacco use and dependence. Participants'' self-rated abilities to teach tobacco cessation increased posttraining (p < 0.001). The curriculum materials were viewed as either moderately (43.9%) or highly (54.0%) compatible for integration into existing curricula, and 68.3% reported they were “highly likely” to implement the program in the upcoming year.

Conclusions

Participation in a national train-the-trainer program significantly increased faculty members'' perceived ability to teach tobacco-related content to pharmacy students, and the majority of participants indicated a high likelihood of adopting the Rx for Change program at their school. The train-the-trainer model appears to be a viable and promising strategy for promoting adoption of curricular innovations on a national scale.     

A Train-the-Trainer Approach to a Shared Pharmacogenomics Curriculum for US Colleges and Schools of Pharmacy

Objective. To assess pharmacy faculty trainers’ perceptions of a Web-based train-the-trainer program for PharmGenEd, a shared pharmacogenomics curriculum for health professional students and licensed clinicians.Methods. Pharmacy faculty trainers (n=58, representing 39 colleges and schools of pharmacy in the United States and 1 school from Canada) participated in a train-the-trainer program consisting of up to 9 pharmacogenomics topics. Posttraining survey instruments assessed faculty trainers’ perceptions toward the training program and the likelihood of their adopting the educational materials as part of their institution’s curriculum.Results. Fifty-five percent of faculty trainers reported no prior formal training in pharmacogenomics. There was a significant increase (p<0.001) in self-reported ability to teach pharmacogenomics to pharmacy students after participants viewed the webinar and obtained educational materials. Nearly two-thirds (64%) indicated at least a “good” likelihood of adopting PharmGenEd materials at their institution during the upcoming academic year. More than two-thirds of respondents indicated interest in using PharmGenEd materials to train licensed health professionals, and 95% indicated that they would recommend the program to other pharmacy faculty members.Conclusion. As a result of participating in the train-the-trainer program in pharmacogenomics, faculty member participants gained confidence in teaching pharmacogenomics to their students, and the majority of participants indicated a high likelihood of adopting the program at their institution. A Web-based train-the-trainer model appears to be a feasible strategy for training pharmacy faculty in pharmacogenomics.     

Evaluation of a Train-the-Trainer Program for Cultural Competence

Objectives

To develop, implement, and evaluate the impact of a cultural competence train-the-trainer workshop for pharmacy educators.

Methods

A 2-day train-the-trainer workshop entitled Incorporating Cultural Competency in Pharmacy Education (1.65 CEUs) was provided to pharmacy faculty from schools across the United States. Baseline, posttraining, and 9-month follow-up surveys assessed participants'' (n = 50) characteristics and self-efficacy in developing and teaching content.

Results

At baseline, 94% of faculty members reported no formal training in teaching cultural competence. After completing the workshop, participants'' self-rated confidence for developing and teaching workshop content significantly increased. The number of participants who rated their ability to teach cultural competence as “very good” or “excellent” increased from 13% to 60% posttraining. Participants reported teaching 1 or more aspects of the workshop curriculum to nearly 3,000 students in the 9-months following training.

Conclusions

The workshop significantly increased faculty members'' perceived and documented ability to teach cultural competence. The train-the-trainer model appears to be a viable and promising strategy for meeting the American Council for Pharmacy Education accreditation standards relating to the teaching of diversity, cultural issues, and health literacy.     

Assessment of Cultural Competence in Pharmacy Students Prior to Advanced Pharmacy Practice Experiences

Objective. To assess various aspects of cultural competence in second year Doctor of Pharmacy students’ and investigate the relationship between cultural competence and students’ demographics, work experience, and prior education.Methods. A 63-item survey modified from the Clinical Cultural Competency Questionnaire (CCCQ) and comprising four domains (knowledge, skills, encounters or situations, and attitudes towards cultural competency) was administered to second year pharmacy students before they started their advanced pharmacy practice experiences (APPEs). Additional questions regarding their ability to identify and recognize elements of cultural competence were asked. The effects of demographics, work experience, and education on cultural competence also were assessed.Results. Ninety-seven students (86.6%) participated in the study. The majority of participants were Asian, female, and in their late 20s. Most students agreed or strongly agreed that they could identify and recognize elements of cultural competence. However, participants indicated they were only a little or somewhat comfortable when asked questions about knowledge, skills, and comfort. Students indicated they had “quite a bit” of competence regarding attitudes towards other cultures. Previous cultural diversity training in undergraduate studies and pharmacy school were associated with higher scores on the modified CCCQ.Conclusion. The findings emphasize the importance of schools providing training in the didactic and experiential portion of the pharmacy curriculum to increase pharmacy students’ knowledge, skills, comfort, and attitudes towards other cultures.     

Train-the-trainer program on cardiovascular health for community pharmacists in Malaysia

Background Studies have highlighted the benefits of having community pharmacists to deliver cardiovascular screening to patients. However, only few of such trainings are provided in Malaysia. Objective To describe the implementation and evaluation of a cardiovascular train-the-trainer program for community pharmacists. Method Community pharmacists’ attended a 5 h train-the-trainer program. A pre and post-training survey was administered to participants who attended the workshop to determine their requirements for education and effectiveness of the training provided. Results Forty community pharmacists participated and were trained with 35 of them completing both the pre and post training assessment. Participants self-reported confidence, knowledge and ability to conduct a workshop on cardiovascular health increased between 0.22 and 0.75 points post-training (p < 0.05). The program was rated as very good or excellent by 55% of participants. Eight participants implemented the program at 6 months follow-up within their own pharmacy organisations to further train another 114 participants on cardiovascular health. Conclusion Participation in a train-the-trainer program significantly increases community pharmacists’ perceived ability and confidence in conducting a cardiovascular health workshop.     

Educating Pharmacy Students About Underserved Populations Using Patient Speakers and Simulation Activities

Objective. To assess the impact of the Patient Voices series on Doctor of Pharmacy (PharmD) students.Methods. A series of patient speakers and integrated simulation activities focused on underserved populations, otherwise known as the Patient Voices series, was embedded into a pharmacy skills laboratory curriculum. First-year PharmD students’ self-ratings of confidence were compared on pre- and post-course surveys. Using evaluations from first-year introductory pharmacy practice experiences (IPPEs), student self-evaluation data were compared to preceptor evaluations of student performance. Open-ended responses to course evaluations from first- and second-year PharmD students and student reflections from third-year PharmD students were assessed using conventional content analysis to identify and characterize student perceptions.Results. Significant increases were observed in first-year students’ confidence to show empathy (mean, 4.2 to 4.7) and to interact with patients from underserved communities (mean, 2.2 to 4.2). Preceptor ratings of students’ empathy were consistent with the students’ self-rated abilities, while students’ self-ratings on cultural sensitivity were higher than the preceptors’ ratings. Qualitative analysis of course evaluation surveys and reflections revealed common themes identified by students, such as understanding different perspectives, increased empathy for patients, and the value of including this content in the curriculum.Conclusion. Student confidence to interact with patients from a variety of underserved populations increased following introduction of the Patient Voices series into the PharmD curriculum. Students perceived the series to be a valuable learning experience.     

Implementation of an Accelerated Physical Examination Course in a Doctor of Pharmacy Program

Objective. To describe the implementation of a 1-day accelerated physical examination course for a doctor of pharmacy program and to evaluate pharmacy students’ knowledge, attitudes, and confidence in performing physical examination.Design. Using a flipped teaching approach, course coordinators collaborated with a physician faculty member to design and develop the objectives of the course. Knowledge, attitude, and confidence survey questions were administered before and after the practical laboratory.Assessment. Following the practical laboratory, knowledge improved by 8.3% (p<0.0001). Students’ perceived ability and confidence to perform a physical examination significantly improved (p<0.0001). A majority of students responded that reviewing the training video (81.3%) and reading material (67.4%) prior to the practical laboratory was helpful in learning the physical examination.Conclusion. An accelerated physical examination course using a flipped teaching approach was successful in improving students’ knowledge of, attitudes about, and confidence in using physical examination skills in pharmacy practice.     

An Educational Tool for Teaching Medication History Taking to Pharmacy Students

Objective. To implement and evaluate the use of a situated-learning experience to prepare second-year pharmacy students to conduct medication history interviews in preparation for introductory pharmacy practice experiences (IPPE) at ambulatory clinic sites.Design. Second-year doctor of pharmacy (PharmD) students (n=200) used the Medication Mysteries Infinite Case Tool, a game-like educational tool in which groups of 3 students assumed the roles of pharmacist, patient, and observer and rolled a die and drew cards to determine the drugs, patient personality, medication problems, and other variables that guided a medication history taking session.Assessment. After the laboratory session, faculty members assessed students’ medication history-taking skills. One hundred sixteen (58%) and 78 (39%) of 200 students achieved excellence or competence, respectively, on the final assessment. Two weeks after the assessment, 53 of 200 (26.5%) students completed a survey instrument. The respondents indicated that their self-confidence in conducting medical history taking significantly improved following completion of the learning experience.Conclusion. Using the Medication Mysteries Infinite Case Tool increased students’ confidence and skills in conducting medication history taking prior to their clinical IPPE experience.     

Factors associated with pharmacy students' attitudes towards learning communication skills – A study among Nordic pharmacy students

Introduction

Good communication skills are essential for pharmacy students to help patients with their medicines. Students' attitudes towards communication skills learning will influence their willingness to engage in communication training, and their skills when dealing with patients later on in their professional life.

Incremental Development of an Integrated Assessment Method for the Professional Curriculum

Objective. To incrementally create and embed biannual integrated knowledge and skills examinations into final examinations of the pharmacy practice courses offered in the first 3 years of the pharmacy curriculum that would account for 10% of each course’s final course grade.Design. An ad hoc integrated examination committee was formed and tasked with addressing 4 key questions. Integrated examination committees for the first, second, and third years of the curriculum were established and tasked with identifying the most pertinent skills and knowledge-based content from each required course in the curriculum, developing measurable objectives addressing the pertinent content, and creating or revising multiple-choice and performance-based questions derived from integrated examination objectives. An Integrated Examination Review Committee evaluated all test questions, objectives, and student performance on each question, and revised the objectives and questions as needed for the following year’s iteration. Eight performance objectives for the examinations were measured.Assessment. All 8 performance objectives were achieved. Sixty-four percent of the college’s faculty members participated in the integrated examination process, improving the quality of the examination. The incremental development and implementation of the examinations over a 3-year period minimized the burden on faculty time while engaging them in the process. Student understanding of expectations for knowledge and skill retention in the curriculum also improved.Conclusions. Development of biannual integrated examinations in the first 3 years of the classroom curriculum enhanced the college’s culture of assessment and addressed accreditation guidelines for formative and summative assessment of students’ knowledge and skills. The course will continue to be refined each year.     

Active-Learning Instruction on Emergency Contraception Counseling

Objective. To increase pharmacy students’ knowledge of and confidence in counseling patients regarding emergency contraception and to identify any barriers to counseling patients about emergency contraception.Design. Approximately 200 third-year pharmacy students participated in the Women’s Health Therapeutics workshop at Midwestern University Chicago College of Pharmacy. Students observed a 5-minute skit of a counseling session on emergency contraception and then were asked to pair up with a classmate and practice counseling each other regarding the use of emergency contraception following a checklist of key points.Assessment. One hundred eighty-nine students completed pre- and post-workshop survey instruments. Students’ knowledge scores increased from 86% to 93% (p<0.001). Approximately 25% of the students stated they were confident in counseling patients on emergency contraception before completing the active-learning exercise compared to 58.5% after (p<0.001). The most common barrier to counseling that students identified on the pre- and post-workshop survey was lack of knowledge.Conclusion. Participation in an active-learning exercise significantly increased pharmacy students’ knowledge of and confidence in counseling patients regarding emergency contraception and significantly reduced several barriers to counseling identified prior to participation.     

Student Scientific Inquiry in the Core Curriculum

Objective. To design and implement a required student-driven research program as a capstone experience in the doctor of pharmacy (PharmD) curriculum.Design. A research proposal in the form of a competitive grant application was required for each of 65 fourth-year students in an inaugural PharmD class at Touro College of Pharmacy in New York. The focus of the proposals was on hypothesis-driven research in basic science, clinical research, health outcomes, and public health.Assessment. Students’ research proposals were graded using a standardized grading instrument. On a post-experience survey, most students rated the overall experience positively, indicating increased confidence in their research skills. About two-thirds of faculty members were satisfied with their students’ performance, and the great majority thought the experience would be useful in the students’ careers.Conclusion. The capstone research project was a positive experience for fourth-year students.     

Student and Faculty Perceptions of Lecture Recording in a Doctor of Pharmacy Curriculum

Objective. To describe students’ and faculty members’ perceptions of the impact of lecture recording in a doctor of pharmacy (PharmD) curriculum.Methods. Second- and third-year pharmacy students and faculty members completed an anonymous survey instrument regarding their perceptions of lecture recording with 2 classroom lecture capture software programs, Camtasia Studio and Wimba Classroom.Results. Most students (82%) responded that Camtasia was very helpful and almost half (49%) responded that Wimba Classroom was helpful (p<0.001). Forty-six percent of the students reported being more likely to miss a class that was recorded; however, few students (10%) reported using recordings as a substitute for attending class. The most common concern of faculty members was decreased student attendance (27%).Conclusion. Pharmacy students consider lecture recordings beneficial, and they use the recordings primarily to review the lecture. While faculty members reported concerns with decreased attendance, few students reported using recordings as an alternative to class attendance.     

A Three-Year Reflective Writing Program as Part of Introductory Pharmacy Practice Experiences

Objectives. To implement and evaluate a 3-year reflective writing program incorporated into introductory pharmacy practice experiences (IPPEs) in the first- through third-year of a doctor of pharmacy (PharmD) program.Design. Reflective writing was integrated into 6 IPPE courses to develop students’ lifelong learning skills. In their writing, students were required to self-assess their performance in patient care activities, identify and describe how they would incorporate learning opportunities, and then evaluate their progress. Practitioners, faculty members, and fourth-year PharmD students served as writing preceptors.Assessment. The success of the writing program was assessed by reviewing class performance and surveying writing preceptor’s opinions regarding the student’s achievement of program objectives. Class pass rates averaged greater than 99% over the 8 years of the program and the large majority of the writing preceptors reported that student learning objectives were met. A support pool of 99 writing preceptors was created.Conclusions. A 3-year reflective writing program improved pharmacy students’ reflection and reflective writing skills.     

Enhancing Team-Based Active Learning Through Hands-On Experience With Nicotine Replacement Therapy

Objectives. To enhance tobacco cessation active-learning in an ambulatory care elective course by adding hands-on experience with nicotine replacement therapy to a team-based learning (TBL) session.Design. A hands-on experience that included students chewing a piece of nicotine gum was added to a TBL class session. Student pairs used a skills checklist to evaluate and give peer feedback on appropriate counseling and gum use.Assessment. Students’ scores on a tobacco cessation examination were higher than those of students enrolled in the previous course in which TBL alone had been used. Based on pre- and post-experience survey responses, students’ perceptions regarding their abilities to provide tobacco cessation counseling improved. Subjective student comments regarding the experience were positive.Conclusion. Participating in a TBL session that incorporated hands-on experience with nicotine gum in an ambulatory care elective course increased students’ confidence in their ability to provide tobacco cessation counseling and provided a unique perspective on the product’s characteristics.     

Incorporating Standardized Colleague Simulations in a Clinical Assessment Course and Evaluating the Impact on Interprofessional Communication

Objective. To determine the impact of incorporating standardized colleague simulations on pharmacy students’ confidence and interprofessional communication skills.Design. Four simulations using standardized colleagues portraying attending physicians in inpatient and outpatient settings were integrated into a required course. Pharmacy students interacted with the standardized colleagues using the Situation, Background, Assessment, Request/Recommendation (SBAR) communication technique and were evaluated on providing recommendations while on simulated inpatient rounds and in an outpatient clinic. Additionally, changes in student attitudes and confidence toward interprofessional communication were assessed with a survey before and after the standardized colleague simulations.Assessment. One hundred seventy-one pharmacy students participated in the simulations. Student interprofessional communication skills improved after each simulation. Student confidence with interprofessional communication in both inpatient and outpatient settings significantly improved.Conclusion. Incorporation of simulations using standardized colleagues improves interprofessional communication skills and self-confidence of pharmacy students.     

Pharmacist instruction of physical assessment for pharmacy students

Objective

To assess the impact of a change from nurse to pharmacist instructors and a new curriculum intended to encourage students’ use of physical assessment skills.

Design

Pharmacist faculty members redesigned the physical assessment curriculum to focus on those assessment skills most likely to be performed by practicing pharmacists. The 5 focus areas were general assessment skills, gastrointestinal system, pulmonary system, central and peripheral nervous system, and cardiovascular system. Instructional methods used included prelaboratory assignments, brief introductory lectures, demonstration of assessment techniques, application of techniques with a laboratory partner, and demonstration of competence using a mannequin.

Assessment

A 16-item survey instrument was administered to determine students’ perceptions of the revised curriculum. Students who received instruction from pharmacist faculty members used their physical assessment skills more, especially during advanced pharmacy practice experiences (APPEs), than students who received instruction from nurse faculty members. Students instructed by pharmacist faculty members also felt more comfortable with their skills and rated the instruction as more practical.

Conclusion

A redesigned curriculum and pharmacist-led instruction resulted in improved pharmacy student comfort with and use of physical assessment skills.