Evaluation of Student Factors Associated with Pre-NAPLEX Scores

Objective: To examine relationships among students’ Pre-NAPLEX scores and prepharmacy, pharmacy school, and demographic variables to better understand factors that may contribute to Pre-NAPLEX performance.Methods: A retrospective review of pharmacy students’ Pre-NAPLEX scores, demographics, prepharmacy factors, and pharmacy school factors was performed. Bivariate (eg, ANOVA) and correlational analyses and stepwise linear regression were conducted to examine the significance of various factors and their relationship to Pre-NAPLEX score.Results: 168 students were included, with the majority being female (60.7%) and White (72%). Mean Pre-NAPLEX score was 68.95 ± 14.5. Non-Hispanic White students had significantly higher Pre-NAPLEX scores compared to minority students (p<0.001). Pre-NAPLEX score was correlated (p<0.001) to race/ethnicity (r=-0.341), PCAT score (r=0.272), and pharmacy school GPA (r=0.346). The regression model (adjusted R²=0.216; p<0.001) included pharmacy school GPA, academic probation, academic remediation, and PCAT composite.Conclusion: This study highlighted that select demographic, prepharmacy, and pharmacy school factors were associated with Pre-NAPLEX outcomes. Such factors may assist colleges/schools of pharmacy in identifying students who may be at risk for poorer NAPLEX performance and may need greater preparation.     

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.     

Performance of Pharmacy Students in a Communications Course Delivered Online During the COVID-19 Pandemic

Objective. To examine pharmacy student readiness, reception, and performance in a communications course during the COVID-19 pandemic and to compare that with the performance of students who completed the same course in person the previous year.Methods. First-year Doctor of Pharmacy students (2020 cohort) enrolled in a professional communications course completed pre- and post-course surveys regarding their readiness for and changes in perception of online learning. Student learning was assessed using midterm and final examination grades. These grades were then compared with those of students who had completed the same course in person (on campus) the previous year (2019 cohort).Results. Students’ preference for face-to-face instruction decreased from the pre-course to the post-course survey as indicated by responses made using a five-point Likert-scale (difference in means = −1.59; p < .05). Their comfort level with online learning increased (difference in means = +0.38, p < .05) by the end of the course. Students did not perceive any appreciable changes in rapport with the instructor by the end of the study. Course performance of students in the online cohort did not differ significantly from that of the 2019 cohort (p>.05).Conclusion. This study demonstrated that first year PharmD students were already somewhat prepared for online learning when they began a communication course, with further adjustment occurring as the quarter progressed. Remote online learning did not seem to impact pharmacy student learning in this communications course conducted during the COVID-19 crisis.     

Critical Thinking and Reflection Exercises in a Biochemistry Course to Improve Prospective Health Professions Students’ Attitudes Toward Physician-Pharmacist Collaboration

Objective. To determine the impact of performing critical-thinking and reflection assignments within interdisciplinary learning teams in a biochemistry course on pharmacy students’ and prospective health professions students’ collaboration scores.Design. Pharmacy students and prospective medical, dental, and other health professions students enrolled in a sequence of 2 required biochemistry courses. They were randomly assigned to interdisciplinary learning teams in which they were required to complete case assignments, thinking and reflection exercises, and a team service-learning project.Assessment. Students were asked to complete the Scale of Attitudes Toward Physician-Pharmacist Collaboration prior to the first course, following the first course, and following the second course. The physician-pharmacist collaboration scores of prospective health professions students increased significantly (p<0.001).Conclusions. Having prospective health professions students work in teams with pharmacy students to think and reflect in and outside the classroom improves their attitudes toward physician-pharmacist collaboration.     

Journal clubs during advanced pharmacy practice experiences to teach literature-evaluation skills

Objective. To determine pharmacy students’ attitudes and academic performance related to journal club during 2 advanced pharmacy practice experiences (APPEs).Design. Fourth-year pharmacy students were required to complete 3 journal club assignments during drug information and internal medicine APPEs.Assessment. A majority (91.3%) of the 105 students who responded to a 21-item survey instrument indicated that journal club assignments during the drug-information APPE were valuable to their understanding of research design and statistics. Students who completed the drug-information APPE before the internal medicine APPE scored higher on their understanding of the strengths and weaknesses and the clinical relevance of studies and had a higher learning slope (p = 0.01) than did students who completed the internal medicine APPE first.Conclusion. Incorporating journal clubs into APPEs is an effective means of teaching literature-evaluation skills to pharmacy students.     

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     

Validation of an Empathy Scale in Pharmacy and Nursing Students

Objective. To validate an empathy scale to measure empathy in pharmacy and nursing students.Methods. A 15-item instrument comprised of the cognitive and affective empathy domains, was created. Each item was rated using a 7-point Likert scale, ranging from strongly disagree to strongly agree. Concurrent validity was demonstrated with the Jefferson Scale of Empathy – Health Professional Students (JSE-HPS).Results. Reliability analysis of data from 216 students (pharmacy, N=158; nursing, N=58) showed that scores on the empathy scale were positively associated with JSE-HPS scores (p<0.001). Factor analysis confirmed that 14 of the 15 items were significantly associated with their respective domain, but the overall instrument had limited goodness of fit.Conclusions. Results of this study demonstrate the reliability and validity of a new scale for evaluating student empathy. Further testing of the scale at other universities is needed to establish validity.     

A Comparison of Pharmacy Students’ and Active Older Adults' Perceptions Regarding Geriatric Quality of Life

Objectives. To measure perceptions of quality of life (QOL) in an active geriatric population and compare their responses with pharmacy students’ perceptions of older adult QOL.Methods. Pharmacy students and active older adults completed the modified and standard version of a validated health survey instrument, respectively, and their responses were compared.Results. Eighty-six students and 20 active older adults participated. Student perceptions of geriatric QOL were significantly lower in all domains except health change compared to older adult perceptions (p<0.001 for all domains). Interest in a geriatric pharmacy career (p=0.04) and previously having taken the Perspectives in Geriatrics course and laboratory (p=0.05 and 0.02, respectively) were significantly associated with higher student scores on the physical component portion of the survey.Conclusion. Stronger emphasis on geriatric QOL within pharmacy curricula may improve pharmacy students’ perceptions regarding outcomes related to healthy older adults.     

Early Clinical Experiences for Second-Year Student Pharmacists at an Academic Medical Center

Objective. To examine student outcomes associated with the Student Medication and Reconciliation Team (SMART) program, which was designed to provide second-year student pharmacists at the University of North Carolina (UNC) Eshelman School of Pharmacy direct patient care experience at UNC Medical Center.Design. Twenty-two second-year student pharmacists were randomly selected from volunteers, given program training, and scheduled for three 5-hour evening shifts in 2013-2014. Pre/post surveys and reflection statements were collected from 19 students. Data were analyzed with a mixed methods approach.Assessment. Survey results revealed an increase in student self-efficacy (p<0.05) and positive perceptions of SMART. Qualitative findings suggest the program provided opportunities for students to develop strategies for practice, promoted an appreciation for the various roles pharmacists play in health care, and fostered an appreciation for the complexity of real-world practice.Conclusion. Early clinical experiences can enhance student learning and development while fostering an appreciation for pharmacy practice.     

Comparing Effectiveness of High-Fidelity Human Patient Simulation vs Case-Based Learning in Pharmacy Education

Objective. To determine whether human patient simulation (HPS) is superior to case-based learning (CBL) in teaching diabetic ketoacidosis (DKA) and thyroid storm (TS) to pharmacy students.Design. In this cross-over, open-label, single center, randomized control trial, final-year undergraduate pharmacy students enrolled in an applied therapeutics course were randomized to HPS or CBL groups. Pretest, posttest, knowledge retention tests, and satisfaction survey were administered to students.Assessment. One hundred seventy-four students participated in this study. The effect sizes attributable to HPS were larger than CBL in both cases. HPS groups performed significantly better in posttest and knowledge retention test compared to CBL groups pertaining to TS case (p<0.05). Students expressed high levels of satisfaction with HPS sessions.Conclusion. HPS was superior to CBL in teaching DKA and TS to final-year undergraduate pharmacy students.     

A Multipreceptor Approach to Ambulatory Care Topic Discussions

Objective. To assess the impact of a multipreceptor approach to facilitating topic discussions on students'' knowledge and confidence in clinical decision-making during an ambulatory care advanced pharmacy practice experiences (APPEs).Design. Faculty members with relevant expertise and experience facilitated discussions with fourth-year doctor of pharmacy (PharmD) students regarding 7 ambulatory care topics. A student self-assessment survey and knowledge-assessment instrument was administered before and after discussions.Assessment. Students'' examination scores increased significantly from 59.1% ± 13.9% at baseline to 76.5% ± 12.6% at the end of the 5-week experience (p<0.001). The majority of participants were comfortable making therapeutic decisions regarding medication use as it related to all discussion topics except heart failure.Conclusions. Participation in topic discussions led by faculty members with expertise and experience for each ambulatory care topic was associated with a significant improvement in knowledge-assessment scores.     

Patient Simulation to Demonstrate Students�� Competency in Core Domain Abilities Prior to Beginning Advanced Pharmacy Practice Experiences

Objective. To implement a simulation-based introductory pharmacy practice experience (IPPE) and determine its effectiveness in assessing pharmacy students’ core domain abilities prior to beginning advanced pharmacy practice experience (APPE). Design. A 60-hour IPPE that used simulation-based techniques to provide clinical experiences was implemented. Twenty-eight students were enrolled in this simulation IPPE, while 60 were enrolled in hospital and specialty IPPEs within the region.Assessment. The IPPE assessed 10 out of 11 of the pre-APPE core domain abilities, and on the practical examination, 67% of students passed compared to 52% of students in the control group. Students performed better on all 6 knowledge quizzes after completing the simulation IPPE. Based on scores on the Perception of Preparedness to Perform (PREP) survey, students felt more prepared regarding “technical” aspects after completing the simulation experience (p<0.001). Ninety-six percent of the respondents agreed with the statement “I am more aware of medication errors after this IPPE.”Conclusion. Simulation is an effective method for assessing the pre-APPE abilities of pharmacy students, preparing them for real clinical encounters, and for making them more aware of medication errors and other patient safety issues.     

Using Grey Literature to Prepare Pharmacy Students for an Evolving Healthcare Delivery System

Objectives. To assess the impact of using “grey literature” (information internally produced in print or electronic format by agencies such as hospitals, government, businesses, etc) rather than a textbook in a course on healthcare delivery systems on students’ perception of the relevance of healthcare delivery system topics and their ability to identify credible sources of this information.Design. A reading from the grey literature was identified and assigned to the students for each topic in the course.Assessment. Pre- and post-course survey instruments were used for the assessment. Students reported healthcare delivery systems topics to be moderately relevant to the profession of pharmacy on both the pre- and post-course survey instruments. Students’ knowledge of current and credible sources of information on healthcare delivery system topics significantly improved based on self-reports and scores on objective assessments (p<0.05).Conclusions. Assignment of grey literature in a course on healthcare delivery systems can be used to ensure that information in the pharmacy school curriculum is the most current and credible information available.     

Pharmacy Students’ Ability to Identify Plagiarism After an Educational Intervention

Objective. To determine if an educational intervention in a doctor of pharmacy (PharmD) degree program increases pharmacy students’ ability to identify plagiarism.Methods. First-year (P1), second-year (P2), and third-year (P3) pharmacy students attended an education session during which types of plagiarism and methods for avoiding plagiarism were reviewed. Students completed a preintervention assessment immediately prior to the session and a postintervention assessment the following semester to measure their ability.Results. Two hundred fifty-two students completed both preintervention and postintervention assessments. There was a 4% increase from preintervention to postintervention in assessment scores for the overall student sample (p<0.05). The mean change was greatest for P1 and P2 students (5% and 4.8%, respectively).Conclusion. An educational intervention about plagiarism can significantly improve students’ ability to identify plagiarism.     

Measuring Achievement Goal Orientations of Pharmacy Students

Objectives. To measure the achievement goal orientations of pharmacy students attending a 3-year (accelerated) doctor of pharmacy (PharmD) program.Methods. A 16-item survey based on the Achievement Goal Questionnaire (AGQ) was administered to first-year (P1) and second-year (P2) pharmacy students at the Appalachian College of Pharmacy (ACP). Students were instructed to indicate to what degree each statement was true for them using a 7-point Likert scale (1=not true of me, 7=very true of me).Results. One hundred twenty of the 155 students (77%) completed the survey. Most students had mastery-approach, mastery-avoidance, performance-approach, and/or performance-avoidance goal orientations; few had work-avoidance goal orientations. Second-year students and male students had higher work-avoidance mean scores than did P1 students and female students (p<0.05).Conclusion. Pharmacy students were mastery- and performance-oriented learners, and most did not have work-avoidance goal orientations. Male students and P2 students had higher work-avoidance than did female students and P1 students, respectively. More longitudinal studies are needed to confirm these findings.     

Pharmacy Students’ Ability to Think About Thinking

Objective. To investigate students’ metacognitive skills to distinguish what they know from what they do not know, to assess students’ prediction of performance on a summative examination, and to compare student-identified incorrect questions with actual examination performance in order to improve exam quality.Methods. Students completed a test-taking questionnaire identifying items perceived to be incorrect and rating their test-taking ability.Results. Higher performing students evidenced better metacognitive skills by more accurately identifying incorrect items on the exam. Most students (86%) underpredicted their performance on the summative examination (actual=73.6 ± 7.1 versus predicted=63.7 ± 10.5, p<0.05). Student responses helped refine items and resulted in examination changes.Conclusion. Metacognition is important to the development of life-long learning in pharmacy students. Students able to monitor what they know and what they do not know can improve their performance.     

The Impact of Advanced Pharmacy Practice Experiences on Students' Readiness for Self-directed Learning

Objective

To evaluate the impact of advanced pharmacy practice experiences (APPEs) on doctor of pharmacy (PharmD) students'' readiness for self-directed learning.

Methods

The Self-Directed Learning Readiness Scale (SDLRS) was administered to students prior to and after completing their APPEs. SDLRS is a validated instrument that determines the relative degree to which students have the attitudes and motivation to engage in self-directed learning.

Results

Seventy-seven (64%) students completed the SDLRS prior to starting their APPEs and 80 (67%) students completed the instrument after completing their APPEs. Forty-six (38%) students completed both. Prior to starting their APPEs, 74% of students scored greater than 150 on the SDLRS, indicating a high level of readiness for self-directed learning. No significant difference was found between the mean scores of students who took the SDLRS both prior to (159 ± 20) and after completing their APPEs (159 ± 24; p > 0.05).

Conclusion

Students at our institution appear to be ready for self-directed learning but APPEs had a minimal impact on their readiness for self-directed learning.     

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.     

A Scale to Measure Pharmacy Students’ Self-Efficacy in Performing Medication Therapy Management Services

Objective. To determine whether a college of pharmacy curriculum creates a sense of self-efficacy among students with respect to providing medication therapy management (MTM) services.Methods. An electronic survey instrument was sent to all pharmacy students to elicit information on their perceived confidence in providing MTM services, and the results were reviewed.Results. Of the 1,160 students targeted, 464 (40%) completed the survey instrument. Responses indicated that overall self-efficacy increased with each successive year of the curriculum that students completed. Fourth-year students completing an advanced pharmacy practice experience (APPE) in medication therapy management (MTM) had significantly higher self-efficacy than did other fourth-year students, whose self-efficacy was similar to that of third-year students.Conclusion. In this study population, students’ self-efficacy increased with each successive year in pharmacy school, with those who completed an APPE in MTM exhibiting the highest level of self-efficacy. These students may be more likely to pursue MTM opportunities in future careers.