Active-Learning Processes Used in US Pharmacy Education

Objective

To document the type and extent of active-learning techniques used in US colleges and schools of pharmacy as well as factors associated with use of these techniques.

Methods

A survey instrument was developed to assess whether and to what extent active learning was used by faculty members of US colleges and schools of pharmacy. This survey instrument was distributed via the American Association of Colleges of Pharmacy (AACP) mailing list.

Results

Ninety-five percent (114) of all US colleges and schools of pharmacy were represented with at least 1 survey among the 1179 responses received. Eighty-seven percent of respondents used active-learning techniques in their classroom activities. The heavier the teaching workload the more active-learning strategies were used. Other factors correlated with higher use of active-learning strategies included younger faculty member age (inverse relationship), lower faculty member rank (inverse relationship), and departments that focused on practice, clinical and social, behavioral, and/or administrative sciences.

Conclusions

Active learning has been embraced by pharmacy educators and is used to some extent by the majority of US colleges and schools of pharmacy. Future research should focus on how active-learning methods can be used most effectively within pharmacy education, how it can gain even broader acceptance throughout the academy, and how the effect of active learning on programmatic outcomes can be better documented.     

An Active-Learning Laboratory on Immunizations

Objective. To implement and evaluate an active-learning laboratory activity to teach pharmacy students about influenza, pneumococcal, and shingles vaccines.Design. The laboratory session was divided into 6 immunization stations: 3 stations on influenza including a pediatrics station, and 1 station each for pneumococcal, shingles, and anaphylaxis.Assessment. Although 118 of 123 (95.9%) students had completed an immunization training certificate prior to attending the laboratory, the average score on a pre-assessment to measure immunization knowledge and confidence was 56%. The post-assessment score was 87.4%. Students’ confidence improved by 18.7% to 51.2% in each of the 5 areas assessed. Most respondents rated the activity overall as good or excellent on a post-activity evaluation.Conclusion. An active-learning approach to teaching immunizations allowed students to gain knowledge in simulated real-world experiences and reinforced key concepts on influenza, pneumococcal, and shingles vaccines.     

美洛昔康用于紧急避孕的系统评价

目的系统评价美洛昔康用于紧急避孕的有效性和安全性。方法全面检索相关文献,对根据纳入标准筛选后的研究进行严格评价和Meta分析。结果最终纳入3个随机对照试验,Meta分析结果显示,关洛昔康可增大主导卵泡直径可延迟女性排卵时间;试验组和对照组的不良反应发生率比较,差异无统计学意义;美洛昔康30mg／d的避孕效果优于15mg／d。结论美洛昔康30mg／d用于紧急避孕有效且相对安全。但该系统评价纳入的研究样本量较小,现有证据尚不足以推荐此方案广泛用于避孕,还需开展更多大样本随机双盲对照试验加以验证。     

Correlation Between Active-Learning Coursework and Student Retention of Core Content During Advanced Pharmacy Practice Experiences

Objective. To implement an active-learning approach in a pharmacotherapy course sequence in the second year (P2) and third (P3) year of a doctor of pharmacy (PharmD) program and determine whether the pedagogical changes correlated with retention of core content in the fourth year (P4).Design. Class sessions were transitioned from slides-based lectures to discussion-based active-learning pedagogy.Assessment. A comprehensive examination was created and administered to assess student retention of therapeutic topics taught. Students demonstrated significantly improved overall scores on questions derived from the active-learning pedagogy used in Pharmacotherapy II and III compared to those derived from Pharmacotherapy I in which content was delivered by lecture.Conclusion. The use of active-learning strategies over lecture-based methods in pharmacotherapy courses resulted in higher retention of core content. Students’ performance in areas taught using the discussion-based methodology was superior to that which was taught using lecture-based slide presentations.     

小剂量米非司酮用于紧急避孕的临床观察

为探讨小剂量米非司酮用于紧急避孕的效果,对200例月经规律,72小时内有无防护性生活或避孕失败的妇女给予米非司酮25mg顿服,观察其避孕有效率为94.7％,月经周期、经期、经量无明显变化者占86.5％。仅有2％有轻微的恶心等副作用。结果表明,单用小剂量米非司酮完全可以用于性生活后72小时内的紧急避孕。     

小剂量米非司酮与左旋18-甲基炔诺酮单方用于紧急避孕的比较研究

目的：探讨小剂量米非司酮与左旋１８－甲基炔诺酮单方用于紧急避孕的有效性和可接受性。方法：房事后服米非司酮１０ｍｇ,１２小时后服安慰剂一片。房事后服左旋１８－甲基炔诺酮０．７５ｍｇ,间隔１２小时再服１次。两种药种外形一致,采用双盲法给药。结果：两药均取得满意避孕效果。但就副反应而言,米非司酮为优,两组发生率差异有显著性（ｕ＝４．８８,Ｐ〈０．０１）。两药对缩短月经周期的机率无显著性差异（Ｐ〉０．０５     

Active-Learning Diabetes Simulation in an Advanced Pharmacy Practice Experience to Develop Patient Empathy

Objective. To develop and integrate an active-learning diabetes simulation into an advanced pharmacy practice experience to improve pharmacy students’ empathy toward patients with diabetes mellitus.Design. Students simulated the experience of having diabetes mellitus by conducting activities commonly prescribed to those with this disease state for 7 days, after which they submitted a standardized diabetes log and narrative reflection. Interpretive phenomenology design with thematic analysis was used to determine the impact of this experience on the students.Assessment. As shown in student reflections, 95% developed empathy, 97% found the experience beneficial, and 67% improved their ability to relate to and counsel patients. Most (95%) found difficulty adhering to the regimen. On average, students consumed 179 grams of carbohydrates per day and exercised 5 days or 215 minutes per week. Additionally, 69% decided to modify their personal habits to become healthier.Conclusions. Inclusion of the 7-day active-learning exercise greatly impacted student pharmacists’ self-reported empathy toward and ability to relate to patients with diabetes mellitus. Completion of this experience may result in long-lasting personal behavior modifications.     

不同剂量米非司酮用于紧急避孕的结果分析

目的观察米非司酮两种剂量用于紧急避孕的临床效果。方法 120例受试者按米非司酮剂量不同,分为米非司酮25mg(A组)60例和米非司酮10mg(B组)60例,观察服药后的不良反应及月经情况、阴道流血情况等。结果 A、B组避孕成功率分别为86.6%和88.3%,组间比较无显着性差异(χ2=2.75,P>0.05);A、B组月经趋于正常者分别为63.3%和61.6%(χ2=2.99,P>0.05);A、B组不良反应11例(18.3%)和B组9例(15.0%)(χ2=2.35,P>0.05)。结论两组在避孕效果、不良反应及月经变化等方面均无明显差异,低剂量米非司酮用于紧急避孕同样有效。     

国内、外左炔诺孕酮紧急避孕药药品说明书的比较和分析

目的:为规范左炔诺孕酮紧急避孕药药品说明书提供参考。方法:对目前我国市场上所使用的左炔诺孕酮紧急避孕药药品说明书的内容与国家相关规定进行比较,同时与国外说明书的内容进行对比,分析目前我国左炔诺孕酮紧急避孕药药品说明书中存在的问题。结果:目前我国左炔诺孕酮紧急避孕药药品说明书中存在的主要问题包括没有规定用药人群、没有明确使用次数和用药间隔、未对左炔诺孕酮紧急避孕药的不良反应提供足够的提示、缺少相关药学研究数据等。结论:目前我国市场上左炔诺孕酮紧急避孕药药品说明书存在缺项、漏项及用药安全性提示不足的情况,建议相关部门和企业对此类药品说明书进行修改和完善。     

Assessment of Emergency Preparedness Modules in Introductory Pharmacy Practice Experiences

Objective. To determine the impact of emergency preparedness simulations in mass triage and mass dispensing on student pharmacist performance and perceived competency when assuming pharmacist roles in disaster situations.Design. Second-year student pharmacists (144) completed two 3-hour simulations focusing on mass triage and mass dispensing. The mass triage simulation consisted of virtual and live victims to be triaged and assigned a transport order. In the mass dispensing simulation, students assumed patient and pharmacist roles in a point-of-dispensing exercise for influenza.Assessment. For the mass triage simulation, students were challenged most by determining which patients could wait for emergency care but did well assessing those who required immediate or minimal care (83% and 64% correct, respectively). During the mass dispensing simulation, students performed screening and dispensing functions with accuracy rates of 88% and 90%, respectively.Conclusion. Student pharmacists performed well in screening and dispensing functions, but struggled with mass casualty triage during emergency preparedness simulations.     

Access to emergency hormonal contraception from community pharmacies and family planning clinics

AIMS: To evaluate differences in the time taken to access progestogen-only emergency hormonal contraception (EHC) by young women from family planning (FP) or community pharmacy settings. METHODS: An observational study of 203 women requesting EHC from FP clinics and community pharmacies in South-west Kent Primary Care Trust (PCT) from December 2002 to October 2003. RESULTS: Access to EHC from community pharmacy was significantly faster than from FP clinics (16 h vs. 41 h, P<0.001). Older teenagers tended to seek EHC more quickly and were more likely to have had a contraceptive failure rather than have used no contraception at all. CONCLUSION: The results provide further support for pharmacist involvement in the supply of EHC.     

母体乐节育器用于紧急避孕的临床观察

目的观察母体乐宫内节育器(MUTILELCu375IUD)用于紧急避孕的临床效果。方法对86名距第一次无保护性交超过72h时,但在120h内的,愿意使用宫内节育器长期避孕的生育期妇女放置母体乐节育器,术后常规给予抗生素及止血药物,随访至下次月经来潮,观察避孕效果;随访至置器后半年,观察续用情况,按Dixon方法计算妊娠概率。结果86例受术者预期妊娠率为8.621%,实际妊娠率为0,避孕有效率为100%,无一例感染发生。随访1个月,续用率为95.35%,随访6个月,续用率为93.02%。结论严格掌握适应证,按照宫内节育器放置常规施术,术后常规应用抗生素和止血药物预防出血感染,母体乐宫内节育器用于紧急避孕是高效安全的,尤其适用于要求长期避孕的育龄妇女。     

Incorporating Active-Learning Techniques and Competency Assessment into a Critical Care Elective Course

Objective. To design, implement, and measure the effectiveness of a critical care elective course for second-year students in a 3-year accelerated doctor of pharmacy (PharmD) program.Design. A critical care elective course was developed that used active-learning techniques, including cooperative learning and group presentations, to deliver content on critical care topics. Group presentations had to include a disease state overview, practice guidelines, and clinical recommendations, and were evaluated by course faculty members and peers.Assessment. Students’ mean scores on a 20-question critical-care competency assessment administered before and after the course improved by 11% (p < 0.05). Course evaluations and comments were positive.Conclusion. A critical care elective course resulted in significantly improved competency in critical care and was well-received by students.     

Vodcasts and Active-Learning Exercises in a “Flipped Classroom” Model of a Renal Pharmacotherapy Module

Objective. To implement a “flipped classroom” model for a renal pharmacotherapy topic module and assess the impact on pharmacy students’ performance and attitudes.Design. Students viewed vodcasts (video podcasts) of lectures prior to the scheduled class and then discussed interactive cases of patients with end-stage renal disease in class. A process-oriented guided inquiry learning (POGIL) activity was developed and implemented that complemented, summarized, and allowed for application of the material contained in the previously viewed lectures.Assessment. Students’ performance on the final examination significantly improved compared to performance of students the previous year who completed the same module in a traditional classroom setting. Students’ opinions of the POGIL activity and the flipped classroom instructional model were mostly positive.Conclusion. Implementing a flipped classroom model to teach a renal pharmacotherapy module resulted in improved student performance and favorable student perceptions about the instructional approach. Some of the factors that may have contributed to students’ improved scores included: student mediated contact with the course material prior to classes, benchmark and formative assessments administered during the module, and the interactive class activities.     

国内外关于左炔诺孕酮紧急避孕药不良反应的数据分析与评价

目的:为我国左炔诺孕酮紧急避孕药安全使用与评价提供参考。方法:对美国食品与药品管理局医药产品不良事件报告体系、我国国家药品不良反应监测中心、世界卫生组织和我国国家人口计生委计划生育药具不良反应监测中心所收集到的左炔诺孕酮紧急避孕药不良反应报告进行分析,并对左炔诺孕酮紧急避孕药的不良反应进行文献检索与分析,找出国内、外关于左炔诺孕酮紧急避孕药不良反应发生类型与报告数据的差距并分析原因。结果:国内、外关于左炔诺孕酮紧急避孕药不良反应的发生类型、种类和报告数据方面均存在较大差距。结论:左炔诺孕酮紧急避孕药不良反应的公众教育、发放人员的专业培训及医师对紧急避孕药不良反应的认知与及时处理是减少与预防紧急避孕药不良反应发生的关键。     

Student Knowledge and Confidence in an Elective Clinical Toxicology Course Using Active-Learning Techniques

Objective. To measure changes in students’ knowledge and confidence scores after completing an elective clinical toxicology course in an accelerated doctor of pharmacy (PharmD) program.Design. Various active-learning techniques were used to create a learner-centered environment. Approximately two-thirds of the course used student-led presentations. Some of those not presenting were assigned to be evaluators, responsible for asking the presenter a question or writing quiz questions based on the presented material. Other learner-centered activities included weekly quizzes and discussions at the conclusion of each presented topic.Assessment. A test instrument designed to measure students’ knowledge and associated level of confidence on each item was administered at the beginning and end of the course. Students’ knowledge and confidence scores increased significantly from pretest to posttest.Conclusions. Students’ increased confidence and knowledge scores were well correlated after course completion, indicating students were better able to self-assess these areas. These findings suggest that confidence could be an additional measure of students'' metacognitive skill development.     

医院药剂科开展中毒急救咨询工作的探讨

本文探讨了如何开展中毒急救工作,总结了开展咨询工作的体会,从工作实践出发明确了咨询人员所需完成的任务,并对开展这一工作提出了一些建议。     

Educational Games as a Teaching Tool in Pharmacy Curriculum

The shift in the pharmacist’s role from simply dispensing medications to effective delivery of pharmaceutical care interventions and drug therapy management has influenced pharmacy education.^1-3 The educational focus has shifted from basic sciences to clinical and integrated courses that require incorporating active-learning strategies to provide pharmacy graduates with higher levels of competencies and specialized skills. As opposed to passive didactic lectures, active-learning strategies address the educational content in an interactive learning environment to develop interpersonal, communication, and problem-solving skills needed by pharmacists to function effectively in their new roles.^4-6 One such strategy is using educational games. The aim of this paper is to review educational games adopted in different pharmacy schools and to aid educators in replicating the successfully implemented games and overcoming deficiencies in educational games. This review also highlights the main pitfalls within this research area.     

An Assessment of State Board of Pharmacy Legal Documents for Public Health Emergency Preparedness

Objective. To estimate pharmaceutical emergency preparedness of US states and commonwealth territories.Methods. A quantitative content analysis was performed to evaluate board of pharmacy legal documents (ie, statutes, rules, and regulations) for the presence of the 2006 Rules for Public Health Emergencies (RPHE) from the National Association of Boards of Pharmacy’s (NABP) Model Pharmacy Practice Act.Results. The median number of state-adopted RPHE was one, which was significantly less than the hypothesized value of four. Rule Two, which recommended policies and procedures for reporting disasters, was adopted significantly more than other RPHE. Ten states incorporated language specific to public health emergency refill dispensing, and among these, only six allowed 30-day refill quantities.Conclusion. Based on the 2006 NABP model rules, it does not appear that states are prepared to expedite an effective pharmaceutical response during a public health emergency. Boards of pharmacy should consider adding the eight RPHE to their state pharmacy practice acts.