The Impact of Blended Learning on Student Performance in a Cardiovascular Pharmacotherapy Course

Objective. To examine student engagement with, perception of, and performance resulting from blended learning for venous thromboembolism in a required cardiovascular pharmacotherapy course for second-year students.Design. In 2013, key foundational content was packaged into an interactive online module for students to access prior to coming to class; class time was dedicated to active-learning exercises.Assessment. Students who accessed all online module segments participated in more in class clicker questions (p=0.043) and performed better on the examination (p=0.023). There was no difference in clicker participation or examination performance based on time of module access (prior to or after class). The majority of participants agreed or strongly agreed that foundational content learned prior to class, applied activities during class, and content-related questions in the online module greatly enhanced learning.Conclusion. This study highlights the importance of integrating online modules with classroom learning and the role of blended learning in improving academic performance.     

Effect of Collaborative vs Noncollaborative Quizzes on Examination Scores in a Pharmaceutical Calculations Course

Objective. To determine if midterm and final examination scores in a pharmaceutical calculations course differ among students who take weekly quizzes collaboratively, noncollaboratively, or half-collaboratively/half-noncollaboratively (“mixed”).Methods. One hundred twenty-three students enrolled in one of 4 laboratory sections: collaborative, noncollaborative, or mixed sections. Students working noncollaboratively completed a 15-minute quiz at the end of weekly laboratories. Students working collaboratively were randomly allocated into groups of 4 and worked independently for 5 minutes before working collaboratively for 10 minutes. Students in mixed sections worked collaboratively during one half of the semester and noncollaboratively during the other half of the semester in a crossover design to control for order effect. All students took midterm and final examinations independently.Results. Mean scores for a pretest did not significantly differ between the 4 laboratory sections at the study’s onset. Multivariate analysis of variance (MANOVA) revealed a significant multivariate effect for the 9 laboratory quizzes in relation to group assignment. Mean scores on the midterm examination did not significantly differ between collaborative and noncollaborative groups. On the final examination, the two mixed groups significantly outperformed the collaborative group, but did not significantly differ from one another or from the noncollaborative group.Conclusion. Peer collaboration improves quiz scores, is favorably perceived by students and enhances their course satisfaction, but does not improve subsequent performance on midterm and final examinations taken noncollaboratively.     

Online Self-testing Resources Prepared by Peer Tutors as a Formative Assessment Tool in Pharmacology Courses

Objective. To assess the effectiveness of optional online quizzes written by peer tutors in a pharmacology course for doctor of pharmacy students.Methods. Online quizzes were written by peer tutors for second-year pharmacy students. Quizzes reflected the material taught during lecture and were in a format similar to that of the examinations. Data related to performance on each quiz and each examination were collected throughout the semester. At the end of the semester, students and peer tutors were surveyed to gather information on the utility and success of the quizzes.Results. Students taking online quizzes performed significantly better on examinations than those who did not take quizzes. In addition, students received higher scores on examinations than when practicing with the quizzes. Surveys suggest that students liked the quizzes and felt they increased their confidence and performance on examinations.Conclusion. The quizzes were beneficial to student performance on examinations as well as student perception of performance and confidence going into the examinations. Quizzes were also beneficial learning experiences for peer tutors.     

Pharmacy Student Engagement,Performance, and Perception in a Flipped Satellite Classroom

Objective. To determine whether “flipping” a traditional basic pharmaceutics course delivered synchronously to 2 satellite campuses would improve student academic performance, engagement, and perception.Design. In 2012, the basic pharmaceutics course was flipped and delivered to 22 satellite students on 2 different campuses. Twenty-five condensed, recorded course lectures were placed on the course Web site for students to watch prior to class. Scheduled class periods were dedicated to participating in active-learning exercises. Students also completed 2 course projects, 3 midterm examinations, 8 graded quizzes, and a cumulative and comprehensive final examination.Assessment. Results of a survey administered at the beginning and end of the flipped course in 2012 revealed an increase in students’ support for learning content prior to class and using class time for more applied learning (p=0.01) and in the belief that learning key foundational content prior to coming to class greatly enhanced in-class learning (p=0.001). Significantly more students preferred the flipped classroom format after completing the course (89.5%) than before completing the course (34.6%). Course evaluation responses and final examination performance did not differ significantly for 2011 when the course was taught using a traditional format and the 2012 flipped-course format. Qualitative findings suggested that the flipped classroom promoted student empowerment, development, and engagement.Conclusion. The flipped pharmacy classroom can enhance the quality of satellite students’ experiences in a basic pharmaceutics course through thoughtful course design, enriched dialogue, and promotion of learner autonomy.     

A Learning and Teaching Resource on Patient Self-Management of Chronic Pain

Objective. To develop, pilot test, and evaluate an instructional module on patient self-management for undergraduate pharmacy students in an Australian university.Design. Learning outcomes and associated content and assessment tasks were developed, featuring lecture and readings, in-class discussions, and online delivery of in-depth interviews with patients who were living with chronic pain.Assessment. Students completed a premodule and postmodule questionnaire and were further assessed by multiple-choice questions following completion of the module and again at the end of the semester. Positive changes were identified in the students’ discourse surrounding patient self-management of chronic pain. Responses to multiple-choice questions showed that knowledge was sustained over the course of the semester.Conclusions. Completion of a comprehensive module on patient self-management increased undergraduate pharmacy students’ understanding and knowledge of patients experiencing chronic pain. The module could be implemented across other healthcare disciplines.     

A distance education course in statistics

Objectives

To evaluate the learning outcomes of an online, distance education course in statistics for doctor of pharmacy (PharmD) students.

Design

Lectures for the course were produced by the course faculty, converted into digital format (mp4), placed within the college''s course management system, and video streamed to students. The course required students to interact with the course content using workbooks and simulations and with the instructor via VoIP examination reviews.

Assessment

A quasi-experimental study involving 4 groups of students was conducted. Second-year (P2) students were assigned randomly to 1 of 3 groups and asked to complete a precourse survey that contained: demographic information only (group 1); demographic items plus 10 items assessing statistics knowledge (group 2); or demographic items plus 20 items assessing statistics knowledge (group 3). At the end of the course, all students were given the same 20 items on the final examination (postcourse survey instrument). A control group consisting of randomly selected first-year (P1) students completed the 20-item precourse survey instrument. P1 and P2 students'' scores on the 20-item precourse survey were not significantly different. Students who had taken a statistics course before entering the PharmD program scored higher on the precourse survey. P2 students in all 3 study groups had similar scores on the final examination (postcourse survey) (p = 0.43).

Conclusions

Students can be taught the basic principles of statistics and how to use statistics to read the pharmacy and medical literature entirely online. This study has significant implications for how classes traditionally taught in the classroom might be taught at a distance using innovative instructional technologies.     

Risky Alcohol Consumption and Online Activity Levels

University students engage in risky patterns of alcohol consumption, which may affect their health and performance at university. This study provides a novel analysis which tracked students’ interaction with online course materials over time, and examined associations between online activity and alcohol related harm (as indicated by the Alcohol Use Disorders Identification Test). Study 1 tracked 63 undergraduate psychology students in the second half of a semester and found risky drinking behaviors were marginally related to reductions in online study activity. Study 2 tracked 88 undergraduate psychology students in the first half of a semester. Risky drinking behaviors were associated with less online activity after midday. Students reporting more alcohol related harm were less likely to login between 7 pm and midnight, and between 1 am and 6 am. This study demonstrates a potential sensitivity of online activity levels to alcohol use.     

An Advanced Cardiovascular Pharmacotherapy Course Blending Online and Face-to-Face Instruction

Objective

To assess the effectiveness of online instruction in a cardiology pharmacotherapy elective.

Design

Eight drug-focused lectures and 6 introductory presentations were added to a cardiology pharmacotherapy course. Students completed an online quiz after each online drug-focused lecture and scores were compared to quizzes taken at the beginning and end of the course, as well as on a cardiology advanced pharmacy practice experience (APPE). For online introductory presentations, students completed a quiz at the beginning of the next face-to-face session. A survey was conducted at the end of the course to obtain student feedback.

Assessment

Compared to baseline scores, student learning was demonstrated after online drug-focused lectures by higher quiz scores attained immediately after completing the lecture, at the end of the course, and at the beginning of the APPE. Furthermore, students performed better on quizzes at the beginning of face-to-face sessions if they first completed an online introductory presentation. Students expressed strong support for the online components of the course.

Conclusions

A blended learning environment with online and face-to-face instruction is an effective way to teach a cardiology pharmacotherapy elective. The online component of this course was well received by students, improved student preparation before attending class, and appeared to enhance long-term cardiovascular drug knowledge.     

Faculty and student perceptions of effective study strategies and materials

Objectives. To evaluate faculty members’ and students’ perceptions of study strategies and materials.Methods. Focus groups were conducted with course directors and first- and second-year students to generate ideas relating to use of course materials, technology, class attendance, and study strategies for mastering class concepts.Results. Students and faculty members differed in their opinions about the utility of textbooks and supplemental resources. The main learning method recommended by students and faculty members was repeated review of course material. Students recommended viewing classroom lectures again online, if possible. Course directors reported believing that class attendance is important, but students based their opinions regarding the importance of attendance on their perceptions of lecture and handout quality. Results did not differ by campus or by student group (first-year vs. second-year students).Conclusions. Students and faculty members have differing opinions on the process that could influence learning and course design. Faculty members should understand the strategies students are using to learn course material and consider additional or alternative course design and delivery techniques based on student feedback.     

Transforming a large-class lecture course to a smaller-group interactive course

Objective

To transition a large pharmacokinetics course that was delivered using a traditional lecture format into a smaller-group course with a discussion format.

Design

An e-book and Web-based multimedia learning modules were utilized to facilitate students'' independent learning which allowed the number of classes they were required to attend to be reduced from 3 to 1 per week. Students were assigned randomly to 1 of 3 weekly class sessions. The majority of lecture time was replaced with active-learning activities including discussion, problem solving, and case studies to encourage higher-order learning.

Assessment

Changes in course delivery were assessed over a 4-year period by comparing students'' grades and satisfaction ratings on course evaluations. Although student satisfaction with the course did not improve significantly, students preferred the smaller-group setting to a large lecture-based class. The resources and activities designed to shift responsibility for learning to the students did not affect examination grades even though a larger portion of examination questions focused on higher orders of learning (eg, application) in the smaller-group format.

Conclusions

Transitioning to a smaller-group discussion format is possible in a pharmacokinetics course by increasing student accountability for acquiring factual content outside of the classroom. Students favored the smaller-class format over a large lecture-based class.     

Comparison of Two Lecture Delivery Platforms in a Hybrid Distance Education Program

Objective

To compare students'' preferences for and academic performance using 2 different distance education course content delivery platforms.

Methods

A randomized, crossover research design was used to compare traditional video with a 4-panel platform among learners on multiple campuses within 1 college of pharmacy.¹ The outcomes were students'' preferences for delivery platform and examination scores. Rasch analysis was used to assess unidimensionality and the difficulty of examination items. Hierarchical logistic and multiple regression models were used to assess students'' preferences and academic performance.

Results

The logistic model predicting preference for the 4-panel or traditional platform was not significant, but African-Americans and Hispanics were more likely to prefer the 4-panel platform than Caucasian and Asian students. The delivery platform did not impact students'' academic performance. Students who did well on the semester''s previous 2 examinations scored higher on the questions related to schizophrenia. Students with higher Pharmacy College Admission Test (PCAT) scores performed better on the bipolar questions than students who preferred the traditional video platform.

Conclusion

The additional faculty time, effort, and cost invested in presenting the class material in a 4-panel platform, and the students'' extra time and effort spent viewing the 4-panel platform did not produce a comparable benefit in student preference and performance.     

Student Preferences Regarding Teaching Methods in a Drug-Induced Diseases and Clinical Toxicology Course

Objectives. To determine which teaching method in a drug-induced diseases and clinical toxicology course was preferred by students and whether their preference correlated with their learning of drug-induced diseases.Design. Three teaching methods incorporating active-learning exercises were implemented. A survey instrument was developed to analyze students’ perceptions of the active-learning methods used and how they compared to the traditional teaching method (lecture). Examination performance was then correlated to students’ perceptions of various teaching methods.Assessment. The majority of the 107 students who responded to the survey found traditional lecture significantly more helpful than active-learning methods (p=0.01 for all comparisons). None of the 3 active-learning methods were preferred over the others. No significant correlations were found between students’ survey responses and examination performance.Conclusions. Students preferred traditional lecture to other instructional methods. Learning was not influenced by the teaching method or by preference for a teaching method.     

Impact of online lecture-capture on student outcomes in a therapeutics course

Objectives

To examine the correlation between students accessing recorded lecture files (audio and slides) online and course grades and class attendance.

Methods

Second professional year (of 6-year program) students in a therapeutics course had access to recorded online lectures for 72 hours following live lectures. The number and duration of lecture accessions were compared to final course grades and class attendance. Course grades were compared to those of a historical control group. At the end of the semester, students completed a brief survey instrument regarding their use and perceptions of online lectures.

Results

No correlation was found between final course grades and the number of lecture accessions (r = 0.0014) or total number of minutes lectures were viewed (r = 0.033), nor between class attendance and minutes viewed (r = 0.2158). Students with access to recorded lectures outperformed the historical control group on the final examination (p < 0.002). Seventy-two percent of students reported no influence of online files on class attendance.

Conclusions

Posting lectures online did not affect student outcomes, but students did score higher on the final examination.     

A Hybrid Jigsaw Approach to Teaching Renal Clearance Concepts

Objectives

To evaluate the effectiveness of using a jigsaw cooperative learning approach to teach basic concepts of renal clearance to pharmacy students.

Design

Students collected information on the mechanisms of renal clearance for a particular drug and proposed a methodology for circumventing a urine drug screen. Attitudinal surveys, an online quiz, and course examinations were used to assess student learning.

Assessment

The majority of students felt apprehensive toward a group assignment prior to the exercise, and afterwards still preferred individual work over group work. Post-exercise quiz and final examination scores showed students successfully learned the material.

Conclusions

Students were successful in learning from each other and there was no difference in examination performance compared to years when the technique was not used. In addition, the relative negative experiences of previous group work decreased the subjective attitudes related to the current learning experience.     

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.     

A process-oriented guided inquiry approach to teaching medicinal chemistry

Objective

To integrate process-oriented guided-inquiry learning (POGIL) team-based activities into a 1-semester medicinal chemistry course for doctor of pharmacy (PharmD) students and determine the outcomes.

Design

Students in the fall 2007 section of the Medicinal Chemistry course were taught in a traditional teacher-centered manner, with the majority of class time spent on lectures and a few practice question sets. Students in the fall 2008 and fall 2009 sections of Medicinal Chemistry spent approximately 40% of class time in structured self-selected teams where they worked through guided-inquiry exercises to supplement the lecture material.

Assessment

The mean examination score of students in the guided-inquiry sections (fall 2008 and fall 2009) was almost 3 percentage points higher than that of students in the fall 2007 class (P < 0.05). Furthermore, the grade distribution shifted from a B-C centered distribution (fall 2007 class) to an A-B centered distribution (fall 2008 and fall 2009 classes).

Conclusions

The inclusion of the POGIL style team-based learning exercises improved grade outcomes for the students, encouraged active engagement with the material during class time, provided immediate feedback to the instructor regarding student-knowledge deficiencies, and created a classroom environment that was well received by students.     

A Flowchart for Selecting an Ointment Base

Objectives. To improve students’ skills in selecting appropriate ointment bases through the development and implementation of a flowchart.Design. A flowchart was designed to help students select the appropriate base for an ointment. Students used the flowchart throughout the semester in both dry and wet laboratory activities. At the end of the semester, students completed a dry laboratory practical that required them to select an appropriate ointment base and levigating agent.Assessment. Student performance data from the year prior to implementation was compared to data for 2 years after implementation. Calculation, procedure, and labeling errors also were compared. Prior to implementation of the flowchart, 51 of 101 students selected the correct base. After implementation, 169 of 212 students selected the correct base (p<0.001). Calculation, procedure, and labeling errors were not significantly different.Conclusion. Use of a flowchart to select an ointment base improved student performance when used in the context of a dry laboratory assignment.     

An Elective Course on Postgraduate Residency Training

Objective. To develop, implement, and assess the impact of an elective course for pharmacy students on postgraduate pharmacy residency training.Design. An elective course on residency training was developed using short lectures, group discussions, and active-learning strategies, such as small-group exercises, mock match, and mock interview.Assessment. Students were asked to self-assess their understanding and abilities related to residency training at the beginning and end of the semester based on course objectives. The median post-semester responses increased for all objectives compared to baseline (p<0.05).Conclusion. A residency elective using a variety of teaching methods increased student knowledge and confidence in their skills regarding residency training.     

Impact of Flipped Classroom Design on Student Performance and Perceptions in a Pharmacotherapy Course

Objective. To determine whether a flipped classroom design would improve student performance and perceptions of the learning experience compared to traditional lecture course design in a required pharmacotherapy course for second-year pharmacy students.Design. Students viewed short online videos about the foundational concepts and answered self-assessment questions prior to face-to-face sessions involving patient case discussions.Assessment. Pretest/posttest and precourse/postcourse surveys evaluated students’ short-term knowledge retention and perceptions before and after the redesigned course. The final grades improved after the redesign. Mean scores on the posttest improved from the pretest. Postcourse survey showed 88% of students were satisfied with the redesign. Students reported that they appreciated the flexibility of video viewing and knowledge application during case discussions but some also struggled with time requirements of the course.Conclusion. The redesigned course improved student test performance and perceptions of the learning experience during the first year of implementation.     

An Online Health Informatics Elective Course for Doctor of Pharmacy Students

Objective. To describe the development and assessment of an online elective health informatics course and determine its potential for universal integration into doctor of pharmacy (PharmD) curricula.Design. A 2-credit hour online elective course was developed and offered to all PharmD students; voiced-over Powerpoint lectures were used to deliver content.Assessment. Assessment of student performance was measured using quantitative metrics via discussion questions, quizzes, written papers, and examinations. Qualitative findings were measured through discussion questions, a goal-setting classroom assessment technique, and an end-of-course reflection. Students report finding value in the course and recognizing how the knowledge gained could impact their future practice as pharmacists. Conclusion. An online course in health informatics can be an effective way to deliver content and provide a blueprint for continued integration of the content into curricula.