Practice skill development through the use of human patient simulation

Human patient simulation (HPS) is used in health care education to enhance the transition from classroom learning to competent performance. It has been used frequently in nursing and medical schools and less often in pharmacy and other allied health professions. HPS is used to improve the development of pharmacy practice skills such as physical assessment, pharmacotherapy plan development, and monitoring plans. Engaging multiple health care disciplines in simulations enables participants to practice teamwork and communication skills that are essential in preventing errors and events of harm to patients. This article reviews current literature and use of simulation in pharmacy curricula for the development, enhancement, and assessment of pharmacy practice skills.     

An interprofessional course using human patient simulation to teach patient safety and teamwork skills

Objectives. To assess the effectiveness of human patient simulation to teach patient safety, team-building skills, and the value of interprofessional collaboration to pharmacy students.Design. Five scenarios simulating semi-urgent situations that required interprofessional collaboration were developed. Groups of 10 to 12 health professions students that included 1 to 2 pharmacy students evaluated patients while addressing patient safety hazards.Assessment. Pharmacy students’ scores on 8 of 30 items on a post-simulation survey of knowledge, skills, and attitudes improved over pre-simulation scores. Students’ scores on 3 of 10 items on a team building and interprofessional communications survey also improved after participating in the simulation exercise. Over 90% of students reported that simulation increased their understanding of professional roles and the importance of interprofessional communication.Conclusions. Simulation training provided an opportunity to improve pharmacy students’ ability to recognize and react to patient safety concerns and enhanced their interprofessional collaboration and communication skills.     

A Modified Delphi Involving Laboratory Faculty to Define Essential Skills for Pharmacy Graduates

Objective. To define essential skills for Doctor of Pharmacy (PharmD) graduates that are needed in the four most common sectors of pharmacy practice as determined by expert faculty who instruct within pharmacy skills laboratories.Methods. A three-round Delphi method was used to establish consensus. In the first round, participants were asked what skills were needed by students at entry to practice in community, health-system, ambulatory care, and managed care pharmacy settings. In rounds two and three, participants were asked to rate each skill with a level of importance using a 10-point Likert scale (1=not important to 10=very important).Results. In round one, participants produced a collective list of 289 essential skills. These skill statements were sent to participants in rounds two and three to assign a level of importance. After the third round, participants reached consensus using a mean level of importance for a final list of 69 community pharmacy skills, 47 health-system, 60 ambulatory care, and 15 managed care skills. These skills were then mapped to entrustable professional activities domains for schools and colleges pharmacy to use as a resource when assessing core competency development in the curriculum.Conclusion. The Delphi technique was used successfully with expert pharmacy skills laboratory faculty to identify laboratory-focused essential skills that recent PharmD graduates should have prior to entering community, health-system, ambulatory care, or managed care pharmacy practice. These essential skills can be used to guide curriculum development, develop milestone markers, and help ensure students are practice ready.     

英格兰社区药师的药学服务及对国内药师参与慢病管理的启示

预计到2020 年,慢性病将成为人类致死和致残的首要原因,我国慢病患者也逐年增加,慢病管理在中国刚刚起步。因此,通过介绍英格兰社区药师不同层次的药学服务,从而为我国药师如何开展慢病管理的工作提供借鉴与启示。     

High-fidelity patient simulation series to supplement introductory pharmacy practice experiences

Objective

To introduce a high-fidelity simulation series into a 5-year doctor of pharmacy (PharmD) curriculum to demonstrate a hybrid model for introductory pharmacy practice experience (IPPE) delivery.

Design

Fourth-year pharmacy students at a satellite campus participated in a 6-week high-fidelity patient simulation series in which small groups of students worked with members of a patient care team to care for patients in the following scenarios: asthma exacerbation, acute decompensated heart failure, and infective endocarditis with a subsequent anaphylactic reaction to the antibiotic. Fourth-year pharmacy students at the main campus who did not participate in the simulation served as a comparator group.

Assessment

Students'' scores on a knowledge-based post-simulation quiz were significantly higher than scores on the presimulation quiz (p < 0.05). Knowledge retention was significantly higher among the simulation participants than students in the comparator group (p = 0.004). The majority (76%) of students felt more confident “making clinical recommendations to a healthcare provider” after completing the simulation series (p = 0.01).

Conclusion

High-fidelity patient simulation is an effective active-learning strategy to augment IPPEs that allows students to apply clinical skills in a realistic but low-risk patient care setting.     

Using the Internet to develop an international learning community of pharmacists

Until recent years, the level of interaction across a profession, necessary to provide for an optimum learning environment which supports professional development, has only been significantly possible in face-to-face interaction and has therefore been place and time dependent. With the explosive development of the Internet, communication barriers are breaking down and international interaction, networking and collaboration is becoming increasingly possible. This short report describes the manner in which an Internet-based postgraduate study programme, entitled Enhancing Pharmacy Practice has made use of these communication opportunities to develop an international learning community of pharmacists. Programme evaluation data collected from surveys completed online by participants and content analysis of online discussion groups during the first four modules of the programme, demonstrates that there is a high level of interaction amongst participants. It also suggests that this interaction has contributed to the learning experience and professional growth of the participants and impacted positively upon their practice.     

Pharmacy student knowledge retention after completing either a simulated or written patient case

Objective. To determine pharmacy students’ knowledge retention from and comfort level with a patient-case simulation compared with a written patient case.Design. Pharmacy students were randomly assigned to participate in either a written patient case or a simulated patient case in which a high-fidelity mannequin was used to portray a patient experiencing a narcotic and acetaminophen overdose.Assessment. Participants’ responses on a multiple-choice test and a survey instrument administered before the case, immediately after the case, and 25 days later indicated that participation in the simulated patient case did not result in greater knowledge retention or comfort level than participation in the written patient case. Students’ knowledge improved post-intervention regardless of which teaching method was used.Conclusions. Although further research is needed to determine whether the use of simulation in the PharmD curriculum is equivalent or superior to other teaching methods, students’ enthusiasm for learning in a simulated environment where they can safely apply patient care skills make this technology worth exploring.     

Use of high-fidelity simulation to teach end-of-life care to pharmacy students in an interdisciplinary course

Objective. To assess the effect of high-fidelity simulation on pharmacy students’ attitudes and perceived competencies in providing end-of-life care in an interdisciplinary palliative care course.Design. Thirty pharmacy students participated in a high-fidelity simulation of the 15 minutes before and 15 minutes after the death of a patient with end-stage renal disease.Assessment. Students completed the Attitudes Toward Death Survey and the End of Life Competency Survey prior to and after experiencing the simulation. A reflections journal exercise was used to capture post-simulation subjective reactions, and a course evaluation was used to assess students’ satisfaction with the simulation experience. Students’ post-simulation attitudes toward death significantly improved compared to pre-simulation attitudes and they felt significantly more competent to take care of dying patients. Students were satisfied with this teaching method.Conclusion. High-fidelity simulation is an innovative way to challenge pharmacy students’ attitudes and help them with knowledge acquisition about end-of-life care.     

Vital sign monitoring using human patient simulators at pharmacy schools in Japan

Objective

To develop, implement, and assess an experience-based education program using human patient simulators to instruct pharmacy students in monitoring vital signs to identify drug treatment effects and adverse events.

Design

Medical emergency care programs using human patient simulators were prepared and facilitated practical clinical training in resuscitation, which required selecting drugs while monitoring changes in blood pressure, pulse, and arterial blood oxygen saturation. Training encompassed the monitoring of routes of drug administration, drawing of simulated blood, vital-sign monitoring based on a pharmaceutical universal training model, vital-sign monitoring devices and simulators, and medical emergency education using biological simulators.

Assessment

Before and after bedside training, students were asked to complete a questionnaire to assess their understanding of vital sign monitoring and emergency care. Students successfully learned how to monitor routes of drug administration, vital signs, and pathological conditions. There was a significant increase in students'' recognition of the importance of vital-sign monitoring.

Conclusion

Experienced-based training using patient simulators successfully prepared pharmacy students to monitor vitals signs and identify drug treatment effects and adverse events.