An elective course in information mastery

Objective

To design and implement an elective course in information mastery and assess its impact on students'' ability to identify information needs and formulate clinically relevant, evidence-based answers.

Design

A semester-long (15-week) elective course was offered to third-year (P3) doctor of pharmacy (PharmD) students that outlined the necessary knowledge and skills for using information mastery in evidence-based practice.

Assessment

Results of a pre- and postcourse survey instrument demonstrated an increase in students'' knowledge of information mastery and confidence in and familiarity with the practice of evidence-based medicine in pharmacy. Students who had completed the elective were able to provide higher quality search strategies and evidence-based answers to a clinical question than other P3 students, and P4 students who did not participate in the elective.

Conclusion

An elective course in information mastery improved students'' knowledge and understanding of information mastery as it pertains to practicing evidence-based medicine.     

An Elective Course in Adult Acute Care Medicine Using a Hybrid Delivery System

Objective

To develop and assess the effectiveness of an elective course modeled after activities students encounter on internal medicine advanced pharmacy practice experiences (APPEs).

Design

This hybrid elective course used a Web-based course management system linking pre-class lectures and assignments, classroom discussions, and projects to promote active student learning.

Assessment

Assessment of student performance was based on assignments, quizzes, and participation in classroom discussions. Students were surveyed to ascertain their opinion of the elective.

Conclusion

This elective in adult acute care medicine increased student exposure to inpatient settings and provided students additional opportunities to communicate effectively, evaluate medical literature, and think critically.     

An Anticoagulation Therapy Elective for Third-Year Pharmacy Students

Objective

To develop an anticoagulation elective course for third-year pharmacy students to enhance their knowledge and skills for providing anticoagulation services.

Design

Content developed for the course focused on standards of care, evaluation of primary literature, clinical application, billing and regulatory issues, written and verbal communication, and patient education. Teaching methods included lectures, discussions, demonstrations, and self-directed learning.

Assessment

Assessment methods included multiple-choice examinations, evaluation of patient cases, student presentations, and a practical examination. Students demonstrated competencies in multiple areas and rated the course favorably. Students who completed the elective reported being more prepared for anticoagulation activities than those who did not. Confidence levels regarding participation in anticoagulation services postgraduation were similar.

Conclusion

The elective provided valuable experience in anticoagulation therapy and increased students'' perception of their preparedness related to dealing with anticoagulation issues while on advanced pharmacy practice experiences (APPEs). More exposure to management topics and the logistics of initiating anticoagulation services should be incorporated.     

An Elective Course on Landmark Trials to Improve Pharmacy Students' Literature Evaluation and Therapeutic Application Skills

Objectives

To determine the impact of a landmark trials elective course on pharmacy students'' attitudes toward evidence-based medicine, students'' comfort with technical concepts used in drug literature, and students'' perceptions of accessibility of PubMed from home computers.

Design

An elective course which gave third-year pharmacy students the opportunity to discuss landmark trials in primary care and reinforced skills in applying evidence from the primary literature to support therapeutic recommendations was design and implemented. The impact of the course was evaluated via a pre- and postcourse questionnaire administered during 3 consecutive course offerings.

Assessment

Overall, students had positive attitudes toward evidence-based medicine before taking the course (97.5% positive or somewhat positive) and these attitudes were unchanged postcourse (p = 0.74). Though 97.6% (n = 40) of students had Internet access at home, only 68.3% (n = 28) indicated having PubMed access at home. The course increased self-assessed comfort with technical concepts used in literature evaluation including random assignment (p < 0.01), placebo-controlled (p < 0.01), and intention-to-treat (p = 0.02).

Conclusion

An elective course on landmark trials allowed third-year pharmacy students to increase their comfort level with literature evaluation and reinforced their positive attitudes toward the use of evidence-based medicine in pharmacy practice.     

Impact of an Introductory Pharmacy Practice Experience on Students' Performance in an Advanced Practice Experience

Objective

To determine the impact of an introductory pharmacy practice experience (IPPE) on students'' clinical skills during their initial advanced pharmacy practice experience (APPE).

Design

A 4-week First Steps course that focused on students developing pharmacy practice skills, clinical communications skills, and effective use of reference materials was introduced in 2006 at the end of the third-year curriculum, prior to students beginning their APPEs.

Assessment

During the third week of the first APPE, faculty members rated students'' demonstration of 9 clinical skills on a 5-point Likert scale (1 being always and 5 being never). The evaluation was performed in 2005 prior to implementation of the course (control group) and again in 2006 after implementation of the course. Students who completed the First Steps course scored better on all 9 skills and had a better average clinical skills value (2.3) compared to the control group (2.6, p < 0.01).

Conclusion

Completion of an IPPE course that focused on critical pharmacy practice aspects, clinical communication skills, and use of reference materials resulted in increased frequency of desired clinical behaviors on a subsequent APPE.     

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.     

Pharmacogenomics training using an instructional software system

Objectives

To implement an elective course in pharmacogenomics designed to teach pharmacy students about the fundamentals of pharmacogenomics and the anticipated changes it will bring to the profession.

Design

The 8 sessions of the course covered the basics of pharmacogenomics, genomic biotechnology, implementation of pharmacogenetics in pharmacy, information security and privacy, ethical issues related to the use of genomic data, pharmacoepidemiology, and use and promotion of GeneScription, a software program designed to mimic the professional pharmacy environment.

Assessment

Student grades were based on completion of a patient education pamphlet, a 2-page paper on pharmacogenomics, and precourse and postcourse survey instruments. In the postcourse survey, all students strongly agreed that genomic data could be used to determine the optimal dose of a drug and genomic data for metabolizing enzymes could be stored in a safe place. Students also were more willing to submit deoxyribonucleic acid (DNA) data for genetic profiling and better understood how DNA analysis is performed after completing the course.

Conclusions

An elective course in pharmacogenomics equipped pharmacy students with the basic knowledge necessary to make clinical decisions based on pharmacogenomic data and to teach other healthcare professionals and patients about pharmacogenomics. For personalized medicine to become a reality, all pharmacists and pharmacy students must learn this knowledge and these skills.     

An Evidence-based Elective on Dietary Supplements

Objective

To implement and evaluate the effectiveness of a pharmacy elective on dietary supplements that emphasized evidence-based care.

Design

A 3-credit elective that employed both traditional lectures and a variety of active-learning exercises was implemented. The course introduction provided a background in dietary supplement use and evidence-based medicine principles before addressing dietary supplements by primary indication.

Assessment

Student learning was assessed through quizzes, case assignments, discussion board participation, and completion of a longitudinal group project. Precourse and postcourse surveys were conducted to assess students'' opinions, knowledge, and skills related to course objectives.

Conclusion

The course was an effective way to increase students'' knowledge of dietary supplements and skills and confidence in providing patient care in this area.     

An Elective Psychiatric Course to Reduce Pharmacy Students�� Social Distance Toward People With Severe Mental Illness

Objective

To determine whether an elective course on mental health could reduce pharmacy students’ social distance toward people with severe mental illness.

Design

Course activities included assigned readings, class discussions, student presentations, review of video and other media for examples of social distance, presentations by patients with mental illness, and visits to hospitalized patients in a variety of psychiatric settings.

Assessment

The Social Distance Scale (SDS) was administered at the beginning and end of the semester to students enrolled in the elective and to a comparator group of students not enrolled in the course. Pharmacy students who did not complete the elective had significantly higher SDS scores than students who completed the elective (18.7 vs. 15.6, p < 0.001). Students enrolled in the course had lower precourse SDS scores, were more likely than their peers to have a personal association with mental illness, and had a decrease in precourse to postcourse scores.

Conclusion

A course designed to reduce stigma towards the mentally ill can reduce pharmacy students'' social distance.     

An elective course on lifestyle modifications in pharmacotherapy

Objectives

Develop and implement a pharmacy course explaining basic lifestyle modification components and assess changes in student knowledge, skills, beliefs, and confidence after completing the course.

Design

A 2-credit hour elective course was offered to pharmacy students in which basic lifestyle modification components were applied to case-based patients with hypertension, dyslipidemia, diabetes mellitus, obesity, and metabolic syndrome in the pharmacy practice setting through comprehensive wellness programs. Knowledge, skills, beliefs, and confidence assessments were embedded into the course.

Assessment

There were significant improvements in students'' skills and confidence, and in most knowledge areas, but not in their beliefs regarding health behaviors.

Conclusion

Implementing an elective course on lifestyle modifications is an effective means of teaching students about wellness and disease prevention.     

A Progress Assessment to Evaluate Pharmacy Students' Knowledge Prior to Beginning Advanced Pharmacy Practice Experiences

Objective

To develop an assessment that would (1) help doctor of pharmacy (PharmD) students review therapeutic decision making and build confidence in their skills, (2) provide pharmacy practice residents with the opportunity to lead small group discussions, and (3) provide the assessment committee with program-level assessment data.

Design

A case-based interactive assessment was developed and delivered to PharmD students immediately prior to advanced pharmacy practice experiences (APPEs). The assessment used an audience response system to allow immediate feedback followed by small group discussions led by pharmacy-practice residents. Students self-assessed their knowledge and confidence levels and developed personalized learning objectives for APPEs.

Assessment

Eighty-nine percent of students found the assessment useful, and pharmacy practice residents reported that it was helpful in developing precepting skills. The college assessment committee was able to use the data to supplement the ongoing College curricular mapping process.

Conclusions

An interactive assessment process can help students build confidence for experiential training, provide a learning opportunity for pharmacy residents, and produce program-level data for college assessment purposes. Planned modifications of the assessment include expanding the content areas covered and adding ability-based assessments such as communication skills.     

A Hospice-based Advanced Pharmacy Experience

Objective

To evaluate a hospice-based advanced pharmacy practice experience (APPE).

Design

Two years of data gathered from student evaluation forms and reflective journals were analyzed.

Assessment

Students completed reflective journals and expressed a high level of satisfaction with the hospice-based learning experience. They gained a better understanding of end-of-life care provided by a hospice and the pharmacist''s role in optimizing supportive care for patients receiving hospice care.

Conclusion

Hospice-based APPEs can provide a rich interdisciplinary learning environment for pharmacy students interested in developing knowledge, attitudes, and skills to effectively manage the pharmacotherapy of patients receiving end-of-life care.     

Web-based Portfolios for Pharmaceutical Care Plans During Advanced Pharmacy Practice Experiences

Objective

To implement and assess a Web-based patient care portfolio system for development of pharmaceutical care plans by students completing advanced pharmacy practice experiences (APPEs) throughout a statewide preceptor network.

Design

Using a Web database, students in APPEs documented 6 patient cases within 5 disease state categories. Through discussion of the disease states and inclusion of patient information such as problems, desired outcomes, and interventions, a complete pharmaceutical care plan was developed for each patient.

Assessment

Student interventions were compared by geographical regions to assess continuity of patient care activities by students. Additionally, students completed an evaluation of the portfolio course to provide feedback on the portfolio process. Students documented an average of 1.8 therapeutic interventions per patient case and documented interventions in all geographical regions. The majority of students indicated that the portfolio process improved their ability to develop a pharmaceutical care plan.

Conclusion

The Web-based patient care portfolio process assisted with documentation of compliance with Accreditation Council of Pharmacy Education (ACPE) standards and College of Pharmacy Competency Statements. Students indicated the portfolio process was beneficial in developing skills needed for creating pharmaceutical care plans.     

Development needs of volunteer pharmacy practice preceptors

Objective

To determine the training needs and interests of volunteer pharmacy preceptors.

Methods

Volunteer preceptors (n=576) were surveyed on various aspects of precepting and their needs related to additional training.

Results

Two hundred thirty-six preceptors (40.9%) responded. Preceptors were less confident about enforcing attendance policies, identifying and managing unmotivated or failing students, identifying dishonesty or plagiarism, and handling conflict. While only 29.5% of respondents agreed that having an APPE student decreased their overall workload, approximately half (48.1%) indicated that student pharmacists helped them complete their daily tasks and 67.8% agreed that APPE students extended patient care. Respondents who had received training were significantly more confident than preceptors who had not received training in their abilities to clarify expectations, evaluate a student''s knowledge, and foster skills related to critical thinking and problem solving.

Conclusions

Training programs for pharmacy preceptors are effective; however, important areas in which additional training is needed or desired were identified among both new and experienced preceptors.     

A Drug Interactions Elective Course

Objectives

To evaluate the impact of a drug interactions elective course on student knowledge and skills.

Design

A drug interactions elective which focused on assessment and application of drug interaction information and identification and management of commonly encountered drug interactions by therapeutic category was offered to third-year PharmD students. Students were expected to (1) determine whether a given interaction was clinically significant or required pharmacist intervention, and (2) make rational, scientifically sound, practical recommendations for management of drug interactions.

Evaluation and Assessment

Assessment included course evaluations, student self-assessments, and knowledge and skills assessments. Students who completed the course were more confident in their abilities relating to drug interactions than students who did not complete the course. Students who completed the course scored significantly better in all areas of the assessment compared to students who did not complete the course. Course evaluation results were also positive.

Conclusion

A course devoted to the identification and management of drug interactions improved PharmD students'' knowledge and skills and could potentially improve the patient care they provide in the future.     

A mental health elective to improve pharmacy students' perspectives on mental illness

Objective

To evaluate the impact of a mental health elective on pharmacy students'' perceptions and stigmatizing views of mental illness.

Design

An elective was designed that featured an advanced overview of psychopharmacology; student training in motivational interviewing; a presentation by the National Alliance on Mental Illness (NAMI) local chapter; introduction to pharmacy collaborations with peer support specialists, social workers, and psychiatrists; mock patient counseling sessions; and a required psychiatric patient interview at a local community mental health center.

Assessment

A survey instrument with 17 Likert-scale items was constructed to measure 2 distinct areas: social distance and stigmatizing views. The survey instrument was administered at the beginning and end of the spring 2010 semester to pharmacy students enrolled in the mental health elective course and to a control group of pharmacy students enrolled in an unrelated clinical elective. The course had a positive impact on pharmacy students'' perceptions of mental illnesses. Students'' social distance and stigmatizing views of mental illnesses improved, while no significant change in views occurred among students in the control group.

Conclusion

Advanced training in psychiatric medicine and exposure to mental health care are vital to prepare pharmacy students to provide unbiased, patient-centered care to this population.     

A Motivational Interviewing Course for Pharmacy Students

Objective

To create, implement, and evaluate a pharmacy course on motivational interviewing.

Design

A 3-hour elective course was created to train doctor of pharmacy (PharmD) students in brief patient-centered motivational interviewing counseling strategies that have proven effective with the types of health issues most commonly addressed in pharmacy settings. Students were assisted in developing their skills through required readings, interactive lectures, in-class demonstrations and practice sessions, out of class skills practice, one-on-one supervision provided by doctoral level clinical health psychology students, and written reflections on each class session.

Assessment

Students demonstrated significant improvement in motivational interviewing skills and a high level of motivation for and confidence in using these skills in their future practice. Students overall assessment of the course and supervision process was highly positive.

Conclusion

This patient-centered counseling skills course was feasible and produced improvements in PharmD students'' counseling skills and increased their motivation and confidence to use motivational interviewing skills in their future communications with patients.     

Electronic Reflective Student Portfolios to Demonstrate Achievement of Ability-based Outcomes During Advanced Pharmacy Practice Experiences

Objectives

To demonstrate achievement of ability-based outcomes through a structured review of electronic student portfolios in an advanced pharmacy practice experience (APPE) program.

Design

One hundred thirty-eight students produced electronic portfolios containing select work products from APPEs, including a self-assessment reflective essay that demonstrated achievement of course manual-specified ability-based outcomes.

Assessment

Through portfolio submissions, all students demonstrated the achievement of ability-based outcomes for providing pharmaceutical care, evaluating the literature, and managing the medication use system with patient case reports most frequently submitted. The rubric review of self-reflective essays addressed student learning through APPEs and continuing professional development plans.

Conclusion

The electronic portfolio with reflective essay proved to be a useful vehicle to demonstrate achievement of ability-based outcomes.     

A Spanish language and culture initiative for a doctor of pharmacy curriculum

Objective

To implement a Spanish language and culture initiative in a doctor of pharmacy (PharmD) curriculum that would improve students'' Spanish language skills and cultural competence so that graduates could provide competent pharmaceutical care to Spanish-speaking patients.

Design

Five elective courses were created and introduced to the curriculum including 2 medical Spanish courses; a medical Spanish service-learning course; a 2-week Spanish language and cultural immersion trip to Mexico; and an advanced practice pharmacy experience (APPE) at a medical care clinic serving a high percentage of Spanish-speaking patients. Advisors placed increased emphasis on encouraging pharmacy students to complete a major or minor in Spanish.

Assessment

Enrollment in the Spanish language courses and the cultural immersion trip has been strong. Twenty-three students have completed the APPE at a Spanish-speaking clinic. Eleven percent of 2010 Butler University pharmacy graduates completed a major or minor in Spanish compared to approximately 1% in 2004 when the initiative began.

Conclusion

A Spanish language and culture initiative started in 2004 has resulted in increased Spanish language and cultural competence among pharmacy students and recent graduates.