Factors Associated With Health-Related Quality of Life of Student Pharmacists

Objective. To assess the health-related quality of life (HRQoL) of student pharmacists and explore factors related to HRQoL outcomes of student pharmacists in a doctor of pharmacy (PharmD) program at a public university.Methods. A survey instrument was administered to all student pharmacists in a PharmD program at a public university to evaluate differences and factors related to the HRQoL outcomes of first-year (P1), second-year (P2), third-year (P3), and fourth-year (P4) student pharmacists in the college. The survey instrument included attitudes and academic-related self-perception, a 12-item short form health survey, and personal information components.Results. There were 304 students (68.6%) who completed the survey instrument. The average health state classification measure and mental health component scale (MCS-12) scores were significantly higher for P4 students when compared with the P1through P3 students. There was no difference observed in the physical component scale (PCS-12) scores among each of the 4 class years. Significant negative impact on HRQoL outcomes was observed in students with higher levels of confusion about how they should study (scale lack of regulation) and concern about not being negatively perceived by others (self-defeating ego orientation), while school satisfaction increased HRQoL outcomes (SF-6D, p<0.001; MCS-12, p=0.013). A greater desire to be judged capable (self-enhancing ego-orientation) and career satisfaction were positively associated with the PCS-12 scores (p<0.05).Conclusion. Factors associated with the HRQoL of student pharmacists were confusion regarding how to study, ego orientation, satisfaction with the chosen college of pharmacy, and career satisfaction. First-year through third-year student pharmacists had lower HRQoL as compared with P4 students and the US general population. Support programs may be helpful for students to maintain or improve their mental and overall health.     

Comparison of Answer-Until-Correct and Full-Credit Assessments in a Team-based Learning Course

Objective. To assess the impact of awarding partial credit to team assessments on team performance and on quality of team interactions using an answer-until-correct method compared to traditional methods of grading (multiple-choice, full-credit).Methods. Subjects were students from 3 different offerings of an ambulatory care elective course, taught using team-based learning. The control group (full-credit) consisted of those enrolled in the course when traditional methods of assessment were used (2 course offerings). The intervention group consisted of those enrolled in the course when answer-until-correct method was used for team assessments (1 course offering). Study outcomes included student performance on individual and team readiness assurance tests (iRATs and tRATs), individual and team final examinations, and student assessment of quality of team interactions using the Team Performance Scale.Results. Eighty-four students enrolled in the courses were included in the analysis (full-credit, n=54; answer-until-correct, n=30). Students who used traditional methods of assessment performed better on iRATs (full-credit mean 88.7 (5.9), answer-until-correct mean 82.8 (10.7), p<0.001). Students who used answer-until-correct method of assessment performed better on the team final examination (full-credit mean 45.8 (1.5), answer-until-correct 47.8 (1.4), p<0.001). There was no significant difference in performance on tRATs and the individual final examination. Students who used the answer-until-correct method had higher quality of team interaction ratings (full-credit 97.1 (9.1), answer-until-correct 103.0 (7.8), p=0.004).Conclusion. Answer-until-correct assessment method compared to traditional, full-credit methods resulted in significantly lower scores for iRATs, similar scores on tRATs and individual final examinations, improved scores on team final examinations, and improved perceptions of the quality of team interactions.     

Impact of a First-Year Student Pharmacist Diabetes Self-Care Education Program

Objective. To evaluate the effectiveness of a first-year diabetes self-care education program by measuring student pharmacists’ confidence and knowledge retention, and the clinical applicability of the skills learned.Design. Integrated into a Pharmacy Practice Course, a 9-hour program consisting of lectures, a home glucose monitor assignment, and active-learning workshops was completed by 2 cohorts of first-year student pharmacists. Three survey instruments were developed and administered to the student pharmacists prior to the program, immediately after the program, and 9 months after the program to assess confidence, knowledge retention, and the clinical applicability of the knowledge and skills learned.Assessment. In cohort 1, 54 student pharmacists (response rate 90%) perceived that their confidence and ability improved significantly (increased by 88% and 110%, respectively, from baseline, p<0.001). Overall knowledge of diabetes increased as well as indicated by a 40% increase in test scores (p<0.001). About two-thirds of student pharmacists used their training to assist patients with diabetes within 9 months of completing the program. Findings in cohort 2 mirrored those observed with cohort 1, indicating good generalizability.Conclusions. An innovative first-year diabetes self-care education program significantly improved student pharmacists’ knowledge and confidence in providing diabetes self-care education, and the majority immediately used their leaned skills to assist diabetes patients and caregivers. Training first-year student pharmacists in diabetes care so they are prepared to use these skills as early as their first year of pharmacy school may be an effective approach to increasing the number of providers available to counsel and care for this expanding patient population.     

Evaluation of Hypertensive Patients after Care Provided by Community Pharmacists in a Rural Setting

We evaluated blood pressure control, quality of life, quality of care, and satisfaction of patients who were monitored by specially trained community pharmacists in a group medical practice. After participating in an intensive skill development program, pharmacists performed in an interdisciplinary team in a rural clinic. The primary objective was assessed by evaluating outcome variables at 6 months compared with baseline in 25 patients randomly assigned to a study group. A control group of 26 patients was also evaluated to determine if outcome variables remained constant from baseline to 6 months. Systolic blood pressure was reduced in the study group (151 mm Hg baseline, 140 mm Hg at 6 mo, p<0.001) and diastolic blood pressure was significantly lower at 2, 4, and 5 months compared with baseline. Ratings from a blinded peer review panel indicated significant improvement in the appropriateness of the blood pressure regimen, going from 8.7 ± 4.7 to 10.9 ± 4.5 in the study group (p<0.01), but they did not change in the control group. Several quality of life scores improved significantly in the study group after 6 months (p<0.05). These included physical functioning (61.6 vs 70.7), physical role limitations (56.8 vs 72.8), and bodily pain (60.0 vs 71.7) at baseline and 6 months, respectively. There were no significant changes in the control group. Patient satisfaction scores were consistently higher in the study group at the end of the study. Our results indicate that when community pharmacists in a clinic setting are trained and included as members of the primary care team, significant improvements in blood pressure control, quality of life, and patient satisfaction can be achieved.     

Pharmacy Students’ Performance and Perceptions in a Flipped Teaching Pilot on Cardiac Arrhythmias

Objective. To implement the flipped teaching method in a 3-class pilot on cardiac arrhythmias and to assess the impact of the intervention on academic performance and student perceptions.Design. An intervention group of 101 first-year pharmacy students, who took the class with the flipped teaching method, were supplied with prerecorded lectures prior to their 3 classes (1 class in each of the following subjects: basic sciences, pharmacology, and therapeutics) on cardiac arrhythmias. Class time was focused on active-learning and case-based exercises. Students then took a final examination that included questions on cardiac arrhythmias. The examination scores of the intervention group were compared to scores of the Spring 2011 control group of 105 first-year students who took the class with traditional teaching methods. An online survey was conducted to assess student feedback from the intervention group.Assessment. The mean examination scores of the intervention group were significantly higher than the mean examination scores of the control group for the cardiac arrhythmia classes in pharmacology (with 89.6 ± 2.0% vs 56.8 ± 2.2%, respectively) and therapeutics (89.2 ± 1.4% vs 73.7 ± 2.1%, respectively). The survey indicated higher student satisfaction for flipped classes with highly rated learning objectives, recordings, and in-class activities.Conclusion. Use of the flipped teaching method in a 3-class pilot on cardiac arrhythmias improved examination scores for 2 of the 3 classes (pharmacology and therapeutics). Student satisfaction was influenced by the quality of the learning objectives, prerecorded lectures, and inclass active-learning activities.     

Evaluation of Clinical and Communication Skills of Pharmacy Students and Pharmacists with an Objective Structured Clinical Examination

Objective. To evaluate how effectively pharmacy students and practicing pharmacists communicate and apply knowledge to simulations of commonly encountered patient scenarios using an objective structured clinical examination (OSCE).Design. Second-, third-, and fourth-year pharmacy students completed an OSCE as part of their required courses in 2012 and 2013. All students in both years completed identical OSCE cases. Licensed pharmacists were recruited to complete the OSCE and serve as controls in 2012. A survey assessed student perception and acceptance of the OSCE as well as student confidence in performance.Assessment. Licensed pharmacists had significantly higher clinical and communication skills scores than did pharmacy students. Student progression in communication and clinical skills improved significantly over time. Survey results indicated that students felt the OSCE was well-structured and assessed clinical skills taught in pharmacy school; 86% of students felt confident they could provide these skills.Conclusion. Objective structured clinical examinations can evaluate clinical competence and communication skills among professional students. Implementation of OSCEs may be an effective tool for assessment of the Center for the Advancement of Pharmacy Education domains.     

Enhancing an Introductory Pharmacy Practice Experience at free medical clinics

Objectives The aim of the study was to assess and improve first‐year student pharmacists' satisfaction and learning experience in a Student‐Run Free Medical Clinic Project (SFMCP) providing medical care to an underserved population. Methods Two consecutive classes of first‐year student pharmacists at the University of California San Diego (UCSD) Skaggs School of Pharmacy and Pharmaceutical Sciences participated in an Introductory Pharmacy Practice Experience (IPPE) at the UCSD SFMCP. This IPPE involved two inter‐professional evening free clinics which provide medical care to an underserved population and opportunities for healthcare professional training and service. Year 1 students completed a self‐assessment survey instrument and year 2 students completed the survey instrument plus a new competency checklist tool. Average scores from the self‐assessment survey instrument were compared between years 1 and 2. Key findings Initial survey results showed that students felt the SFMCP was worthwhile; however, they did not experience enough involvement in the patient assistance programme or non‐pharmacy‐related clinic activities. After the competency checklist tool implementation, overall student pharmacist satisfaction of the SFMCP IPPE remained high (88%), participation in identified weak areas improved and students agreed that the tool helped focus their clinic experience. Conclusions Areas of improvement were identified with the survey instrument and the competency checklist tool increased achievement of learning objectives. Overall, student pharmacists felt the SFMCP IPPE was a good learning experience. Practising pharmacists can employ these or similar tools in specific practice settings, to evaluate and help ensure that student pharmacists or interns are achieving applicable learning objectives.     

Use of Virtual Patients in an Advanced Therapeutics Pharmacy Course to Promote Active,Patient-Centered Learning

Objective. To assess student satisfaction and learning of course objectives following the integration of virtual patient cases designed to promote active, patient-centered learning in an advanced therapeutics pharmacy course.Design. A dynamic virtual patient platform that incorporated a branched-narrative, decision-making teaching model was used in an advanced therapeutics course to supplement lecture content.Assessment. Presimulation and postsimulation tests were used to assess student learning. The use of virtual patients significantly enhanced student learning for both higher- and lower-level test questions (p<0.001 and p=0.01, respectively). Students agreed or strongly agreed that the virtual patient cases provided an effective way to learn (72%), were enjoyable (69%), and were appropriate in content (80%), and that more should be incorporated (59%).Conclusion. The use of virtual patients in an advanced therapeutics practicum effectively promoted active, patient-centered learning; engaged students in an interactive and dynamic educational technology; encouraged teamwork; enhanced higher-level student learning; and improved student satisfaction in the course.     

Online Virtual-Patient Cases Versus Traditional Problem-Based Learning in Advanced Pharmacy Practice Experiences

Objective. To evaluate the efficacy of faculty-led problem-based learning (PBL) vs online simulated-patient case in fourth-year (P4) pharmacy students.Design. Fourth-year pharmacy students were randomly assigned to participate in either online branched-case learning using a virtual simulation platform or a small-group discussion. Preexperience and postexperience student assessments and a survey instrument were completed.Evaluation. While there were no significant differences in the preexperience test scores between the groups, there was a significant increase in scores in both the virtual-patient group and the PBL group between the preexperience and postexperience tests. The PBL group had higher postexperience test scores (74.8±11.7) than did the virtual-patient group (66.5±13.6) (p=0.001).Conclusion. The PBL method demonstrated significantly greater improvement in postexperience test scores than did the virtual-patient method. Both were successful learning methods, suggesting that a diverse approach to simulated patient cases may reach more student learning styles.     

Online versus Live Delivery of Education to Pharmacists in a Large Multicentre Health Region: A Non-inferiority Assessment of Learning Outcomes

Background

The prevalence of online modules for continuing education in the health professions has been increasing in recent years. However, the effectiveness of online modules for pharmacist learning has not been thoroughly studied.

Objectives:

The primary aim of this study was to determine if providing education to pharmacists through a self-paced enhanced online module was non-inferior to a face-to-face learning module with respect to knowledge application on the topic of postoperative insulin dosing. Secondary aims were to determine pharmacists’ knowledge gain and retention, as well as their satisfaction with the modules.

Methods:

The participants in this prospective, randomized, parallel-group non-inferiority trial were pharmacists in a large multicentre health region. Outcomes were measured by comparing scores obtained on pre- and post-module knowledge-assessment questionnaires. A between-group difference in change on knowledge application scores of less than 25 percentage points was the predetermined non-inferiority margin.

Results:

A total of 74 pharmacists consented to participate, 38 randomly assigned to use the enhanced online module and 36 to attend the face-to-face learning session. For questions examining knowledge application, the mean improvement achieved by the online learning group was 26 percentage points greater than that achieved by the face-to-face learning group (95% confidence interval [CI] 25 to 27; p < 0.001). For questions testing knowledge gain, the improvement achieved by the online learning group was 7 percentage points less than that achieved by the face-to-face learning group (95% CI 2 to 12; p = 0.008). Therefore, the enhanced online module was deemed to be non-inferior to the face-to-face learning session in terms of knowledge application and knowledge gain. Insufficient data were available to analyze the secondary outcome of knowledge retention over time. Participant satisfaction was similar for the 2 groups (p = 0.62).

Conclusion:

The self-paced enhanced online module was non-inferior to facilitated face-to-face learning in terms of improving application and knowledge of insulin dosing. Pharmacists had similar levels of satisfaction with the 2 modes of learning.     

Incorporating Hypertensive Patient Education on Salt Intake Into an Introductory Pharmacy Practice Experience

Objective. To evaluate the impact of the Salt Education Program for hypertensive adults on student pharmacists'' knowledge, behaviors, and attitudes regarding sodium consumption.Design. As part of the introductory pharmacy practice experience program in community pharmacies, student pharmacists assessed patients'' sodium intake knowledge and behaviors, taught them how to read nutrition labels, and obtained information about their hypertensive conditions. Students completed pre-and post-intervention questionnaires in April and August 2012, respectively.Assessment. One hundred thirty student pharmacists (70% female, 78% white) completed pre- and post-intervention questionnaires. Students demonstrated significant improvements in knowledge scores (p<0.001) and perceived benefit of a low-salt diet (p=0.004). Further, there were significant improvements in the self-reported frequency of looking at sodium content of foods when shopping (p<0.001) and purchasing low-salt foods (p=0.004).Conclusion. Changes in students'' knowledge, behaviors, and attitudes after participating in the Salt Education program suggested that the program was effective in improving student knowledge, behaviors, and attitudes.     

Rational and Experiential Decision-Making Preferences of Third-Year Student Pharmacists

Objective. To examine the rational (systematic and rule-based) and experiential (fast and intuitive) decision-making preferences of student pharmacists, and to compare these preferences to the preferences of other health professionals and student populations.Methods. The Rational-Experiential Inventory (REI-40), a validated psychometric tool, was administered electronically to 114 third-year (P3) student pharmacists. Student demographics and preadmission data were collected. The REI-40 results were compared with student demographics and admissions data to identify possible correlations between these factors.Results. Mean REI-40 rational scores were higher than experiential scores. Rational scores for younger students were significantly higher than students aged 30 years and older (p<0.05). No significant differences were found based on gender, race, or the presence of a prior degree. All correlations between REI-40 scores and incoming grade point average (GPA) and Pharmacy College Admission Test (PCAT) scores were weak.Conclusion. Student pharmacists favored rational decision making over experiential decision making, which was similar to results of studies done of other health professions.     

Long-Term Maintenance of Pharmacists' Inhaler Technique Demonstration Skills

Objective

To assess the effectiveness of a single educational intervention, followed by patient education training, in pharmacists retaining their inhaler technique skills.

Methods

A convenience sample of 31 pharmacists attended an educational workshop and their inhaler techniques were assessed. Those randomly assigned to the active group were trained to assess and teach correct Turbuhaler and Diskus inhaler techniques to patients and provided with patient education tools to use in their pharmacies during a 6-month study. Control pharmacists delivered standard care. All pharmacists were reassessed 2 years after initial training.

Results

Thirty-one pharmacists participated in the study. At the initial assessment, few pharmacists demonstrated correct technique (Turbuhaler:13%, Diskus:6%). All pharmacists in the active group demonstrated correct technique following training. Two years later, pharmacists in the active group demonstrated significantly better inhaler technique than pharmacists in the control group (p < 0.05) for Turbuhaler and Diskus (83% vs.11%; 75% vs.11%, respectively).

Conclusion

Providing community pharmacists with effective patient education tools and encouraging their involvement in educating patients may contribute to pharmacists maintaining their competence in correct inhaler technique long-term.     

Impact of Student- Versus Instructor-Directed Case Discussions on Student Performance in a Pharmacotherapy Capstone Course

Objective. To evaluate the impact of incorporating student-directed (SD) vs instructor-directed (ID) active learning on student performance in a pharmacotherapy capstone course.Design. This 9-credit course was redesigned from exclusively ID case discussions to a format in which half were SD and half were ID. Student performance on evaluation questions derived from SD sessions was compared with that from ID sessions.Assessment. Overall, students (n=299) performed better on ID-session questions than on SD-session questions (78.7% vs 75.3%, correctly answered, respectively; p<0.001). For written evaluations, students performed better on ID-session questions than on SD-session questions (79.8% vs 73.9%, respectively; p<0.001). For verbal evaluations, students performed better on SD-session questions than on ID-session questions (79.5% vs 74.5%, respectively; p<0.001). After the course revision, student confidence regarding their ability to think critically, solve problems, make decisions, and pursue lifelong learning was high, and student and faculty feedback was positive.Conclusion. Student performance in a pharmacotherapy capstone course remained acceptable when a combination of SD and ID active learning was used, but the addition of SD learning did not translate to better performance on course evaluations.     

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.     

Public’s perception and satisfaction on the roles and services provided by pharmacists – Cross sectional survey in Sultanate of Oman

Background and objectives: An important factor that will help in advancement of the pharmacy services in any country would be to understand the public needs, expectation and satisfaction. There are limited published studies conducted in Sultanate of Oman regarding the perception and satisfaction of public on the role and services provided by pharmacists. The present study was conducted to assess the perception and satisfaction of general public in Sultanate of Oman on the roles, and services received from the pharmacists. Methods: The survey was conducted among public in the Governorates of A’Dahera and Muscat in Oman during 2013. The questionnaire had items to assess two aspects: perception on the roles and responsibilities of pharmacists and satisfaction on the services provided. The responses to the questions marked in a five point Likert scale were assessed using a scoring scheme. Accordingly, the median perception, and satisfaction score and median total score for the participants were estimated. The median scores of the participants were related with the demographics of the participants and frequency of visit to pharmacy. Results: A total of 390 completed questionnaires were obtained. The median total score of the participants based on all the questions was 79 (Inter Quartile Range (IQR), 12) which represents a moderate score. The median perception and satisfaction scores were 44 (IQR 5) and 34 (IQR 7) which represent a good and moderate score, respectively. Perception of the participants differed based on employment status, frequency of visit to pharmacy and governorate represented by participants while satisfaction was influenced by educational qualification and frequency of visit to pharmacy. Conclusions: Public had a good perception regarding the roles of the pharmacists while they were only moderately satisfied with the services provided. Steps have to be taken to improve the services and relationship of pharmacists, and thereby improve the satisfaction of the customers. An extended study in a broader population involving more governorates will provide an enhanced representation regarding this important aspect.     

An objective structured clinical examination to assess problem-based learning

Objectives. To compare pharmacy students’ performance on an objective structured clinical examination (OSCE) to their performance on a written examination for the assessment of problem-based learning (PBL); and to determine students’ and faculty members’ perceptions of OSCEs for PBL evaluations.Design. Four OSCEs were added to the written examination to assess 4 PBL cases in a third-year pharmacotherapy course. OSCE scores were compared to written examination scores. Faculty members evaluated student performance.Assessment. OSCE performance did not correlate with the written-examination scores. Most students (≥ 75%) agreed that OSCEs reflected their learning from PBL and measured knowledge, communication, and clinical skills. A majority of faculty members (≥75%) agreed that OSCEs should be part of PBL assessment.Conclusions. Addition of an OSCE to written examinations was valued and provided a more comprehensive assessment of the PBL experience.     

团体体检规范化管理经验探讨

目的 探讨规范化团体体检的管理经验.方法 对比常规体检模式及规范化体检模式在体检前、体检中及体检后的组织管理,对两组的平均体检时间、漏检弃检率及患者满意率进行统计学分析,获得团体体检的路径并总结经验.结果 规范化体检组与常规体检组比较,规范化体检组每天平均体检时间明显缩短（P＜0.01）,漏检率及弃检率均低于常规体检组（P＜0.01）,而受检者的满意率明显高于常规体检组（P＜0.01）.结论 团体体检的规范化管理可缩短体检时间,有效降低了漏检及弃检率,同时提高了受检者的满意度,可作为一项长期的体检路径实施应用.