Best Practices Assessment to Guide Curricular Change in a Bachelor of Pharmacy Program

Objectives

To identify best practices in global pharmacy education and curriculum design as the basis for decisions about major curriculum change in an existing 4-year bachelor of pharmacy curriculum.

Design

We investigated international best-practice standards, conducted semi-structured interviews with faculty members, and used standardized instruments to investigate student perceptions of the existing curriculum and how they approached their learning.

Assessment

Faculty recommendations included horizontal and vertical integration of curriculum content to replace the previous discipline-based approach; and a theme-based structure underpinned by a detailed statement of learning outcomes that describe the knowledge, skills, and attitudinal milestones to be achieved each year and by the time of graduation. The triangulation of student survey data highlighted issues that needed to be addressed at the individual course unit level, with a particular focus on feedback, assessment, and workload.

Conclusions

The results of the curriculum review provided clear guidance for decisions relating to major curriculum change. An ongoing program of staff development will address the wide range of learning and teaching issues identified by both staff members and students. The results of our investigation of students'' approaches to learning will also be used to guide staff development workshops, focusing on strategies to promote “meaningful learning.”     

An Outcomes-based Approach to Curriculum Development in Pharmacy

Objective

To implement an outcomes-based approach to pharmacy curriculum development.

Design

Desired learning outcomes were identified; course content, learning activities, and assessment instruments were designed; and evaluation was conducted and feedback obtained to refine the curriculum.

Assessment

All professional skills, 4 generic capabilities, and the coherence of the curriculum scales showed significant improvement compared to graduates'' performance under both the old and transitional curriculum.

Conclusion

An outcomes-based approach to pharmacy curriculum development provided convincing evidence of enhancement to the curriculum. Such an approach should be considered when implementing or revising pharmacy curriculum.     

Curriculum Reform in Finnish Pharmacy Education

Objective

To improve pharmacy education through integrating theory and practice, coherent constructively aligned course entities, and enhanced deep-level learning.

Design

The reform was conducted collaboratively with faculty and staff members, students, and stakeholders in pharmacy. The curriculum, syllabus, and teaching methods were assessed through evaluations and research, conducting core content analyses, and measuring the workload of pharmacy education courses. The new curriculum, launched in August 2005, consists of 6 strands, comprised of different courses which run through the entire program.

Assessment

Three years after the introduction of the reformed curriculum, the results of the reform are being evaluated. Ongoing assessments of teaching and learning will reveal how the education at the faculty level has developed since the reform. These assessment procedures are an integral part of the faculty''s quality assurance program.

Conclusion

The integration of practical training and theoretical studies was improved with personal study plans introduced to enhance students’ learning.     

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.     

Implementing Standards 2007 to Improve Students�� Preparation for Advanced Pharmacy Practice Experiences

Objective

To examine the impact of implementation of the Accreditation Council for Pharmacy Education''s (ACPE''s) Standards 2007 on pharmacy students’ preparation for their first advanced pharmacy practice experience (APPE).

Design

The doctor of pharmacy (PharmD) curriculum was altered to include introductory pharmacy practice experiences (IPPE), second-year therapeutics, classroom integration of practice experiences, more biomedical sciences, an electronic portfolio system, life-long learning exercises, and additional content based on Appendix B of Standards 2007. Curricular outcomes and the assessment plan also were revised based on Standards 2007.

Assessment

To evaluate the impact of these changes to the curriculum, faculty members rated 9 behaviors of students observed during the third week of their first APPE and compared their scores with those of students who were evaluated in 2004 before the curriculum had been revised. Students completing the revised curriculum performed all 9 behaviors more often and had a better average score than students evaluated in 2004.

Conclusion

Curricular revisions implemented to address ACPE Standards 2007 were associated with positive clinical behaviors in students beginning their experiential education.     

Redesign and Evaluation of a Patient Assessment Course

Objectives

To redesign a patient assessment course using a structured instructional design process and evaluate student learning.

Design

Course coordinators collaborated with an instructional design and development expert to incorporate new pedagogical approaches (eg, Web-based self-tests), create new learning activities (eg, peer collaboration on worksheets, SOAP note writing), and develop grading rubrics.

Assessment

Formative and summative surveys were administered for student self-assessment and course evaluation. Seventy-six students (78%) completed the summative survey. The mean course grade was 91.8% ± 3.6%, with more than 75% of students reporting achievement of primary course learning objectives. All of the additional learning activities helped students meet the learning objectives with the exception of the written drug information response.

Conclusion

The use of a structured instructional design process to redesign a patient assessment course was successful in creating a curriculum that succeeded in teaching students the specified learning objectives. Other colleges and schools are encouraged to collaborate with an instructional design and development expert to improve the pharmacy curriculum.     

Incorporating an Immunization Certificate Program into the Pharmacy Curriculum

Objective

To describe the method of incorporating an immunization certificate training program, such as the American Pharmacists Association''s (APhA) Pharmacy-Based Immunization Delivery into a pharmacy curriculum.

Design

The program was delivered over 3 weeks in the spring semester of the third professional year (P3) as part of a required Pharmacy Care Lab sequence.

Assessment

Student response surveys and faculty input were used to evaluate the placement of the program in the curriculum.

Conclusion

Optional comments yielded more than 44% of students providing positive open-ended feedback regarding the course while almost 10% felt the course should not be mandated in the curriculum.     

Development of a Reliable,Valid Annual Skills Mastery Assessment Examination

Objective

To develop a methodology for a reliable, valid annual skills mastery assessment examination to provide formative student feedback, inform curricular review, and comply with the Accreditation Council for Pharmacy Education (ACPE) Standards 2007.

Design

A sample of program-level ability-based outcomes skills were chosen for the examination. Test items were written, underwent quality control, and were scored for level of difficulty. Versions of the examination for first-, second-, third-, and fourth-year pharmacy students were developed and administered, the results were analyzed, reliability and validity were evaluated, and reports were generated. Item-writing guidelines, quality control procedures, and examination production steps were codified to create a criterion-referenced examination. Students and faculty advisors received detailed score reports and results were used to guide student performance and stimulate a review of curricular outcomes.

Assessment

Content, criterion, and construct validity were analyzed as defined in the literature for the intended use of this assessment tool. Data suggest the Annual Skills Mastery Assessment (ASMA) examination is both reliable and valid. Students and faculty members were surveyed regarding the usefulness of the examination. Results indicate general satisfaction with the assessment program.

Conclusion

A reasonably reliable, reasonably valid multiple-choice annual skills mastery assessment for selected outcomes statements providing formative feedback and informed curricular review was developed.     

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 Service-Learning Course for First-Year Pharmacy Students

Objectives

To describe the design of a required service-learning course offered to first- year (P1) pharmacy students, and to assess student learning and the relevance of this learning in the pharmacy curriculum.

Design

A 14-week service-learning course was designed and community organizations were recruited to participate. All first-year students enrolled in the School completed the course. A post-course survey was administered to the students, inquiring about what they had learned from the course; supervisors at the students'' service sites also completed a short survey.

Assessment

The course and the student survey instrument were completed by 195 students, and of these 190 gave permission for the information they provided to be used in the study. Notable learning outcomes were identified, especially in the areas of communication and the social and behavioral aspects of pharmacy.

Conclusion

The survey administered at the conclusion of the course described in this article demonstrated that students in the course had achieved the desired learning outcomes. This shows that service-learning is a pedagogy that educators can employ to effect relevant learning in the pharmacy curriculum.     

Graphic Strategies for Analyzing and Interpreting Curricular Mapping Data

Objective

To describe curricular mapping strategies used in analyzing and interpreting curricular mapping data and present findings on how these strategies were used to facilitate curricular development.

Design

Nova Southeastern University''s doctor of pharmacy curriculum was mapped to the college''s educational outcomes. The mapping process included development of educational outcomes followed by analysis of course material and semi-structured interviews with course faculty members. Data collected per course outcome included learning opportunities and assessment measures used.

Assessment

Nearly 1,000 variables and 10,000 discrete rows of curricular data were collected. Graphic representations of curricular data were created using bar charts and stacked area graphs relating the learning opportunities to the educational outcomes. Graphs were used in the curricular evaluation and development processes to facilitate the identification of curricular holes, sequencing misalignments, learning opportunities, and assessment measures.

Conclusion

Mapping strategies that use graphic representations of curricular data serve as effective diagnostic and curricular development tools.     

Team-based Learning in Therapeutics Workshop Sessions

Objectives

To implement team-based learning in the workshop portion of a pathophysiology and therapeutics sequence of courses to promote integration of concepts across the pharmacy curriculum, provide a consistent problem-solving approach to patient care, and determine the impact on student perceptions of professionalism and teamwork.

Design

Team-based learning was incorporated into the workshop portion of 3 of 6 pathophysiology and therapeutics courses. Assignments that promoted team-building and application of key concepts were created.

Assessment

Readiness assurance tests were used to assess individual and team understanding of course materials. Students consistently scored 20% higher on team assessments compared with individual assessments. Mean professionalism and teamwork scores were significantly higher after implementation of team-based learning; however, this improvement was not considered educationally significant. Approximately 91% of students felt team-based learning improved understanding of course materials and 93% of students felt teamwork should continue in workshops.

Conclusion

Team-based learning is an effective teaching method to ensure a consistent approach to problem-solving and curriculum integration in workshop sessions for a pathophysiology and therapeutics course sequence.     

Concept mapping to evaluate an undergraduate pharmacy curriculum

Objectives

To explore a pharmacy school curriculum for opportunities for student engagement and to determine how these might shape student identity as pharmacists.

Methods

The learning aims and objectives and methods of assessment from the curriculum of a bachelor of pharmacy (BPharm) program were collected and a concept map was generated. The concept map was interpreted using Barnett and Coates'' curricular domains of knowing, acting and being.

Results

The key concepts within the intended curriculum that were identified from the concept map were drugs, pharmacy, understanding, practice, and skills. Concepts such as patient and consumer, which would indicate a patient-centered approach to the curriculum, were limited. The main form of assessment used in the curriculum was multiple-choice and short-answer examinations.

Conclusion

There was an emphasis in the curriculum on student acquisition of knowledge and this was reinforced by the use of theoretical examinations. The content of the curriculum was drug-centered rather than patient-centered and the emergence of students'' identity as pharmacists may be fragmented as a result.     

Learning bridge tool to improve student learning, preceptor training, and faculty teamwork

Objectives

To implement a Learning Bridge tool to improve educational outcomes for pharmacy students as well as for preceptors and faculty members.

Design

Pharmacy faculty members collaborated to write 9 case-based assignments that first-year pharmacy (P1) students worked with preceptors to complete while at experiential sites.

Assessment

Students, faculty members, and preceptors were surveyed about their perceptions of the Learning Bridge process. As in our pilot study,¹ the Learning Bridge process promoted student learning. Additionally, the Learning Bridge assignments familiarized preceptors with the school''s P1 curriculum and its content. Faculty teamwork also was increased through collaborating on the assignments.

Conclusions

The Learning Bridge assignments provided a compelling learning environment and benefited students, preceptors, and faculty members.     

Pharmacy Students' Approaches to Learning in an Australian University

Objectives

To investigate how pharmacy students'' approaches to learning change over the duration of a bachelor of pharmacy degree program.

Methods

Data were obtained from a cross-sectional, repeated measures design, using a validated self-report survey instrument. Areas examined included processing and regulation strategies, motivational preferences for learning, and the relationship between approaches to learning and academic performance.

Results

Pharmacy students were strongly vocationally oriented in their studies across all year groups. This approach had a significant relationship to academic performance. Overall, students indicated a preference for external regulation strategies. There was little evidence of maturation in approaches to learning as students progressed through the curriculum.

Conclusions

Students'' preference for vocationally related strategies can be harnessed to increase both adoption of self-regulation behaviors and motivation for mastery of material. Comparison of our results with other studies indicates that approaches to learning may be influenced more by the learning environment than the discipline of study.     

Pharmacy Students' Perceptions of Their Preparedness to Provide Pharmaceutical Care

Objective

To assess students'' perceptions of their preparedness to perform advanced pharmacy practice competencies.

Design

The Preparedness to Provide Pharmaceutical Care (PREP) survey was modified and administered to each class at a Midwestern university from 2005-2008. Factor analysis and 1-way ANOVA with multiple comparisons were applied to assess the effectiveness of changes made in the pharmacy curriculum.

Assessment

Factor analysis yielded patterns similar to those reported in the literature. Students rated themselves highest on the psychological aspects and lowest on the administrative aspects of care. Perceived pharmaceutical care skills grew as students progressed through the curriculum, and changes in coursework were reflected in the competencies.

Conclusion

Students’ perceived competencies (ie, communication, psychological, technical, administrative) were similar to those at other institutions and perceptions of competencies increased in a manner consistent with actual program outcomes.     

Theoretical and conceptual framework for a high school pathways to pharmacy program

Objectives

To determine whether participation in the University of Illinois at Chicago College of Pharmacy (UIC-COP) Pathways to Pharmacy, an early urban pipeline program, motivated underrepresented minority students to pursue a prepharmacy curriculum in college and choose pharmacy as a career.

Methods

Over a 4-year period, underrepresented minority high school students participated in a comprehensive 6-week program that included 3 weeks of prepharmacy curriculum and intensive socialization and 3 weeks working as a pharmacy technician in a chain pharmacy. The High School Survey of Student Engagement (HSSSE) was administered 3 times to 120 program participants from 2005-2008, with 4 open-ended questions added to the pretest, 3 open-ended questions added to the test administered at the midpoint of the program, and 7 open-ended questions added to the posttest.

Results

After completing the program, 88 (75%) of the 120 students enrolled in the college''s prepharmacy curriculum and planned to pursue a career in pharmacy, 10 (8%) were not interested in pursuing a career in pharmacy, and 20 (17%) were undecided, compared to the pretest data which showed that 40 (33%) were interested in a career in pharmacy, and 80 (67%) were undecided (p < 0.0001).

Conclusions

Participation in a Pathways to Pharmacy program grounded in both a theoretical and conceptual socialization model framework increased the number of underrepresented minority students in the pipeline to pharmacy schools.     

Using Cooperative Learning for a Drug Information Assignment

Objectives

To implement a cooperative learning activity to engage students in analyzing tertiary drug information resources in a literature evaluation course.

Design

The class was divided into 4 sections to form expert groups and each group researched a different set of references using the jigsaw technique. Each member of each expert group was reassigned to a jigsaw group so that each new group was composed of 4 students from 4 different expert groups. The jigsaw groups met to discuss search strategies and rate the usefulness of the references. In addition to group-based learning, teaching methods included students'' writing an independent research paper to enhance their abilities to search and analyze drug information resources.

Assessment

The assignment and final course grades improved after implementation of the activity. Students agreed that class discussions were a useful learning experience and 75% (77/102) said they would use the drug information references for other courses.

Conclusion

The jigsaw technique was successful in engaging students in cooperative learning to improve critical thinking skills regarding drug information.