A Peer-Teaching Model to Reinforce Pharmacy Students’ Clinical Knowledge of Commonly Prescribed Medications

Objective. To implement and assess the effectiveness of a peer teaching series to increase third year Doctor of Pharmacy (PharmD) students’ knowledge of and confidence regarding commonly prescribed medications.Methods. All third-year pharmacy students (n=98) at a college of pharmacy were encouraged to participate in the RxReady peer teaching series prior to beginning their advanced pharmacy practice experiences. Each student in the class was assigned a drug to learn in-depth. Twenty-four of the students were randomly selected to provide peer teaching regarding a single medication. These students were required to meet with a faculty member to prepare for their presentation. Assessment methods included completion of pre- and post-intervention quizzes and anonymous surveys regarding the peer-teaching modality. Students also provided qualitative feedback on the series as part of a course survey.Results. Among the 96 students who completed the pre- and post-intervention quizzes, there was a mean increase of 15% (SD=11%) on the post-intervention quiz score compared to the pre-intervention quiz score. Ninety-two (96%) students achieved a higher score on the post-intervention quiz. There was no difference in mean percent change in scores between the pre-and post-intervention quiz for students who presented in class compared with students who did not present (17% [SD=10%] vs 15% [SD=11%], respectively). Student-reported confidence significantly improved across all drug knowledge categories. In each category, the median confidence score increased from 2 (somewhat confident) to 3 (moderately confident). The students’ qualitative feedback was generally positive, and they provided suggestions to improve the content and design of the RxReady peer teaching series.Conclusion. A peer teaching approach to reviewing drug information can assist in targeting gaps in PharmD students’ drug knowledge and help to build their confidence in their readiness to begin APPEs.     

Student Scientific Inquiry in the Core Curriculum

Objective. To design and implement a required student-driven research program as a capstone experience in the doctor of pharmacy (PharmD) curriculum.Design. A research proposal in the form of a competitive grant application was required for each of 65 fourth-year students in an inaugural PharmD class at Touro College of Pharmacy in New York. The focus of the proposals was on hypothesis-driven research in basic science, clinical research, health outcomes, and public health.Assessment. Students’ research proposals were graded using a standardized grading instrument. On a post-experience survey, most students rated the overall experience positively, indicating increased confidence in their research skills. About two-thirds of faculty members were satisfied with their students’ performance, and the great majority thought the experience would be useful in the students’ careers.Conclusion. The capstone research project was a positive experience for fourth-year students.     

The Impact of Two Longitudinal Professionalism Courses on Student Pharmacists’ Empathy

Objective. To determine whether empathy increased in first-year student pharmacists after completing longitudinal professionalism courses at two schools of pharmacy, identify potential moderators, and assess whether students’ conceptualization of empathy changed with time.Methods. Surveys to assess empathy and other variables were administered to student pharmacists at baseline and at the end of two professionalism courses. Baseline and follow-up scores were compared to detect changes over time. Multivariable analysis was used to identify predictors of empathy scores. Factor analysis was performed to ascertain changes in the dimensionality of empathy.Results. Students’ demographics and baseline empathy scores differed between the two schools. Predictors of empathy at baseline included age, female gender, prior health care experience, and altruism score. A small increase in empathy was observed at one school but not in the combined cohort. Empathy was more likely to increase among female students, those with less health care experience, and those who did not work during the school year. Factor analyses suggested that students’ conceptual clarity about empathy improved over time and became more consistent with existing models.Conclusion. Although an increase in empathy was not observed in the overall cohort, subgroups of students who may derive greater benefit from empathy-related interventions were identified. Factor analyses suggested that students’ conceptual understanding of empathy improved, representing a potential alternative outcome assessment for affective domains. Given differences in demographics, instructional methodologies, and changes in empathy at each school, this study reinforces the importance of replication and multicenter studies to understand the generalizability of educational research.     

A Three-Year Reflective Writing Program as Part of Introductory Pharmacy Practice Experiences

Objectives. To implement and evaluate a 3-year reflective writing program incorporated into introductory pharmacy practice experiences (IPPEs) in the first- through third-year of a doctor of pharmacy (PharmD) program.Design. Reflective writing was integrated into 6 IPPE courses to develop students’ lifelong learning skills. In their writing, students were required to self-assess their performance in patient care activities, identify and describe how they would incorporate learning opportunities, and then evaluate their progress. Practitioners, faculty members, and fourth-year PharmD students served as writing preceptors.Assessment. The success of the writing program was assessed by reviewing class performance and surveying writing preceptor’s opinions regarding the student’s achievement of program objectives. Class pass rates averaged greater than 99% over the 8 years of the program and the large majority of the writing preceptors reported that student learning objectives were met. A support pool of 99 writing preceptors was created.Conclusions. A 3-year reflective writing program improved pharmacy students’ reflection and reflective writing skills.     

Heart of Pharmacy: A Course Exploring the Psychosocial Issues of Patient Care

Objective

To implement and assess the impact of a course utilizing reflective learning to explore the complex, psychosocial human issues encountered in pharmacy practice.

Design

A 1-credit-hour elective course, The Heart of Pharmacy, was offered to all pharmacy students. The course utilized both content and reflective techniques to produce a mutual exploratory learning experience for students, staff, and faculty members. Faculty and staff facilitators observed competencies and used a single group posttest design to assess students’ attitudes. In year four, students’ written reflections for each session were added and reviewed on a continuous basis throughout the course.

Assessment

Faculty and staff observations indicated that educational outcomes were achieved and student perceptions and evaluations of the course were highly positive. Three major themes were identified in the students’ qualitative responses: a recognition of communal support among student and faculty colleagues; a grounding for personal growth and professional formation; a deeper insight into and experience with the role of the pharmacist as compassionate listener and caregiver.

Conclusion

Faculty observations of student competencies and students’ perceptions of this course point to the need for pharmacy education to provide organized, structured reflective learning opportunities for students and faculty members to explore the deeper human issues of pharmacy practice and patient care.     

An Elective Course in Aromatherapy Science

Objective. To evaluate the impact of an innovative team-taught elective course on second-year (P2) students’ knowledge and skills relating to the relationship between aromatherapy and pharmacy.Design. An Aromatherapy Science elective course was offered to P2 students in an accelerated doctor of pharmacy (PharmD) degree program and was designed to provide an elective course experience while focusing on active-learning skills such as group work, student-led presentations, and in-class activities. Lectures were designed to reinforce core curricular threads from the basic sciences within the pharmaceutical sciences department while highlighting key aromatherapy principles.Assessment. Course evaluations, grades, and student self-assessments were used to evaluate student fulfillment and knowledge gained. Students agreed this hands-on course integrated pharmaceutical science experiences, enriched their pharmacy education, and provided knowledge to enhance their confidence in describing essential oil uses, drug interactions, and key aromatherapy clinical implications.Conclusion. Students agreed this course prepared them to identify essential oil therapeutic uses and potential essential oil-drug interactions, and interpret literature. The introduction of aromatherapy principles to pharmacy students will prepare a new generation of healthcare professionals on the role of alternative medicines.     

Evaluation of an Instrument to Assess Students’ Personal and Professional Development During the Faculty Advising Process

Objective. To evaluate a tool designed to assess Doctor of Pharmacy (PharmD) students’ personal and professional development prior to beginning advanced pharmacy practice experiences (APPEs).Methods. A five-item instrument, entitled the Faculty Advisor’s Assessment of the Advisee (FAAA) tool, was developed to assess and monitor pharmacy students’ progress over the three-year didactic curriculum. Question anchors were created to describe characteristics exhibited by the student that matched categories of not engaged, beginning, emerging, or engaged. Possible FAAA composite scores ranged from 7 to 20. Using the FAAA tool, faculty advisors assessed their advisees’ values, engagement, self-awareness, professionalism, and leadership in 2017, 2018, and 2019. Individual and aggregate cohort reports were run and data for each of the three years were matched with students. To determine if the FAAA showed progression in assessed dimensions in the students during the first, second, and third professional (P1, P2, and P3) years, a Friedman test was performed. Cronbach alpha was used to assess the reliability of the instrument.Results. The data of 93 students were matched for the P1 through the P3 years. Median (IQR) for the FAAA composite score levels for the P1, P2, and P3 were 13 (12-16), 17 (15-19) and 18 (16-20), respectively. Significant differences existed at all timepoints compared, including from the P1 to P2, P2 to P3, and P1 to P3 years. The reliability of the FAAA scale was strong across all three years (winter 2017, α=0.87; winter 2018, α=0.89; and winter 2019, α=0.87). All items appeared worthy of retention as removal did not significantly increase their reliability.Conclusion. A five-item tool which assesses pharmacy students’ personal and professional development during the first three years of a PharmD program could be used by faculty advisors to assess student’s progress across the didactic curriculum.     

Incorporating Ethics Content Throughout an Integrated Pharmacy Curriculum

Objective. To incorporate ethics content into nine courses across three years of the didactic pharmacy curriculum and in introductory and advanced pharmacy practice experiences to ensure Doctor of Pharmacy (PharmD) students are prepared to address ethical issues.Methods. A free-standing, one-credit ethics course from the existing curriculum was eliminated. Partnering with course directors from nine required PharmD courses across all three years of the didactic curriculum and with the Office of Experiential Education, an Integrated Ethics syllabus was created that provided each class of approximately 170 students with at least one credit of didactic ethics instruction and added ethics activities to the experiential curriculum. Learning approaches included lecture, case analysis, and discussion with preceptors. Assessment approaches included written case analyses, tests with multiple-choice and true/false questions, case vignette-based short-answer essay questions, and student discussions with preceptors.Results. The newly integrated curriculum provided students with opportunities to discuss and apply ethics concepts several times throughout their coursework. The integration also ensured that ethics topics were relevant to the material students were learning in the host course at the time. The majority of students consistently rated the ethics sessions as useful, but some found the repeated application of the ethics problem-solving framework to be tedious and duplicative.Conclusion. It is possible to embed ethics topics within different courses in the PharmD curriculum rather than offering a stand-alone ethics course at a single point in the curriculum. Challenges remain to assessing students’ ability to apply ethics principles once they are presented.     

Resilience and First-Year Pharmacy Students’ Academic Performance in a Pharmacy Math Course

Objective. The purpose of this study was to examine the relationship between academic resilience and academic success in Doctor of Pharmacy (PharmD) students.Methods. A cross-sectional survey using the Academic Pharmacy Resilience Scale (APRS-16) was conducted in two cohorts of first year pharmacy (P1) students (n = 374) during fall orientation in 2019 and 2020. The following data were also collected from student records: demographics, pre-pharmacy grade point average (GPA), Pharmacy Math outcome (passing or failing the course), and Pharmacy Math final numerical grade. Academic success was defined as achieving a passing grade in a Pharmacy Math course. Correlational, multiple logistic regression, and multiple linear regression analysis were conducted.Results. The survey response rate was 98.1%, and approximately 95% of participants passed Pharmacy Math. No significant correlations were found between Pharmacy Math final pass/fail outcome or Pharmacy Math final numerical grade and APRS-16 overall and subscale scores. In multiple logistic regression, neither pre-pharmacy GPA nor APRS overall scale or subscale scores were significantly associated with final Pharmacy Math outcome (passing/failing). In multiple linear regression, pre-pharmacy GPA was significantly associated with Pharmacy Math final numerical grade, but APRS-16 overall score and subscale scores were not.Conclusion. First-year pharmacy students’ performance in Pharmacy Math was not influenced by academic resilience. Studies like this one examining the relationship between pharmacy students’ resilience and academic performance are lacking. Future studies should assess whether academic resilience may affect performance in other courses as well as performance in the PharmD curriculum.     

Teaching and Learning Health Literacy in a Doctor of Pharmacy Program

Objective. To evaluate the impact of health literacy (HL) activities incorporated into a required, first professional year (P1), patient-centered communication course on pharmacy students’ knowledge, abilities, confidence, and attitudes related to HL.Design. Integrated, active-learning HL activities were incorporated into the course. Students’ knowledge and abilities were assessed with course evaluations. Students’ knowledge, confidence levels, and attitudes were evaluated by a precourse and postcourse survey. Third professional year (P3) students who did not complete HL activities were also surveyed.Assessment. Almost all students “met” or “exceeded” expectations (the top 2 levels of achievement on the objective structured clinical examination (OSCE) grading rubrics) on HL course evaluations. Survey results showed significant improvement in P1 students’ knowledge, confidence, and attitudes related to HL after completing the course. First year students (postcourse) rated their confidence levels and attitudes higher than P3 students.Conclusion. The use of integrated, active-learning activities is effective at improving P1 pharmacy students’ knowledge, abilities, confidence levels, and attitudes related to HL.     

Pharmacy Students’ Ability to Identify Plagiarism After an Educational Intervention

Objective. To determine if an educational intervention in a doctor of pharmacy (PharmD) degree program increases pharmacy students’ ability to identify plagiarism.Methods. First-year (P1), second-year (P2), and third-year (P3) pharmacy students attended an education session during which types of plagiarism and methods for avoiding plagiarism were reviewed. Students completed a preintervention assessment immediately prior to the session and a postintervention assessment the following semester to measure their ability.Results. Two hundred fifty-two students completed both preintervention and postintervention assessments. There was a 4% increase from preintervention to postintervention in assessment scores for the overall student sample (p<0.05). The mean change was greatest for P1 and P2 students (5% and 4.8%, respectively).Conclusion. An educational intervention about plagiarism can significantly improve students’ ability to identify plagiarism.     

Sterile Compounding Knowledge,Skills, and Confidence Among Graduating Doctor of Pharmacy Students

Objective. To determine whether the exposure to sterile compounding in the pharmacy curriculum produces Doctor of Pharmacy graduates who are both competent and confident in the area of sterile compounding, and to identify additional variables that may predict student performance.Methods. Participants were recruited from the fourth-year pharmacy class of 2018 at one university. The students were asked to complete a questionnaire assessing the following domains: demographics, confidence in compounding performance, prior experience, and theoretical knowledge. A written assessment was followed by a faculty-evaluated practicum in which the students were required to prepare two sterile products using a standardized rubric. Results were analyzed with a Student t test and linear regression to determine differences in performance based upon prior experience, confidence, and theoretical knowledge.Results. Overall, the 158 students performed well on the knowledge and skill examination, achieving an average total score of 89.8%. Of the 158 total participants, the 122 survey respondents had an overall mean confidence score of 2.9 on a four-point Likert scale, with 40.2% of students scoring in the confident or very confident range of the survey. In our analysis, we found that neither prior compounding experience or self-rated confidence were predictive of students’ total score.Conclusion. The results of this study suggest that the inclusion of sterile compounding education and training in all four years of the pharmacy curriculum produces PharmD graduates who are competent, with varying levels of confidence in the area of sterile compounding.     

Student and Faculty Perceptions of Lecture Recording in a Doctor of Pharmacy Curriculum

Objective. To describe students’ and faculty members’ perceptions of the impact of lecture recording in a doctor of pharmacy (PharmD) curriculum.Methods. Second- and third-year pharmacy students and faculty members completed an anonymous survey instrument regarding their perceptions of lecture recording with 2 classroom lecture capture software programs, Camtasia Studio and Wimba Classroom.Results. Most students (82%) responded that Camtasia was very helpful and almost half (49%) responded that Wimba Classroom was helpful (p<0.001). Forty-six percent of the students reported being more likely to miss a class that was recorded; however, few students (10%) reported using recordings as a substitute for attending class. The most common concern of faculty members was decreased student attendance (27%).Conclusion. Pharmacy students consider lecture recordings beneficial, and they use the recordings primarily to review the lecture. While faculty members reported concerns with decreased attendance, few students reported using recordings as an alternative to class attendance.     

Implementation of an Integrated Longitudinal Curricular Activity for Graduating Pharmacy Students

Objectives. To evaluate whether a novel integrated longitudinal curricular activity to prepare graduating doctor of pharmacy (PharmD) students for 2 comprehensive examinations was successful, and to assess whether it engaged other pharmacy students in curricular discussion and learning.Design. Thirty-eight of 91graduating third-year (P3) students in a PharmD program formed 11 teams to create and present pharmacotherapeutic posters to their peers. The impact of the novel activity on graduating students’ performance on the North American Pharmacist Licensure Examination (NAPLEX) and a comprehensive commercial examination was assessed. All first-year (P1), second-year (P2), and P3 students reviewed and discussed the content of each poster.Assessment. Participants in the integrated longitudinal curricular activity performed better than nonparticipants on the commercial examination (p=0.023) and NAPLEX (p=0.033). However, regardless of participation, commercial examination scores predicted a significant amount of variance (ie, 34%) in NAPLEX scores. The P3 participants (83%) believed the curricular activity assisted them in their NAPLEX preparation, while 75% of P1 students, 79% of P2 students, and 80% of P3 students agreed that poster review provided an effective summary of different disease states. Ninety percent of faculty poster evaluators reported that the posters were professional, and all evaluators agreed that participants effectively conveyed their message to the intended audience.Conclusion. The integrated longitudinal curricular activity provided a positive learning environment for all pharmacy students and may have better prepared graduating students’ for the NAPLEX.     

Evaluation of an Injection Training and Certification Program for Pharmacy Students

Objective. To evaluate an injection training and certification program for third-year (P3) pharmacy students, and to measure the impact of students’ administration of immunizations at an influenza clinic on their knowledge, skills, and competence in immunization.Design. A repeated measures design was used to assess students’ injection skills across the injection training and certification program and the influenza clinic. A repeated measures design was also used to evaluate students’ self-reported knowledge, experience, and confidence.Assessment. Postcertification and during influenza clinic comparisons showed significant improvement in students’ knowledge, experience, and confidence after taking part in the influenza clinic. University staff members and students indicated in a survey that they were satisfied with the clinic services provided by pharmacy students.Conclusion. The injection training and certification program and the university influenza clinic were effective in enhancing and fostering student skills development.     

A Training Program for Pharmacy Students on Providing Diabetes Care

Objective. To compare second- and third-year pharmacy students’ competence, attitudes, and self-confidence in providing diabetes care before and after completing a hand-on diabetes training program and to determine if the program had an impact on students’ attitude and self-confidence based on their year in the curriculum.Design. The program included classroom lectures and hands-on learning sessions in 5 facets of diabetes care. Pre- and post-test instruments measured students’ competence, attitudes, and confidence in diabetes care.Assessment. Students’ competence and the mean overall confidence score significantly improved after completing the program, while mean overall attitude score did not. Third-year students had significantly higher confidence scores than did second-year students on both pre- and post-program tests. No significant difference was found for attitude scores between second- and third-year students.Conclusion. The hands-on learning program was an effective approach to training pharmacy students in diabetes care, improving both their competence and confidence.     

Student Knowledge and Confidence in an Elective Clinical Toxicology Course Using Active-Learning Techniques

Objective. To measure changes in students’ knowledge and confidence scores after completing an elective clinical toxicology course in an accelerated doctor of pharmacy (PharmD) program.Design. Various active-learning techniques were used to create a learner-centered environment. Approximately two-thirds of the course used student-led presentations. Some of those not presenting were assigned to be evaluators, responsible for asking the presenter a question or writing quiz questions based on the presented material. Other learner-centered activities included weekly quizzes and discussions at the conclusion of each presented topic.Assessment. A test instrument designed to measure students’ knowledge and associated level of confidence on each item was administered at the beginning and end of the course. Students’ knowledge and confidence scores increased significantly from pretest to posttest.Conclusions. Students’ increased confidence and knowledge scores were well correlated after course completion, indicating students were better able to self-assess these areas. These findings suggest that confidence could be an additional measure of students'' metacognitive skill development.     

Multiple Interprofessional Education Activities Delivered Longitudinally Within a Required Clinical Assessment Course

Objective. To determine if the incorporation of multiple interprofessional educational (IPE) activities delivered as a longitudinal curriculum within a required clinical assessment course changed pharmacy students’ perceptions regarding interprofessional collaboration.Design. Seventy-one third-year pharmacy students participated in Clinical Assessment, a required applications-based course with a laboratory component. Nine separate IPE activities were embedded into the course longitudinally over the semester using various active-learning strategies and simulated patients. The IPE activities required student participation from medical, nursing, and physician assistant students.Assessment. Pharmacy students completed an 18-item validated survey instrument, the Interdisciplinary Education Perception Scale (IEPS), on the first (pre-survey) and last (post-survey) day of the course. After completing the course, scores improved on 16 of 18 survey items that measured pharmacy students’ perceptions of interprofessional collaboration.Conclusion. Incorporating multiple IPE activities longitudinally into a required clinical assessment course significantly changed pharmacy students’ perceptions of interprofessional collaboration.     

Impact of Providing a Living Learning Community for First-Year Pre-Pharmacy Students

Objective. To conduct a retrospective cohort pilot study to evaluate the impact of a living learning community (LLC) designed for undergraduate pre-pharmacy students interested in pursuing a Doctor of Pharmacy (PharmD) degree program.Methods. Persistence, retention, and progression within the pre-pharmacy program, as well as grade point average (GPA) were measured for LLC students and their pre-pharmacy peers who did not participate in the LLC. Information was obtained from the university’s data system and analyzed. Persistence was defined as the student continuing at the university from the fall to spring academic terms. Retention was defined as the student being enrolled at the university during a subsequent fall term. Progression was determined by whether the student had successfully completed the pre-pharmacy curriculum and began pharmacy school within two or three years of initial enrollment in the pre-pharmacy program.Results. Despite having admissions characteristics comparable to other pre-pharmacy students, students who participated in the LLC demonstrated significantly higher grade-point averages and retention than their peers who did not participate.Conclusion. Living learning community programs may be a valuable contributor to pre-pharmacy student success in terms of students’ persistence, retention, and progression in a pre-pharmacy program.