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.     

Comparison of Patient Simulation Methods Used in a Physical Assessment Course

Objective. To determine whether there is a difference in student pharmacists’ learning or satisfaction when standardized patients or manikins are used to teach physical assessment.Design. Third-year student pharmacists were randomized to learn physical assessment (cardiac and pulmonary examinations) using either a standardized patient or a manikin.Assessment. Performance scores on the final examination and satisfaction with the learning method were compared between groups. Eighty and 74 student pharmacists completed the cardiac and pulmonary examinations, respectively. There was no difference in performance scores between student pharmacists who were trained using manikins vs standardized patients (93.8% vs. 93.5%, p=0.81). Student pharmacists who were trained using manikins indicated that they would have probably learned to perform cardiac and pulmonary examinations better had they been taught using standardized patients (p<0.001) and that they were less satisfied with their method of learning (p=0.04).Conclusions. Training using standardized patients and manikins are equally effective methods of learning physical assessment, but student pharmacists preferred using standardized patients.     

The Impact of Prematriculation Admission Characteristics on Graduation Rates in an Accelerated Doctor of Pharmacy Program

Objective. To evaluate the impact of admission characteristics on graduation in an accelerated doctor of pharmacy (PharmD) program.Methods. Selected prematriculation characteristics of students entering the graduation class years of 2009-2012 on the Worcester and Manchester campuses of MCPHS University were analyzed and compared for on-time graduation.Results. Eighty-two percent of evaluated students (699 of 852) graduated on time. Students who were most likely to graduate on-time attended a 4-year school, previously earned a bachelor’s degree, had an overall prematriculation grade point average (GPA) greater than or equal to 3.6, and graduated in the spring just prior to matriculating to the university. Factors that reduced the likelihood of graduating on time were also identified. Work experience had a marginal impact on graduating on time.Conclusion. Although there is no certainty in college admission decisions, prematriculation characteristics can help predict the likelihood for academic success of students in an accelerated PharmD program.     

Integration of physical assessment within a pathophysiology course for pharmacy

Objective. To determine first-year pharmacy students’ analysis, confidence, and knowledge of patient physical assessment integrated within a pathophysiology curriculum.Design. A prospective quasi-experimental study using validated pre- and post-surveys and follow-up examinations was conducted to objectively assess the confidence and knowledge of pharmacy students’ physical assessment skills.Assessment. Students’ perceived ability to perform physical assessment techniques improved. Topic mastery was demonstrated by a final comprehensive examination with a composite student class score of 83%.Conclusion. First-year pharmacy students demonstrated acquisition of patient physical assessment skills when integrated into a pathophysiology course.     

Pharmacy Informatics Syllabi in Doctor of Pharmacy Programs in the US

Objectives

To assess pharmacy informatics education, identify current competencies, and develop a foundational set of recommendations.

Methods

Accredited pharmacy programs were contacted. Data were collected using a mixed-mode procedure. Didactic and experiential syllabi were analyzed for compliance with informatics competencies in Accreditation Council for Pharmacy Education (ACPE) Standards 2007.

Results

Thirty-two of 89 schools responded; 25 provided syllabi (36% response rate, 28% submission rate). Twenty-seven didactic and 9 experiential syllabi were received. The syllabi contained a diverse mix of educational content, some of which represented pharmacy informatics content as defined by ACPE. Schools are teaching clinical system terminology, applications, and evaluation.

Conclusions

Many professional programs are not providing instruction in pharmacy informatics. There may be confusion within the academy/profession between pharmacy informatics and drug information practice. Much work is required for programs to become compliant with the ACPE 2007 pharmacy informatics competencies.     

Assessment of Students’ Critical-Thinking and Problem-Solving Abilities Across a 6-Year Doctor of Pharmacy Program

Objective. To determine the feasibility of using a validated set of assessment rubrics to assess students’ critical-thinking and problem-solving abilities across a doctor of pharmacy (PharmD) curriculum.Methods. Trained faculty assessors used validated rubrics to assess student work samples for critical-thinking and problem-solving abilities. Assessment scores were collected and analyzed to determine student achievement of these 2 ability outcomes across the curriculum. Feasibility of the process was evaluated in terms of time and resources used.Results. One hundred sixty-one samples were assessed for critical thinking, and 159 samples were assessed for problem-solving. Rubric scoring allowed assessors to evaluate four 5- to 7-page work samples per hour. The analysis indicated that overall critical-thinking scores improved over the curriculum. Although low yield for problem-solving samples precluded meaningful data analysis, it was informative for identifying potentially needed curricular improvements.Conclusions. Use of assessment rubrics for program ability outcomes was deemed authentic and feasible. Problem-solving was identified as a curricular area that may need improving. This assessment method has great potential to inform continuous quality improvement of a PharmD program.     

Pharmacy Students' Attitudes Toward a Required Public Health Course and Developing a Public Health Program

Objective

To determine pharmacy students'' attitudes towards a required public health course and developing a public health program.

Method

Two hundred ten first-year pharmacy students enrolled in a public health course at a large private pharmacy school were surveyed. A 24-item adjective rating scale and a 10-item scale were used to measure students'' attitudes towards the course and developing a public health program.

Results

Of 198 respondents, two-thirds found the course to be extremely or very appealing, of practical value, and only slightly demanding and difficult. The majority of the students indicated that establishing a public health program would be an opportunity to help the community and make a difference. Few students indicated that it would be a poor use of time or an example of busy work.

Conclusion

Pharmacy students had positive attitudes towards a required public health course and developing a public health program. Strategies to mold positive attitudes into actual behaviors of engaging in public health activities are needed.     

Effects of Remote Proctoring on Composite Examination Performance Among Doctor of Pharmacy Students

Objective. To determine the impact of remote proctoring on the academic performance of Doctor of Pharmacy (PharmD) students.Methods. This was a retrospective, observational study that compared first professional year (P1) and second professional year (P2) pharmacy students’ scores on eight composite examinations administered in spring 2020 (n = 387), the final three of which were proctored remotely, to that of a historical cohort of pharmacy students who took the same examinations in spring 2019 (n = 368). To assess whether remote proctoring affected academic performance, spring 2020 scores for examinations 6, 7, and 8 were compared to those of a historical cohort who took the same examinations in person with a proctor present in spring 2019. Academic performance on examinations 1 through 4 was also compared between the two cohorts to evaluate any possible year-to-year variation in academic performance during non-remote circumstances. Mann Whitney tests were used to compare scores between the two cohorts.Results. The median scores of students in the spring 2020 cohort were significantly lower than the scores of the historical cohort on the first composite examination administered to P1 students after the implementation of remote proctoring. In contrast, median scores were significantly higher on two of the three examinations administered to P2 students using remote proctoring.Conclusion. Remote proctoring has minimal impact on pharmacy students’ examination performance and its use should be considered to ensure academic honesty and security of testing content in a distance learning environment.     

An Advanced Objective Structured Clinical Examination Using Patient Simulators to Evaluate Pharmacy Students’ Skills in Physical Assessment

Objective. To implement an advanced objective structured clinical examination (OSCE) in the curriculum and to evaluate Japanese pharmacy students’ skills in physical assessment such as measuring pulse and blood pressure, and assessing heart, lung, and intestinal sounds.Design. An advanced OSCE was implemented in a hospital pharmacy seminar as a compulsory subject. We programmed patient simulators with 21 different patient cases in which normal and abnormal physiological conditions were produced. The virtual patients were then used to evaluate the physical assessment skills of fifth-year pharmacy students.Assessment. Significant differences were observed between the average of all the detailed evaluations and the mean results for the following skills: pulse measurement, blood pressure measurement, deflating the cuff at a rate of 2-3 mmHg/sec, listening to heart sounds, and listening to lung sounds.Conclusion. Administering an advanced OSCE using virtual patients was an effective way of assessing pharmacy students’ skills in a realistic setting. Several areas in which pharmacy students require further training were identified.     

A Virtual Patient Software Program to Improve Pharmacy Student Learning in a Comprehensive Disease Management Course

Objective. To implement and assess the impact of a virtual patient pilot program on pharmacy students’ clinical competence skills.Design. Pharmacy students completed interactive software-based patient case scenarios embedded with drug-therapy problems as part of a course requirement at the end of their third year.Assessment. Assessments included drug-therapy problem competency achievement, performance on a pretest and posttest, and pilot evaluation survey instrument. Significant improvements in students’ posttest scores demonstrated advancement of clinical skills involving drug-therapy problem solving. Students agreed that completing the pilot program improved their chronic disease management skills and the program summarized the course series well.Conclusion. Using virtual patient technology allowed for assessment of student competencies and improved learning outcomes.     

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.     

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.     

1 115名健康体检者血脂结果分析

目的:通过对1 115名健康体检者的血脂结果进行分析,以了解公众的血脂情况,探讨血脂升高的原因及预防措施.方法:选取2009年8-9月来我院做健康体检者1 115名,对其血脂结果分年龄段进行统计分析.结果:18～30岁组高血脂检出率为38.26%,31～40岁组高脂检出率为54.94%,41～50岁组高血脂检出率为72.68%,51～60岁组高血脂检出率为75.35%.各年龄段比较,随年龄增长高脂血症检出率有明显增高趋势,40岁以上年龄组检出率最高.男性检出率明显高于女性.结论:应加强对公众的卫生保健知识的宣传教育,加强体育锻炼,定期体检,以减少控制和高脂血症的发生率.     

Preprofessional Curriculum in Preparation for Doctor of Pharmacy Educational Programs

The preprofessional pharmacy curriculum provides the foundation for the professional curriculum. Basic requirements are noted in the ACPE Standards and Guidelines, but there is considerable variation in the preprofessional curriculum requirements for entry into doctor of pharmacy programs in the United States. Changes in higher education, pharmacy practice, and health care continue to drive the need to evaluate the preprofessional curriculum. The objectives of this white paper were to create model preprofessional curricula that would enable students to be successful during and after entry into the professional curriculum. Using an evidence-based approach where possible, a number of factors were found to be associated with academic success during a pharmacy program and on licensing examinations. These data and other information were used to create 2 preprofessional curricular models that include the development of general and discipline-specific abilities. Challenges remain in accurately evaluating the abilities and attributes of applicants and the impact of those abilities and attributes on their success as a student and a practitioner. Colleges and schools of pharmacy should consider adopting a more consistent preprofessional curriculum on a national level. This preprofessional curriculum should be multi-dimensional, based on needs for future practice, and revised over time.     

优良药房工作实务课程开发的设计与实施

优良药房工作实务是药学专业开发的一门综合实训课程。该文从课程开发的意义、课程开发的条件、课程任务的构建等方面阐述了优良药房工作实务课程开发的整体设计;从课程的教材、教学模式和教学方法等几方面阐述课程任务的实施。     

Assessment of Pharmacy Student Professionalism Across a Curriculum

Objectives

To evaluate changes in professionalism across the curriculum among pharmacy students in different classes.

Methods

A professionalism instrument was administered early in the first (P1) year, upon completing the introductory pharmacy practice experiences (IPPE) near the end of the second (P2) year, and upon completing the advanced pharmacy practice experiences (APPE) at the end of the fourth (P4) year.

Results

The professionalism scale and its subscales were compared for the 3 time points for the class of 2009. Significant differences were noted in professionalism scores between the P1 and P4 years and for altruism, accountability, and honor/integrity subscale scores for the class of 2009. No significant differences were noted when the scores for 4 P1 classes, and 3 P2 classes were compared.

Conclusion

An increase in professionalism scores and altruism, accountability, and honor/integrity scores was demonstrated, providing evidence that the curricular and co-curricular activities in the school of pharmacy helped develop professionalism in the class of 2009 students.     

Enhancing the Emotional Intelligence of Student Leaders Within an Accelerated Pharmacy Program

Objective. To determine student pharmacists’ perceptions of a leadership development program for student organization officers and report the changes in their Emotional Intelligence Appraisal (EIA) scores.Methods. Between 2015-2018, three different cohorts of Doctor of Pharmacy students participated in a voluntary leadership development program that spanned six academic quarters. The program included a variety of self-assessments and large-group topic discussions, followed by quarterly individual written reflections with feedback from faculty mentors. These activities primarily addressed the topics of emotional intelligence, strengths-based leadership, and continuous leadership development. Participants’ EIA scores near the beginning and end of the program were compared. An anonymous online survey of participant perceptions was administered at the end of the program.Results. One hundred sixty-six student pharmacists completed all program activities. Each cohort’s final mean overall, self-awareness, self-management, and social awareness EIA scores were higher than their corresponding mean initial scores. The overall response rate for the online survey was 61%. All respondents either strongly agreed or agreed that participating in the program enhanced their leadership skills. The majority of respondents additionally rated each of the program’s activities as being either beneficial or very beneficial. The emotional intelligence assessment and strengths-based leadership assessment were the activities that were most frequently cited as being very beneficial.Conclusion. The pilot implementation of this leadership development program appears to have been both impactful and well received. Programs structured like this one may provide an effective way of increasing the emotional intelligence of student pharmacists, particularly within accelerated pharmacy programs.     

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.