An Advanced Cardiovascular Pharmacotherapy Course Blending Online and Face-to-Face Instruction

Objective

To assess the effectiveness of online instruction in a cardiology pharmacotherapy elective.

Design

Eight drug-focused lectures and 6 introductory presentations were added to a cardiology pharmacotherapy course. Students completed an online quiz after each online drug-focused lecture and scores were compared to quizzes taken at the beginning and end of the course, as well as on a cardiology advanced pharmacy practice experience (APPE). For online introductory presentations, students completed a quiz at the beginning of the next face-to-face session. A survey was conducted at the end of the course to obtain student feedback.

Assessment

Compared to baseline scores, student learning was demonstrated after online drug-focused lectures by higher quiz scores attained immediately after completing the lecture, at the end of the course, and at the beginning of the APPE. Furthermore, students performed better on quizzes at the beginning of face-to-face sessions if they first completed an online introductory presentation. Students expressed strong support for the online components of the course.

Conclusions

A blended learning environment with online and face-to-face instruction is an effective way to teach a cardiology pharmacotherapy elective. The online component of this course was well received by students, improved student preparation before attending class, and appeared to enhance long-term cardiovascular drug knowledge.     

Factors affecting prepharmacy students' perceptions of the professional role of pharmacists

Objective

To assess prepharmacy students'' perceptions of the professional role of pharmacists prior to enrollment in pharmacy school, and the association between perceptions and student demographics.

Methods

A 58-question survey instrument regarding pharmacists'' roles, work experiences, and demographics was developed and administered to students (N = 127) enrolled in an organic chemistry laboratory experience at Purdue University.

Results

Theory of planned behavior subscales (attitude, subjective norm, perceived behavioral control) were influenced by students'' grade point average, gender, and application to pharmacy school, while unpaid work experience affected professional commitment. Students evaluated work experience related to their pharmacy studies more positively than non-pharmacy-related areas in the theory of planned behavior subscales.

Conclusions

Evaluating students'' perceptions may be beneficial in helping pharmacy educators design their curricula, as well as allowing admissions committees to select the most qualified students to promote the development of positive perceptions toward the professional role of pharmacists. Grade point average (GPA) and application to pharmacy school were associated with significant differences for the theory of planned behavior and professional commitment subscales.     

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.     

Impact of Hybrid Delivery of Education on Student Academic Performance and the Student Experience

Objectives

To compare student academic performance and the student experience in the first-year doctor of pharmacy (PharmD) program between the main and newly opened satellite campuses of the University of Maryland.

Methods

Student performance indicators including graded assessments, course averages, cumulative first-year grade point average (GPA), and introductory pharmacy practice experience (IPPE) evaluations were analyzed retrospectively. Student experience indicators were obtained via an online survey instrument and included involvement in student organizations; time-budgeting practices; and stress levels and their perceived effect on performance.

Results

Graded assessments, course averages, GPA, and IPPE evaluations were indistinguishable between campuses. Students'' time allocation was not different between campuses, except for time spent attending class and watching lecture videos. There was no difference between students'' stress levels at each campus.

Conclusions

The implementation of a satellite campus to expand pharmacy education yielded academic performance and student engagement comparable to those from traditional delivery methods.     

Capacity of Hospitals to Partner with Academia to Meet Experiential Education Requirements for Pharmacy Students

Purpose

Current hospital and health-system participation in and the future capacity for experiential education for pharmacy students was investigated.

Methods

An online survey of ASHP members identified as U.S. pharmacy directors was conducted to assess their current and future involvement in partnering with colleges and schools to meet the experiential education requirements for doctor of pharmacy students and the current status of the student learning experiences. Questionnaire items examined the factors on which expanded involvement in experiential education would depend, the nature of support provided by colleges and schools, the types of experiences available for students, respondents'' perceptions of factors influencing the quality of experiential education, the value of experiential education to the sites, respondents'' challenges and concerns about experiential education, and respondents'' current capacity and projections for introductory and advanced experiences through 2012.

Results

Data from 549 respondents were analyzed. Most respondents indicated that they had conducted advanced experiences for their 2007 graduates and anticipated that they would continue to do so. Among the top challenges identified regarding advanced experiences were concerns about time to serve and be trained as preceptors and a lack of standardization and coordination among colleges and schools. Hospitals forecasting their future capacity to accommodate students indicated that their projections were highly dependent on the number of pharmacists at their hospitals. Many respondents noted that their capacity projections were tied to their ability to expand clinical services at their hospitals.

Conclusion

A survey of pharmacy directors suggested an ability of U.S. hospitals to conduct advanced experiential education opportunities for pharmacy students through 2012 and to expand introductory experiences.     

Student pharmacists' perceptions of testing and study strategies

Objectives

To solicit student pharmacists'' perceptions of testing, study strategies, and recall ability, and use of retrieval practices in metacognitive learning strategies.

Methods

A 42-item survey instrument was constructed that covered the following areas of interest: perceptions of the purpose of testing, perceptions of study strategies, perceptions of recall ability, use of retrieval practice, and demographic characteristics. The survey instrument was administered to first-, second-, and third-year doctor of pharmacy (PharmD) students (N = 425) at Purdue University.

Results

Students perceived the primary purpose of tests to be to assess the amount of material they had learned. Massed practice was a technique that they frequently used in studying for course examinations. Students did not express confidence in their ability to recall learned information once they became pharmacists. The use of retrieval practice in learning was not used by most student pharmacists, nor did students perceive retrieval practice to increase retention or learning.

Conclusion

Perceptions of testing and the manner in which student pharmacists engage in learning activities may not be optimal for the development of lifelong learners.     

Pharmacy Students' Facebook Activity and Opinions Regarding Accountability and E-Professionalism

Objective

To assess pharmacy students'' Facebook activity and opinions regarding accountability and e-professionalism and determine effects of an e-professionalism education session on pharmacy students'' posting behavior.

Methods

A 21-item questionnaire was developed, pilot-tested, revised, and administered to 299 pharmacy students at 3 colleges of pharmacy. Following a presentation regarding potential e-professionalism issues with Facebook, pharmacy students with existing profiles answered an additional question concerning changes in online posting behavior.

Results

Incoming first-year pharmacy students'' Facebook usage is consistent with that of the general college student population. Male students are opposed to authority figures'' use of Facebook for character and professionalism judgments and are more likely to present information they would not want faculty members, future employers, or patients to see. More than half of the pharmacy students planned to make changes to their online posting behavior as a result of the e-professionalism presentation.

Conclusions

There is high social media usage among pharmacy students and many do not fully comprehend the issues that arise from being overly transparent in online settings. Attitudes toward accountability for information supplied via social networking emphasize the need for e-professionalism training of incoming pharmacy students.     

A Sequence of Introductory Pharmacy Practice Experiences to Address the New Standards for Experiential Learning

Objective

To implement an introductory pharmacy practice experience (IPPE) curricular sequence in a manner that optimized preceptor availability, fostered significant learning, and addressed the new standards for experiential education.

Design

A 4-course, 300+ hour IPPE sequence was developed with 1 module in each semester of the first 2 professional years. Semesters were 18 weeks in length with IPPE taking place in the middle weeks as dedicated time blocks when no concurrent didactic courses were scheduled. Learning exercises were developed to build a progressive foundation in preparation for advanced pharmacy practice experiences (APPE).

Assessment

During 2 academic years, 161 students participated in the IPPE program. Eighty-one students completed the 4-course sequence and another 80 students completed the first 2 courses. Collectively, 486 individual IPPE placements were made at over 120 community pharmacies and 60 hospital pharmacies or alternative practice sites located over a broad geographic region. Student evaluations by preceptors, evaluation of student journals by faculty, and surveys of students and preceptors demonstrated that course objectives were being achieved.

Conclusion

An innovative approach to scheduling IPPE optimized preceptor availability, exceeded the minimum number of IPPE hours required by current accreditation standards, and achieved development of desired competencies.     

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.     

An Enhanced Community Advanced Pharmacy Practice Experience Model to Improve Patient Care

Objective

To quantify the benefits of an enhanced advanced pharmacy practice experience (APPE) community pharmacy model compared to the traditional program by comparing basic and comprehensive pharmaceutical care provided by students and assessing preceptors’ perceptions of the APPE.

Methods

A pilot study consisting of 1 enhanced APPE arm and 2 traditional APPE (control) arms was conducted. The enhanced APPE consisted of a preceptor education program, a 5-day onsite student orientation, and an 8-week experience completed at 1 rather than 2 community sites.

Results

The level of interventions provided by students in the enhanced APPE arm significantly surpassed that of students in the control arms. In addition, preceptor questionnaires indicated overwhelming support for the enhanced model over the traditional APPE.

Conclusions

The study''s findings demonstrated that the enhanced APPE model enabled the participating pharmacies to provide increased level of patient care (as compared to the control sites) and improved preceptor satisfaction with the APPE.     

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.     

Pharmacist instruction of physical assessment for pharmacy students

Objective

To assess the impact of a change from nurse to pharmacist instructors and a new curriculum intended to encourage students’ use of physical assessment skills.

Design

Pharmacist faculty members redesigned the physical assessment curriculum to focus on those assessment skills most likely to be performed by practicing pharmacists. The 5 focus areas were general assessment skills, gastrointestinal system, pulmonary system, central and peripheral nervous system, and cardiovascular system. Instructional methods used included prelaboratory assignments, brief introductory lectures, demonstration of assessment techniques, application of techniques with a laboratory partner, and demonstration of competence using a mannequin.

Assessment

A 16-item survey instrument was administered to determine students’ perceptions of the revised curriculum. Students who received instruction from pharmacist faculty members used their physical assessment skills more, especially during advanced pharmacy practice experiences (APPEs), than students who received instruction from nurse faculty members. Students instructed by pharmacist faculty members also felt more comfortable with their skills and rated the instruction as more practical.

Conclusion

A redesigned curriculum and pharmacist-led instruction resulted in improved pharmacy student comfort with and use of physical assessment skills.     

Shared-Learning Experience During a Clinical Pharmacy Practice Experience

Objective

To implement a shared learning approach through fourth-year students’ mentorship of third-year students and to assess the perceptions of the mentored students on the value of their shared learning experience.

Design

We introduced the shared learning experience in clinical pharmacy and pharmacotherapeutic practice experiences involving 87 third-year and 51 fourth-year students. Both student groups undertook the practice experiences together, with third-year students working in smaller groups mentored by fourth-year students.

Assessment

A majority of the students (> 75%) believed that they learned to work as a team during their practice experiences and that the shared learning approach provided an opportunity to practice their communication skills. Similarly, most respondents (> 70%) agreed that the new approach would help them become effective members of the healthcare team and would facilitate their professional relationships in future practice. Almost two-thirds of the students believed that the shared learning enhanced their ability to understand clinical problems. However, about 31% of the pharmacy students felt that they could have learned clinical problem-solving skills equally well working only with peers from their own student group.

Conclusions

The pharmacy students in the current study generally believed that the shared-learning approach enhanced their ability to understand clinical problems and improved their communication and teamwork skills. Both groups of students were positive that they had acquired some skills through the shared-learning approach.     

A Required Course in the Development, Implementation, and Evaluation of Clinical Pharmacy Services

Objective

To develop, implement, and assess a required pharmacy practice course to prepare pharmacy students to develop, implement, and evaluate clinical pharmacy services using a business plan model.

Design

Course content centered around the process of business planning and pharmacoeconomic evaluations. Selected business planning topics included literature evaluation, mission statement development, market evaluation, policy and procedure development, and marketing strategy. Selected pharmacoeconomic topics included cost-minimization analysis, cost-benefit analysis, cost-effectiveness analysis, cost-utility analysis, and health-related quality of life (HRQoL). Assessment methods included objective examinations, student participation, performance on a group project, and peer evaluation.

Assessment

One hundred fifty-three students were enrolled in the course. The mean scores on the objective examinations (100 points per examination) ranged from 82 to 85 points, with 25%-35% of students in the class scoring over 90, and 40%-50% of students scoring from 80 to 89. The mean scores on the group project (200 points) and classroom participation (50 points) were 183.5 and 46.1, respectively. The mean score on the peer evaluation was 30.8, with scores ranging from 27.5 to 31.7.

Conclusion

The course provided pharmacy students with the framework necessary to develop and implement evidence-based disease management programs and to assure efficient, cost-effective utilization of pertinent resources in the provision of patient care.     

Teaching Electrocardiogram Basics Using Dance and Movement

Objective

To implement and assess an innovative approach to teaching electrocardiogram (ECG) rhythms using dance and movement.

Design

Recognition of ECG rhythms was taught to a group of third-year pharmacy students using dance and movement via collaboration with a dance faculty member. A control group was taught using traditional pharmacy lecture and PowerPoint slides.

Assessment

A pretest and posttest were administered to both groups. There was a trend in test score improvement in the dance and movement group. After the sessions, a focus group was held to assess student perceptions using qualitative methods. Students thought the addition of dance helped them with speed of retention and recognition of ECG rhythms. Some students reported feeling out of their comfort zone.

Conclusion

Interprofessional collaboration between pharmacy and dance faculty members resulted in an innovative teaching methodology for ECG rhythms that increased test scores.     

Health Promotion Integrated Into a Thai PharmD Curriculum to Improve Pharmacy Practice Skills

Objective

To implement and evaluate 5 integrated teaching modules in the fifth-year doctor of pharmacy (PharmD) curriculum to increase students'' ability to promote patients'' health as part of their pharmacy practice.

Design

Activity-based learning was added to each module: (1) a practice experience in which students provided health information and counseling to the public; (2) academic debates on current issues in pharmacy (3) journal clubs on articles from the pharmacy literature; and (4) research projects relating to ongoing faculty research on diabetes. Students on 12-week practice experiences had visits to patients in inpatient wards, outpatient clinics, and either primary care units or community pharmacies.

Assessment

Practice examinations at the end of the first semester, the average student score was above 80% as determined by preceptors in experience sites and from faculty members. Group interviews found that students were positive about the benefits of integrated teaching.

Conclusion

The integration of the teaching between modules in the same semester is possible and greatly benefits student learning.     

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

Objective

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

Design

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

Assessment

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

Conclusion

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

Guest speakers in a professional development seminar series

Objective

To evaluate the impact guest speakers have on student development in a professional development seminar series.

Design

Over a 5-semester period, presentations were given by 18 guest speakers as part of a professional development seminar series.

Assessment

A 28-item survey instrument was constructed and administered to 68 students to assess the impact of the guest speakers on the students'' professional development. Forty-six (68%) students completed the survey instrument, and the results demonstrated the value of the guest speakers, most notably in the areas of career development and professional responsibility.

Conclusion

Exposing pharmacy students to guest speakers from varied pharmacy career paths positively impacted students'' knowledge of career options and professional development.     

Pharmaceutical Care Plan Examinations to Identify Students at Risk for Poor Performance in Advanced Pharmacy Practice Experiences

Objectives

To evaluate early predictors of advanced pharmacy practice experience (APPE) performance using either timed pharmaceutical care plan (TPCP) reports of 4 case histories or traditional lecture-based pharmacotherapy course examinations.

Methods

Statistical process control (SPC) methods were used to identify a group of third-year pharmacy students “at risk” for poor APPE performance (defined as an APPE grade point average of < 3.0). Examination scores from an integrated lecture-based pharmacotherapy sequence were used for comparison.

Results

TPCP scores but not lecture-based examination scores successfully identified 6 of 10 students who ultimately performed poorly in their APPEs.

Conclusion

Adaptation of SPC methods to assess student performance during problem-based learning (PBL) case reports is a useful technique for identifying students “at risk” for poor APPE performance.