Active-learning strategies to develop health literacy knowledge and skills

Objective

To implement active-learning exercises in a required pharmacy course and assess their impact on students'' knowledge and confidence in identifying and communicating with patients with low health literacy, as part of a required course in cultural competency, health literacy, and health beliefs.

Design

Active-learning activities including administering health literacy assessments, identifying informal signs of low health literacy, conducting mock patient counseling sessions, rating the readability of drug information, analyzing information in drug advertisements, and writing patient education materials were incorporated into the 6-sesssion health literacy portion of the course.

Assessment

A pretest and posttest showed that students'' knowledge of health literacy increased, and a retrospective pretest found improvement in students'' confidence in their ability to care for patients with low health literacy. In-class discussions provided informal evidence that students gained new knowledge from the active-learning activities.

Conclusion

The addition of active-learning activities was effective in teaching health literacy concepts to pharmacy students.     

An elective course in information mastery

Objective

To design and implement an elective course in information mastery and assess its impact on students'' ability to identify information needs and formulate clinically relevant, evidence-based answers.

Design

A semester-long (15-week) elective course was offered to third-year (P3) doctor of pharmacy (PharmD) students that outlined the necessary knowledge and skills for using information mastery in evidence-based practice.

Assessment

Results of a pre- and postcourse survey instrument demonstrated an increase in students'' knowledge of information mastery and confidence in and familiarity with the practice of evidence-based medicine in pharmacy. Students who had completed the elective were able to provide higher quality search strategies and evidence-based answers to a clinical question than other P3 students, and P4 students who did not participate in the elective.

Conclusion

An elective course in information mastery improved students'' knowledge and understanding of information mastery as it pertains to practicing evidence-based medicine.     

Expanding voluntary active-learning opportunities for pharmacy students in a Respiratory Physiology Module

Objectives

To expand voluntary active-learning opportunities for bachelor of pharmacy students enrolled in a third-year human physiology and pharmacology course and determine whether the additional course components improved learning outcomes.

Design

Additional voluntary active-learning opportunities including a large-class tutorial, additional formative assessment, and an online discussion were added to the Respiratory Physiology Module of the course. Examination scores were compared with those from previous years. A questionnaire was administered to assess students'' perception of the active-learning components.

Assessment

Mean examination scores increased from 69.3% ± 24.4% in 2003 to 88.9% ± 13.4% in 2004 and 86.9% ± 17.6% in 2005, after the addition of the active-learning components. Students'' overall perception of the value of the active-learning activities was positive.

Summary

The addition of voluntary active-learning course components to a required pharmacy course resulted in improved student examination scores, and decreased failure rate, and were accomplished at low cost and with little additional staff time.     

Cultural competence knowledge and confidence after classroom activities

Objectives

To determine change in cultural competency knowledge and perceived confidence of second-year pharmacy students to deliver culturally competent care after completing a required cultural competency curriculum.

Design

Cultural competence material was covered in the second-year PharmD curriculum through lectures, laboratories, and an experiential/out-of-class assignment.

Assessment

Eighty-five second-year (P2) pharmacy students completed a survey which assessed influence of classroom activities related to cultural competence. Mean values for knowledge and perceived confidence were significantly higher for posttest compared to pretest (p < 0.01), after cultural competency activities. Focus groups were used to solicit students'' opinions on instructional effectiveness, relevance of activities, and areas for enhancement.

Conclusion

The cultural competency curriculum increased pharmacy students'' awareness of and confidence in addressing cultural diversity issues that affect pharmaceutical care delivery.     

A clinical nutrition course to improve pharmacy students' skills and confidence in counseling patients

Objective

To create, implement, and evaluate a PharmD course on primary care nutrition.

Design

A 2-credit hour elective course was offered to second- and third-year pharmacy students. It was informed by the Socratic method using a minimum number of formal lecture presentations and featured problem-based learning exercises, case-based scenarios, and scientific literature to fuel informed debate. A single group posttest design with a retrospective pretest was used to assess students'' self-efficacy.

Assessment

There was a significant overall improvement in students'' self-efficacy in their ability to practice primary care nutrition.

Conclusion

Completion of a nutrition course improved students'' confidence in providing primary care nutrition and empowered them to speak more comfortably about the role of nutrition in the prevention of chronic diseases.     

An Evidence-based Elective on Dietary Supplements

Objective

To implement and evaluate the effectiveness of a pharmacy elective on dietary supplements that emphasized evidence-based care.

Design

A 3-credit elective that employed both traditional lectures and a variety of active-learning exercises was implemented. The course introduction provided a background in dietary supplement use and evidence-based medicine principles before addressing dietary supplements by primary indication.

Assessment

Student learning was assessed through quizzes, case assignments, discussion board participation, and completion of a longitudinal group project. Precourse and postcourse surveys were conducted to assess students'' opinions, knowledge, and skills related to course objectives.

Conclusion

The course was an effective way to increase students'' knowledge of dietary supplements and skills and confidence in providing patient care in this area.     

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.     

Third-year pharmacy students' work experience and attitudes and perceptions of the pharmacy profession

Objectives

To describe PharmD students'' work experiences and activities; examine their attitudes towards their work; examine perceptions of preceptor pharmacists they worked with; and determine important issues associated with career preference.

Methods

A written survey was administered to third-year doctor of pharmacy (PharmD) students at 8 colleges and schools of pharmacy in the Midwest.

Results

Five hundred thirty-three students (response rate = 70.4%) completed the survey instrument. Nearly 100% of PharmD students reported working in a pharmacy by the time their advanced pharmacy practice experiences (APPEs) began. Seventy-eight percent reported working in a community pharmacy, and 67% had worked in a chain community pharmacy. For all practice settings, students reported spending 69% of their time on activities such as compounding, dispensing, and distribution of drug products.

Conclusions

Most students are working in community pharmacy (mainly chain) positions where their primary function is traditional drug product dispensing and distribution. Having a controllable work schedule was the variable most strongly associated with career choice for all students.     

A public health discussion series in an advanced pharmacy practice experience

Objectives

To develop and integrate a student-centered, active-learning public health discussion series into an existing advanced pharmacy practice experience (APPE) to enhance knowledge and encourage integration of public health activities into students'' future careers.

Design

Students participated in 3 hour-long discussions to define and identify the scope of public health and to examine public health initiatives outside of and within health care.

Assessment

Improvement in the ability to accurately define public health was observed after students participated in the discussion series compared to baseline. Post-discussion definitions were more broad and accurate. Unsolicited comments about the discussion series documented in post-APPE reflections described students'' initial lack of knowledge, improved knowledge base, and improved interest in participating in public health initiatives.

Conclusions

Time devoted to public health discussions during an APPE can substantially impact student pharmacists'' knowledge base and interest in public health. Additionally, this active-learning technique aids in meeting the Accreditation Council for Pharmacy Education (ACPE) public health standards.     

A health policy course based on Fink's Taxonomy of Significant Learning

Objective

To incorporate Fink''s Taxonomy of Significant Learning into a course and determine whether doing so increased students'' knowledge of and interest in healthcare policy.

Design

A healthcare policy course for second-year doctor of pharmacy (PharmD) students was redesigned to incorporate activities reflecting Fink''s Taxonomy including completing a required reading, outlining the required reading, presenting the outline to a small group of peers, attending lectures, and completing a final policy project and simulation activity.

Assessment

The effectiveness of the course was assessed using a pre-post non-randomized control design, with nursing and social work students serving as the control group. Interest and knowledge scores increased significantly among students in the intervention group. Differences between the low-interest students and the rest of the class identified on the precourse tests were not apparent on the postcourse test.

Implications

Applying Fink''s Taxonomy to course activities increased students'' interest in and importance placed on learning health policy.     

A summer research training program to foster PharmD students' interest in research

Objectives

To establish and assess the effectiveness of a 10-week summer research program on increasing doctor of pharmacy (PharmD) students'' interest in research, particularly as it related to future career choices.

Design

Survey instruments were sent to 25 participants who had completed the research program in the summer of 2004, 2005, or 2006 to assess their satisfaction with the program and its influence on their career choices after graduation.

Assessment

Respondents reported a high degree of satisfaction with the program, indicating that the program allowed them to determine their suitability for a career in research, and 55% reported their intention to pursue additional research training.

Conclusion

A brief introduction to the clinical research environment helped pharmacy students understand the clinical sciences and careers in research. The introduction increased the likelihood of students pursuing a research career path after obtaining their PharmD degree.     

Objective structured clinical examinations in doctor of pharmacy programs in the United States

Objectives

To describe current objective structured clinical examination (OSCE) practices in doctor of pharmacy (PharmD) programs in the United States.

Methods

Structured interviews were conducted with PharmD faculty members between September 2008 and May 2010 to collect information about awareness of and interest in OSCE, current OSCE practices, and barriers to OSCEs.

Results

Of 108 US colleges and schools of pharmacy identified, interviews were completed for a representative sample of 88 programs (81.5% participation rate). Thirty-two pharmacy programs reported using OSCEs; however, practices within these programs varied. Eleven of the programs consistently administered examinations of 3 or more stations, required all students to complete the same scenario(s), and had processes in place to ensure consistency of standardized patients'' role portrayal. Of the 55 programs not using OSCEs, approximately half were interested in using the technique. Common barriers to OSCE implementation or expansion were cost and faculty members'' workloads.

Conclusions

There is wide interest in using OSCEs within pharmacy education. However, few colleges and schools of pharmacy conduct OSCEs in an optimal manner, and most do not adhere to best practices in OSCE construction and administration.     

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.     

An Elective Course in Women's Health

Objective

To design, implement, and assess a women''s health elective course for second- and third-year doctor of pharmacy (PharmD) students.

Design

A women''s health course was developed, focusing on health promotion, disease prevention, and treatment throughout a woman''s lifespan. Course format included didactic lectures, in-class activities, peer teaching, case studies, and reading assignments.

Assessment

Student performance and learning were assessed based on class participation, (graded 3 times during the semester), activities and assignments, (graded weekly), and 2 formal written assessments. Student survey results indicated perceptions of women''s health had changed in 3 ways: a realization that many diseases manifest differently in women than men, an increased awareness of numerous diseases not addressed in the required curriculum that affect women, and a greater appreciation of the physiological and pharmacokinetic differences that increase the potential for adverse drug reactions in women.

Conclusion

An elective course in women''s health was well received by PharmD students. Excellent student performance in weekly active-learning activities and class participation, however, did not translate into excellent performance on subsequent formal assessments.     

Active-Learning Laboratory Session to Teach the Four M's of Diabetes Care

Objective

To implement an active-learning methodology for teaching diabetes care to pharmacy students and evaluate its effectiveness.

Design

Laboratory instruction was divided into 4 primary areas of diabetes care, referred to by the mnemonic, the 4 M''s: meal planning, motion, medication, and monitoring. Students participated in skill-based learning laboratory stations and in simulated patient experiences. A pretest, retrospective pretest, and posttest were administered to measure improvements in students'' knowledge about diabetes and confidence in providing care to diabetes patients.

Assessment

Students knowledge of and confidence in each area assessed improved. Students enjoyed the laboratory session and felt it contributed to their learning.

Conclusion

An active-learning approach to teaching diabetes care allowed students to experience aspects of the disease from the patient''s perspective. This approach will be incorporated in other content areas.     

A Motivational Interviewing Course for Pharmacy Students

Objective

To create, implement, and evaluate a pharmacy course on motivational interviewing.

Design

A 3-hour elective course was created to train doctor of pharmacy (PharmD) students in brief patient-centered motivational interviewing counseling strategies that have proven effective with the types of health issues most commonly addressed in pharmacy settings. Students were assisted in developing their skills through required readings, interactive lectures, in-class demonstrations and practice sessions, out of class skills practice, one-on-one supervision provided by doctoral level clinical health psychology students, and written reflections on each class session.

Assessment

Students demonstrated significant improvement in motivational interviewing skills and a high level of motivation for and confidence in using these skills in their future practice. Students overall assessment of the course and supervision process was highly positive.

Conclusion

This patient-centered counseling skills course was feasible and produced improvements in PharmD students'' counseling skills and increased their motivation and confidence to use motivational interviewing skills in their future communications with patients.     

Impact of a diabetes certificate program on PharmD students' knowledge and skills

Objectives

To determine the impact of a pregraduation diabetes certificate program on PharmD students'' knowledge and skills.

Methods

A comprehensive elective in diabetes was created and implemented in the third-professional year of the PharmD curriculum. A nonrandomized, single-blinded, controlled, 2-year study was conducted to determine the impact of the elective. Written and oral examinations were administered to the participants and students in a control group.

Results

The certificate students'' (N = 25) and control students'' (N = 12) average oral examination grades were 88.5% ± 13.4% and 89.5% ± 15.8%, respectively (p = 0.58). The certificate students'' average grade on the counseling section of the oral examination was 9% higher than that of the students in the control group (p = 0.01). The certificate students'' and control students'' grades on the written examination were 80.9 ± 11.1% and 61.1 ± 17.4% (p = 0.0062), respectively.

Conclusions

A diabetes certificate program improved students'' knowledge of diabetes disease state management and patient education skills compared to students who did not take the elective.     

A Computer-based Module for Prescribing Error Instruction

Objective

To evaluate an instructional module''s effectiveness at changing third-year doctor of pharmacy (PharmD) students'' ability to identify and correct prescribing errors.

Design

Students were randomized into 2 groups. Using a computer-based module, group 1 completed worksheet A, watched a presentation on medication errors, and then completed worksheets B and C. Group 2 completed worksheets A and B, watched the presentation, and then completed worksheet C.

Assessment

Both groups scored a median 50% on worksheet A and 66.7% on worksheet C (p < 0.001). Median scores on worksheet B differed between groups (p = 0.0014). Group 1 viewed the presentation before completing worksheet B and scored 62.5%, while group 2 viewed the presentation after scoring 50% on worksheet B.

Conclusion

The module effectively taught pharmacy students to identify and correct prescribing errors.     

An electronic NAPLEX review program for longitudinal assessment of pharmacy students' knowledge

Objectives

To track pharmacy student knowledge over time using a proprietary software program in an accelerated program for curricular assessment.

Methods

All students were required to complete a computerized comprehensive diagnostic examination 3 times during the doctor of pharmacy (PharmD) program: at the beginning of the second year, and near the end of the second and third years. The examination was comprised of 100 questions in 3 content areas: pharmacotherapy, preparation and dispensing of medications, and providing health care information. Within-subject differences in mean area and total percent scores were compared.

Results

Based on 123 students'' data, mean scores for pharmacotherapy and total percent scores for examination 1 were significantly different from examinations 2 and 3.

Conclusion

The computer-based comprehensive diagnostic examination shows promise for use as a component of a comprehensive assessment plan.     

A mental health elective to improve pharmacy students' perspectives on mental illness

Objective

To evaluate the impact of a mental health elective on pharmacy students'' perceptions and stigmatizing views of mental illness.

Design

An elective was designed that featured an advanced overview of psychopharmacology; student training in motivational interviewing; a presentation by the National Alliance on Mental Illness (NAMI) local chapter; introduction to pharmacy collaborations with peer support specialists, social workers, and psychiatrists; mock patient counseling sessions; and a required psychiatric patient interview at a local community mental health center.

Assessment

A survey instrument with 17 Likert-scale items was constructed to measure 2 distinct areas: social distance and stigmatizing views. The survey instrument was administered at the beginning and end of the spring 2010 semester to pharmacy students enrolled in the mental health elective course and to a control group of pharmacy students enrolled in an unrelated clinical elective. The course had a positive impact on pharmacy students'' perceptions of mental illnesses. Students'' social distance and stigmatizing views of mental illnesses improved, while no significant change in views occurred among students in the control group.

Conclusion

Advanced training in psychiatric medicine and exposure to mental health care are vital to prepare pharmacy students to provide unbiased, patient-centered care to this population.