Curriculum Reform in Finnish Pharmacy Education

Objective

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

Design

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

Assessment

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

Conclusion

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

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

Objectives

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

Design

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

Assessment

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

Conclusions

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

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

Objectives

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

Design

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

Assessment

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

Conclusions

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

A Hospice-based Advanced Pharmacy Experience

Objective

To evaluate a hospice-based advanced pharmacy practice experience (APPE).

Design

Two years of data gathered from student evaluation forms and reflective journals were analyzed.

Assessment

Students completed reflective journals and expressed a high level of satisfaction with the hospice-based learning experience. They gained a better understanding of end-of-life care provided by a hospice and the pharmacist''s role in optimizing supportive care for patients receiving hospice care.

Conclusion

Hospice-based APPEs can provide a rich interdisciplinary learning environment for pharmacy students interested in developing knowledge, attitudes, and skills to effectively manage the pharmacotherapy of patients receiving end-of-life care.     

Comparing team-based and mixed active-learning methods in an ambulatory care elective course

Objectives

To assess students'' performance and perceptions of team-based and mixed active-learning methods in 2 ambulatory care elective courses, and to describe faculty members'' perceptions of team-based learning.

Methods

Using the 2 teaching methods, students'' grades were compared. Students'' perceptions were assessed through 2 anonymous course evaluation instruments. Faculty members who taught courses using the team-based learning method were surveyed regarding their impressions of team-based learning.

Results

The ambulatory care course was offered to 64 students using team-based learning (n = 37) and mixed active learning (n = 27) formats. The mean quality points earned were 3.7 (team-based learning) and 3.3 (mixed active learning), p < 0.001. Course evaluations for both courses were favorable. All faculty members who used the team-based learning method reported that they would consider using team-based learning in another course.

Conclusions

Students were satisfied with both teaching methods; however, student grades were significantly higher in the team-based learning course. Faculty members recognized team-based learning as an effective teaching strategy for small-group active learning.     

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.     

Pharmacy education instruction: Preference and practices,Saudi students’ perception

Aim/Background

The methods of instruction in pharmacy education are crucial and meant to suit the professional development and encompass the advanced variety of services and functions provided by the pharmacists to serve individual patients. The aim of this study was to determine the students’ opinions on the adopted and preferred methods of instruction in pharmacy colleges in Kingdom of Saudi Arabia.

Methods

Opinions of Saudi pharmacy students regarding the adopted methods of learning were measured using a pretested questionnaire combined with Likert-type scales.

Results

Three hundred pharmacy students were interviewed. Direct type of lecturing was dominant (53.7%). The most frequently used language of instruction was combined English and Arabic (48.8%), that was mostly preferred by 52.5% of the students. Handouts were the most adopted post-lecture learning method (48.3%), while only 5.9% used student’s self-written notes. A cocktail of traditional and electronic aids was used as admitted by 68.7% and 59.3% of the students who preferred this lecture delivery method. Almost half (49.3%) of the students agreed of having a routine fair guidance and support when referring to their lecturers.

Conclusion

The study outcomes had revealed a practical guidance to be considered for instituting preferred modes of instruction to upgrading students’ capacities for better understanding and acquiring academic and professional skills.     

Faculty attitudes and scholarly productivity resulting from a seminar course

Objectives

To determine faculty attitudes toward a professional seminar course for PharmD students, document scholarly production derived from the course, and ascertain whether that scholarly production or other faculty characteristics affected attitudes toward the course.

Methods

Faculty members served as facilitators for pharmacy students enrolled in a professional seminar course. A 34-item survey instrument intended to identify faculty attitudes toward the course and document scholarly productivity was developed. All 40 faculty facilitators involved in the course were asked to complete the survey instrument.

Results

Of the 30 (75%) faculty members who completed the survey instrument, 20 had an overall positive attitude toward the course. Faculty members had generated approximately 90 peer-reviewed scholarly works over a 9-year period as a result of the course. Significant associations were found between faculty members'' attitudes toward the course and academic rank, academic department, and scholarly production derived from the course.

Conclusions

Faculty members who had advanced academic rank, an appointment in the pharmacy practice department, and scholarly productivity as a result of serving as a facilitator for a Professional Seminar Course were more likely to have positive attitudes toward the course.     

Identifying Perceptions of Professionalism in Pharmacy Using a Four-Frame Leadership Model

Objectives

To determine whether professionalism in pharmacy education is addressed from Bolman and Deal''s four-frame leadership model.

Methods

Students (N = 624), faculty (N = 57), preceptors (N = 56), and academic administrators (N = 8) at 6 colleges and schools of pharmacy were surveyed to assess professionalism. Using grounded theory methodology and a constant comparative process, common themes were identified for each question in each group. Themes were assigned to the four-frame model and the data were compared.

Results

Mechanisms of addressing professionalism consistent with all 4 frames of the Bolman and Deal''s model were identified. Faculty assessment of student professionalism was significantly lower (P < 0.05) than the student group, preceptors, and administrators.

Conclusions

Mechanisms of addressing professionalism in pharmacy education span all four frames of Bolman and Deal''s leadership model. The values students bring into a pharmacy program may play an important role in the process of professional socialization. Faculty members have a tremendous opportunity to enhance student professionalism with their daily verbal and nonverbal interactions with students.     

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.     

Poster project to emphasize public health in the pharmacy curriculum

Objective

To implement and assess a required public health poster project in a doctor of pharmacy (PharmD) program.

Design

Third-year PharmD students collaborated in pairs to research a public health topic relating to pharmacy practice. Each student group prepared an informational poster, while receiving feedback from a faculty mentor at each stage of the project. The students presented their completed posters at a statewide pharmacy conference.

Assessment

Faculty members evaluated the posters with a grading rubric, and students completed a survey instrument that assessed the overall experience. In general, faculty members rated the class highly across all domains of the grading rubric. The class generally agreed that the poster project increased their awareness of public health issues related to pharmacy practice, overall knowledge of public health, and presentation skills.

Conclusion

The implementation of a poster project was well received by students and faculty members as an effective method for enhancing public health instruction in the PharmD program at North Dakota State University.     

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.     

Development of a supervisory skills course for hospital pharmacy workplaces

Background and Objective:

Many Canadian hospital pharmacies are experiencing difficulties recruiting supervisory personnel. It was expected that, through a “learning-by-doing” course, pharmacy staff would learn to apply basic skills in the day-to-day supervision of pharmacy operations and human resources and to apply the principles of supervisory documentation.

Methods:

A supervisory skills course targeted to pharmacy staff members was developed and implemented by the pharmacy department of a large urban health region. The course was initially offered to practising pharmacy technicians. The course design emphasized a constructivist framework incorporating authentic learning and reflective practice during seminars, with experiential and self-directed learning in the workplace. Preceptors assisted learners to achieve the course goals. Learners and preceptors provided feedback about hours spent (as the course progressed) and about their satisfaction with the course itself (at the end of the course). Learners and preceptors completed a post-program evaluation 2 months after completing the course to help in the assessment of the transfer of learning (lasting impact) associated with the course. Overall performance in the course was assessed on a pass/fail basis.

Results:

Eighteen pharmacy technicians were admitted to the program, but one withdrew because of a job change. All learners successfully completed the course. Two months after the course, learners and preceptors described enhanced organization, time management, leadership, communication, and conflict-resolution skills on the part of learners, as well as their increased confidence, maturity, and ability to supervise staff. Learners’ evaluations revealed a broadened perspective of pharmacy. The preceptors valued the enhancement of learners’ skills and their increased enthusiasm. At the time of writing, 6 of the participants had secured supervisory positions.

Conclusion:

Creating formal instruction that engages pharmacy staff to pursue management positions is challenging. Instructional design grounded in constructivist theory and incorporating authentic learning experiences and reflection resulted in high learner satisfaction with learning outcomes.     

Validation of a Survey Instrument to Evaluate Students' Learning During Community-based Advanced Pharmacy Practice Experiences

Objective

To develop and validate a preceptor/student self-report survey instrument to distinguish between different advanced pharmacy practice experience (APPE) models based on pharmaceutical care competencies.

Methods

The survey instrument''s psychometric properties and differential impacts of 3 community-based APPE models were evaluated retrospectively.

Results

Five dimensions characterized APPE learning: importance of 14 pharmaceutical care competencies; agreement with pharmaceutical care procedures in practice; gains in perceived pharmaceutical care abilities; and learning climate and preceptor support. Most of the survey instrument scales detected student/preceptor differences as well as differences in APPE model structures. A streamlined, 30-item short form was validated against the full 78-item survey instrument.

Conclusions

This study confirms that APPE learning can be quantified to: (1) identify high-risk students, (2) train new or continuing preceptors, (3) promote skills-training for select pharmaceutical care competencies, (4) add clarity and structure to APPE learning objectives, and (5) provide students and preceptors with common frameworks for negotiating the APPE experience.     

An evidence-based medicine elective course to improve student performance in advanced pharmacy practice experiences

Objective

To implement and evaluate the impact of an elective evidence-based medicine (EBM) course on student performance during advanced pharmacy practice experiences (APPEs).

Design

A 2-hour elective course was implemented using active-learning techniques including case studies and problem-based learning, journal club simulations, and student-driven wiki pages. The small class size (15 students) encouraged independent student learning, allowing students to serve as the instructors and guest faculty members from a variety of disciplines to facilitate discussions.

Assessment

Pre- and posttests found that students improved on 83% of the core evidence-based medicine concepts evaluated. Fifty-four APPE preceptors were surveyed to compare the performance of students who had completed the EBM course prior to starting their APPEs with students who had not. Of the 38 (70%) who responded, the majority (86.9%) agreed that students who had completed the course had stronger skills in applying evidence-based medicine to patient care than other students. The 14 students who completed the elective also were surveyed after completing their APPEs and the 11 who responded agreed the class had improved their skills and provided confidence in using the medical literature.

Conclusions

The skill set acquired from this EBM course improved students'' performance in APPEs. Evidence-based medicine and literature search skills should receive more emphasis in the pharmacy curriculum.     

Plaintiff or Defendant: Using Legal Cases to Teach Students Pharmacy Law

Objective

To demonstrate the value of students using actual legal cases during collaborative “breakout” sessions in a pharmacy law class.

Design

Students were broken into smaller groups and randomly assigned a legal case to arbitrate or defend. One week prior to the groups'' presentation, all students were given the facts of a case that was reflective of issues covered during the lecture component of the course. Formative assessments were utilized in addition to an overall breakout satisfaction survey administered at the end of the course.

Assessment

Overall, students felt the breakout sessions enhanced their learning environment and reinforced material covered during the didactic portion of the course. Students also recommended the breakout sessions for future pharmacy law courses.

Conclusion

Dividing a large pharmacy law class into 2 sections of 12 groups each and conducting mock trials resulted in increased student participation and interaction and deeper understanding of the course content.     

Pharmacy students' preferences for various types of simulated patients

Objective

To evaluate pharmacy students'' preferences for various types of simulated patients.

Methods

Second-professional year (P2) pharmacy students participated in 7 learning activities that used simulated patients including community volunteers, College administrative staff, course instructors, and student peers. Students ranked each simulated patient type according to believability, skill development, and preference using a 5-point Likert scale.

Results

One-hundred seven of 155 students (69%) completed the survey instrument. Students preferred community volunteers as simulated patients (mean rank 1.39), followed by peers (2.22), instructors (2.63), and staff members (2.81) (p < 0.001). Greater than 89% agreed or strongly agreed that their work with simulated patients prepared them for actual patients, with community volunteers receiving the highest ratings (p < 0.03).

Conclusions

Although pharmacy students found value in interactions will all types of simulated patients, they preferred community volunteers over staff members and their peers. Future scholarship should explore the relationship among simulated patient types and student learning outcomes.Key words: simulated patient, survey, practice laboratory     

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.     

A Service-Learning Course for First-Year Pharmacy Students

Objectives

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

Design

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

Assessment

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

Conclusion

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

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.