Learning outcomes and program-level evaluation in a four-year undergraduate pharmacy curriculum

Objective

To determine the successful implementation and effectiveness of program-level learning outcomes for a 4-year bachelor of science pharmacy degree program.

Methods

A comprehensive and iterative program evaluation framework was implemented and quantitative and qualitative data were gathered.

Results

The critical factors in the successful development and implementation of program-level learning outcomes in this context were program accreditation, the leadership qualities of the curriculum chair, a strong and adequately resourced curriculum team that was able to engage and mobilize the faculty learning community, and scholarly approaches to curriculum reform.

Conclusion

An integrated range of institutional and programmatic strategies enhance the implementation of program-level learning outcomes in a 4-year undergraduate curriculum.     

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.”     

Incorporating an Immunization Certificate Program into the Pharmacy Curriculum

Objective

To describe the method of incorporating an immunization certificate training program, such as the American Pharmacists Association''s (APhA) Pharmacy-Based Immunization Delivery into a pharmacy curriculum.

Design

The program was delivered over 3 weeks in the spring semester of the third professional year (P3) as part of a required Pharmacy Care Lab sequence.

Assessment

Student response surveys and faculty input were used to evaluate the placement of the program in the curriculum.

Conclusion

Optional comments yielded more than 44% of students providing positive open-ended feedback regarding the course while almost 10% felt the course should not be mandated in the curriculum.     

An Outcomes-based Approach to Curriculum Development in Pharmacy

Objective

To implement an outcomes-based approach to pharmacy curriculum development.

Design

Desired learning outcomes were identified; course content, learning activities, and assessment instruments were designed; and evaluation was conducted and feedback obtained to refine the curriculum.

Assessment

All professional skills, 4 generic capabilities, and the coherence of the curriculum scales showed significant improvement compared to graduates'' performance under both the old and transitional curriculum.

Conclusion

An outcomes-based approach to pharmacy curriculum development provided convincing evidence of enhancement to the curriculum. Such an approach should be considered when implementing or revising pharmacy curriculum.     

Implementing Standards 2007 to Improve Students�� Preparation for Advanced Pharmacy Practice Experiences

Objective

To examine the impact of implementation of the Accreditation Council for Pharmacy Education''s (ACPE''s) Standards 2007 on pharmacy students’ preparation for their first advanced pharmacy practice experience (APPE).

Design

The doctor of pharmacy (PharmD) curriculum was altered to include introductory pharmacy practice experiences (IPPE), second-year therapeutics, classroom integration of practice experiences, more biomedical sciences, an electronic portfolio system, life-long learning exercises, and additional content based on Appendix B of Standards 2007. Curricular outcomes and the assessment plan also were revised based on Standards 2007.

Assessment

To evaluate the impact of these changes to the curriculum, faculty members rated 9 behaviors of students observed during the third week of their first APPE and compared their scores with those of students who were evaluated in 2004 before the curriculum had been revised. Students completing the revised curriculum performed all 9 behaviors more often and had a better average score than students evaluated in 2004.

Conclusion

Curricular revisions implemented to address ACPE Standards 2007 were associated with positive clinical behaviors in students beginning their experiential education.     

Concept mapping to evaluate an undergraduate pharmacy curriculum

Objectives

To explore a pharmacy school curriculum for opportunities for student engagement and to determine how these might shape student identity as pharmacists.

Methods

The learning aims and objectives and methods of assessment from the curriculum of a bachelor of pharmacy (BPharm) program were collected and a concept map was generated. The concept map was interpreted using Barnett and Coates'' curricular domains of knowing, acting and being.

Results

The key concepts within the intended curriculum that were identified from the concept map were drugs, pharmacy, understanding, practice, and skills. Concepts such as patient and consumer, which would indicate a patient-centered approach to the curriculum, were limited. The main form of assessment used in the curriculum was multiple-choice and short-answer examinations.

Conclusion

There was an emphasis in the curriculum on student acquisition of knowledge and this was reinforced by the use of theoretical examinations. The content of the curriculum was drug-centered rather than patient-centered and the emergence of students'' identity as pharmacists may be fragmented as a result.     

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.     

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.     

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.     

Learning Across the Curriculum: Connecting the Pharmaceutical Sciences to Practice in the First Professional Year

Objectives

To facilitate the student''s ability to make the connection of the core foundational basic science courses to the practice of pharmacy.

Design

In 2000, 10 faculty members from basic science and practice courses created and implemented an integrated Patient Care Project for which students chose a volunteer patient and completed 15 different assignments

Assessment

Evidence of student learning, such as grades and reflective comments along with collected evaluative data, indicated an enhancement in students'' perceived understanding of the connection between basic science and patient care.

Conclusion

The Patient Care Project provided students an opportunity to use knowledge gained in their first-year foundational courses to the care of a patient, solidifying their understanding of the connection between basic science and patient care.     

Graphic Strategies for Analyzing and Interpreting Curricular Mapping Data

Objective

To describe curricular mapping strategies used in analyzing and interpreting curricular mapping data and present findings on how these strategies were used to facilitate curricular development.

Design

Nova Southeastern University''s doctor of pharmacy curriculum was mapped to the college''s educational outcomes. The mapping process included development of educational outcomes followed by analysis of course material and semi-structured interviews with course faculty members. Data collected per course outcome included learning opportunities and assessment measures used.

Assessment

Nearly 1,000 variables and 10,000 discrete rows of curricular data were collected. Graphic representations of curricular data were created using bar charts and stacked area graphs relating the learning opportunities to the educational outcomes. Graphs were used in the curricular evaluation and development processes to facilitate the identification of curricular holes, sequencing misalignments, learning opportunities, and assessment measures.

Conclusion

Mapping strategies that use graphic representations of curricular data serve as effective diagnostic and curricular development tools.     

Academic pharmacy administrators' perceptions of core requirements for entry into professional pharmacy programs

Objectives

To determine which basic and social science courses academic pharmacy administrators believe should be required for entry into the professional pharmacy program and what they believe should be the required length of preprofessional study.

Methods

An online survey was sent to deans of all colleges and schools of pharmacy in the United States. Survey respondents were asked to indicate their level of agreement as to whether the basic and social science courses listed in the survey instrument should be required for admission to the professional program. The survey instrument also included queries regarding the optimal length of preprofessional study, whether professional assessment testing should be part of admission requirements, and the respondents'' demographic information.

Results

The majority of respondents strongly agreed that the fundamental coursework in the basic sciences (general biology, general chemistry, organic chemistry) and English composition should be required for entrance into the professional program. Most respondents also agreed that public speaking, ethics, and advanced basic science and math courses (physiology, biochemistry, calculus, statistics) should be completed prior to entering the professional program. The preprofessional requirements that respondents suggested were not necessary included many of the social science courses. Respondents were evenly divided over the ideal length for preprofessional pharmacy education programs.

Conclusions

Although requirements for preprofessional admission have been changing, there is no consistent agreement on the content or length of the preprofessional program.     

Integrating Complementary and Alternative Medicine Education Into the Pharmacy Curriculum

Objectives

To evaluate the effectiveness of an integrated approach to the teaching of evidence-based complementary and alternative medicine (CAM) in a pharmacy curriculum.

Design

Evidence-based CAM education was integrated throughout the third, fourth, and fifth years of the pharmacy curriculum. Specifically, an introductory module focusing on CAM familiarization was added in the third year and integrated, evidence-based teaching related to CAM was incorporated into clinical topics through lectures and clinical case studies in the fourth and fifth years.

Assessment

Students'' self-assessed and actual CAM knowledge increased, as did their use of evidence-based CAM resources. However, only 30% of the fourth-year students felt they had learned enough about CAM. Students preferred having CAM teaching integrated into the curriculum beginning in the first year rather than waiting until later in their education.

Conclusion

CAM education integrated over several years of study increases students'' knowledge and application.     

A Spanish language and culture initiative for a doctor of pharmacy curriculum

Objective

To implement a Spanish language and culture initiative in a doctor of pharmacy (PharmD) curriculum that would improve students'' Spanish language skills and cultural competence so that graduates could provide competent pharmaceutical care to Spanish-speaking patients.

Design

Five elective courses were created and introduced to the curriculum including 2 medical Spanish courses; a medical Spanish service-learning course; a 2-week Spanish language and cultural immersion trip to Mexico; and an advanced practice pharmacy experience (APPE) at a medical care clinic serving a high percentage of Spanish-speaking patients. Advisors placed increased emphasis on encouraging pharmacy students to complete a major or minor in Spanish.

Assessment

Enrollment in the Spanish language courses and the cultural immersion trip has been strong. Twenty-three students have completed the APPE at a Spanish-speaking clinic. Eleven percent of 2010 Butler University pharmacy graduates completed a major or minor in Spanish compared to approximately 1% in 2004 when the initiative began.

Conclusion

A Spanish language and culture initiative started in 2004 has resulted in increased Spanish language and cultural competence among pharmacy students and recent graduates.     

A Pharmacy Course on Leadership and Leading Change

Objective

To develop and implement a course that develops pharmacy students'' leadership skills and encourages them to become leaders within the profession.

Design

A leadership course series was offered to pharmacy students on 2 campuses. The series incorporated didactic, experiential, and self-directed learning activities, and focused on developing core leadership skills, self-awareness, and awareness of the process for leading change.

Assessment

Students reported increased knowledge and confidence in their ability to initiate and lead efforts for change. The learning activities students'' valued most were the StrengthsFinder assessment (67% of students rated “very useful”) and a Leadership Networking Partners (LNP) program (83% of students rated “very useful”).

Conclusion

Teaching leadership skills poses a significant challenge in curriculum development and requires multifaceted course design elements that resonate with students and engage the practice community. Addressing these requirements results in a high level of student engagement and a desire to continue the development of leadership skills.     

A capstone advanced pharmacy practice experience in research

Objective

To implement a required capstone experience in research for pharmacy students, assess course outcomes, and solicit mentors'' and students'' opinions regarding the structure and efficacy of the course.

Design

Fourth-year pharmacy students chose a research project, selected a mentor, and completed a 5-week capstone advanced pharmacy practice experience (APPE), during which they wrote a research paper and presented their research at a poster session.

Assessment

Eighty students completed the capstone experience in 2008-2009 and 56 faculty and non-faculty pharmacists served as mentors. Based on their responses on a course evaluation, the students'' experience with their mentor and course instructor were positive. Thirty-one mentors completed a survey on which they indicated their overall support of the capstone project, but wanted their role to be better defined and felt the students needed to have additional training in statistics, survey question design, and the IRB process before completing the APPE.

Conclusion

The capstone APPE was perceived by students and mentors as a positive learning experience that allowed the student to take information from the curriculum and apply it to a real-world situation. Additional research is needed to determine whether pharmacy students will use the research skills acquired in their future careers.     

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.     

Seminar Series Course to Teach Essential Knowledge and Skills Not Covered in the Traditional Pharmacy Curriculum

Objective

To create a required seminar series that instructed students in both clinical and non-clinical subjects that were often difficult to incorporate into the traditional pharmacy curriculum.

Design

A required course was developed to introduce learners to basic professional skills, contemporary information, topics, and issues surrounding and influencing pharmacy practice Students were also required to take part in a mock board examination, construct a letter of intent and curriculum vitae, and prepare a 10-minute micro-teach on a clinical topic.

Assessment

Students rated this course favorably and reported increased confidence with regards to several skill sets as well as in terms of licensing examinations.

Conclusion

Through this required course students gained a better understanding of the external issues influencing and mitigating the profession of pharmacy.     

A Public Health Pharmacy Course at a Malaysian Pharmacy School

Objectives

To develop and implement a new course on public health into the bachelor of pharmacy (BPharm) curriculum in Malaysia.

Design

A required 2-credit-hour course was designed to provide an overview of public health pharmacy roles and the behavioral aspects of human healthcare issues. Graded activities included nursing home visits, in-class quizzes, mini-projects, and poster sessions, and a comprehensive final examination.

Assessment

The majority of the students performed well on the class activities and 93 (71.5%) of the 130 students enrolled received a grade of B or higher. A Web-based survey was administered at the end of the semester and 90% of students indicated that they had benefited from the course and were glad that it was offered. The majority of students agreed that the course made an impact in preparing them for their future role as pharmacists and expanded their understanding of the public health roles of a pharmacist.

Conclusions

A public health pharmacy course was successfully designed and implemented in the BPharm curriculum. This study highlighted the feasibilities of introducing courses that are of global relevance into a Malaysian pharmacy curriculum. The findings from the students'' evaluation suggest the needs to incorporate a similar course in all pharmacy schools in the country and will be used as a guide to improve the contents and methods of delivery of the course at our school.     

Active-Learning Processes Used in US Pharmacy Education

Objective

To document the type and extent of active-learning techniques used in US colleges and schools of pharmacy as well as factors associated with use of these techniques.

Methods

A survey instrument was developed to assess whether and to what extent active learning was used by faculty members of US colleges and schools of pharmacy. This survey instrument was distributed via the American Association of Colleges of Pharmacy (AACP) mailing list.

Results

Ninety-five percent (114) of all US colleges and schools of pharmacy were represented with at least 1 survey among the 1179 responses received. Eighty-seven percent of respondents used active-learning techniques in their classroom activities. The heavier the teaching workload the more active-learning strategies were used. Other factors correlated with higher use of active-learning strategies included younger faculty member age (inverse relationship), lower faculty member rank (inverse relationship), and departments that focused on practice, clinical and social, behavioral, and/or administrative sciences.

Conclusions

Active learning has been embraced by pharmacy educators and is used to some extent by the majority of US colleges and schools of pharmacy. Future research should focus on how active-learning methods can be used most effectively within pharmacy education, how it can gain even broader acceptance throughout the academy, and how the effect of active learning on programmatic outcomes can be better documented.