Clinical impact of a community pharmacy-based health and wellness introductory pharmacy practice experience

ObjectiveTo assess the clinical impact of an intensive community pharmacy-based Health and Wellness Introductory Pharmacy Practice Experience (IPPE) completed by second-year (P2) student pharmacists.DesignThe Health and Wellness IPPE was a 1-week rotation developed to provide P2 student pharmacists with opportunities to provide clinical services to patients within the community pharmacy setting. Student pharmacists administered immunizations, performed blood pressure screenings and blood glucose measurements, and provided education to patients under the guidance of licensed pharmacist preceptors.Setting and participantsSecond-year student pharmacists completing a required Health and Wellness IPPE rotation in the community pharmacy setting.Outcomes measuredStudent pharmacist interventions were assessed to determine the course’s clinical impact, and preceptors were surveyed regarding the feasibility of student pharmacists performing clinical services at their training sites.ResultsA total of 147 student pharmacists completed the IPPE at 89 community pharmacy training sites and administered 9392 injections, 90% of which were influenza vaccinations. Student pharmacists performed 3458 patient health assessments, including measuring patients’ blood pressure and blood glucose and reviewing patient education materials. Most preceptors indicated that core activities were feasible during the experience.ConclusionThis study found that implementing a concentrated IPPE focused on immunizations and health screenings allowed student pharmacists to enhance their clinical skills and fulfill a large public health need, improving patient outcomes. Future studies should explore utilizing student pharmacists in community pharmacy settings to expand clinical services offered beyond these 2 services, such as diabetes risk tests, influenza point-of-care testing, and smoking cessation counseling.     

An elective course to engage student pharmacists in elementary school science education

Objective. To develop and assess the impact of an elective course (HealthWISE) on student pharmacists’ skills in communication and health promotion and elementary school students’ knowledge of and attitudes toward science.Design. Three colleges and schools of pharmacy collaborated to develop a 1-credit elective course that used online and classroom teaching and learning techniques to prepare student pharmacists to teach science in elementary school classrooms. Student pharmacists delivered 6 science lessons to elementary students over the course of 2 months.Assessment. In weekly journal reflections and a final paper, student pharmacists reported improved communication and health promotion skills. Elementary teachers reported they were satisfied with student pharmacists’ performance in the classroom. On pretest and posttest evaluations, elementary students demonstrated increased science knowledge and enhanced enthusiasm for science following the lessons taught by student pharmacists.Conclusions. The HealthWISE elective course provided positive benefit for student pharmacists, elementary school teachers, and elementary students.     

An Anticoagulation Therapy Elective for Third-Year Pharmacy Students

Objective

To develop an anticoagulation elective course for third-year pharmacy students to enhance their knowledge and skills for providing anticoagulation services.

Design

Content developed for the course focused on standards of care, evaluation of primary literature, clinical application, billing and regulatory issues, written and verbal communication, and patient education. Teaching methods included lectures, discussions, demonstrations, and self-directed learning.

Assessment

Assessment methods included multiple-choice examinations, evaluation of patient cases, student presentations, and a practical examination. Students demonstrated competencies in multiple areas and rated the course favorably. Students who completed the elective reported being more prepared for anticoagulation activities than those who did not. Confidence levels regarding participation in anticoagulation services postgraduation were similar.

Conclusion

The elective provided valuable experience in anticoagulation therapy and increased students'' perception of their preparedness related to dealing with anticoagulation issues while on advanced pharmacy practice experiences (APPEs). More exposure to management topics and the logistics of initiating anticoagulation services should be incorporated.     

An Elective Course in Aromatherapy Science

Objective. To evaluate the impact of an innovative team-taught elective course on second-year (P2) students’ knowledge and skills relating to the relationship between aromatherapy and pharmacy.Design. An Aromatherapy Science elective course was offered to P2 students in an accelerated doctor of pharmacy (PharmD) degree program and was designed to provide an elective course experience while focusing on active-learning skills such as group work, student-led presentations, and in-class activities. Lectures were designed to reinforce core curricular threads from the basic sciences within the pharmaceutical sciences department while highlighting key aromatherapy principles.Assessment. Course evaluations, grades, and student self-assessments were used to evaluate student fulfillment and knowledge gained. Students agreed this hands-on course integrated pharmaceutical science experiences, enriched their pharmacy education, and provided knowledge to enhance their confidence in describing essential oil uses, drug interactions, and key aromatherapy clinical implications.Conclusion. Students agreed this course prepared them to identify essential oil therapeutic uses and potential essential oil-drug interactions, and interpret literature. The introduction of aromatherapy principles to pharmacy students will prepare a new generation of healthcare professionals on the role of alternative medicines.     

A Global Health Elective Course in a PharmD Curriculum

Objective. To describe the design, development, and the first 4 implementations of a Global Health elective course intended to prepare pharmacy students pursue global health careers and to evaluate student perceptions of the instructional techniques used and of skills developed during the course.Design. Following the blended curriculum model used at Touro College of Pharmacy, the Global Health course combined team-based learning (TBL) sessions in class, out-of-class team projects, and online self-directed learning with classroom teaching and discussion sessions.Assessment. Student performance was assessed with TBL sessions, team projects, and class presentations, online quizzes, and final examinations. A precourse and postcourse survey showed improvement in global health knowledge and attitudes, and in the perception of pharmacists’ role and career opportunities in global health. Significant improvement in skills applicable to global health work was reported and students rated highly the instructional techniques, value, and relevance of the course.Conclusion. The Global Health elective course is on track to achieve its intended goal of equipping pharmacy students with the requisite knowledge and applicable skills to pursue global health careers and opportunities. After taking this course, students have gone on to pursue global field experiences.     

An elective course on lifestyle modifications in pharmacotherapy

Objectives

Develop and implement a pharmacy course explaining basic lifestyle modification components and assess changes in student knowledge, skills, beliefs, and confidence after completing the course.

Design

A 2-credit hour elective course was offered to pharmacy students in which basic lifestyle modification components were applied to case-based patients with hypertension, dyslipidemia, diabetes mellitus, obesity, and metabolic syndrome in the pharmacy practice setting through comprehensive wellness programs. Knowledge, skills, beliefs, and confidence assessments were embedded into the course.

Assessment

There were significant improvements in students'' skills and confidence, and in most knowledge areas, but not in their beliefs regarding health behaviors.

Conclusion

Implementing an elective course on lifestyle modifications is an effective means of teaching students about wellness and disease prevention.     

An Elective Course on Postgraduate Residency Training

Objective. To develop, implement, and assess the impact of an elective course for pharmacy students on postgraduate pharmacy residency training.Design. An elective course on residency training was developed using short lectures, group discussions, and active-learning strategies, such as small-group exercises, mock match, and mock interview.Assessment. Students were asked to self-assess their understanding and abilities related to residency training at the beginning and end of the semester based on course objectives. The median post-semester responses increased for all objectives compared to baseline (p<0.05).Conclusion. A residency elective using a variety of teaching methods increased student knowledge and confidence in their skills regarding residency training.     

An elective course to promote academic pharmacy as a career

Objective. To implement and assess an elective course that engages pharmacy students’ interest in and directs them toward a career in academia.Design. A blended-design elective that included online and face-to-face components was offered to first through third-year pharmacy studentsAssessment. Students’ knowledge, skills, and attitudes toward academic pharmacy were measured by pre- and post-course assessments, online quizzes, personal journal entries, course assignments, and exit interviews. The elective course promoting academic pharmacy as a profession was successful and provided students with an awareness about another career avenue to consider upon graduation. The students demonstrated mastery of the course content.Conclusions. Students agreed that the elective course on pharmacy teaching and learning was valuable and that they would recommend it to their peers. Forty percent responded that after completing the course, they were considering academic pharmacy as a career.     

Medication therapy management services provided by student pharmacists

Objectives. To evaluate the impact of student pharmacists delivering medication therapy management (MTM) services during an elective advanced pharmacy practice experience (APPE).Methods. Student pharmacists provided MTM services at community pharmacy APPE sites, documented their recommendations, and then made follow-up telephone calls to patients to determine the impact of the MTM provided. Students were surveyed about the MTM experience.Results. Forty-seven students provided MTM services to 509 patients over 2 years and identified 704 drug-related problems (average of 1.4 problems per patient). About 53% of patients relayed the recommendations to their physician and 205 (75%) physicians accepted the recommendations. Eighty-eight percent of patients reported feeling better about their medications after receiving MTM services. A majority of the students perceived their provision of MTM services as valuable to their patients.Conclusions. Providing MTM services to patients in a pharmacy practice setting allowed student pharmacists to apply skills learned in the doctor of pharmacy (PharmD) curriculum.     

A Leadership Elective Course Developed and Taught by Graduate Students

Objective. To develop and implement a flexible-credit elective course to empower student pharmacists to develop lifelong leadership skills and provide teaching practice opportunities for graduate students.Design. An elective course focusing on leadership development for second- and third-year doctor of pharmacy (PharmD) students was designed and taught by 4 graduate students under the mentorship of 2 faculty members. Student pharmacists could enroll in a 1-, 2-, or 3-credit-hour version of the course.Assessment. Attainment of course objectives was measured using student pharmacist reflection papers and continuing professional development portfolios. Additionally, self-assessments of graduate students and faculty members delivering the course were conducted. In their responses on course evaluations, student pharmacists indicated they found the course a valuable learning experience. Graduate students found course development to be challenging but useful in developing faculty skills.Conclusion. This flexible-credit elective course taught by graduate students was an innovative way to offer formal leadership instruction using limited college resources.     

Integration of physical assessment within a pathophysiology course for pharmacy

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

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.     

A Drug Interactions Elective Course

Objectives

To evaluate the impact of a drug interactions elective course on student knowledge and skills.

Design

A drug interactions elective which focused on assessment and application of drug interaction information and identification and management of commonly encountered drug interactions by therapeutic category was offered to third-year PharmD students. Students were expected to (1) determine whether a given interaction was clinically significant or required pharmacist intervention, and (2) make rational, scientifically sound, practical recommendations for management of drug interactions.

Evaluation and Assessment

Assessment included course evaluations, student self-assessments, and knowledge and skills assessments. Students who completed the course were more confident in their abilities relating to drug interactions than students who did not complete the course. Students who completed the course scored significantly better in all areas of the assessment compared to students who did not complete the course. Course evaluation results were also positive.

Conclusion

A course devoted to the identification and management of drug interactions improved PharmD students'' knowledge and skills and could potentially improve the patient care they provide in the future.     

A Team-Based Learning Course on Nutrition and Lifestyle Modification

Objective. To create, implement, and evaluate an elective team-based learning (TBL) course on nutrition and lifestyle modification for pharmacy students.Design. An elective course with 15 contact hours was developed for second-year pharmacy students based on the principles of TBL. Student knowledge gained and satisfaction with the course were measured.Assessment. Sixty-two students completed the course. Knowledge about nutrition and lifestyle modification was significantly improved by completing the course (59% and 91%, respectively, p=<0.001). The satisfaction survey instrument had a response rate of 97%, and the majority of students (>85%) responded favorably to the TBL components.Conclusion. An elective course using TBL effectively delivered course content while teaching students communication and teamwork skills. The course was well received by students.     

Home Medication Reviews in a Patient Care Experience for Undergraduate Pharmacy Students

Objectives. To evaluate the effectiveness of conducting medication management reviews (MMRs) and home medication reviews (HMRs) on improving undergraduate pharmacy students'' pharmaceutical care skills and clinical knowledge.Design. Fifth-year bachelor of science in pharmacy students were enrolled in a structured course in which MMR cases based on real patient scenarios were completed, findings were discussed in groups, and comprehensive feedback was provided by course instructors. Each student was then asked to recruit a real patient through a community pharmacy and conduct an HMR.Assessment. Students’ pre- and post-course scores on the same MMR case improved significantly, with 84.6% of students passing the post-course assessment. Students also completed a new post-course MMR case and 74.8% received a passing score. Students'' answers on a post-course self-assessment showed a significant improvement in their scores regarding knowledge and skills in conducting MMRs and HMRs.Conclusion. Medication management reviews and home medication reviews are excellent tools for educating pharmacy students and providing them with needed actual clinical practice experience.     

Teaching principles of geriatrics through a home health care rotation

To provide pharmacy students with ambulatory geriatric training, the University of Georgia School of Pharmacy developed a clinical rotation in home health care. This one-week experience in which students encounter patients in the home environment is offered as part of the four-week required clinical clerkship. While in the home setting the student is exposed to the various medical, social, and economic problems of the elderly and in turn provides the patient with nondispensing pharmaceutical services such as drug use review, drug histories, and patient education. The patients' medication regimens are discussed prospectively and retrospectively at daily conferences with the clinical preceptor and student peers. Students have evaluated the program as valuable in improving their communication skills and their knowledge of drugs and diseases of the geriatric patient.     

An Oncology Pharmacy Practice Elective Course for Third-Year Pharmacy Students

Objective. To develop and implement a 1-credit-hour oncology pharmacy practice elective course for third-year pharmacy students and assess its impact on examination scores in a required pharmacotherapeutics course.Design. Major topics were identified to focus on therapeutic management and supportive care of the oncology patient. Psychosocial topics were incorporated to help pharmacy students better relate to oncology patients.Assessment. Learning was assessed by means of 2 computer-based examinations, weekly reflection posts, and a completed oncology service-learning project and reflection paper. Students enrolled in the course achieved higher pharmacotherapeutics oncology section examination scores than students who had not taken the course. Also, this course increased students’ interest in oncology pharmacy.Conclusion. The oncology pharmacy elective course has received overwhelmingly positive feedback from students and student enrollment continues to grow. We will continue to offer this course to future practitioners.     

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.     

An Online Health Informatics Elective Course for Doctor of Pharmacy Students

Objective. To describe the development and assessment of an online elective health informatics course and determine its potential for universal integration into doctor of pharmacy (PharmD) curricula.Design. A 2-credit hour online elective course was developed and offered to all PharmD students; voiced-over Powerpoint lectures were used to deliver content.Assessment. Assessment of student performance was measured using quantitative metrics via discussion questions, quizzes, written papers, and examinations. Qualitative findings were measured through discussion questions, a goal-setting classroom assessment technique, and an end-of-course reflection. Students report finding value in the course and recognizing how the knowledge gained could impact their future practice as pharmacists. Conclusion. An online course in health informatics can be an effective way to deliver content and provide a blueprint for continued integration of the content into curricula.     

A Required Online Course with a Public Health Focus for Third Professional Year Pharmacy Students

Objective. To design, deliver, and evaluate the impact of a required course on student knowledge acquisition and ability to evaluate contemporary public health issues.Design. A 2-credit course was implemented using asynchronous, online delivery. Learning activities included literature retrieval and assessment, analytic writing, quizzes, and creation of a group wiki evaluating a current public health issue. Course topics included health care reform, social determinants of health, health disparities, evidence-based medicine, end-of-life care, patient safety, and research ethics.Assessment. Strong student performance on assessments indicated an ability to use higher-order cognitive domains. Online delivery provided students with the flexibility to complete assignments at their convenience, allowed participation by all students, and encouraged self-directed learning.Conclusion. Completion of a required, online, asynchronous course with a public health focus allowed pharmacy students to increase their knowledge of and ability to evaluate contemporary ethical, social, cultural, and governmental issues affecting pharmacy practice.