In the U.K. there has been a gradual expansion of the incorporation of non-medical prescribing (NMP) within the health care system. The range of health care professionals to whom prescribing privileges have been extended include nurses, pharmacists, physiotherapists, radiographers and podiatrists [1
]. While all of these groups of health professionals can train to become supplementary prescribers, prescribing in partnership with a doctor [2
], nurses and pharmacists also have independent prescribing rights allowing them access to almost the same formulary of drugs as doctors [3
In order to practice as non-medical prescribers, completion of an accredited NMP course at a Higher Education Institute is required. Pharmacology is one of the eight core components of the NMP course [4
], and is recognised as being important in terms of patient safety by both educators and students alike [6
]. Indeed, prescribing has been recognised by the medical profession as being an essential skill which is underpinned by a sound knowledge of the principles of pharmacology and therapeutics [10
While pharmacists have a thorough knowledge of pharmacology gained from their pre-registration training they require education in relation to the clinical examination and consultation skills required for non-medical prescribing [11
]. The same cannot be said of nurses, however, who are experienced in clinical examination and patient consultation but whose training has moved away from the biological to the social model of care [12
]. Indeed, pharmacology has been specifically identified as an area of weakness in nursing education, both in the U.K. and elsewhere [7
]. The implications of this for NMP education and ultimately patient safety are profound [15
]. In terms of pharmacology education in NMP, our aim should be to encourage students not just to memorise enough pharmacology to pass the examination but to assimilate this knowledge and be able to integrate it into clinical practice.
Pharmacology education in NMP, however, can be complicated by a number of factors, including the range of academic levels and capabilities of students accessing such courses [9
]. While pharmacists wishing to register on a NMP course must be educated to a degree level, there is no such prerequisite for nurses. According to a study performed by Tyler and Hicks [16
], only 20% of nurses accessing prescribing courses would be accepted for training if these eligibility criteria were enforced. The situation is further complicated by the fact that approximately 50% of students accessing NMP courses have no more than a GCSE level qualification in a biological science [17
]. Given the variation in student knowledge of biological and specifically pharmacological concepts at the beginning of the NMP course, and the limited number of teaching days on the course (n = 26), the communication of the necessary depth and breadth of pharmacology topics to this diverse group of students can be a significant challenge.
The availability of rapidly advancing technology has opened up a number of possibilities in relation to the teaching and learning environment available to students today. While reusable learning objects (RLOs) have been used to promote pharmacological understanding in nurses undertaking prescribing education, with some success [17
], these tools are time-consuming and expensive to produce. This, coupled with many students' unfamiliarity with pharmacological terminology and concepts, suggests that podcasts may be a useful way of providing students with increased opportunities to familiarise themselves with lecture materials. As learning tools, podcasts usually constitute an audio recording of a lecture which can be listened to via a computer (at home or elsewhere) or downloaded to a portable media player such as an MP3 player or iPod [18
]. Whilst some definitions of podcasts specify that media files are downloaded through web syndication (RSS fed) [21
], a number of studies have used virtual learning environments to house podcasts [23
]. Indeed, relating to the use of an RSS feed, Dale states that 'Alternatively, and within an educational context, the podcast could be uploaded onto a virtual learning environment (VLE) for students to listen to' [[22
], pg 50] while Wolff argues that 'while the process hasn't been strictly that of a podcast, the end result is the same' [[23
], pg 416].
The potential advantages of academic podcasts include: the proliferation of MP3 players or iPods among students, the ease of recording any lectures which have limited student involvement, the provision of distance learning opportunities and adding to existing course materials. Conversely, the potential disadvantages include: difficulties in searching through podcasts, recording multiple voices, concerns for classroom attendance, and the additional time requirements involved in recording, editing and producing the podcasts [26
Reports of the use of podcasts in both undergraduate medical [27
] and nurse education [30
] in the U.K. and elsewhere are slowly beginning to emerge. Evaluative studies of the use of podcasts in medical education have indicated that podcasts helped students to learn their course materials and reduce their anxiety and stress relating to the subject [28
] without impacting on classroom attendance [29
]. Students found that podcasts positively impacted on their subject knowledge [29
], and they considered podcasts to be useful supplementary learning tools [27
]. Evaluation studies of the use of podcasts in other subject areas suggest that students rate podcasts as highly useful [24
], find them helpful as review tools [32
] and use podcasts to prepare for homework or exams [33
]. Students also report using podcasts to enhance their understanding of complex parts of the lecture materials and to clarify the content of lectures [33
]. While there is a growing literature on podcast use in a variety of academic settings, there is currently no data regarding the use of these learning tools for supporting pharmacology teaching, for use in NMP or for post-registration nurse education.
NMP students at the University of Nottingham are exposed to a degree-level pharmacology curriculum which cross-maps well with those of undergraduate medical curricula in pharmacology and therapeutics. Many of these students, however, arrive at University with limited biological science knowledge [17
] and, perhaps unsurprisingly, struggle with this component of the course. Indeed, many students view pharmacology as a foreign language. Listening has been shown to be an effective educational tool, not least because the spoken word adds clarity and meaning, as well as communicating enthusiasm and thus stimulating motivation [34
]. Indeed the cognitive theory of multimedia learning suggests that humans have distinct channels for processing both visual and auditory information and that combinations which include narration are effective in terms of knowledge transfer regardless of individual cognitive conditions [36
]. In this current era of advanced technology, aural learning can even become mobile learning through the use of downloadable MP3 files. For all these reasons, this project aimed to utilise audio recordings of pharmacology lectures in an attempt to improve understanding of this subject in NMP students.
The purpose of this study was to provide an evaluation of the usefulness of podcasts of pharmacology lectures as a supplementary learning tool for NMP students. Specifically, the focus of this evaluation is on student use of the podcasts on offer, their perceptions of the usefulness of these podcasts and any potential impact on students' pharmacological knowledge.