To implement the Partner for Promotion (PFP) program which was designed to enhance the skills and confidence of students and community pharmacy preceptors to deliver and expand advanced patient care services in community pharmacies and also to assess the program's impact.
A 10-month longitudinal community advanced pharmacy practice experience was implemented that included faculty mentoring of students and preceptors via formal orientation; face-to-face training sessions; online monthly meetings; feedback on service development materials; and a web site offering resources and a discussion board. Pre- and post-APPE surveys of students and preceptors were used to evaluate perceptions of knowledge and skills.
The skills survey results for the first 2 years of the PFP program suggest positive changes occurring from pre- to post-APPE survey in most areas for both students and preceptors. Four of the 7 pharmacies in 2005-2006 and 8 of the 14 pharmacies in 2006-2007 were able to develop an advanced patient care service and begin seeing patients prior to the conclusion of the APPE. As a result of the PFP program from 2005-2007, 14 new experiential sites entered into affiliation agreements with The Ohio State University College of Pharmacy.
The PFP program offers an innovative method for community pharmacy faculty members to work with students and preceptors in community pharmacies in developing patient care services.
community pharmacy; pharmaceutical services; administration; advanced pharmacy practice experience
To develop an assessment that would (1) help doctor of pharmacy (PharmD) students review therapeutic decision making and build confidence in their skills, (2) provide pharmacy practice residents with the opportunity to lead small group discussions, and (3) provide the assessment committee with program-level assessment data.
A case-based interactive assessment was developed and delivered to PharmD students immediately prior to advanced pharmacy practice experiences (APPEs). The assessment used an audience response system to allow immediate feedback followed by small group discussions led by pharmacy-practice residents. Students self-assessed their knowledge and confidence levels and developed personalized learning objectives for APPEs.
Eighty-nine percent of students found the assessment useful, and pharmacy practice residents reported that it was helpful in developing precepting skills. The college assessment committee was able to use the data to supplement the ongoing College curricular mapping process.
An interactive assessment process can help students build confidence for experiential training, provide a learning opportunity for pharmacy residents, and produce program-level data for college assessment purposes. Planned modifications of the assessment include expanding the content areas covered and adding ability-based assessments such as communication skills.
audience response system; assessment; ability-based outcomes; confidence; advanced pharmacy practice experience
Objectives. To evaluate pharmacy students' drug-drug interaction (DDI) knowledge retention over 1 year and to determine whether presenting DDI vignettes increased knowledge retention.
Methods. A knowledge assessment tool was distributed to fourth-year pharmacy students before and after completing a DDI educational session. The questionnaire was re-administered after 1 year to assess knowledge retention. During the intervening year, students had the option of presenting DDI case vignettes to preceptors and other health professionals as part of their advanced pharmacy practice experiences (APPEs).
Results. Thirty-four of 78 pharmacy students completed both the post-intervention and 1-year follow-up assessments. Students’ knowledge of 4 DDI pairs improved, knowledge of 3 DDI pairs did not change, and knowledge of the remainder of DDI pairs decreased. Average scores of the 18 students who completed all tests and presented at least 1 vignette during their APPEs were higher on the 1-year follow-up assessment than students who did not, suggesting greater DDI knowledge retention (p = 0.04).
Conclusion. Although pharmacy students’ overall DDI knowledge decreased in the year following an educational session, those who presented vignettes to health professionals retained more DDI knowledge, particularly on those DDIs for which they gave presentations. Other methods to enhance pharmacy students’ retention of DDI knowledge of clinically important DDIs are needed.
drug-drug interaction; assessment
Pharmacy schools across North America have been charged to ensure their students are adequately skilled in the principles and practices of pharmaceutical care. Despite this mandate, a large percentage of students experience insufficient opportunities to practice the activities, tasks and processes essential to pharmaceutical care. The objective of this retrospective study of pharmacy students was to: (1) as "proof of concept", test the overall educational impact of an enhanced advanced pharmacy practice experiential (APPE) model on student competencies; (2) develop an instrument to measure students' and preceptors' experiences; and (3) assess the psychometric properties of the instrument.
A comparative-experimental design, using student and preceptor surveys, was used to evaluate the impact of the enhanced community-based APPE over the traditional APPE model. The study was grounded in a 5-stage learning model: (1) an enhanced learning climate leads to (2) better utilization of learning opportunities, including (3) more frequent student/patient consultation, then to (4) improved skills acquisition, thence to (5) more favorable attitudes toward pharmaceutical care practice. The intervention included a one-day preceptor workshop, a comprehensive on-site student orientation and extending the experience from two four-week experiences in different pharmacies to one eight-week in one pharmacy.
The 35 student and 38 preceptor survey results favored the enhanced model; with students conducting many more patient consultations and reporting greater skills improvement. In addition, the student self-assessment suggested changes in attitudes favoring pharmaceutical care principles. Psychometric testing showed the instrument to be sensitive, valid and reliable in ascertaining differences between the enhanced and traditional arms.
The enhanced experiential model positively affects learning opportunities and competency acquisition, as measured by a new instrument showing sound psychometric properties.
Increasing challenges to recruit hospital sites with full-time on-site pharmacy preceptors for institutional-based Advanced Pharmacy Practice Experiences (APPE) has made it necessary to consider alternate experiential models. Sites with on-site discipline specific preceptors to supervise students have typically been referred to in the literature as “role-established” sites. In British Columbia, long-term care (LTC) facilities offered a unique opportunity to address placement capacity issues. However, since the majority of these facilities are serviced by off-site community pharmacists, this study was undertaken to explore the viability of supervising pharmacy students remotely – a model referred to in the literature as “role-emergent” placements. This paper’s objectives are to discuss pharmacy preceptors’ and LTC non-pharmacist staff experiences with this model.
The study consisted of three phases: (1) the development phase which included delivery of a training program to create a pool of potential LTC preceptors, (2) an evaluation phase to test the viability of the LTC role-emergent model with seven pharmacists (two role-established and five role-emergent) together with their LTC staff, and (3) expansion of LTC role-emergent sites to build capacity. Both qualitative and quantitative methods were used to obtain feedback from pharmacists and staff and t-tests and Mann–Whitney U tests were used to examine equivalency of survey outcomes from staff representing both models.
The 76 pharmacists who completed the training program survey rated the modules as “largely” meeting their learning needs. All five role-emergent pharmacists and 29 LTC participating staff reported positive experiences with the pharmacy preceptor-student-staff collaboration. Preceptors reported that having students work side-by-side with facility staff promoted inter-professional collaboration. The staff viewed students’ presence as a mutually beneficial experience, suggesting that the students’ presence had enabled them to deliver better care to the residents. As a direct result of the study findings, the annual role-emergent placement capacity was increased to over 45 by the end of the study.
This study demonstrated that role-emergent LTC facilities were not only viable for quality institutional APPEs but also provided more available sites, greater student placement capacity, and more trained pharmacy preceptors than could be achieved in role-established facilities.
Residential care; Long-term care; Pharmacy; Clerkship; Clinical education; Clinical practice; Non-traditional clinical placements; Role-emergent; Role-emerging; Institutional; Experiential
The use of mobile phones, and specifically smartphones, in the last decade has become more and more prevalent. The latest mobile phones are equipped with comprehensive features that can be used in health care, such as providing rapid access to up-to-date evidence-based information, provision of instant communications, and improvements in organization. The estimated number of health care apps for mobile phones is increasing tremendously, but previous research has highlighted the lack of critical appraisal of new apps. This lack of appraisal of apps has largely been due to the lack of clinicians with technical knowledge of how to create an evidence-based app.
We discuss two freely available methodologies for developing Web-based mobile phone apps: a website builder and an app builder. With these, users can program not just a Web-based app, but also integrate multimedia features within their app, without needing to know any programming language.
We present techniques for creating a mobile Web-based app using two well-established online mobile app websites. We illustrate how to integrate text-based content within the app, as well as integration of interactive videos and rich site summary (RSS) feed information. We will also briefly discuss how to integrate a simple questionnaire survey into the mobile-based app. A questionnaire survey was administered to students to collate their perceptions towards the app.
These two methodologies for developing apps have been used to convert an online electronic psychiatry textbook into two Web-based mobile phone apps for medical students rotating through psychiatry in Singapore. Since the inception of our mobile Web-based app, a total of 21,991 unique users have used the mobile app and online portal provided by WordPress, and another 717 users have accessed the app via a Web-based link. The user perspective survey results (n=185) showed that a high proportion of students valued the textbook and objective structured clinical examination videos featured in the app. A high proportion of students concurred that a self-designed mobile phone app would be helpful for psychiatry education.
These methodologies can enable busy clinicians to develop simple mobile Web-based apps for academic, educational, and research purposes, without any prior knowledge of programming. This will be beneficial for both clinicians and users at large, as there will then be more evidence-based mobile phone apps, or at least apps that have been appraised by a clinician.
smartphone application; mobile application; creation
Objective. To implement a simulation-based introductory pharmacy practice experience (IPPE) and determine its effectiveness in assessing pharmacy students’ core domain abilities prior to beginning advanced pharmacy practice experience (APPE).
Design. A 60-hour IPPE that used simulation-based techniques to provide clinical experiences was implemented. Twenty-eight students were enrolled in this simulation IPPE, while 60 were enrolled in hospital and specialty IPPEs within the region.
Assessment. The IPPE assessed 10 out of 11 of the pre-APPE core domain abilities, and on the practical examination, 67% of students passed compared to 52% of students in the control group. Students performed better on all 6 knowledge quizzes after completing the simulation IPPE. Based on scores on the Perception of Preparedness to Perform (PREP) survey, students felt more prepared regarding “technical” aspects after completing the simulation experience (p<0.001). Ninety-six percent of the respondents agreed with the statement “I am more aware of medication errors after this IPPE.”
Conclusion. Simulation is an effective method for assessing the pre-APPE abilities of pharmacy students, preparing them for real clinical encounters, and for making them more aware of medication errors and other patient safety issues.
standardized patients; introductory pharmacy practice experience; simulation; ability; advanced pharmacy practice experience
Surgical procedures are complex motion sequences that require a high level of preparation, training, and concentration. In recent years, Internet platforms providing surgical content have been established. Used as a surgical training method, the effect of multimedia-based training on practical surgical skills has not yet been evaluated. This study aimed to evaluate the effect of multimedia-based training on surgical performance.
A 2 × 2 factorial, randomized controlled trial with a pre- and posttest design was used to test the effect of multimedia-based training in addition to or without practical training on 70 participants in four groups defined by the intervention used: multimedia-based training, practical training, and combination training (multimedia-based training + practical training) or no training (control group). The pre- and posttest consisted of a laparoscopic cholecystectomy in a Pelvi-Trainer and was video recorded, encoded, and saved on DVDs. These were evaluated by blinded raters using a modified objective structured assessment of technical skills (OSATS). The main evaluation criterion was the difference in OSATS score between the pre- and posttest (ΔOSATS) results in terms of a task-specific checklist (procedural steps scored as correct or incorrect).
The groups were homogeneous in terms of demographic parameters, surgical experience, and pretest OSATS scores. The ΔOSATS results were highest in the multimedia-based training group (4.7 ± 3.3; p < 0.001). The practical training group achieved 2.5 ± 4.3 (p = 0.028), whereas the combination training group achieved 4.6 ± 3.5 (p < 0.001), and the control group achieved 0.8 ± 2.9 (p = 0.294).
Multimedia-based training improved surgical performance significantly and thus could be considered a reasonable tool for inclusion in surgical curricula.
Internet platforms; Multimedia-based training; Webop; Surgical training; Pelvi-Trainer
To determine the availability of experiential learning opportunities in culturally diverse areas and to identify opportunities and barriers to attract and sustain sites for the University of Illinois at Chicago College of Pharmacy.
Utilizing variables of census tract income, racial/ethnicity composition and crime index, data analyses included descriptive statistics and multivariate logistic regression. Faculty members involved in experiential education were interviewed to identify other factors influencing site placement and selection for community-based advanced pharmacy practice experiences (APPEs).
Median family income and Asian population were significantly higher and black population was significantly lower in census tracts with community APPE sites than in census tracts without APPE sites (p < 0.05). No significant differences were found in the population variables of white and Latino populations and crime index. The Asian population variable was the only significant predictor of an APPE site (p = 0.0148) when controlling for other variables. Distance from the College, pharmacy staffing issues, goodwill, influence of district and corporate managers, and strategic initiatives were critical considerations in site establishment and overall sustainability.
Advanced community pharmacy practice sites were fairly well distributed across metropolitan Chicago, indicating that exposure to diverse populations during the advanced community practice experiences parallels with strategic College objectives of expanding and diversifying experiential sites to enhance pharmacy students' abilities to meet emerging patient care challenges and opportunities.
experiential education; advanced pharmacy practice experiences; community pharmacy; students; cultural diversity
Web-based learning is becoming an increasingly important instructional tool in nursing education. Multimedia advancements offer the potential for creating authentic nursing activities for developing nursing competency in clinical practice.
This study aims to describe the design, development, and evaluation of an interactive multimedia Web-based simulation for developing nurses’ competencies in acute nursing care.
Authentic nursing activities were developed in a Web-based simulation using a variety of instructional strategies including animation video, multimedia instructional material, virtual patients, and online quizzes. A randomized controlled study was conducted on 67 registered nurses who were recruited from the general ward units of an acute care tertiary hospital. Following a baseline evaluation of all participants’ clinical performance in a simulated clinical setting, the experimental group received 3 hours of Web-based simulation and completed a survey to evaluate their perceptions of the program. All participants were re-tested for their clinical performances using a validated tool.
The clinical performance posttest scores of the experimental group improved significantly (P<.001) from the pretest scores after the Web-based simulation. In addition, compared to the control group, the experimental group had significantly higher clinical performance posttest scores (P<.001) after controlling the pretest scores. The participants from the experimental group were satisfied with their learning experience and gave positive ratings for the quality of the Web-based simulation. Themes emerging from the comments about the most valuable aspects of the Web-based simulation include relevance to practice, instructional strategies, and fostering problem solving.
Engaging in authentic nursing activities using interactive multimedia Web-based simulation can enhance nurses’ competencies in acute care. Web-based simulations provide a promising educational tool in institutions where large groups of nurses need to be trained in acute nursing care and accessibility to repetitive training is essential for achieving long-term retention of clinical competency.
acute nursing care; authentic learning; clinical competency; deterioration; multimedia; instructional strategies; simulation; Web-based simulation
The provision of education, training and pedagogy, its associated science is being radically impacted by technological developments and changing methodologies in the imparting and acquisition of knowledge. This is resulting in the thrust and focus of higher education moving from a traditional university centred process to a more student-orientated one. The Internet's propensity for real-time interaction makes computer-based training, or distance learning, viable for accommodating medical education needs. In medicine many concepts are visual or structural and in many cases clinical reasoning is based on spatial abstraction of structures. Incorporating these principles, the Institute developed the concept of the Virtual Study Centre (VSC), utilising methodologies which take advantage of the developments in web based computing and communication infrastructures to specifically address the difficulties associated with existing methods of distance learning.
The VSC is a 'hypermedia' learning environment, which offers a more flexible approach to learning for both producers and users of educational material. It is achieved through distributed student access to networked learning resources. A project team was established to define the specific models of learning scenarios where synchronous interaction played an important role. Utilising an assessment matrix based on the requirement outcomes of the learning scenarios, it evaluated products available in the web-based training area for quality, extent and complexity in respect to multimedia design, interactivity and overall ease of use. Each product had to comply with their criteria under the following headings: technical composition, infra-structural design, regional and cultural constraints. A compromise in the quality and speed of audio and video was not an option. To provide the best we expected the best from the products so that we could provide a well-crafted teaching system, which could be used throughout the medical profession.
We have identified the optimal model based standards required in software tool-sets to develop and support multimedia web-based training.
A fundamental element in the provision of distance education is interaction. This paper illustrates the considerable deficit in the availability of quality media-rich tool-sets on the market, which enables optimum interaction. It details the research undertaken in the provision of the levels of interaction necessary to provide a fully integrated web-based education facility and the difficulties of tailoring a traditionally taught course for the web. It develops and explores the issues surrounding the monitoring, examination and identification of students and defines an approach to underpin optimum tool-set assessment and utilisation.
Web-Based Training; Education; Multimedia Tool-Sets; Distance Learning; Internet
To quantify the benefits of an enhanced advanced pharmacy practice experience (APPE) community pharmacy model compared to the traditional program by comparing basic and comprehensive pharmaceutical care provided by students and assessing preceptors’ perceptions of the APPE.
A pilot study consisting of 1 enhanced APPE arm and 2 traditional APPE (control) arms was conducted. The enhanced APPE consisted of a preceptor education program, a 5-day onsite student orientation, and an 8-week experience completed at 1 rather than 2 community sites.
The level of interventions provided by students in the enhanced APPE arm significantly surpassed that of students in the control arms. In addition, preceptor questionnaires indicated overwhelming support for the enhanced model over the traditional APPE.
The study's findings demonstrated that the enhanced APPE model enabled the participating pharmacies to provide increased level of patient care (as compared to the control sites) and improved preceptor satisfaction with the APPE.
pharmaceutical care; medication therapy management; advanced pharmacy practice experience; community pharmacy; evaluation; student impact; assessment
To assess a community geriatrics advanced pharmacy practice experience (APPE) that aimed to improve students' attitudes towards older adults and provide a student-directed learning experience.
Students provided blood pressure monitoring and medication counseling to older adults living in a low-income residential facility as part of a required 6-week ambulatory care service-learning APPE. Pre-experience and post-experience essays on students' perceptions of the elderly and their intended and actual learning were retrospectively reviewed using a qualitative process to determine whether the course objectives were met.
Many students initially described older adults in factual terms or using negative descriptors. Most expressed a desire to increase their knowledge of diseases commonly occurring in and drugs commonly prescribed for the elderly or to improve specific skills. Many students initially had difficulty articulating clear and measurable learning objectives and appropriate assessment metrics, which are important components of self-directed learning. The final essays revealed many students learned more about the humanistic aspects of care than they had anticipated.
This community-based geriatrics experience improved students' attitudes towards working with older adults and provided practice in developing and assessing their personal learning objectives.
student-directed learning; community pharmacy geriatrics; advanced pharmacy practice experience; service learning
Objective. To determine whether sequential assignment of students to the same facility for institutional practice experiences improves their advanced pharmacy practice experience (APPE) examination scores.
Design. Student volunteers were assigned to the same healthcare facility for all institutional introductory pharmacy practice experiences (IPPEs) and advanced pharmacy practice experiences (APPEs). Other students completed institutional IPPEs and APPEs at separate healthcare facilities, ranging from 2 to 4 different facilities per student. APPE examination scores of students assigned to the same facility for all institutional learning experiences were compared with those of students assigned to more than 1 institutional practice site.
Assessment. Holding grade point average constant, students assigned to the same facility for institutional IPPEs and APPEs scored 3 percentage points higher on the APPE institutional examination compared with students assigned to separate facilities for these experiences.
Conclusion. Assigning students to the same facility for both institutional IPPEs and APPEs positively influenced knowledge-based APPE examination performance.
experiential education; introductory pharmacy practice experiences; advanced pharmacy practice experiences; sequential learning; institutional practice; assessment
Objective. To create a capstone course that provides a comprehensive and integrated review of the pharmacy curriculum with a broad range of assessment tools to evaluate student knowledge and skills as a final preparation prior to beginning fourth-year advanced pharmacy practice experiences (APPEs).
Design. The capstone course was a 4 credit-hour, case-based course. Eight comprehensive cases were assigned to students over the course of the term. The cases were designed to mimic complex clinical scenarios that students were likely to encounter during an APPE. Students were required to prepare a written and oral presentation for each case and were assessed on material covered during the cases. Faculty members presented weekly reviews on selected topics such as calculations, pharmacokinetics, and pharmaceutical compounding. At the end of the course, students took an observed structured clinical examination (OSCE), which simulated the Georgia Board of Pharmacy Practical Examination, and a comprehensive examination designed to mimic the NAPLEX (North American Pharmacy Licensure Examination).
Assessment. Evaluation of student outcomes was based on written and verbal presentations of the cases, multiple-choice examinations, a short-answer calculations examination, an “Errors and Omissions” examination, a standardized patient encounter, and pharmaceutical compounding examinations. Ninety-five percent of students successfully passed the course on their first attempt. Student feedback indicated satisfaction with the depth, breadth, and organization of material covered and felt that the course helped prepare them for APPEs.
Conclusion. The culminating experience of the capstone course gave students a thorough review of practical, clinical, and communication skills and provided faculty members with feedback regarding the curriculum through robust assessment.
Capstone; case-based learning; integrated curriculum; communication; advanced pharmacy practice experience
Pharmacy students should be given opportunities to learn and practice interpersonal communication skills during their community advanced pharmacy practice experience (APPE). Preceptors have the responsibility of setting the stage for the pharmacy students during their initial encounter. During this orientation to the site, students should become familiar with the history of the practice, the types of services provided, and the staff members. Once the orientation is completed, preceptors can develop strategies for incorporating the students into the practice's patient care activities. Students should participate in patient counseling, interviewing, and educational sessions. Also, students should participate in collaborative work with other health care providers. To ensure the development of communication skills in pharmacy students, preceptors can incorporate the teaching process “see one, do one, teach one” into their teaching activities. By following these strategies, preceptors can effectively and positively impact the communication skills of their students.
community pharmacy; advanced pharmacy practice experience; communication skills; preceptor
To determine the impact of an introductory pharmacy practice experience (IPPE) on students' clinical skills during their initial advanced pharmacy practice experience (APPE).
A 4-week First Steps course that focused on students developing pharmacy practice skills, clinical communications skills, and effective use of reference materials was introduced in 2006 at the end of the third-year curriculum, prior to students beginning their APPEs.
During the third week of the first APPE, faculty members rated students' demonstration of 9 clinical skills on a 5-point Likert scale (1 being always and 5 being never). The evaluation was performed in 2005 prior to implementation of the course (control group) and again in 2006 after implementation of the course. Students who completed the First Steps course scored better on all 9 skills and had a better average clinical skills value (2.3) compared to the control group (2.6, p < 0.01).
Completion of an IPPE course that focused on critical pharmacy practice aspects, clinical communication skills, and use of reference materials resulted in increased frequency of desired clinical behaviors on a subsequent APPE.
introductory pharmacy practice experience; assessment; evaluation; experiential learning; advanced pharmacy practice experience
Objective. To assess the effect of using simulation in pharmacy student training on correct device technique.
Methods. A single-blinded, repeated measures, parallel group design study was conducted in 2011, involving all final-year pharmacy students in year 5 (final year) enrolled in the Clinical Pharmacy and Therapeutics course. Students were assessed on device technique at baseline based on previously published checklists for Diskus (DIS), Turbuhaler (TH), and pressurized Metered Dose Inhaler (pMDI). Students were randomly assigned to 2 groups: Intervention A, which included supervised hands-on education in groups and peer assessment/education; and Intervention B, which included supervised hands-on education in groups, peer assessment/education, and a simulated scenario counseling real asthma patients. The simulation involved groups of 6 students counseling 3 asthma patients on inhaler device technique. The counseling involved verbal information and physical demonstration until the patient performed all steps correctly. Student assessments on device technique were repeated 1 week postintervention.
Results. At baseline, none of the students in Intervention A (n=54) or Intervention B (n=55) performed correct technique for any of the 3 devices. One week following the intervention, a significantly higher proportion of students in Intervention B demonstrated correct technique for the Diskus, Turbuhaler, and pMDI (60.0%, 70.9%, and 69.1%, respectively) than did students in Intervention A (27.8%, 40.7%, and 42.6%, respectively, p<0.005).
Conclusion. Engaging pharmacy students with real asthma patients in a simulated scenario involving correct device technique education resulted in better device technique demonstration skills among students.
Simulation; pharmacy education; device technique; asthma; Jordan
Interactive pharmacy case studies are an essential component of the pharmacy curriculum. We recently developed an elective course at the Rangel College of Pharmacy in pharmacy case studies for second- and third-year Doctor of Pharmacy students using Second Life® (SL), an interactive three-dimensional virtual environment that simulates the real world. This course explored the use of SL for education and training in pharmacy, emphasizing a case-based approach. Virtual worlds such as SL promote inquiry-based learning and conceptual understanding, and can potentially develop problem-solving skills in pharmacy students. Students were presented ten case scenarios that primarily focused on drug safety and effective communication with patients. Avatars, representing instructors and students, reviewed case scenarios during sessions in a virtual classroom. Individually and in teams, students participated in active-learning activities modeling both the pharmacist’s and patient’s roles. Student performance and learning were assessed based on SL class participation, activities, assignments, and two formal, essay-type online exams in Blackboard 9. Student course-evaluation results indicated favorable perceptions of content and delivery. Student comments included an enhanced appreciation of practical issues in pharmacy practice, flexibility of attendance, and an increased ability to focus on course content. Excellent student participation and performance in weekly active-learning activities translated into positive performance on subsequent formal assessments. Students were actively engaged and exposed to topics pertinent to pharmacy practice that were not covered in the required pharmacy curriculum. The multiple active-learning assignments were successful in increasing students’ knowledge, and provided additional practice in building the communication skills beneficial for students preparing for experiential clinical rotations.
Second Life; virtual worlds; pharmacy case studies; computer simulation; health education; pharmacy education
To describe the practice, education and research concerning medication adherence in Danish community pharmacy.
The authors supplemented their expertise in the area of medication adherence through their contacts with other educators and researchers as well as by conducting searches in the Danish Pharmacy Practice Evidence Database, which provides annually updated literature reviews on intervention research in Danish pharmacy practice.
Practice: Medication adherence is the focus of and/or is supported by a large number of services and initiatives used in pharmacy practice such as governmental funding, IT-supported medicine administration systems, dose-dispensing systems, theme years in pharmacies on adherence and concordance, standards for counselling at the counter, pharmacist counselling, medication reviews and inhaler technique assessment. Education: In Denmark, pharmacy and pharmaconomist students are extensively trained in the theory and practice of adherence to therapy.
Pharmacy staff can choose from a variety of continuing education and post-graduate programmes which address patient adherence.
Nine ongoing and recently completed studies are described. Early research in Denmark comprised primarily smaller, qualitative studies centred on user perspectives, whereas later research has shifted the focus towards larger, quantitative, controlled studies and action-oriented studies focusing on patient groups with chronic diseases (such as diabetes, asthma, coronary vascular diseases).
Our analysis has documented that Danish pharmaceutical education and research has focused strongly on adherence to treatment for more than three decades. Adherence initiatives in Danish community pharmacies have developed substantially in the past 5-10 years, and, as pharmacies have prioritised their role in health care and patient safety, this development can be expected to continue in future years.
Medication Adherence; Pharmacists; Denmark
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.
The survey instrument's psychometric properties and differential impacts of 3 community-based APPE models were evaluated retrospectively.
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.
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.
survey; pharmaceutical care competencies; advanced pharmacy practice experience (APPE); assessment; community pharmacy
Undergraduate and postgraduate medical education in general practice is complex as a wide medical spectrum needs to be covered. Modern guidelines demand students to be able to recall immense amounts of information relating to the diagnosis and management of clinical problems. With the intent of making a medical textbook digitally available on student mobile devices, preferences of students and potential of the idea was aimed to be researched. A total estimation among fourth year medical students at the Leipzig Medical School was conducted in June 2013. Students were asked to answer a semi-structured self-designed questionnaire regarding their detailed smartphone and app usage as well as their attitude and expectations towards education and practice supporting apps. The response rate was 93.2 % (n = 290/311). The majority (69.3 %) were female students. The mean age was 24.5 years. Of the respondents, 64.2 % owned a smartphone and 22.5 % a tablet computer. A total of 32.4 % were already using medical apps for the smartphone - mostly drug reference or disease diagnosis and management apps. Regarding their wishes, 68.7 % would like or very like to see an app on general practice. The respective means of the most important desired features on a Likert scale reaching from 1 (not important) to 5 (very important) were 4.3 for drug reference information, 4.2 for guidelines for differential diagnosis, 3.9. for medical pictures libraries and 3.9 for physical examination videos. The willingness to pay for a profound app averages at 14.35 Euros (SD = 16.21). Concluding, students clearly demand for an app on general practice. Such an app should ideally be smartphone optimized. Aside of what is usually available in traditional textbooks, multimedia features such as videos on examining methods or a medical picture library are very important to students and may help to bridge the gap between text-based knowledge and practical application. Therefore, authors of medical textbooks need to be aware that the development of an app is no trivial technical translation as raised students expectations demand for multimedia and interactive features as well as comprehensive drug information. Further research should focus on developing concepts to bring together developers and university professionals as well as experienced medical specialists to enable the development of apps that satisfy the demands of undergraduate and postgraduate educational needs.
Smartphone; Elearning; Ehealth; General practice; App specifications
Objective. To describe the development, implementation, and assessment of an introductory and an advanced pharmacy practice experience (IPPE and APPE) integrated within campus-based influenza clinics.
Design. The influenza clinics were designed to incorporate the learning objectives for the IPPE and APPE, and included preparatory sessions, online learning, and direct patient interactions tailored to the appropriate education level of the learner.
Assessment. The clinics provided influenza vaccinations to 2,292 and 2,877 individuals in 2010 and 2011, respectively. The clinics allowed for experiential education of 39 students earning a total of 467 IPPE and APPE hours in 2010 and 58 students earning a total of 656 IPPE and APPE hours in 2011. Third-year students were assessed before and after completing the IPPE, and improvement was seen in knowledge and self-ratings of perceptions and attitudes toward administering immunizations.
Conclusions. Integrating pharmacy practice experiences within campus-based influenza clinics was an effective way to provide students with direct patient care experience and preventive health services knowledge.
introductory pharmacy practice experience; advanced pharmacy practice experience; immunizations; influenza clinic; community outreach
Little information is available describing the pharmacy student’s experience working in community practice with people with lived experience of mental illness. Students’ perspectives as observers, learners, technical staff and future pharmacists are important.
To gain a better understanding of the pharmacy student experience in community pharmacy–based service provision to people with lived experience of mental illness.
We conducted a qualitative study using interpretive description and application of the Theoretical Domains Framework. Focus groups were held with third- and fourth-year undergraduate pharmacy students from one Canadian university.
Two student focus groups were held in the fall of 2012 with 11 students (7 third year and 4 fourth year), 6 women and 5 men, mean age 24.5 (range, 21 to 30) years, averaging 3.2 years (range, 2 weeks to 7 years) of cumulative, mostly part-time, community pharmacy experience. Three broad themes emerged from the pharmacy student experience: (1) business tension; (2) roles, responsibilities and relationships; and (3) stigma. Students discussed their own roles, responsibilities and relationships in a pluralistic identity experience (i.e., pharmacy student, technician, future pharmacist). Application of the Theoretical Domains Framework demonstrated numerous influences on behaviour.
From the students’ description of community pharmacy–based care of people with lived experience of mental illness, significant issues exist with current practices and behaviours. Advancing the role of pharmacists and pharmacy students to meet the needs of people with mental illness will require strategies to address multifactorial influences on behaviour.
Objective. To implement and assess the effectiveness of a capstone pharmacotherapy course designed to integrate in-class curriculum using patient cases and drug-information questions. The course was intended to improve third-year doctor of pharmacy (PharmD) students' clinical documentation skills in preparation for beginning advanced pharmacy practice experiences (APPEs).
Design. This 2-credit, semester-long course consisted of 6 patient cases and 12 drug-information questions posted electronically on an Internet-based medical chart, a public health presentation, a knowledge examination, and an objective standardized performance assessment. In class, students engaged in active-learning exercises and clinical problem-solving. Students worked outside of class in small groups to retrieve and discuss assigned articles and review medication information in preparation for in-class discussions.
Assessment. A rubric was used to assess the patient cases and questions that students completed and submitted individually. Data for 4 consecutive course offerings (n=622) were then analyzed. A significant improvement was found in the “misplaced” but not the “missing” documentation ratings for both assessment and plan notes in the final assessment compared with baseline. In course evaluations, the majority of students agreed that the course integrated material across the curriculum (97%) and improved their clinical writing skills (80.5%).
Conclusion. A capstone pharmacy course was successful in integrating and reviewing much of the material covered across the PharmD curriculum and in improving students’ clinical documentation skills.
clinical documentation; clinical thinking; case-based learning; pharmacotherapy