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1.  Faculty Perceptions of the Educating Pharmacy Students to Improve Quality (EPIQ) Program 
Objective. To investigate users’ initial perceptions of and potential applications for the Educating Pharmacy Students and Pharmacists to Improve Quality (EPIQ) program, a 5-module education program designed to educate pharmacists and pharmacy students about quality improvement in pharmacy practice.
Methods. The 5-module EPIQ program was distributed to pharmacy faculty members, pharmacy practitioners, and other health professionals across the country upon request. A 6-item survey instrument was sent to the first 97 people who requested the program.
Results. Twenty-seven (56%) of the 55 respondents had reviewed the EPIQ program and 22 (82%) intended to use some or all of the content to teach about quality improvement or patient safety primarily in pharmacy management and medication safety courses.
Conclusion. Initial perceptions of the EPIQ program were positive; however, further evaluation is needed after more extensive implementation of the program in pharmacy colleges and schools and other settings.
doi:10.5688/ajpe758163
PMCID: PMC3220344  PMID: 22102753
medication safety; qualitative research; science of safety; education; pharmacy curriculum
2.  WEB VS PAPER-BASED COMPLETION OF THE EPIDEMIOLOGY OF PROLAPSE AND INCONTINENCE QUESTIONNAIRE (EPIQ) 
Objectives
To examine the validity and reliability of a web-based version of the Epidemiology of Prolapse and Incontinence Questionnaire (EPIQ).
Methods
Participants included 876 women ages 38 to 65 attending primary care clinics in the Salt Lake Valley. Women completed a single web or paper based version of the symptom bother questions from EPIQ, and a subset repeated the same or opposite method at 2 separate time points. To assess subscales for the web-based version factor analysis of the 22 EPIQ items related to pelvic floor disorder (PFD) symptoms was performed using principal components analysis and varimax rotation. Internal consistency was assessed using coefficient alpha. Test-retest and inter-method reliability were assessed using intraclass correlation coefficients (ICC) for domain scores. Correlations above 0.70 were considered acceptable.
Results
Overall, 384 and 492 women completed at least 1 web and 1 paper EPIQ and 93% were Caucasian with mean age of 50±7 years. Of these, 63 completed web-web, 57 web-paper, 47 paper-web and 109 paper-paper test-retest. Overall, factor analyses were consistent with the 7 domains of the original EPIQ. Cronbach’s alpha for the 4 symptomatic PFD domains and range of test-retest reliability for the various administration methods were similar to the original EPIQ instrument. Correlations for domain scores were above 0.70, except the anal incontinence scale (ICC=0.68.)
Conclusions
Web administration of the EPIQ has similar psychometric properties with comparable internal consistency and test-retest reliability when administered in the same modality. Reliability between both methods of administration is acceptable.
doi:10.1097/SPV.0b013e31827bfd93
PMCID: PMC3774148  PMID: 23321654
Epidemiology; internet survey; pelvic floor disorders; questionnaire; web
3.  Implementation of multidimensional knowledge translation strategies to improve procedural pain in hospitalized children 
Background
Despite extensive research, institutional policies, and practice guidelines, procedural pain remains undertreated in hospitalized children. Knowledge translation (KT) strategies have been employed to bridge the research to practice gap with varying success. The most effective single or combination of KT strategies has not been found. A multifaceted KT intervention, Evidence-based Practice for Improving Quality (EPIQ), that included tailored KT strategies was effective in improving pain practices and clinical outcomes at the unit level in a prospective comparative cohort study in 32 hospital units (16 EPIQ intervention and 16 Standard Care), in eight pediatric hospitals in Canada.
In a study of the 16 EPIQ units (two at each hospital) only, the objectives were to: determine the effectiveness of evidence-based KT strategies implemented to achieve unit aims; describe the KT strategies implemented and their influence on pain assessment and management across unit types; and identify facilitators and barriers to their implementation.
Methods
Data were collected from each EPIQ intervention unit on targeted pain practices and KT strategies implemented, through chart review and a process evaluation checklist, following four intervention cycles over a 15-month period.
Results
Following the completion of the four cycle intervention, 78% of 23 targeted pain practice aims across units were achieved within 80% of the stated aims. A statistically significant improvement was found in the proportion of children receiving pain assessment and management, regardless of pre-determined aims (p < 0.001). The median number of KT strategies implemented was 35 and included reminders, educational outreach and materials, and audit and feedback. Units successful in achieving their aims implemented more KT strategies than units that did not. No specific type of single or combination of KT strategies was more effective in improving pain assessment and management outcomes. Tailoring KT strategies to unit context, support from unit leadership, staff engagement, and dedicated time and resources were identified as facilitating effective implementation of the strategies.
Conclusions
Further research is required to better understand implementation outcomes, such as feasibility and fidelity, how context influences the effectiveness of multifaceted KT strategies, and the sustainability of improved pain practices and outcomes over time.
doi:10.1186/s13012-014-0120-1
PMCID: PMC4263210
Pediatric procedural pain; Knowledge translation strategies; Tailored interventions; Quality improvement
4.  Pharmacy cases in Second Life: an elective course 
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.
doi:10.2147/AMEP.S35358
PMCID: PMC3650877  PMID: 23762008
Second Life; virtual worlds; pharmacy case studies; computer simulation; health education; pharmacy education
5.  Pharmaceutical care education in Kuwait: pharmacy students’ perspectives 
Pharmacy Practice  2014;12(3):411.
Background
Pharmaceutical care is defined as the responsible provision of medication therapy to achieve definite outcomes that improve patients’ quality of life. Pharmacy education should equip students with the knowledge, skills, and attitudes they need to practise pharmaceutical care competently.
Objective
To investigate pharmacy students’ attitudes towards pharmaceutical care, perceptions of their preparedness to perform pharmaceutical care competencies, opinions about the importance of the various pharmaceutical care activities, and the barriers to its implementation in Kuwait.
Methods
A descriptive, cross-sectional survey of pharmacy students (n=126) was conducted at Faculty of Pharmacy, Kuwait University. Data were collected via a pre-tested self-administered questionnaire. Descriptive statistics including percentages, medians and means Likert scale rating (SD) were calculated and compared using SPSS, version 19. Statistical significance was accepted at a p value of 0.05 or lower.
Results
The response rate was 99.2%. Pharmacy students expressed overall positive attitudes towards pharmaceutical care. They felt prepared to implement the various aspects of pharmaceutical care, with the least preparedness in the administrative/management aspects. Perceived pharmaceutical care competencies grew as students progressed through the curriculum. The students also appreciated the importance of the various pharmaceutical care competencies. They agreed/strongly agreed that the major barriers to the integration of pharmaceutical care into practice were lack of private counseling areas or inappropriate pharmacy layout (95.2%), lack of pharmacist time (83.3%), organizational obstacles (82.6%), and pharmacists’ physical separation from patient care areas (82.6%).
Conclusion
Pharmacy students’ attitudes and perceived preparedness can serve as needs assessment tools to guide curricular change and improvement. Student pharmacists at Kuwait University understand and advocate implementation of pharmaceutical care while also recognizing the barriers to its widespread adoption. The education and training provided at Kuwait University Faculty of Pharmacy is designed to develop students to be the change agents who can advance pharmacist-provided direct patient care.
PMCID: PMC4161404  PMID: 25243027
Students; Pharmacy; Education; Pharmacy; Curriculum; Attitude of Health Personnel; Professional Role; Kuwait
6.  Factors Associated With Health-Related Quality of Life of Student Pharmacists 
Objective. To assess the health-related quality of life (HRQoL) of student pharmacists and explore factors related to HRQoL outcomes of student pharmacists in a doctor of pharmacy (PharmD) program at a public university.
Methods. A survey instrument was administered to all student pharmacists in a PharmD program at a public university to evaluate differences and factors related to the HRQoL outcomes of first-year (P1), second-year (P2), third-year (P3), and fourth-year (P4) student pharmacists in the college. The survey instrument included attitudes and academic-related self-perception, a 12-item short form health survey, and personal information components.
Results. There were 304 students (68.6%) who completed the survey instrument. The average health state classification measure and mental health component scale (MCS-12) scores were significantly higher for P4 students when compared with the P1through P3 students. There was no difference observed in the physical component scale (PCS-12) scores among each of the 4 class years. Significant negative impact on HRQoL outcomes was observed in students with higher levels of confusion about how they should study (scale lack of regulation) and concern about not being negatively perceived by others (self-defeating ego orientation), while school satisfaction increased HRQoL outcomes (SF-6D, p<0.001; MCS-12, p=0.013). A greater desire to be judged capable (self-enhancing ego-orientation) and career satisfaction were positively associated with the PCS-12 scores (p<0.05).
Conclusion. Factors associated with the HRQoL of student pharmacists were confusion regarding how to study, ego orientation, satisfaction with the chosen college of pharmacy, and career satisfaction. First-year through third-year student pharmacists had lower HRQoL as compared with P4 students and the US general population. Support programs may be helpful for students to maintain or improve their mental and overall health.
doi:10.5688/ajpe7817
PMCID: PMC3930255  PMID: 24558275
health-related quality of life; student pharmacists; perceived self-efficacy; ego-orientation
7.  Perceptions of the educational environment of a new medical school, Saudi Arabia 
Background
Educational environment hugely impacts the learning process. An assessment of perceptions of students about the educational environment at Qassim University College of Medicine (QUCOM) would assist educators and college administration in gauging the quality of the learning in this venue. The aim of this study is to see the educational environment of an innovative undergraduate medical program through the eyes of students.
Methods
During the academic year 2011/2012, a survey was performed at QUCOM using the Dundee Ready Education Environment Measure (DREEM) questionnaire. All undergraduate students participated in the survey. Comparisons between, students’ responses according to their study years in the college and gender were taken into consideration. Data were entered and analyzed using SPSS version 17.0. The scores assigned by the students to questionnaire items were converted into and continuous variables and summarized as means.
Results
Out of 467 students enrolled at QUCOM 454 students (61% males and 39% females)participated in the study (response rate of 97%). The mean age of the participants was 21.4 (standard deviation: 2.2). The mean total score was 112, out of a possible maximum of 200. The mean total score for Perception of Learning was 26/48; for Perceptions of Teaching 25/44; for Academic Self perceptions 20/32; for Perceptions of Atmosphere 26/48 and for Social Self Perceptions 15/28. The mean score of 1.13 for Item 3 “There is a good support system for students who get stressed” was the lowest and is indicative of the pressures felt by the students. While the mean score of 3.24 for Item 15 “I have good friends in this school” was the highest showing good relationship between students. There were no significant differences of perceptions between genders and between basic sciences and clinical phases.
Conclusion
Students perceive the educational environment at QUCOM as having more positives than negatives. Certain areas need further exploration and improvements, which should serve as a decision support mechanism for educationists at QUCOM in rationalizing their priorities for reforms.
PMCID: PMC3883605  PMID: 24421744
Educational climate; Educational environment; Medical culture; Medical education
8.  Medicare Part D Community Outreach Train-the-Trainer Program for Pharmacy Faculty 
Objectives
To assess the train-the-trainer component of an initiative (Partners in D) to train pharmacy students to facilitate patient enrollment in the best Medicare Part D prescription drug plan (Part D).
Methods
Faculty members from 6 California colleges or schools of pharmacy were taught how to train pharmacy students about Medicare Part D and how to conduct outreach events targeting underserved patient populations. A preintervention and postintervention survey instrument was administered to determine participants' (1) knowledge of the Part D program; (2) skill using the Medicare Prescription Drug Plan Finder tool; and (3) confidence in their ability to train pharmacy students. Implementation of the Partners in D curriculum in faculty members' colleges or schools of pharmacy was also determined.
Results
Participants' knowledge of Part D, mastery of the Plan Finder, and confidence in teaching the material to pharmacy students all significantly improved. Within 8 weeks following the program, 5 of 6 colleges or schools of pharmacy adopted Partners in D coursework and initiated teaching the Partners-in-D curriculum. Four months afterwards, 21 outreach events reaching 186 Medicare beneficiaries had been completed.
Conclusions
The train-the-trainer component of the Partners in D program is practical and effective, and merits serious consideration as a national model for educating patients about Medicare Part D.
PMCID: PMC2703286  PMID: 19564996
Medicare Part D; Medicare Prescription Drug Plan Finder; train-the-trainer; faculty development
9.  Teaching Evaluation Practices in Colleges and Schools of Pharmacy 
Objective
To document teaching evaluation practices in colleges and schools of pharmacy.
Methods
A 51-item questionnaire was developed based on the instrument used in a previous study with modifications made to address changes in pharmacy education. An online survey service was used to distribute the electronic questionnaire to the deans of 98 colleges and schools of pharmacy in the United States.
Results
Completed surveys were received from 89 colleges and schools of pharmacy. All colleges/schools administered student evaluations of classroom and experiential teaching. Faculty peer evaluation of classroom teaching was used by 66% of colleges/schools. Use of other evaluation methods had increased over the previous decade, including use of formalized self-appraisal of teaching, review of teaching portfolios, interviews with samples of students, and review by teaching experts. While the majority (55%) of colleges/schools administered classroom teaching evaluations at or near the conclusion of a course, 38% administered them at the midpoint and/or conclusion of a faculty member's teaching within a team-taught course. Completion of an online evaluation form was the most common method used for evaluation of classroom (54%) and experiential teaching (72%).
Conclusion
Teaching evaluation methods used in colleges and schools of pharmacy expanded from 1996 to 2007 to include more evaluation of experiential teaching, review by peers, formalized self-appraisal of teaching, review of teaching portfolios, interviews with samples of students, review by teaching experts, and evaluation by alumni. Procedures for conducting student evaluations of teaching have adapted to address changes in curriculum delivery and technology.
PMCID: PMC2769525  PMID: 19885072
teaching; evaluation; assessment; survey
10.  Evaluation of Pre-Service Training on Integrated Management of Neonatal and Childhood Illness in Ethiopia 
Background
The Integrated Management of Newborn and Childhood Illness strategy equips health workers with essential knowledge and skills to effectively manage sick children with common neonatal and childhood diseases. Since in-service training is very demanding to achieve the desired coverage of training of health workers, pre-service training is taken as a solution. At the time of the survey, most public and some private health professionals' training institutions were conducting pre-service training. However, several concerns have been expressed on the training. Therefore, this survey was conducted to assess the status of pre-service Integrated Management of New-born and Childhood Illness training.
Methods
A cross sectional survey on health professional training institutes/schools to evaluate pre-service Integrated Management of Newborn and Childhood Illness training was conducted in November 2007. Data was collected using pre-tested questionnaires, focused group interviews with teachers and students, observation of students while managing sick children using Integrated Management of Newborn and Childhood Illness guidelines, and reviews of pediatric course outlines and other teaching/learning materials. Data was entered in computer and analyzed using SPSS for Windows version 12.0.1.
Results
Twenty nine health professionals' training institutions (34 academic programs) which have started pre-service training were included in the survey. Of the 34 programs 22 were diploma nursing, 6 Bachelor of Sciences nursing, 4 health officer and the remaining two medicine. Thirty (88.2%) programs have integrated it in their curriculum. All academic programs had at least one fulltime staff for Integrated Management of Newborn and Childhood Illness classroom instruction. Twenty nine (85.3%) programs had staff trained in case management skills. All the 34 academic programs taught health workers skills, 28(82.3%) used mixed approach. Integrated Management of Newborn and Childhood Illness was either incorporated for 21 (61.8%) or added to the previous teaching 11 (32.3%). The instructor to student ratio was low for most of the schools. Main challenges encountered in the pre-service teaching were constraints with trained staff and other resources each by 28 (82.3%) programs. Integrated Management of Newborn and Childhood Illness was included in student evaluation by all programs (100%). All students and instructors (100%) rated that Integrated Management of Newborn and Childhood Illness concept is very relevant or extremely relevant but majority said the time given was short. The over all mean score of students clinical practice was 63.5%.
Conclusion
This study demonstrated that Integrated Management of Newborn and Childhood Illness was introduced into the teaching programs of most health professional training institutions. The most preferred teaching style was the mixed approach. Group discussion and demonstration were commonly used methods and Integrated Management of Newborn and Childhood Illness questions were included in students' evaluation in almost all programs. Shortage of IMNCI trained staff and teaching materials were major challenges. The use of teaching materials prepared for pre-service training like handbook and model chapter was limited. Instructors and students attitude towards IMNCI was very good. The students overall performance in managing sick child as per the IMNCI guidelines was above average. We recommend that the respective bodies at every level make every effort to strengthen IMNCI pre-service teaching through revisiting curricula, facilitating staff training, availing teaching materials and allocating adequate time. Exploring for an alternative/innovative and sustainable training approach is an assignment for all.
PMCID: PMC3275900  PMID: 22434956
IMNCI; pre-service; Ethiopia
11.  Pharmacists’ attitude, perceptions and knowledge towards the use of herbal products in Abu Dhabi, United Arab Emirates 
Pharmacy Practice  2010;8(2):109-115.
Objective
The purpose of the study was to assess pharmacists’ current practice, perception and knowledge towards the use of herbal products in Abu Dhabi, United Arab Emirates (UAE). The study assessed the need for incorporating herbal medicine as a separate topic in under- graduate pharmacy student curricula.
Methods
The study was done on 600 pharmacists employed in Abu Dhabi, who were contacted electronically, out of which 271 had completed the survey. The data was collected using a structured questionnaire.
Results
Pharmacists’ use of herbal products is high in the UAE, as they have a high belief on the effectiveness of herbal products, and only age was found to be the most predominant variable that was influencing pharmacists’ personal use of herbal products (p-value=0.0171). Pharmacists were more knowledgeable on the uses/indications of herbal products (47%) rather than on other areas. Knowledge of the dispensing mode (prescription only or over the counter medicines) mandated by the Ministry of Health was quite good, however, it is to be noted that the source of information on the dispensing mode was provided by medical representatives (48%). Knowledge of dispensing mode of herbal products was found to be significantly influenced by the place of work with more knowledge of the dispensing mode by pharmacists working in the private sector (p-value 0.0007). The results from the study also underscores the need for including herbal medicine as a separate topic in pharmacy college curriculum and to provide for more seminars and continuing pharmacy education programs targeting pharmacists in the Emirate of Abu Dhabi.
Conclusions
Pharmacists need to be informed on indications, drug interactions, adverse events and precautions of herbal products. Concerned bodies must also provide them with regular continuing education programs apart from putting their efforts to incorporate relevant topics on herbal medicine in the pharmacy students’ curriculum.
PMCID: PMC4133064  PMID: 25132878
Herbal Medicine; Education; Pharmacy; United Arab Emirates
12.  Capacity of Hospitals to Partner with Academia to Meet Experiential Education Requirements for Pharmacy Students 
Purpose
Current hospital and health-system participation in and the future capacity for experiential education for pharmacy students was investigated.
Methods
An online survey of ASHP members identified as U.S. pharmacy directors was conducted to assess their current and future involvement in partnering with colleges and schools to meet the experiential education requirements for doctor of pharmacy students and the current status of the student learning experiences. Questionnaire items examined the factors on which expanded involvement in experiential education would depend, the nature of support provided by colleges and schools, the types of experiences available for students, respondents' perceptions of factors influencing the quality of experiential education, the value of experiential education to the sites, respondents' challenges and concerns about experiential education, and respondents' current capacity and projections for introductory and advanced experiences through 2012.
Results
Data from 549 respondents were analyzed. Most respondents indicated that they had conducted advanced experiences for their 2007 graduates and anticipated that they would continue to do so. Among the top challenges identified regarding advanced experiences were concerns about time to serve and be trained as preceptors and a lack of standardization and coordination among colleges and schools. Hospitals forecasting their future capacity to accommodate students indicated that their projections were highly dependent on the number of pharmacists at their hospitals. Many respondents noted that their capacity projections were tied to their ability to expand clinical services at their hospitals.
Conclusion
A survey of pharmacy directors suggested an ability of U.S. hospitals to conduct advanced experiential education opportunities for pharmacy students through 2012 and to expand introductory experiences.
PMCID: PMC2630142  PMID: 19214271
curriculum; data collection; education; pharmaceutical; pharmacy; institutional; hospital; pharmacy
13.  Emerging frontiers of pharmacy education in Saudi Arabia: The metamorphosis in the last fifty years 
The trends in the quality of biomedical education in pharmacy schools have witnessed significant changes in the 21st century. With the advent of continuous revision and standardization processes of medical curricula throughout the world, the focus has been on imparting quality education. This pedagogic paradigm has shifted to pharmacy schools. In Saudi Arabia, the concept of “medical and pharmacy education” is relatively new as mainstream pharmacy curriculum and universities were established only half a century ago. This period has seen major changes in the dimension of “pharmacy education” to keep pace with the education systems in the United States and Europe. As our knowledge and perceptions about pharmaceuticals change with time, this motivates educators to search for better teaching alternatives to the ever increasing number of enthusiastic and budding pharmacists. Recently, the academic system in Saudi Arabian Pharmacy has adopted a more clinically-oriented Pharm. D. curriculum. This paper deals with the major changes from the inception of a small pharmacy faculty in 1959, the College of Pharmacy at the King Saud University, Riyadh, to the model of progress and a prototype of pharmacy colleges in Saudi Arabia. The fifty year chronological array can be regarded as an epitome of progress in pharmacy education in Saudi Arabia from its traditional curriculum to the modern day Pharm. D. curriculum with a high population growth and expanding health care sector, the demand for qualified pharmacists is growing and is projected to grow considerably in the future. The number of pharmacy graduates is increasing each year by many folds and to meet the needs the system lays stress upon a constant revising and updating of the current curriculum from a global perspective.
doi:10.1016/j.jsps.2010.10.006
PMCID: PMC3744965  PMID: 23960737
Pharmacy education; Pharmacy curriculum; Pharm. D.; King Saud University; Saudi Arabia
14.  Basic life support knowledge of healthcare students and professionals in the Qassim University 
Objective
To evaluate the knowledge of basic life support (BLS) among students and health providers in Medicine, Pharmacy, Dentistry, and Allied Health Science Colleges at Qassim University.
Methodology
A cross sectional study was performed using an online BLS survey that was completed by 139 individuals.
Results
Ninety-three responders were medical students, 7 were medical interns, 6 were dental students, 7 were pharmacy students, 11 were medical science students and 15 were clinical practitioners. No responder scored 100% on the BLS survey. Only two out of the 139 responders (1.4%) scored 90–99%. Both of these individuals were fifth year medical students. Six responders (4.3%) scored 80–89%. Of these, 5 were fifth year medical students, and one was fourth-year medical student. Eleven responders (7.9%) scored 70–79%. Of these, eight were fifth year medical students, two were medical interns and one was a pharmacist. Twenty-three responders (16.5%) scored 60–69%. Of these, 11 were fifth year medical students, 1 was a fourth-year medical student, 3 were medical interns, 2 were medical science students, 1 was a dentistry student, and 5 were pharmacists. Twenty-eight responders (20.1%) scored 50–59%. Of these, 11 were fifth year medical students, 3 were fourth-year medical students, 1 was a third-year medical student, 1 was a second-year medical student, 2 were first-year medical students, 1 was a pharmacy student, 3 were dental students, 1 was a allied health science student, 2 were doctors, and 3 were pharmacists. The remaining 69 responders (49.6%) scored less than 50%.
Conclusion
Knowledge of BLS among medicine, pharmacy, dentistry, and allied health science students and health providers at Qassim University is poor and needs to be improved. We suggest that inclusion of a BLS course in the undergraduate curriculum with regular reassessment would increase awareness and application of this valuable life-saving skill set.
PMCID: PMC4166986  PMID: 25246881
15.  Online discussion for block teaching in postgraduate health professionals’ curriculum: the Ethiopian experience 
BMC Medical Education  2014;14:29.
Background
Online discussions as a method of instruction are a new approach in Ethiopia. There is no previous study in the Ethiopian context that has assessed students’ engagement and learning experience using this instruction method, which may offer a valuable complement to other instruction methods for intensive block teaching in a resource-limited environment. The aim of this study was to assess the value of online discussions in supporting students’ engagement and interaction with their peers and teachers in a block teaching postgraduate health professionals’ curriculum.
Methods
The research was conducted at Addis Ababa University College of Health Sciences, School of Medical Laboratory Sciences (SMLS), which has structured the curriculum around intensive block teaching. Between December 2011 and February 2012, two groups of full-time (N = 21) and part-time (N = 52) postgraduate students participated in online discussions as part of a Biostatistics and Research Methods module, in addition to other instructional methods. Every week, the course instructor initiated the online discussion by posting an assignment and articles with a few discussion questions. To evaluate the participants’ collective learning experience, the content of the email messages generated during these online discussions was analyzed qualitatively.
Result
A total of 702 emails were exchanged during the three week module, of which 250 emails (35.6%) were posted by full-time students and 452 emails (64.4%) by part-time Continuing Education Program (CEP) students. During the online discussion forum, students identified different statistical data analysis tools and their application for given data sets. In terms of message contents, 67% of full-time and 64% of part-time students’ messages were classified as learning experiences. However, a slightly higher proportion of part-time students’ posts were social messages. The majority of students in both groups reported high levels of satisfaction with their online experience.
Conclusion
Online discussion could be a valuable addition to face-to-face classroom teaching to improve students’ engagement and interaction in an intensive block teaching postgraduate curriculum where learners are engaged in a full work load with academic studies.
doi:10.1186/1472-6920-14-29
PMCID: PMC3924913  PMID: 24521146
Online discussion; Block teaching; Ethiopia
16.  Awareness, use, attitude and perceived need for Complementary and Alternative Medicine (CAM) education among undergraduate pharmacy students in Sierra Leone: a descriptive cross-sectional survey 
Background
The widespread use of CAM around the world requires health professionals including pharmacists to have the required knowledge to better advise their patients. This has lead to an increased need for the inclusion of CAM instruction into the mainstream undergraduate Pharmacy education. This study was designed to describe pharmacy students awareness, use, attitude and perceived need for CAM education at COMAHS-USL and at the same time, determine how these descriptive outcomes are influenced by the socio-demographic variables considered in this study.
Methods
A descriptive cross-sectional survey was conducted among undergraduate pharmacy students (n = 90) at the College of Medicine and Allied Health Sciences, University of Sierra Leone using a structured questionnaire. Chi square, fisher exact test, and general linear model univariate analysis were used to compare data between independent cohorts.
Results
All 90 (100%) of the students were aware and have used (except Ayurveda) at least one of the listed CAM modalities. Herbal/Botanical/Supplements followed by Spirituality/Prayer were the most commonly known and used CAM modalities. Almost two thirds of students considered the CAM modalities they have used to be effective and not harmful. Overall, pharmacy students had a positive attitude towards CAM (Mean attitudinal score = 34.9 ± 4. 5 (range 19–43)) with fourth and fifth year students showing a significantly less positive attitude as compared to the first, second and third year (B = −3.203 p = 0.001, 95% confidence interval - 5.093 to −1.314). The media [53 (58.9%)] was the most frequent source of information about CAM. Nearly all students [89 (98.9%)] agreed that CAM knowledge is important to them as future pharmacist and that CAM should be included into the Pharmacy curriculum at COMAHS-USL [81 (90.0%)].
Conclusion
Pharmacy students in Sierra Leone are aware of and have used at least one of the CAM modalities and do show a positive attitude towards CAM. This was demonstrated by their overwhelming endorsement for CAM course to be part of the undergraduate pharmacy training at COMAHS-USL. This study among others will inform and guide the development and implementation of CAM instruction at COMAHS-USL.
Electronic supplementary material
The online version of this article (doi:10.1186/1472-6882-14-438) contains supplementary material, which is available to authorized users.
doi:10.1186/1472-6882-14-438
PMCID: PMC4236455  PMID: 25380656
Complementary and alternative medicine; Pharmacy students; Awareness; Attitude; Use; Education; Sierra Leone
17.  Writing to Learn: An Evaluation of the Calibrated Peer Review™ Program in Two Neuroscience Courses 
Although the majority of scientific information is communicated in written form, and peer review is the primary process by which it is validated, undergraduate students may receive little direct training in science writing or peer review. Here, I describe the use of Calibrated Peer Review™ (CPR), a free, web-based writing and peer review program designed to alleviate instructor workload, in two undergraduate neuroscience courses: an upper- level sensation and perception course (41 students, three assignments) and an introductory neuroscience course (50 students; two assignments). Using CPR online, students reviewed primary research articles on assigned ‘hot’ topics, wrote short essays in response to specific guiding questions, reviewed standard ‘calibration’ essays, and provided anonymous quantitative and qualitative peer reviews. An automated grading system calculated the final scores based on a student’s essay quality (as determined by the average of three peer reviews) and his or her accuracy in evaluating 1) three standard calibration essays, 2) three anonymous peer reviews, and 3) his or her self review. Thus, students were assessed not only on their skill at constructing logical, evidence-based arguments, but also on their ability to accurately evaluate their peers’ writing. According to both student self-reports and instructor observation, students’ writing and peer review skills improved over the course of the semester. Student evaluation of the CPR program was mixed; while some students felt like the peer review process enhanced their understanding of the material and improved their writing, others felt as though the process was biased and required too much time. Despite student critiques of the program, I still recommend the CPR program as an excellent and free resource for incorporating more writing, peer review, and critical thinking into an undergraduate neuroscience curriculum.
PMCID: PMC3592621  PMID: 23493247
peer review, writing to learn; web-based learning; learning technology; Calibrated Peer Review
18.  Implementation of Integrated Learning Program in neurosciences during first year of traditional medical course: Perception of students and faculty 
Background
Our college introduced an integrated learning program (ILP) for first year undergraduates with an aim to develop, implement and evaluate a module for CNS in basic sciences and to assess the feasibility of an ILP in phase I of medical education in a college following traditional medical curriculum.
Methods
The idea of implementing ILP for Central Nervous System (CNS) in phase one was conceived by curriculum development committee drawn from faculty of all phases. After a series of meetings of curriculum development committee, inputs from basic science and clinical departments, a time table was constructed. Various teaching learning methods, themes for integrated didactic lectures, case based learning and clinical exposure were decided. Basic science faculty were made to participate actively in both case based learning and hospital visits along with clinical experts. The completed program was evaluated based on structured questionnaire.
Results
Sixty percent students rated the program good to excellent with reference to appreciation, understanding and application of basic science knowledge in health and disease. Seventy eight percent felt that this program will help them perform better in later days of clinical training. However sixty percent students felt that ILP will not help them perform better at the first professional examination. Seventy two per cent of faculty agreed that this program improved understanding and application of basic science knowledge of students. Ninety percent of faculty felt that this program will help them perform better in later days of clinical training.
Conclusion
The adoption of present integrated module for CNS and the use of multiple teaching learning methods have been proven to be useful in acquisition of knowledge from the student satisfaction point of view. Students and faculty expressed an overall satisfaction towards ILP for CNS. The study showed that it is possible to adopt an integrated learning module in the first year of medical course under a conventional curriculum.
doi:10.1186/1472-6920-8-44
PMCID: PMC2569025  PMID: 18811978
19.  Association of Medical Students' Reports of Interactions with the Pharmaceutical and Medical Device Industries and Medical School Policies and Characteristics: A Cross-Sectional Study 
PLoS Medicine  2014;11(10):e1001743.
Aaron Kesselheim and colleagues compared US medical students' survey responses regarding pharmaceutical company interactions with the schools' AMSA PharmFree scorecard and Institute on Medicine as a Profession's (IMAP) scores.
Please see later in the article for the Editors' Summary
Background
Professional societies use metrics to evaluate medical schools' policies regarding interactions of students and faculty with the pharmaceutical and medical device industries. We compared these metrics and determined which US medical schools' industry interaction policies were associated with student behaviors.
Methods and Findings
Using survey responses from a national sample of 1,610 US medical students, we compared their reported industry interactions with their schools' American Medical Student Association (AMSA) PharmFree Scorecard and average Institute on Medicine as a Profession (IMAP) Conflicts of Interest Policy Database score. We used hierarchical logistic regression models to determine the association between policies and students' gift acceptance, interactions with marketing representatives, and perceived adequacy of faculty–industry separation. We adjusted for year in training, medical school size, and level of US National Institutes of Health (NIH) funding. We used LASSO regression models to identify specific policies associated with the outcomes. We found that IMAP and AMSA scores had similar median values (1.75 [interquartile range 1.50–2.00] versus 1.77 [1.50–2.18], adjusted to compare scores on the same scale). Scores on AMSA and IMAP shared policy dimensions were not closely correlated (gift policies, r = 0.28, 95% CI 0.11–0.44; marketing representative access policies, r = 0.51, 95% CI 0.36–0.63). Students from schools with the most stringent industry interaction policies were less likely to report receiving gifts (AMSA score, odds ratio [OR]: 0.37, 95% CI 0.19–0.72; IMAP score, OR 0.45, 95% CI 0.19–1.04) and less likely to interact with marketing representatives (AMSA score, OR 0.33, 95% CI 0.15–0.69; IMAP score, OR 0.37, 95% CI 0.14–0.95) than students from schools with the lowest ranked policy scores. The association became nonsignificant when fully adjusted for NIH funding level, whereas adjusting for year of education, size of school, and publicly versus privately funded school did not alter the association. Policies limiting gifts, meals, and speaking bureaus were associated with students reporting having not received gifts and having not interacted with marketing representatives. Policy dimensions reflecting the regulation of industry involvement in educational activities (e.g., continuing medical education, travel compensation, and scholarships) were associated with perceived separation between faculty and industry. The study is limited by potential for recall bias and the cross-sectional nature of the survey, as school curricula and industry interaction policies may have changed since the time of the survey administration and study analysis.
Conclusions
As medical schools review policies regulating medical students' industry interactions, limitations on receipt of gifts and meals and participation of faculty in speaking bureaus should be emphasized, and policy makers should pay greater attention to less research-intensive institutions.
Please see later in the article for the Editors' Summary
Editors' Summary
Background
Making and selling prescription drugs and medical devices is big business. To promote their products, pharmaceutical and medical device companies build relationships with physicians by providing information on new drugs, by organizing educational meetings and sponsored events, and by giving gifts. Financial relationships begin early in physicians' careers, with companies providing textbooks and other gifts to first-year medical students. In medical school settings, manufacturers may help to inform trainees and physicians about developments in health care, but they also create the potential for harm to patients and health care systems. These interactions may, for example, reduce trainees' and trained physicians' skepticism about potentially misleading promotional claims and may encourage physicians to prescribe new medications, which are often more expensive than similar unbranded (generic) drugs and more likely to be recalled for safety reasons than older drugs. To address these and other concerns about the potential career-long effects of interactions between medical trainees and industry, many teaching hospitals and medical schools have introduced policies to limit such interactions. The development of these policies has been supported by expert professional groups and medical societies, some of which have created scales to evaluate the strength of the implemented industry interaction policies.
Why Was This Study Done?
The impact of policies designed to limit interactions between students and industry on student behavior is unclear, and it is not known which aspects of the policies are most predictive of student behavior. This information is needed to ensure that the policies are working and to identify ways to improve them. Here, the researchers investigate which medical school characteristics and which aspects of industry interaction policies are most predictive of students' reported behaviors and beliefs by comparing information collected in a national survey of US medical students with the strength of their schools' industry interaction policies measured on two scales—the American Medical Student Association (AMSA) PharmFree Scorecard and the Institute on Medicine as a Profession (IMAP) Conflicts of Interest Policy Database.
What Did the Researchers Do and Find?
The researchers compared information about reported gift acceptance, interactions with marketing representatives, and the perceived adequacy of faculty–industry separation collected from 1,610 medical students at 121 US medical schools with AMSA and IMAP scores for the schools evaluated a year earlier. Students at schools with the highest ranked interaction policies based on the AMSA score were 63% less likely to accept gifts as students at the lowest ranked schools. Students at the highest ranked schools based on the IMAP score were about half as likely to accept gifts as students at the lowest ranked schools, although this finding was not statistically significant (it could be a chance finding). Similarly, students at the highest ranked schools were 70% less likely to interact with sales representatives as students at the lowest ranked schools. These associations became statistically nonsignificant after controlling for the amount of research funding each school received from the US National Institutes of Health (NIH). Policies limiting gifts, meals, and being a part of speaking bureaus (where companies pay speakers to present information about the drugs for dinners and other events) were associated with students' reports of receiving no gifts and of non-interaction with sales representatives. Finally, policies regulating industry involvement in educational activities were associated with the perceived separation between faculty and industry, which was regarded as adequate by most of the students at schools with such policies.
What Do These Findings Mean?
These findings suggest that policies designed to limit industry interactions with medical students need to address multiple aspects of these interactions to achieve changes in the behavior and attitudes of trainees, but that policies limiting gifts, meals, and speaking bureaus may be particularly important. These findings also suggest that the level of NIH funding plays an important role in students' self-reported behaviors and their perceptions of industry, possibly because institutions with greater NIH funding have the resources needed to implement effective policies. The accuracy of these findings may be limited by recall bias (students may have reported their experiences inaccurately), and by the possibility that industry interaction policies may have changed in the year that elapsed between policy grading and the student survey. Nevertheless, these findings suggest that limitations on gifts should be emphasized when academic medical centers refine their policies on interactions between medical students and industry and that particular attention should be paid to the design and implementation of policies that regulate industry interactions in institutions with lower levels of NIH funding.
Additional Information
Please access these websites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1001743.
The UK General Medical Council provides guidance on financial and commercial arrangements and conflicts of interest as part of its good medical practice document, which describes what is required of all registered doctors in the UK
Information about the American Medical Student Association (AMSA) Just Medicine campaign (formerly the PharmFree campaign) and about the AMSA Scorecard is available
Information about the Institute on Medicine as a Profession (IMAP) and about its Conflicts of Interest Policy Database is also available
“Understanding and Responding to Pharmaceutical Promotion: A Practical Guide” is a manual prepared by Health Action International and the World Health Organization that medical schools can use to train students how to recognize and respond to pharmaceutical promotion
The US Institute of Medicine's report “Conflict of Interest in Medical Research, Education, and Practice” recommends steps to identify, limit, and manage conflicts of interest
The ALOSA Foundation provides evidence-based, non-industry-funded education about treating common conditions and using prescription drugs
doi:10.1371/journal.pmed.1001743
PMCID: PMC4196737  PMID: 25314155
20.  Perceptions of newly admitted undergraduate medical students on experiential training on community placements and working in rural areas of Uganda 
BMC Medical Education  2010;10:47.
Background
Uganda has an acute problem of inadequate human resources partly due to health professionals' unwillingness to work in a rural environment. One strategy to address this problem is to arrange health professional training in rural environments through community placements. Makerere University College of Health Sciences changed training of medical students from the traditional curriculum to a problem-based learning (PBL) curriculum in 2003. This curriculum is based on the SPICES model (student-centered, problem-based, integrated, community-based and services oriented). During their first academic year, students undergo orientation on key areas of community-based education, after which they are sent in interdisciplinary teams for community placements. The objective was to assess first year students' perceptions on experiential training through community placements and factors that might influence their willingness to work in rural health facilities after completion of their training.
Methods
The survey was conducted among 107 newly admitted first year students on the medical, nursing, pharmacy and medical radiography program students, using in-depth interview and open-ended self-administered questionnaires on their first day at the college, from October 28-30, 2008. Data was collected on socio-demographic characteristics, motivation for choosing a medical career, prior exposure to rural health facilities, willingness to have part of their training in rural areas and factors that would influence the decision to work in rural areas.
Results
Over 75% completed their high school from urban areas. The majority had minimal exposure to rural health facilities, yet this is where most of them will eventually have to work. Over 75% of the newly admitted students were willing to have their training from a rural area. Perceived factors that might influence retention in rural areas include the local context of work environment, support from family and friends, availability of continuing professional training for career development and support of co-workers and the community.
Conclusion
Many first year students at Makerere University have limited exposure to health facilities in rural areas and have concerns about eventually working there.
doi:10.1186/1472-6920-10-47
PMCID: PMC2904351  PMID: 20573221
21.  A Distance Education Course in Statistics 
Objectives
To evaluate the learning outcomes of an online, distance education course in statistics for doctor of pharmacy (PharmD) students.
Design
Lectures for the course were produced by the course faculty, converted into digital format (mp4), placed within the college's course management system, and video streamed to students. The course required students to interact with the course content using workbooks and simulations and with the instructor via VoIP examination reviews.
Assessment
A quasi-experimental study involving 4 groups of students was conducted. Second-year (P2) students were assigned randomly to 1 of 3 groups and asked to complete a precourse survey that contained: demographic information only (group 1); demographic items plus 10 items assessing statistics knowledge (group 2); or demographic items plus 20 items assessing statistics knowledge (group 3). At the end of the course, all students were given the same 20 items on the final examination (postcourse survey instrument). A control group consisting of randomly selected first-year (P1) students completed the 20-item precourse survey instrument. P1 and P2 students' scores on the 20-item precourse survey were not significantly different. Students who had taken a statistics course before entering the PharmD program scored higher on the precourse survey. P2 students in all 3 study groups had similar scores on the final examination (postcourse survey) (p = 0.43).
Conclusions
Students can be taught the basic principles of statistics and how to use statistics to read the pharmacy and medical literature entirely online. This study has significant implications for how classes traditionally taught in the classroom might be taught at a distance using innovative instructional technologies.
PMCID: PMC2996762  PMID: 21301606
distance education; statistics; online learning
22.  Evaluation of an Evidence-based Peer Teaching Assessment Program 
Objective
To determine faculty perceptions about an evidence-based peer teaching assessment system.
Methods
Faculty members who served as instructors and assessors completed questionnaires after year 1 (2002-2003) and year 4 (2005-2006) of the peer assessment program. Factors were evaluated using a Likert scale (1 = strongly disagree; 5 = strongly agree) and included logistics, time, fostering quality teaching, diversifying teaching portfolios, faculty mentoring, and value of structured discussion of teaching among faculty members. Mean responses from instructors and assessors were compared using student t tests.
Results
Twenty-seven assessors and 52 instructors completed survey instruments. Assessors and instructors had positive perceptions of the process as indicated by the following mean (SD) scores: logistics = 4.0 (1.0), time = 3.6 (1.1), quality teaching = 4.0 (0.9), diversifying teaching portfolios = 3.6 (1.2), faculty mentoring = 3.9 (0.9), and structured discussion of teaching = 4.2 (0.8). Assessors agreed more strongly than instructors that the feedback provided would improve the quality of lecturing (4.5 vs. 3.9, p < 0.01) and course materials (4.3 vs. 3.6, p < 0.01).
Conclusion
This peer assessment process was well-accepted and provided a positive experience for the participants. Faculty members perceived that the quality of their teaching would improve and enjoyed the opportunity to have structured discussions about teaching.
PMCID: PMC1913296  PMID: 17619645
teaching; assessment; peer assessment; faculty development; academic training
23.  Association of a quality improvement program with neonatal outcomes in extremely preterm infants: a prospective cohort study 
Background:
We previously demonstrated improvement in bronchopulmonary dysplasia and nosocomial infection among preterm infants at 12 neonatal units using the Evidence-based Practice for Improving Quality (EPIQ). In the current study, we assessed the association of Canada-wide implementation of EPIQ with mortality and morbidity among preterm infants less than 29 weeks gestational age.
Methods:
This prospective cohort study included 6026 infants admitted to 25 Canadian units between 2008 and 2012 (baseline year, n = 1422; year 1, n = 1611; year 2, n = 1508; year 3, n = 1485). Following a 1-year baseline period and 6 months of training and planning, EPIQ was implemented over 3 years. Our primary outcome was a composite of neonatal mortality and any of bronchopulmonary dysplasia, severe neurologic injury, severe retinopathy of prematurity, necrotizing enterocolitis and nosocomial infection. We compared outcomes for baseline and year 3 using multivariable analyses.
Results:
In adjusted analyses comparing baseline with year 3, the composite outcome (70% v. 65%; adjusted odds ratio [OR] 0.63, 95% confidence interval [CI] 0.51 to 0.79), severe retinopathy (17% v. 13%; OR 0.60, 95% CI 0.45 to 0.79), necrotizing enterocolitis (10% v. 8%; OR 0.73, 95% CI 0.52 to 0.98) and nosocomial infections (32% v. 24%; OR 0.63, 95% CI 0.48 to 0.82) were significantly reduced. The composite outcome was lower among infants born at 26 to 28 weeks gestation (62% v. 52%; OR 0.62, 95% CI 0.49 to 0.78) but not among infants born at less than 26 weeks gestational age (90% v. 88%; OR 0.73, 95% CI 0.44 to 1.20).
Interpretation:
EPIQ methodology was generalizable within Canada and was associated with significantly lower likelihood of the composite outcome, severe retinopathy, necrotizing enterocolitis and nosocomial infections. Infants born at 26 to 28 weeks gestational age benefited the most.
doi:10.1503/cmaj.140399
PMCID: PMC4162801  PMID: 25135927
24.  Impact of a First-Year Student Pharmacist Diabetes Self-Care Education Program 
Objective. To evaluate the effectiveness of a first-year diabetes self-care education program by measuring student pharmacists’ confidence and knowledge retention, and the clinical applicability of the skills learned.
Design. Integrated into a Pharmacy Practice Course, a 9-hour program consisting of lectures, a home glucose monitor assignment, and active-learning workshops was completed by 2 cohorts of first-year student pharmacists. Three survey instruments were developed and administered to the student pharmacists prior to the program, immediately after the program, and 9 months after the program to assess confidence, knowledge retention, and the clinical applicability of the knowledge and skills learned.
Assessment. In cohort 1, 54 student pharmacists (response rate 90%) perceived that their confidence and ability improved significantly (increased by 88% and 110%, respectively, from baseline, p<0.001). Overall knowledge of diabetes increased as well as indicated by a 40% increase in test scores (p<0.001). About two-thirds of student pharmacists used their training to assist patients with diabetes within 9 months of completing the program. Findings in cohort 2 mirrored those observed with cohort 1, indicating good generalizability.
Conclusions. An innovative first-year diabetes self-care education program significantly improved student pharmacists’ knowledge and confidence in providing diabetes self-care education, and the majority immediately used their leaned skills to assist diabetes patients and caregivers. Training first-year student pharmacists in diabetes care so they are prepared to use these skills as early as their first year of pharmacy school may be an effective approach to increasing the number of providers available to counsel and care for this expanding patient population.
doi:10.5688/ajpe7710215
PMCID: PMC3872934  PMID: 24371339
diabetes; survey; pharmacy education; knowledge retention; self-care
25.  A Multi-Instructor, Team-Based, Active-Learning Exercise to Integrate Basic and Clinical Sciences Content 
Objectives. To introduce a multiple-instructor, team-based, active-learning exercise to promote the integration of basic sciences (pathophysiology, pharmacology, and medicinal chemistry) and clinical sciences in a doctor of pharmacy curriculum.
Design. A team-based learning activity that involved pre-class reading assignments, individual-and team-answered multiple-choice questions, and evaluation and discussion of a clinical case, was designed, implemented, and moderated by 3 faculty members from the pharmaceutical sciences and pharmacy practice departments.
Assessment. Student performance was assessed using a multiple-choice examination, an individual readiness assurance test (IRAT), a team readiness assurance test (TRAT), and a subjective, objective, assessment, and plan (SOAP) note. Student attitudes were assessed using a pre- and post-exercise survey instrument. Students’ understanding of possible correct treatment strategies for depression improved. Students were appreciative of this true integration of basic sciences knowledge in a pharmacotherapy course and to have faculty members from both disciplines present to answer questions. Mean student score on the on depression module for the examination was 80.4%, indicating mastery of the content.
Conclusions. An exercise led by multiple instructors improved student perceptions of the importance of team-based teaching. Integrated teaching and learning may be achieved when instructors from multiple disciplines work together in the classroom using proven team-based, active-learning exercises.
doi:10.5688/ajpe76233
PMCID: PMC3305942  PMID: 22438605
team-based learning; depression; team teaching; active learning; pharmacotherapy

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