To evaluate an instructional model for teaching clinically relevant medicinal chemistry.
An instructional model that uses Bloom's cognitive and Krathwohl's affective taxonomy, published and tested concepts in teaching medicinal chemistry, and active learning strategies, was introduced in the medicinal chemistry courses for second-professional year (P2) doctor of pharmacy (PharmD) students (campus and distance) in the 2005-2006 academic year. Student learning and the overall effectiveness of the instructional model were assessed. Student performance after introducing the instructional model was compared to that in prior years.
Student performance on course examinations improved compared to previous years. Students expressed overall enthusiasm about the course and better understood the value of medicinal chemistry to clinical practice.
The explicit integration of the cognitive and affective learning objectives improved student performance, student ability to apply medicinal chemistry to clinical practice, and student attitude towards the discipline. Testing this instructional model provided validation to this theoretical framework. The model is effective for both our campus and distance-students. This instructional model may also have broad-based applications to other science courses.
medicinal chemistry; distance education; instructional model
Objective. To provide doctor of pharmacy (PharmD) students with highly integrated, comprehensive and up-to-date instruction related to the pharmacology of antiarrhythmic drugs.
Design. Students were taught the medicinal chemistry, pharmacology, and therapeutics of antiarrhythmic agents in the cardiology module presented in quarter 7 of the PharmD curriculum. Important foundational information for this topic was presented to students in prerequisite physiology courses and pathophysiology courses offered earlier in the curriculum. Emphasis was placed on student critical thinking and active involvement. Weekly recitation sessions afforded students the opportunity to apply the information they learned regarding arrhythmia pharmacotherapy to comprehensive patient cases.
Assessment. Student comprehension was measured using class exercises, short quizzes, case write-ups, comprehensive examinations, group exercises, and classroom discussion. Students were afforded the opportunity to evaluate the course, and the instructors as well as rate the degree to which the course achieved its educational outcomes.
Conclusion. Students learned about cardiac arrhythmias through a high-quality, interdisciplinary series of classes presented by faculty members with extensive experience related to the pharmacology and pharmacotherapy of cardiac arrhythmias.
arrhythmia; antiarrhythmic agents; pharmacology; integrated curriculum
To integrate process-oriented guided-inquiry learning (POGIL) team-based activities into a 1-semester medicinal chemistry course for doctor of pharmacy (PharmD) students and determine the outcomes.
Students in the fall 2007 section of the Medicinal Chemistry course were taught in a traditional teacher-centered manner, with the majority of class time spent on lectures and a few practice question sets. Students in the fall 2008 and fall 2009 sections of Medicinal Chemistry spent approximately 40% of class time in structured self-selected teams where they worked through guided-inquiry exercises to supplement the lecture material.
The mean examination score of students in the guided-inquiry sections (fall 2008 and fall 2009) was almost 3 percentage points higher than that of students in the fall 2007 class (P < 0.05). Furthermore, the grade distribution shifted from a B-C centered distribution (fall 2007 class) to an A-B centered distribution (fall 2008 and fall 2009 classes).
The inclusion of the POGIL style team-based learning exercises improved grade outcomes for the students, encouraged active engagement with the material during class time, provided immediate feedback to the instructor regarding student-knowledge deficiencies, and created a classroom environment that was well received by students.
medicinal chemistry; guided inquiry; active learning; process-oriented guided-inquiry learning (POGIL); team-based learning
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
Objectives. To implement and evaluate a 3-year reflective writing program incorporated into introductory pharmacy practice experiences (IPPEs) in the first- through third-year of a doctor of pharmacy (PharmD) program.
Design. Reflective writing was integrated into 6 IPPE courses to develop students’ lifelong learning skills. In their writing, students were required to self-assess their performance in patient care activities, identify and describe how they would incorporate learning opportunities, and then evaluate their progress. Practitioners, faculty members, and fourth-year PharmD students served as writing preceptors.
Assessment. The success of the writing program was assessed by reviewing class performance and surveying writing preceptor’s opinions regarding the student’s achievement of program objectives. Class pass rates averaged greater than 99% over the 8 years of the program and the large majority of the writing preceptors reported that student learning objectives were met. A support pool of 99 writing preceptors was created.
Conclusions. A 3-year reflective writing program improved pharmacy students’ reflection and reflective writing skills.
pharmacy student; introductory pharmacy practice experience; lifelong learning
To design, implement, and assess a women's health elective course for second- and third-year doctor of pharmacy (PharmD) students.
A women's health course was developed, focusing on health promotion, disease prevention, and treatment throughout a woman's lifespan. Course format included didactic lectures, in-class activities, peer teaching, case studies, and reading assignments.
Student performance and learning were assessed based on class participation, (graded 3 times during the semester), activities and assignments, (graded weekly), and 2 formal written assessments. Student survey results indicated perceptions of women's health had changed in 3 ways: a realization that many diseases manifest differently in women than men, an increased awareness of numerous diseases not addressed in the required curriculum that affect women, and a greater appreciation of the physiological and pharmacokinetic differences that increase the potential for adverse drug reactions in women.
An elective course in women's health was well received by PharmD students. Excellent student performance in weekly active-learning activities and class participation, however, did not translate into excellent performance on subsequent formal assessments.
women's health; active learning; peer teaching
To create, implement, and evaluate a pharmacy course on motivational interviewing.
A 3-hour elective course was created to train doctor of pharmacy (PharmD) students in brief patient-centered motivational interviewing counseling strategies that have proven effective with the types of health issues most commonly addressed in pharmacy settings. Students were assisted in developing their skills through required readings, interactive lectures, in-class demonstrations and practice sessions, out of class skills practice, one-on-one supervision provided by doctoral level clinical health psychology students, and written reflections on each class session.
Students demonstrated significant improvement in motivational interviewing skills and a high level of motivation for and confidence in using these skills in their future practice. Students overall assessment of the course and supervision process was highly positive.
This patient-centered counseling skills course was feasible and produced improvements in PharmD students' counseling skills and increased their motivation and confidence to use motivational interviewing skills in their future communications with patients.
motivational interviewing; communication; counseling; curricular development; multidisciplinary learning
To provide students with an understanding of the principles and applications of human genetics and genomics in drug therapy optimization, patient care, and counseling.
A 2-credit hour course entitled Principles of the Human Genome, Pharmacogenomics, and Bioinformatics was offered to third-professional year PharmD students. Written examinations, in-class exercises, and a written paper evaluating the current literature were used to evaluate student learning.
Student course ratings on the pedagogical format of the course and the relevance of course material to professional practice have improved significantly since first implementation in 2002.
This course provided pharmacy students with an understanding of pharmacogenetics ranging from genetic principles and the inheritance of complex traits to specific examples of pharmacogenomics in drug therapy.
pharmacogenomics; pharmacogenetics; new course; genomics; bioinformatics
To implement and assess a current events project added to the curriculum of a pharmacotherapy course in a doctor of pharmacy (PharmD) program.
Third-year PharmD students researched a current event topic related to infectious diseases and prepared a written and verbal summary that was presented to their classmates.
Scores on course examinations and quizzes to assess students' knowledge of current events material were equal to or better than non-current events material. Based upon a student self-assessment survey, this active-learning activity increased students' awareness of current events related to pharmacy practice, and their understanding of the process to prepare and present information to a group in a statistically significant manner. There was a positive but not significant improvement in students' desire to prepare and present information to a group; ability to evaluate, organize, and present information in a written report; and ability to verbally present material to a group.
The addition of a current events presentation as an active-learning activity significantly increased students' awareness of current events related to pharmacy practice and their understanding of the process to prepare and present information to a group.
current events; peer teaching; active learning; pharmacotherapy
To design, implement, and evaluate a strategy to actively engage doctor of pharmacy (PharmD) students at local and distant sites in a pharmacokinetics course.
A Web-based system was designed that allowed second-year pharmacy students to choose whether to participate in a instructor-led class discussion session by registering prior to or during the first 10 minutes of each class. The instructor then used the program to randomly select students to respond to questions based on the assigned reading. Five percent of the overall course grade was based on class participation.
For each class session, an average of 85% of students at both the local and distant campuses registered for participation in class discussion and approximately 5% were called on to respond to questions. Student responses to course survey questions regarding the participation strategy were overwhelmingly positive, with 75%-90% agreeing that the strategy more actively engaged them in classroom activities, resulting in improved learning. Student performance in all assessment categories was almost identical at the local and distant sites.
Implementation of a participation strategy in a large course synchronously taught on 2 campuses is feasible and results in successful engagement of most students at both sites.
class participation; class discussion; active learning; synchronous teaching; distance learning
Objective. To determine whether longitudinal design and delivery of evidence-based decision making (EBDM) content was effective in increasing students’ knowledge, skills, and confidence as they progressed through a doctor of pharmacy (PharmD) curriculum.
Design. Three student cohorts were followed from 2005 to 2009 (n=367), as they learned about EBDM through lectures, actively researching case-based questions, and researching and writing answers to therapy-based questions generated in practice settings.
Assessment. Longitudinal evaluations included repeated multiple-choice examinations, confidence surveys, and written answers to practice-based questions (clinical inquiries). Students’ knowledge and perception of EBDM principles increased over each of the 3 years. Students’ self-efficacy (10-items, p<0.0001) and perceived skills (7-items, p<0.0001) in applying EBDM skills to answer practice-based questions also increased. Graded clinical inquiries verified that students performed satisfactorily in the final 2 years of the program.
Conclusions. This study demonstrated a successful integration of EBDM throughout the curriculum. EBDM can effectively be taught by repetition, use of real examples, and provision of feedback.
evidence-based decision making; longitudinal evaluation; curriculum; evidence-based medicine
Students’ writing can provide better insight into their thinking than can multiple-choice questions. However, resource constraints often prevent faculty from using writing assessments in large undergraduate science courses. We investigated the use of computer software to analyze student writing and to uncover student ideas about chemistry in an introductory biology course. Students were asked to predict acid–base behavior of biological functional groups and to explain their answers. Student explanations were rated by two independent raters. Responses were also analyzed using SPSS Text Analysis for Surveys and a custom library of science-related terms and lexical categories relevant to the assessment item. These analyses revealed conceptual connections made by students, student difficulties explaining these topics, and the heterogeneity of student ideas. We validated the lexical analysis by correlating student interviews with the lexical analysis. We used discriminant analysis to create classification functions that identified seven key lexical categories that predict expert scoring (interrater reliability with experts = 0.899). This study suggests that computerized lexical analysis may be useful for automatically categorizing large numbers of student open-ended responses. Lexical analysis provides instructors unique insights into student thinking and a whole-class perspective that are difficult to obtain from multiple-choice questions or reading individual responses.
Medicinal chemistry instruction at Creighton University is designed to provide an in-depth scientifically grounded and clinically relevant learning experience for pharmacy students. Each topic covered in the 2-semester required course sequence is selected based on the general utility of the compounds in question and/or the therapeutic importance of the drugs in treating life-threatening diseases. All lessons provided to campus- and Web-based students by the author are in the form of a descriptive and conversational narrative and course requirements are in place to assure that students read the lesson prior to the class period in which it is discussed. Learning tools and aids are provided to help students more readily discern the most critical aspects of each lesson, to practice required critical thinking and structure analysis skills, and to self-assess competency in meeting specific learning objectives. This manuscript illustrates this approach by sharing a lesson on the chemistry and clinically relevant structure-activity relationships of proton pump inhibitors.
medicinal chemistry; proton pump inhibitors; gastroesophageal reflux disease; ulcer
To teach doctor of pharmacy (PharmD) students how to apply organ clearance concepts in a clinical setting in order to optimize dose management, select the right drug product, and promote better patient-centered care practices.
A student-focused 5-hour topic entitled "Organ Clearance Concepts: Modeling and Clinical Applications" was developed and delivered to second-year PharmD students. Active-learning techniques, such as reading assignments and thought-provoking questions, and collaborative learning techniques, such as small groups, were used. Student learning was assessed using application cards and a minute paper.
Overall student responses to topic presentation were overwhelmingly positive. The teaching strategies here discussed allowed students to play an active role in their own learning process and provided the necessary connection to keep them motivated, as mentioned in the application cards and minute paper assessments. Students scored an average of 88% on the examination given at the end of the course.
By incorporating active-learning and collaborative-learning techniques in presenting material on organ clearance concept, students gained a more thorough knowledge of dose management and drug-drug interactions than if the concepts had been presented using a traditional lecture format. This knowledge will help students in solving critical patient situations in a real-world context.
To describe the development and assessment of monographs as an assignment to incorporate evidence-based medicine (EBM) and pharmacoeconomic principles into a third-year pharmacoeconomic course.
Eight newly FDA-approved drugs were assigned to 16 teams of students, where each drug was assigned to 2 teams. Teams had to research their drug, write a professional monograph, deliver an oral presentation, and answer questions posed by faculty judges. One team was asked to present evidence for inclusion of the drug into a formulary, while another team presented evidence against inclusion.
The teams' average score on the written report was 99.1%; on the oral presentation, 92.5%, and on the online quiz given at the end of the presentations, 77%.
Monographs are a successful method of incorporating and integrating learning across different concepts, as well as increasing relevance of pharmacoeconomics in the PharmD curriculum.
evidence-based medicine; pharmacoeconomics; pharmacy and therapeutics committee
Objectives. To build an integrated medicinal chemistry learning community of campus and distance pharmacy students though the use of innovative technology and interdisciplinary teaching.
Design. Mechanisms were implemented to bring distance students into campus-based medicinal chemistry classrooms in real time, stimulate interaction between instructors and various student cohorts, and promote group work during class. Also, pharmacy clinician colleagues were recruited to contribute to the teaching of the 3 medicinal chemistry courses.
Assessment. Student perceptions on the value of technology to build community and advance learning were gleaned from course evaluations, in class feedback, and conversations with class officers and student groups. Responses on a survey of second-year students confirmed the benefits of interdisciplinary content integration on engagement and awareness of the connection between drug chemistry and pharmacy practice. A survey of clinician colleagues who contributed to teaching the 3 medicinal chemistry courses found their views were similar to those of students.
Conclusions. The purposeful use of technology united learners, fostered communication, and advanced content comprehension in 3 medicinal chemistry courses taught to campus and distance students. Teaching collaboration with pharmacy clinicians enhanced learner interest in course content and provided insight into the integrated nature of the profession of pharmacy.
interdisciplinary; technology; medicinal chemistry; learning communities
To create and implement a web-based written assignment to evaluate student's abilities to select appropriate nonprescription medications and recommend therapy.
Each student developed a patient case study from an assigned condition, made treatment recommendations, and provided patient counseling information using at least 2 nonprescription medicines. The active-learning exercise required students to apply information previously presented in a large classroom setting.
Cases most commonly submitted included therapy for burns, acne, conjunctivitis, lacerations, and poison ivy. One-hundred five students completed a 5-item questionnaire regarding the assignment. The majority of the respondents (51.9%) felt the assignment helped to reinforce course content and 58.1% felt it made them more comfortable with making product recommendations.
The Personal Pharmacy assignment was an effective learning activity for enhancing student's understanding and appropriate selection of nonprescription medicines.
active learning; nonprescription medicines; self-care
To develop, implement, and assess a required patient safety course for second-year doctor of pharmacy students.
A patient safety course was developed that included didactic lectures, case studies, in-class activities, and reading assignments. Written examinations and essays were used to evaluate student learning. In addition, a modified minute paper and a pre- and post-intervention student self-assessment survey were used to assess course outcomes.
Results examining the utility of the course teaching format and the relevance of the material in meeting the course outcomes are presented and discussed. The self-assessment course survey indicated major improvements in the students' knowledge and skills, readiness for knowledge application, and commitment to improve patient safety.
The course provided pharmacy students with an increased level of understanding of the principles and concepts of patient safety.
patient safety; medication errors; medical errors
To implement and assess a required public health poster project in a doctor of pharmacy (PharmD) program.
Third-year PharmD students collaborated in pairs to research a public health topic relating to pharmacy practice. Each student group prepared an informational poster, while receiving feedback from a faculty mentor at each stage of the project. The students presented their completed posters at a statewide pharmacy conference.
Faculty members evaluated the posters with a grading rubric, and students completed a survey instrument that assessed the overall experience. In general, faculty members rated the class highly across all domains of the grading rubric. The class generally agreed that the poster project increased their awareness of public health issues related to pharmacy practice, overall knowledge of public health, and presentation skills.
The implementation of a poster project was well received by students and faculty members as an effective method for enhancing public health instruction in the PharmD program at North Dakota State University.
poster presentations; public health; active-learning
Objective. To evaluate pharmacy students' self-assessment skills with an electronic portfolio program using mentor evaluators.
Design. First-year (P1) and second-year (P2) pharmacy students used online portfolios that required self-assessments of specific graded class assignments. Using a rubric, faculty and alumni mentors evaluated students' self-assessments and provided feedback.
Assessment. Eighty-four P1 students, 74 P2 students, and 59 mentors participated in the portfolio program during 2010-2011. Both student groups performed well overall, with only a small number of resubmissions required. P1 students showed significant improvements across semesters for 2 of the self-assessment questions; P2 students' scores did not differ significantly. The P1 scores were significantly higher than P2 scores for 3 questions during spring 2011. Mentors and students had similar levels of agreement with the extent to which students put forth their best effort on the self-assessments.
Conclusion. An electronic portfolio using mentors based inside and outside the school provided students with many opportunities to practice their self-assessment skills. This system represents a useful method of incorporating self-assessments into the curriculum that allows for feedback to be provided to the students.
portfolio; assessment; self-assessment; professional development; mentor
To evaluate the learning outcomes of an online, distance education course in statistics for doctor of pharmacy (PharmD) students.
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.
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).
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.
distance education; statistics; online learning
To determine whether a required course addressing complementary and alternative medicine would change students' attitudes and perceptions toward the subject and the likelihood that they would recommend various complementary and alternative medicine therapies
A survey instrument was administered to all third-year PharmD students on the first and last days of the course. The degree of change in response for each question was assessed and analyzed in order to determine the impact of the course.
Fifty-five students (93%) completed both the preintervention and postintervention survey instrument. Over half of the students had changes in their attitudes regarding their future competence, their personal interest and experience with complementary and alternative medicine, and their personal beliefs towards the subject after completion of the course. A large proportion of students also had changes in the likelihood that they would recommend a natural product for various conditions and that they would recommend complementary and alternative medicine therapies in general.
A required course addressing complementary and alternative medicine and natural products significantly changed students' attitudes and perceptions toward the subject, as well as their likelihood to recommend various complementary and alternative medicine therapies and natural products in a professional setting.
complementary medicine; alternative medicine
Objective. To develop and implement a 1-credit-hour oncology pharmacy practice elective course for third-year pharmacy students and assess its impact on examination scores in a required pharmacotherapeutics course.
Design. Major topics were identified to focus on therapeutic management and supportive care of the oncology patient. Psychosocial topics were incorporated to help pharmacy students better relate to oncology patients.
Assessment. Learning was assessed by means of 2 computer-based examinations, weekly reflection posts, and a completed oncology service-learning project and reflection paper. Students enrolled in the course achieved higher pharmacotherapeutics oncology section examination scores than students who had not taken the course. Also, this course increased students’ interest in oncology pharmacy.
Conclusion. The oncology pharmacy elective course has received overwhelmingly positive feedback from students and student enrollment continues to grow. We will continue to offer this course to future practitioners.
oncology; cancer; pharmacy; elective course; curriculum; pharmacotherapy
To implement an audience response system (ARS) to improve student motivation and attention during lectures and provide immediate feedback to the instructor concerning student understanding of lecture content in a Physiological Chemistry/Molecular Biology course.
Students used ARS devices to respond to strategically placed questions throughout physiological chemistry/molecular biology lectures. The instructor inserted 6 to 7 questions that promoted student/class interactivity into each of several 50-minute lectures to focus students' attention and provide feedback on students' comprehension of material.
Ninety-eight percent of first-year pharmacy (P1) students (n = 109) reported that strategically placed ARS questions throughout lectures helped them maintain attention. Reports from an independent focus group indicated that students favored this strategy. Furthermore, ARS feedback helped the instructor gauge student comprehension and adjust lectures accordingly.
Focused, strategically placed ARS questions throughout lectures may help students maintain attention and stay motivated to learn. Feedback from these questions also allows instructors to adapt lectures to address areas of deficiency.
audience response system; physiological chemistry course; technology; active learning
Objective. To develop and implement an elective course to increase pharmacy students’ awareness of legislation that might affect the pharmacy profession and to promote advocacy for the profession.
Design. Students participated in class discussions regarding current legislative issues and methods to advocate for the pharmacy profession. Assignments included a student-led presentation of the advocacy agendas for various pharmacy organizations, a take-home examination, participation in class debates, and a legislative presentation.
Assessment. Forty-eight students enrolled in the elective course over 3 years. Assignments and class participation were assessed using grading rubrics. At the end of the semester, students completed a questionnaire to assess the overall benefit of the course.
Conclusions. Participation in an elective course devoted to pharmacy political advocacy increased awareness of legislation and the desire to become involved in pharmacy organizations to promote the pharmacy profession.
pharmacy; advocacy; legislation; policy; elective