The shift in the pharmacist’s role from simply dispensing medications to effective delivery of pharmaceutical care interventions and drug therapy management has influenced pharmacy education.1-3 The educational focus has shifted from basic sciences to clinical and integrated courses that require incorporating active-learning strategies to provide pharmacy graduates with higher levels of competencies and specialized skills. As opposed to passive didactic lectures, active-learning strategies address the educational content in an interactive learning environment to develop interpersonal, communication, and problem-solving skills needed by pharmacists to function effectively in their new roles.4-6 One such strategy is using educational games. The aim of this paper is to review educational games adopted in different pharmacy schools and to aid educators in replicating the successfully implemented games and overcoming deficiencies in educational games. This review also highlights the main pitfalls within this research area.
Educational games; pharmacy education; students’ feedback; pharmacy students; active learning
To compare the regulations of state boards of pharmacy for pharmacist intern supervision and review publications of service-learning experiences in pharmacy curricula for methods of supervision.
Online state pharmacy statutes and board of pharmacy regulations were searched to characterize which states' regulations included provisions for the supervision of pharmacist interns, permitted nonpharmacist supervision for student volunteers, and included provisions on interns participating in the practice of pharmacy. Additionally, a PubMed search was conducted for articles describing the supervision of service-learning experiences of pharmacy students at various colleges and schools of pharmacy.
The state boards of pharmacy in all 51 jurisdictions included regulations for the supervision of pharmacist interns. Regulations specifically permitted only pharmacist supervision of interns in 45 (88%) jurisdictions, and 3 (6%) states included provisions allowing nonpharmacist supervision of pharmacist interns. Provisions allowing nonpharmacist supervision on a case-by-case basis existed in 6 (12%) jurisdictions. Among the 32 identified reports of service-learning experiences offered in pharmacy curricula, 14 contained the words “supervision” or “supervise,” and 9 indirectly described methods of student supervision.
State boards of pharmacy regulations largely prohibited nonpharmacist supervision of pharmacy students, and reports of pharmacy student service-learning experiences frequently omitted descriptions of student supervision. Boards of pharmacy should consider revising existing regulations to address the growing need for service-learning in pharmacy curricula.
service-learning; pharmacy intern; law; preceptor; experiential education; boards of pharmacy
Objectives. To characterize the use of high-fidelity mannequins and standardized patients in US pharmacy colleges and schools.
Methods. A survey instrument was sent to 105 doctor of pharmacy (PharmD) programs to collect data on the use of simulation and to identify barriers to using simulation-based teaching methods.
Results. Eighty-eight colleges and schools completed the survey instrument (response rate 84%). Of these, 14 did not use high-fidelity mannequins or standardized patients within the curriculum. Top barriers were logistical constraints and high resource cost. Twenty-three colleges and schools used simulation for introductory pharmacy practice experiences (IPPEs), 34 for interprofessional education, and 68 for evaluation of at least 1 core competency prior to advanced pharmacy practice experiences (APPEs).
Conclusions. Although the majority of US colleges and schools of pharmacy use simulation-based teaching methodologies to some extent in the pharmacy curricula, the role of simulation in IPPEs, interprofessional education, and assessment of competency-based skills could be expanded.
simulation; high-fidelity mannequins; standardized patients; survey research
Objective. To characterize and describe admission variables predictive of poor grade attainment by students in 2 pathways to a doctor of pharmacy (PharmD) program.
Methods. A retrospective analysis of course grades of PharmD students admitted from 2000 to 2009 (N= 1,019) in the traditional degree pathway (“1 plus 5” degree program) and the provisional pathway (admitted directly from high school) was performed.
Results. Four hundred three grades of D or less were earned by 183 (18%) students. There were more grades of D or less in the first pharmacy year. Receipt of an unsatisfactory grade was associated with all Pharmacy College Admission Test (PCAT) subcategory scores, PCAT composite score, cumulative prepharmacy coursework hours, prepharmacy grade point average (GPA), prepharmacy science and math GPA, and interview score for accepted students in the traditional pathway. For students in the provisional pathway, PCAT-quantitative analysis, PCAT composite score, prepharmacy cumulative GPA, prepharmacy science and math GPA, English American College Testing (ACT) score, and composite ACT score predicted poor grades.
Conclusion. Admissions committees should heed PCAT scores and GPAs, regardless of program pathway, while progression committees should focus on early program coursework when designing strategies to optimize retention.
admission; pharmacy students; grades; academic performance; retention
To document the type and extent of active-learning techniques used in US colleges and schools of pharmacy as well as factors associated with use of these techniques.
A survey instrument was developed to assess whether and to what extent active learning was used by faculty members of US colleges and schools of pharmacy. This survey instrument was distributed via the American Association of Colleges of Pharmacy (AACP) mailing list.
Ninety-five percent (114) of all US colleges and schools of pharmacy were represented with at least 1 survey among the 1179 responses received. Eighty-seven percent of respondents used active-learning techniques in their classroom activities. The heavier the teaching workload the more active-learning strategies were used. Other factors correlated with higher use of active-learning strategies included younger faculty member age (inverse relationship), lower faculty member rank (inverse relationship), and departments that focused on practice, clinical and social, behavioral, and/or administrative sciences.
Active learning has been embraced by pharmacy educators and is used to some extent by the majority of US colleges and schools of pharmacy. Future research should focus on how active-learning methods can be used most effectively within pharmacy education, how it can gain even broader acceptance throughout the academy, and how the effect of active learning on programmatic outcomes can be better documented.
pharmacy education; active learning; teaching; survey
Objective. To design and evaluate a doctor of pharmacy course exploring disease states commonly encountered in ambulatory care, while applying literature to clinical practice and promoting a continual learning mindset.
Design. This elective incorporated a learner-centered teaching approach. Each week, 2 groups of students were assigned a clinical trial to present to their peers. The focus was on clinical application and impact, rather than literature evaluation. A social networking group on Facebook was used to expose students to pharmacy information outside the classroom.
Assessment. Student grades were determined by multiple activities: presentations, participation and moderation of the Facebook group, class participation, quiz scores, and quiz question development. Course evaluations served as a qualitative assessment of student learning and perceptions, quizzes were the most objective assessment of student learning, and presentation evaluations were the most directed assessment of course goals.
Conclusion. This elective was an innovative approach to teaching ambulatory care that effectively filled a curricular void. Successful attainment of the primary course goals and objectives was demonstrated through course evaluations, surveys, and quiz and presentation scores.
pharmacy education; ambulatory care; elective development
To identify prepharmacy variables that predicted graduate performance on the North American Pharmacist Licensure Examination (NAPLEX) test.
Undergraduate and pharmacy school transcripts for 424 students admitted to the Texas Tech University Health Sciences Center (TTUHSC) Doctor of Pharmacy program from the fall of 1996 to the fall of 2001 were reviewed. NAPLEX scores were provided by the Texas State Board of Pharmacy (TSBP). Statistical analyses were performed using SPSS, 11.5.
Grade point average, composite Pharmacy College Admission Test (PCAT) score, and California Critical Thinking Skills Test (CCTST) score were each positively correlated with NAPLEX score (p < 0.001 for each). Type of school where organic chemistry was completed; age; advanced courses taken in chemistry, biology, and math; and attainment of a BS, BA, or MS degree were not significantly correlated with NAPLEX score (p > 0.05). When comparing students who successfully graduated and passed the NAPLEX with students who were academically suspended or who failed the NAPLEX, there were significant differences in mean PCAT scores, CCTST score, and age (p < 0.05 for all). Stepwise regression analysis applying all admission variables except PCAT subscores revealed a correlation between predictors (composite PCAT, prepharmacy GPA, and age) and NAPLEX score (p < 0.001).
Composite PCAT score was the strongest predictor of success and failure on the NAPLEX. However, the combined predictive ability of PCAT and CCTST scores, prepharmacy GPA, and age was relatively low. Thus, a full review of each candidate's application is justified.
North American Pharmacist Licensure Examination (NAPLEX); admissions; PCAT; grade point average; performance; CCTST
To evaluate the correlation between specific prepharmacy college variables and academic success in the Texas Tech doctor of pharmacy degree program.
Undergraduate and pharmacy school transcripts for 424 students admitted to the Texas Tech doctor of pharmacy degree program between May 1996 and May 2001 were reviewed in August of 2005. Statistical analyses were performed using SPSS Release 11.5. The undergraduate college variables included prepharmacy grade point-average (GPA), organic chemistry school type (2- or 4-year institution), chemistry, biology, and math courses beyond required prerequisites, and attainment of a bachelor of science (BS), bachelor of arts (BA), or master of science (MS) degree. Measurements of academic success in pharmacy school included cumulative first-professional year (P1) GPA, cumulative GPA (grade point average of all coursework finished to date), and graduation without academic delay or suspension.
Completing advanced biology courses and obtaining a BS degree prior to pharmacy school were each significantly correlated with a higher mean P1 GPA. Furthermore, the mean cumulative GPA of students with a BS degree was 86.4 versus cumulative GPAs of those without a BS degree which were 84.9, respectively (p = 0.039). Matriculates with advanced prerequisite biology coursework or a BS degree prior to pharmacy school were significantly more likely to graduate from the doctor of pharmacy program without academic delay or suspension (p = 0.021 and p = 0.027, respectively). Furthermore, advanced biology coursework was significantly and independently associated with graduating on time (p = 0.044).
Advanced biology coursework and a science baccalaureate degree were significantly associated with academic success in pharmacy school. On multivariate analysis, only advanced biology coursework remained a significant predictor of success.
academic success; pharmacy students; grade point average; graduation; prerequisites; performance
Objective. To qualitatively analyze free-text responses gathered as part of a previously published survey in order to systematically identify common concerns facing pharmacy experiential education (EE) programs.
Methods. In 2011, EE directors at all 118 accredited pharmacy schools in the US were asked in a survey to describe the most pressing issues facing their programs. Investigators performed qualitative, thematic analysis of responses and compared results against demographic data (institution type, class size, number of practice sites, number and type of EE faculty member/staff). Expert and novice investigators identified common themes via an iterative process. To check validity, additional expert and novice reviewers independently coded responses. The Cohen kappa coefficient was calculated and showed good agreement between investigators and reviewers.
Results. Seventy-eight responses were received (66% response rate) representing 75% of publicly funded institutions and 71% of schools with class sizes 51-150. Themes identified as common concerns were site capacity, workload/financial support, quality assurance, preceptor development, preceptor stipends, assessment, onboarding, and support/recognition from administration. Good agreement (mean percent agreement 93%, ƙ range=0.59-0.92) was found between investigators and reviewers.
Conclusion. Site capacity for student placements continues to be the foremost concern for many experiential education programs. New concerns about preceptor development and procedures for placing and orienting students at individual practice sites (ie, “onboarding”) have emerged and must be addressed as new accreditation standards are implemented.
experiential learning; pharmacy education; clinical clerkship; qualitative research; capacity building; advanced pharmacy practice experiences; introductory pharmacy practice experiences; preceptor development; quality assurance
A review of the literature on the effectiveness of educational technologies to teach patient care skills to pharmacy students was conducted. Nineteen articles met inclusion criteria for the review. Seven of the articles included computer-aided instruction, 4 utilized human-patient simulation, 1 used both computer-aided instruction and human-patient simulation, and 7 utilized virtual patients. Educational technology was employed with more than 2700 students at 12 colleges and schools of pharmacy in courses including pharmacotherapeutics, skills and patient care laboratories, drug diversion, and advanced pharmacy practice experience (APPE) orientation. Students who learned by means of human-patient simulation and virtual patients reported enjoying the learning activity, whereas the results with computer-aided instruction were mixed. Moreover, the effect on learning was significant in the human-patient simulation and virtual patient studies, while conflicting data emerged on the effectiveness of computer-aided instruction.
computer-aided instruction; human-patient simulators; virtual patients; pharmacy
Objective. To determine which student characteristics and performance criteria in the prepharmacy and doctor of pharmacy (PharmD) program predict success on the North American Pharmacist Licensure Examination (NAPLEX).
Methods. Transcripts and NAPLEX scores were reviewed for 432 graduates from the Xavier University of Louisiana College of Pharmacy between 2008 and 2011.
Results. The preadmission variables that correlated with NAPLEX scores included math-science grade point average (GPA), cumulative GPA, student type (internal or transfer), and having no unsatisfactory grades (p<0.001). In the PharmD program, cumulative GPA, on-time graduation, and having no unsatisfactory grades in the prepharmacy and PharmD programs correlated with NAPLEX scores (p<0.001).
Conclusion. Having no unsatisfactory grades in the prepharmacy program and a high cumulative GPA in the PharmD program were identified as significant predictors of success on the NAPLEX.
North American Pharmacist Licensure Examination; admissions; grade point average
Objective. To determine whether human patient simulation (HPS) is superior to case-based learning (CBL) in teaching diabetic ketoacidosis (DKA) and thyroid storm (TS) to pharmacy students.
Design. In this cross-over, open-label, single center, randomized control trial, final-year undergraduate pharmacy students enrolled in an applied therapeutics course were randomized to HPS or CBL groups. Pretest, posttest, knowledge retention tests, and satisfaction survey were administered to students.
Assessment. One hundred seventy-four students participated in this study. The effect sizes attributable to HPS were larger than CBL in both cases. HPS groups performed significantly better in posttest and knowledge retention test compared to CBL groups pertaining to TS case (p<0.05). Students expressed high levels of satisfaction with HPS sessions.
Conclusion. HPS was superior to CBL in teaching DKA and TS to final-year undergraduate pharmacy students.
human patient simulation; case based learning; diabetic ketoacidosis; thyroid storm; pharmacy education
Objective. To evaluate the impact on pharmacy students of a communication course, which used role-playing to develop active-learning skills.
Design. Students role-playing pharmacists in patient care scenarios were critiqued by students and pharmacist faculty members. Grading was performed using the rubric inspired by Bruce Berger’s Communication Skills for Pharmacists. Written skills were evaluated using student written critique questionnaires. Students completed precourse and postcourse self-assessment surveys. Preceptor evaluations were analyzed for course impact.
Assessment. Students demonstrated improvement in oral skills based on role-play scores (45.87/50) after practice sessions. The average score based on the student questionnaire was 9.31/10. Gain was demonstrated in all defined course objectives. Impact on introductory pharmacy practice experience (IPPE) communication objectives was insignificant. Student evaluations for course and teaching strategy reflected a high average.
Conclusion. Study results demonstrated improvement in oral and written communication skills that may help improve interprofessional teamwork between pharmacists and other health care providers.
interprofessional communication; role-play; pharmacist; oral communication skills; written communication
Objective. To assess pharmacy students’ ability to retain advanced cardiac life support (ACLS) knowledge and skills within 120 days of previous high-fidelity mannequin simulation training.
Design. Students were randomly assigned to rapid response teams of 5-6. Skills in ACLS and mannequin survival were compared between teams some members of which had simulation training 120 days earlier and teams who had not had previous training.
Assessment. A checklist was used to record and assess performance in the simulations. Teams with previous simulation training (n=10) demonstrated numerical superiority to teams without previous training (n=12) for 6 out of 8 (75%) ACLS skills observed, including time calculating accurate vasopressor infusion rate (83 sec vs 113 sec; p=0.01). Mannequin survival was 37% higher for teams who had previous simulation training, but this result was not significant (70% vs 33%; p=0.20).
Conclusion. Teams with students who had previous simulation training demonstrated numerical superiority in ACLS knowledge and skill retention within 120 days of previous training compared to those who had no previous training. Future studies are needed to add to the current evidence of pharmacy students’ and practicing pharmacists’ ACLS knowledge and skill retention.
simulation; retention; instructional design; advanced cardiac life support
During the past 15 years, the curriculum content for nonprescription medication and self-care therapeutics has expanded significantly. Self-care courses ranging from stand-alone, required courses to therapeutic content and skills laboratories, have evolved in colleges and schools of pharmacy to accommodate rapid changes related to nonprescription medications and to meet the needs of students. The design of and content delivery methods used in self-care courses vary among institutions. Teaching innovations such as team-based learning, role playing/vignettes, videos, and social media, as well as interdisciplinary learning have enhanced delivery of this content. Given that faculty members train future pharmacists, they should be familiar with the new paradigms of Nonprescription Safe Use Regulatory Expansion (NSURE) Initiative, nonprescription medications for chronic diseases, and the growing trends of health and wellness in advancing patient-care initiatives. This paper reviews the significant changes that may be impacting self-care curriculums in the United States.
self-care; nonprescription medications; pharmacy education
To determine the value of employing the Learning and Study Strategies Inventory (LASSI), Defining Issues Test (DIT), and Watson-Glaser Critical Thinking Appraisal (WGCTA) in predictive models for first-year pharmacy student academic performance.
Six years of pharmacy student admission and progression data were evaluated. Additional predictive validity offered by these variables over a model of prepharmacy grade point average and pharmacy college admission test (PCAT) score was examined.
None of the 3 measures offered the ability to predict first-semester or first-year academic performance over and above GPA and PCAT.
The LASSI, DIT, and WGCTA do not appear to assess abilities that are directly related to academic performance; however, these instruments may be useful in assessing other student attributes that are highly desirable for the practice of pharmacy.
Learning and Study Strategies Inventory (LASSI); Defining Issues Test (DIT); Watson-Glaser Critical Thinking Appraisal (WGCTA); academic progression, admission requirements, grade point average (GPA); pharmacy college admission test (PCAT), performance, admission
innovation; pharmacy education; accreditation; admissions
A review of the literature relating to the use of virtual patients in teaching pharmaceutical care to pharmacy students was conducted. Only 7 articles met the inclusion criteria for the review and 4 of the studies were conducted in North America. Few articles identified by the review used virtual patient technology that was true-to-life and/or validated.
virtual patient; pharmaceutical care; systematic review
Objective. To provide students with an opportunity to participate in medicinal chemistry research within the doctor of pharmacy (PharmD) curriculum.
Design. We designed and implemented a 3-course sequence in drug design or drug synthesis for pharmacy students consisting of a 1-month advanced elective followed by two 1-month research advanced pharmacy practice experiences (APPEs). To maximize student involvement, this 3-course sequence was offered to third-year and fourth-year students twice per calendar year.
Assessment. Students were evaluated based on their commitment to the project’s success, productivity, and professionalism. Students also evaluated the course sequence using a 14-item course evaluation rubric. Student feedback was overwhelmingly positive. Students found the experience to be a valuable component of their pharmacy curriculum.
Conclusion. We successfully designed and implemented a 3-course research sequence that allows PharmD students in the traditional 4-year program to participate in drug design and synthesis research. Students report the sequence enhanced their critical-thinking and problem-solving skills and helped them develop as independent learners. Based on the success achieved with this sequence, efforts are underway to develop research APPEs in other areas of the pharmaceutical sciences.
APPE; research; drug design; synthesis; medicinal chemistry
Objective. To determine the degree to which 3 different educational interventions enhance cultural competency in pharmacy students.
Methods. Students were equally divided among a simulated-patient activity group, a written case-scenarios group, and a formal lecture group. Mean scores for pre- and post-intervention cultural self-assessment surveys were compared.
Results. In the simulation group, there were significant positive changes in the cultural skills and cultural desire components; in the case-scenario group, there was a significant positive change in the cultural awareness component; and in the lecture group, there were significant positive changes in the cultural skills and cultural empathy components. With respect to the cultural skills component, there was greater post-intervention improvement in the simulation and lecture groups than in the case-scenario group.
Conclusions. There were significant positive changes within each group, indicating that ideologies and behaviors may be altered based on the educational intervention received. However, a 1-hour practicum may not be sufficient to enhance cultural competency.
cultural competency; simulated patients; written case scenarios; pharmacy students
This paper describes the faculty enrichment activities and outcomes of a faculty orientation and development committee at a college of pharmacy. The committee used a continuous quality improvement (CQI) framework that included needs assessment, planning and implementation of programs and workshops, assessment of activities, and evaluation of feedback to improve future programming. Some of the programs established by the committee include a 3-month orientation process for new hires and development workshops on a broad range of topics including scholarship (eg, research methods), teaching (eg, test-item writing), and general development (mentorship). Evidence of the committee's success is reflected by high levels of faculty attendance at workshops, positive feedback on workshop evaluations, and overall high levels of satisfaction with activities. The committee has served as a role model for improving faculty orientation and retention.
faculty; faculty retention; faculty orientation; faculty development
Objective: To identify differences among faculty members in various health professional training programs in perceived benefits and challenges of implementing interprofessional education (IPE).
Methods: A 19-item survey using a 5-point Likert scale was administered to faculty members across different health disciplines at a west coast, multicollege university with osteopathic medicine, pharmacy, and physician assistant programs.
Results: Sixty-two of 103 surveys (60.2%) were included in the study. Faculty members generally agreed that there were benefits of IPE on patient outcomes and that implementing IPE was feasible. However, group differences existed in belief that IPE improves care efficiency (p=0.001) and promotes team-based learning (p=0.001). Program divergence was also seen in frequency of stressing importance of IPE (p=0.009), preference for more IPE opportunities (p=0.041), and support (p=0.002) within respective college for IPE.
Conclusions: Despite consensus among faculty members from 3 disciplines that IPE is invaluable to their curricula and training of health care students, important program level differences existed that would likely need to be addressed in advance IPE initiatives.
Interprofessional education (IPE); interdisciplinary education; interprofessional relations; pharmacy education; faculty member attitudes and opinions
Objective. To develop, implement, and assess student-learning outcomes from an assignment designed to expose first-year pharmacy students (P1) to a wide range of pharmacy career pathways.
Design. Students enrolled in a required Pharmacy Practice and Ethics course at the Lebanese American University chose 1 pharmacist career to investigate from a suggested list of 28 career pathways. Students completed a literature review on the selected career, interviewed a pharmacist practicing that career path in Lebanon, wrote a paper, and prepared and delivered a summary presentation to their classmates about the career pathway. Students peer evaluated their classmates after each presentation.
Assessment. More than 85% of the students scored ≥70% on the assignment based on their achievement of student learning outcomes. Responses on an anonymous questionnaire showed that more than 94.6% of students were satisfied with the extent to which the course allowed them to meet the established learning outcomes.
Conclusion. A career exploration assignment provided pharmacy students with an opportunity to widen their knowledge and understanding of the different career pathways that are available for them.
career; pharmacy; students; career pathways
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
Using simulation to teach pharmacy practice skills may result in knowledge that is transferable to patient care. Key areas in which simulation is being used in pharmacy education include therapeutics, communication, physical assessment, patient safety, and populations to which students may have infrequent exposure. Enhancing interprofessional healthcare team dynamics and the skills of practicing healthcare professionals are other practical applications for simulation education. Educators should continue to be creative in the incorporation of simulation into pharmacy education and conduct more studies on the impact of simulation education on patient care to demonstrate the efficacy of this teaching modality.
assessment; interprofessional education; simulation