The development and impact of active learning strategies on self-confidence in a newly designed first-year self-care pharmacy course - outcomes and experiences

Empowering competence: A program-wide active learning framework for a pharmacy program

OBJECTIVE

This study aimed to develop and implement a program-wide active learning framework to guide active learning and assessment efforts in an entry-to-practice competency-based Doctor of Pharmacy program.

METHODS

The development of the framework involved 3 stages: creation of a framework aligned with the program's guiding principles, provision of training and support to faculty and students, and evaluation of the students' and academic staff satisfaction using an online survey over 2 academic years (2022-2023). Data from this survey were analyzed descriptively.

RESULTS

An active learning framework that was aligned with the program's guiding principles while allowing flexibility for individual teaching styles was developed. It consisted of 4 stages: preclass preparation, in-class work, prelaboratory preparation, and in-laboratory activities (emphasizing knowledge acquisition and competency development). Academic staff surveys reported higher satisfaction of staff in year 2 than year 3 of the program, with indications of further training on specific modalities. Students' satisfaction improved from year 2 to 3, particularly, in areas related to class objectives, learning environment, and feedback.

CONCLUSION

The transformation of a curriculum that includes the evolution of the teaching and learning strategy is a complex, long-term project that deserves continuing attention. Having frameworks in place helps the management, instructors, and students to understand the global direction, stay focused, and support the implementation of competency-based education and student-centered learning.

Community pharmacies and the empowerment of self-care in the United States

Background

As part of self-care, patients prevent diseases or conditions, maintain, or enhance their current health status, and address current health challenges. As a key member of the healthcare team, the role of the pharmacist in relation to self-care is important, given the ease of access to pharmacists in a variety of care settings.

Objectives

To describe the structure and function of self-care within community pharmacies throughout the United States (U.S.).

Methods

The literature within the U.S. was reviewed related to self-care definitions and practice, the role and training of the pharmacist, and challenges and opportunities for pharmacists.

Results

Within the U.S., self-care is broader than simply products found in the "over-the-counter" (OTC) section of pharmacies; it includes pharmacists involvement in disease prevention, evaluation and maintenance of current health status, and assistance in managing health challenges. There is growing recognition of the significance of pharmacists in aiding patients in self-care, due to publication of outcomes related to pharmacist-provided self-care support. Accreditation standards require student pharmacists to develop knowledge and competency related to the broadest definition of self-care; resources exist related to curricular content and student evaluation and assessment support. The evolving role of the pharmacist in relation to self-care has presented challenges in terms of recognition and renumeration for services and workload issues. Efforts are currently underway to address these challenges.

Conclusions

Spiraling health care costs, poor health outcomes, and continued health disparities indicate a need to better support U.S. patients on their health care journey, which often begins with self-care. There is a plethora of opportunities for pharmacists to advocate for expanding roles related to self-care, including participation in national efforts to recognize the outcomes of pharmacists in self-care.

Gamification in pharmacy education: a systematic quantitative literature review

OBJECTIVES

Gamification involves applying game attributes to non-game contexts and its educational use is increasing. It is essential to review the outcomes and the efficacy of gamification to identify evidence to support its use in pharmacy education.

THIS ARTICLE

systematically and quantitatively reviews and evaluates the alignment of learning outcomes and the quality of peer-reviewed literature reporting gamification in pharmacy education.

KEY FINDINGS

A literature search was undertaken in February 2022 using CINAHL Complete, MEDLINE, Science Direct, Scopus and ERIC databases, via keywords (game* OR gaming OR gamif*) AND pharmac* AND education. Google Scholar was searched using 'gamification of pharmacy education' and 'serious games in pharmacy education'. Data extracted included type of gamified intervention, mode of delivery, game fidelity, intended learning outcomes and outcomes reported. Quality assessments aligned with key aspects of the SQUIRE-EDU Reporting Guidelines. Of 759 abstracts and 95 full-text papers assessed, 66 articles met the inclusion criteria. They described gamification from 12 countries in the education of 8272 pharmacy and health professional students. Gamified interventions ranged from board games to immersive simulations, with escape rooms most frequently reported. Reporting quality was inconsistent, with observed misalignment between intended learning outcomes and outcomes reported, an apparent overreliance on student perceptions as primary data and a lack of reference to reporting guidelines.

SUMMARY

Gamification is included in the curricula of many pharmacy degrees, across multiple subject areas. This review identified evidence gaps and reinforces the need for improved quality of gamification research, critical alignment of learning outcomes with evaluation, and use of reporting guidelines.

Exploring the Effect of Virtual Education on Student Pharmacists’ Confidence toward APPE Readiness

A drop in confidence in Advanced Pharmacy Practice Experience (APPE) readiness was observed in students in the Class of 2022 prior to starting APPEs. We aim to investigate potential causes of students’ low confidence in APPE preparedness to provide solutions and to prevent this outcome with future students. We evaluated students’ perceived confidence to start APPEs and compared this to curricular changes, employment obligations, and the impact of COVID-19 on delivery of the pre-APPE and APPE curriculum. Students’ low confidence with APPE readiness was not indicative of the following factors: (1) delivery of the didactic curriculum, (2) students’ performance in the didactic curriculum, or (3) number of summative assessments in key didactic courses. Rather, the low confidence perception may have been due to differences such as a fully remote didactic experience in the P3 year, more virtual Introductory Pharmacy Practice Experiences (IPPEs), a reduced course load in the P3 spring semester, and changes to a pre-APPE preparatory course compared to other class years. The students’ self-reported midpoint scores during their first APPE block and preceptor’s evaluations on their performance contrasted their pre-APPE perceptions. Frequent in-person and on-site skills assessments throughout the didactic curriculum seem to reinforce confidence before APPEs.

Digital Storytelling Review in a Pharmacy Self-Care Course

Digital storytelling is a type of active learning that allows instructors to simulate real-life situations through a series of connected videos. While this technique has been used in other healthcare education disciplines, its use in pharmacy has not been well documented. A digital storytelling model was incorporated in a required self-care pharmacy course to assess if the technique was helpful to improve the knowledge, confidence, and satisfaction of students. Due to a shift in online learning, the self-care course offered a remote exam review session containing a digital storytelling model, and this approach was compared to an in-person exam review that followed a lecture-based model held earlier in the course. Pre- and post-knowledge assessments were given to determine the impact of the digital storytelling review. There were 50 students involved in both sessions and there was a 70% response rate in the digital storytelling group and a 90% response rate in the lecture-based group. Students’ knowledge numerically improved, but not to a statistically significant level for most questions. Nonetheless, students reported more confidence (p < 0.05) in their ability to pass the upcoming exam following the digital storytelling review. Thematic analysis revealed that the digital storytelling session was engaging and interactive, though time-management and breakout rooms could be further optimized. Based on these results, exam review in a required self-care pharmacy course using a digital storytelling format may be a suitable method for students to apply course content and may particularly be of utility in online or hybrid courses.

Improvement of student confidence and competence through a self-care skills multi-course integration

INTRODUCTION

Our goal was to evaluate the impact of integrating self-care concepts in class, a pharmacy practice laboratory, and an introductory pharmacy practice experience on student confidence and competence in self-care counseling.

METHODS

Two cohorts of first-year professional pharmacy students were taught self-care topics using team-based learning (TBL) pedagogy. Students then applied their knowledge in two different settings: a patient-counseling simulation in a pharmacy practice laboratory and a real patient encounter at a pharmacy practice site. Students were evaluated on their performance at both settings using a validated rubric as well as on their self-reported confidence before and after the classroom engagement and after the counseling practice. Wilcoxon signed-rank and Friedman tests were used to examine pre-post changes and changes across all three assessments.

RESULTS

Reported student confidence levels rose after classroom learning and again after the real patient encounter. Student improvement was mirrored in rubric scores from the pharmacy practice laboratory simulation as well as from the pharmacy practice site encounter.

CONCLUSIONS

This research showed that integration of self-care topics across three different settings improved student confidence and competence in self-care counseling, demonstrating the value of providing multiple opportunities for students to apply knowledge and practice skills. Further research is needed to apply this longitudinal structure of learning to other classes in the pharmacy curriculum.

Factors Associated with Student Pharmacists' Academic Progression and Performance on the National Licensure Examination

Objective. To examine predictors of Doctor of Pharmacy (PharmD) students' on-time graduation, dismissal from pharmacy school, and scores on their first attempt at taking the North American Pharmacist Licensure Examination (NAPLEX). Methods. A retrospective review of student records for the graduating classes of 2015-2018 at a college of pharmacy was performed. Data on the following were collected: student demographics/characteristics (age, gender, race/ethnicity, financial need), having an undergraduate degree, undergraduate science grade point average (GPA), Pharmacy College Admission Test composite score percentile, pharmacy school GPAs for the didactic portion of the curriculum, Pre-NAPLEX score, on-time graduation from pharmacy school, dismissal from pharmacy school, and outcome (pass/fail) of first-attempt at taking the NAPLEX. Binary logistic regression analysis was conducted. Results. Of the 657 students whose records were included in the study, the majority were female (60%) and non-Hispanic white (70%). Higher first-year GPA was associated with increased likelihood of on-time graduation, while increased age and having an undergraduate degree were associated with a decreased likelihood of on-time graduation. A higher first-year GPA was associated with decreased likelihood of being dismissed from pharmacy school. Appearing before the Academic Standing and Promotion Review Committee for unsatisfactory academic performance was associated with decreased likelihood of passing the NAPLEX. Conclusion. First-year pharmacy school GPA is a critical predictor for student pharmacists in terms of on-time graduation and dismissal, and may have consequences for later NAPLEX outcome. Pharmacy schools should closely monitor students' performance during the first year and provide support to students experiencing academic difficulties.

Flipped classroom as an effective approach in enhancing student learning of a pharmacy course with a historically low student pass rate

BACKGROUND AND PURPOSE

The flipped classroom has not been fully exploited to improve tertiary education in Malaysia. A transformation in pharmacy education using flipped classrooms will be pivotal to resolve poor academic performance in certain courses. This study aimed to investigate the effectiveness of the flipped classroom in improving student learning and academic performance in a course with a historically low pass rate.

EDUCATIONAL ACTIVITY AND SETTING

A quasi-experimental pre- and posttest control group design was employed. The experimental group experienced the flipped classroom for selected topics while the control group learned in a traditional classroom. Analysis of covariance was utilized to compare the performance on the final exam using the grade point of a pre-requisite course as the covariate. Students' perceptions of their experience in the flipped classroom were gauged through a web-based survey.

FINDINGS

Student performance on the final exam was significantly higher in the flipped classroom group. The lowest-scoring students benefitted the most in terms of academic performance. More than two-thirds of students responded positively to the use of the flipped classroom and felt more confident while participating in classes and tests.

SUMMARY

The flipped classroom is academically beneficial in a challenging course with a historically low pass rate; it was also effective in stimulating learning interest. The current study identified that for the flipped classroom to be successful, the role of educators, the feasibility of the approach, and the acceptance of students were important.

Scoping Pharmacy Students' Learning Outcomes: Where Do We Stand?

Background: The professional abilities of graduate pharmacists have been associated with pharmacy undergraduates’ educational settings and features. This study aimed to perform a scoping review on how students’ learning outcomes are achieved, including learning assessment strategies, focusing on current pharmacy practice education. Methods: Relevant keywords, e.g., “pharmacy practice”, “(students or undergraduates)” and “outcomes” were browsed in Public/Publisher MEDLINE, Scientific Electronic Library Online, Directory of Open Access Journals, and other relevant databases for recently published sources (2018 and 2017). Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria were followed to assure the scoping quality. All types of students’ learning outcomes were addressed for indexed publications in English, Portuguese or Spanish. Reviews, descriptive studies and commentaries were excluded. Study data are presented in tables comprising objectives, methods, number of participants and main research findings. Results: Overall, 100 studies were identified and 22 were selected. The selected studies were distributed into seven main topics: real practices (n = 9); active-learning strategies (n = 5); comparisons between different teaching pedagogies (n = 3); pharmacy curriculum (n = 2); and other evaluations (n = 3). Conclusions: Studies on pharmacy students’ learning outcomes are limited. Pharmacy undergraduates’ performance was dependent on the learning strategies and extension of syllabus implementation.