The use of a disease state simulation assignment increased students' empathy and comfort with diabetes nutrition counseling

Assessing Person-Centered Care in Pharmacy Education

OBJECTIVES

The ability to provide person-centered care is an important aspect of the Pharmacists' Patient Care Process (PPCP); therefore, the assessment of students' skills in this area is essential in pharmacy curricula. The objectives of this article were to: (1) review literature on the assessment of student pharmacists' ability to provide person-centered care, (2) describe trends in assessment practices relevant to this skill, and (3) provide recommendations for pharmacy educators on the assessment of this skill and further research.

FINDINGS

A total of 62 sources were included in the analysis for this review. Results were characterized by the educational setting in which the assessment took place (ie, didactic, skills, and/or experiential), assessment strategies (eg, self-evaluations, simulations, knowledge-based quizzes, reflections, objective structured clinical exams), and themes observed for commonly assessed skill areas (eg, empathy, communication, interprofessional teamwork, and social determinants of health). Gaps in the assessment of person-centered care, particularly regarding specific steps of the PPCP (follow-up and documentation) were identified in the sources reviewed.

SUMMARY

Assessment practices of students' ability to provide person-centered care within the context of the PPCP were reviewed, and key findings relevant to pharmacy education were described. More holistic person-centered care assessment strategies that encompass the full PPCP are recommended.

Curricular Assessment Blueprint and Needs Analysis for the Social, Administrative, and Behavioral Foundational Sciences

OBJECTIVES

The objective of this integrative review is to analyze conceptual topics, applied content, teaching and learning strategies, and assessment methods within social, administrative, and behavioral sciences (SAS) syllabi and literature. The goal is to evaluate opportunities for enhancing the adoption and implementation of Curricular Outcomes and Entrustable Professional Activities 2022. Recommendations to better inform curriculum and assessment planning efforts are presented for programs and faculty seeking to optimize the integration of SAS content.

FINDINGS

Our search yielded 69 SAS-related syllabi from the American Association of Colleges of Pharmacy Connect repository and 296 publications from pharmacy journals focused on education. Most SAS literature was published in the didactic setting, which represents an opportunity to interweave and apply SAS knowledge concepts through the experiential, cocurricular, and interprofessional settings. In the future, it would be prudent to thoughtfully design assessment measures that encompass both summative and formative evaluations. The literature findings offer valuable insights and examples regarding content, teaching strategies, and assessment methods. These findings can serve as a practical framework, providing ideas and guidance for programs and faculty aiming to enhance the integration of SAS content into their curricula.

SUMMARY

In response to the recent guidelines from Curricular Outcomes and Entrustable Professional Activities 2022 and the release of the Accreditation Council for Pharmacy Education Standards 2025, programs and faculty have the responsibility to thoughtfully revise and improve the delivery and assessment of SAS content. The intentional integration of SAS knowledge, skills, and attitudes should be guided by a collaborative effort to develop pharmacists who deliver effective person-centered care and are well-equipped to navigate the complexities of health care.

Impact of a Geriatric Pharmacy Elective on Student Knowledge, Attitudes, and Empathy Regarding Older Adults

OBJECTIVE

To evaluate the impact of a Geriatric Pharmacy elective on pharmacy students' knowledge, attitudes, and empathy regarding older adults.

METHODS

Enrolled students in a 15-week Geriatric Pharmacy elective during 3 consecutive academic years were invited to complete a precourse and postcourse survey. The survey consisted of the revised Palmore facts on aging quiz, the University of California at Los Angeles geriatric attitudes scale, the Kiersma-Chen empathy scale, and demographic questions. The presurvey and postsurvey data were compared and the impact of demographic factors on student knowledge, attitudes, and empathy was assessed in an exploratory analysis.

RESULTS

Sixty-six students participated in the study. Scores on the revised Palmore facts on aging quiz and the University of California at Los Angeles geriatric attitudes scale increased significantly postsurvey compared with presurvey. Student scores on the Kiersma-Chen empathy scale increased on the postsurvey compared with the presurvey, but this increase was not statistically significant. Student self-reported experience with older adults, race, and the course year impacted student performance.

CONCLUSION

A geriatric elective positively impacted the students' knowledge and attitudes toward older adults. Future research should include validity and reliability testing of geriatric assessment scales in a diverse student population to ensure effective assessment of student knowledge, attitudes, and empathy in this patient population.

Advancing empathy and emotional intelligence among pharmacy students: A comparative mixed-methods study with peer role-play simulation intervention

INTRODUCTION

Due to the significance of interpersonal empathy and emotional intelligence in pharmaceutical practices, it has become essential to emphasize its importance in pharmacy education. The aim of this study is to provide pharmacy students, who require proper communication skills throughout their professional careers, with a simulation-based intervention focusing on empathy and emotional intelligence, and to evaluate the influence of this educational intervention on emotional intelligence and empathy levels.

METHODS

The methodological approach adopted in this study aims to integrate both qualitative and quantitative data for a comprehensive analysis, that is, the mixed method, and to provide in-depth answers to the research questions.

RESULTS

There was a difference observed in the change in empathy and emotional intelligence scores between the control and intervention groups. When the pre-test and mid-test results with the intervention group were analyzed, there was a difference in the values for emotional intelligence when only education was offered. Conversely, no difference was found in empathy scores under the same conditions. In the intervention group, after the implementation of both training and simulation practice resulted in a difference in the scores for emotional intelligence and empathy when comparing the results before and after the test. Gender and the interaction between gender and group had small effect sizes on both empathy and emotional intelligence. The comprehensive data collected from these interviews enabled a rigorous thematic analysis, culminating in the identification of three primary themes accompanied by respective categories: the contribution of theoretical education to simulation, perceptions of simulation practice, the significance of debriefing sessions. Students highlighted the development of various communication skills, such as improving patient-provider relationships, conveying empathy to patients, being aware of and managing their emotions, and building self-confidence through simulated encounters and debriefing sessions.

CONCLUSION

Based on these findings, it is recommended that simulation methods be made mandatory in pharmacy school curricula and be disseminated nationwide.

Effectiveness of simulation-based interventions on empathy enhancement among nursing students: a systematic literature review and meta-analysis

BACKGROUND

This study aimed to secure and analyze evidence regarding the enhancement of nursing students' empathy through simulation-based interventions. It comprehensively analyzed self-reported emotions and reactions as primary outcomes, along with the results reported by nursing students who experienced simulation-based interventions, including empathy.

METHODS

This systematic literature review and meta-analysis investigated the effects of simulation-based interventions on enhancing empathy among nursing students. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for the systematic review and meta-analysis. The following details were considered: population, nursing students; intervention, simulation-based interventions targeting empathy enhancement; comparators, control groups without intervention or those undergoing general non-simulation-based classes; and outcomes, self-reported empathy.

RESULTS

In the systematic review of 28 studies, it was found that the use of simulation-based interventions among nursing students led to an increase in empathy, albeit with a small effect size. This was demonstrated through a pooled, random-effects meta-analysis, yielding an effect size (Hedge's g) of 0.35 (95% CI: 0.14, 0.57, p = 0.001). The results of meta-regression and subgroup analysis significantly increased in empathy for studies published after 2019 (Hedge's g = 0.52, 95% CI: 0.31 to 0.73, p < 0.001), quasi-experimental research design (Hedge's g = 0.51, 95% CI: 0.27 to 0.74, p < 0.001), more than 60 participants (Hedge's g = 0.31, 95% CI: 0.02 to 0.59, p = 0.034), and simulation-based interventions in nursing education (Hedge's g = 0.43, 95% CI: 0.22 to 0.65, p < 0.001).

CONCLUSIONS

Considering factors such as variations in sample size, research approaches, and the effects of independent studies on empathy, this systematic literature review and meta-analysis suggests that simulation-based education can significantly improve nursing students' overall empathy skills.

A therapeutic lifestyle changes elective and its impact on student knowledge, empathy, and perceptions

BACKGROUND AND PURPOSE

Engaging in therapeutic lifestyle changes (TLC) such as healthy eating and physical activity can help prevent or manage various conditions. This study's purpose is to describe a TLC elective course and examine its impact on student knowledge, empathy, and perceptions of confidence with lifestyle modifications counseling.

EDUCATIONAL ACTIVITY AND SETTING

An elective was developed to increase student pharmacists' knowledge and confidence in educating patients about lifestyle modifications. Activities were intended to foster student empathy. A questionnaire, given at course initiation and conclusion, incorporated a knowledge quiz and Kiersma-Chen Empathy Scale (KCES). Student perceptions of confidence were assessed at course conclusion.

FINDINGS

Knowledge significantly increased (P < .001) from 54.1% at course initiation to 75% at course conclusion when comparing average quiz scores. Average KCES scores (out of 105 points) were 84.9 (n = 26) and 86 (n = 22) at course initiation and conclusion, respectively, showing no significant change in empathy scores (P = .01). For each course topic, most students reported being somewhat or very confident in their TLC counseling abilities at course conclusion.

SUMMARY

An elective course significantly improved TLC knowledge and perceived confidence regarding TLC counseling was high at course conclusion. Although there was no significant change in KCES scores, including dedicated TLC instruction in pharmacy curricula can help students build knowledge and confidence in TLC counseling in preparation for pharmacy practice.

Activities to promote empathy for patients among pharmacy learners: A scoping review

BACKGROUND

Provider empathy has been shown to be directly linked to improved patient outcomes. The objective of this scoping review of the literature was to identify and describe learning activities that promote empathy for patients among pharmacy learners.

METHODS

This scoping review was conducted using the following inclusion criteria: publication in English, activities conducted in any academic pharmacy training program (professional degree program, experiential, residency, or fellowship), description of the learning activity(ies) provided, and focus on the experience of empathy/caring/compassion for patients, either human or animal. Articles were excluded if they focused only on skills such as empathic responding or if they did not describe the learning experience. All study designs other than reviews were included.

RESULTS

The scoping review revealed 89 full-text articles that met the inclusion criteria. Included studies demonstrated a wide variety of approaches to the design of learning experiences as well as methods of measurement of empathy. Various types of learning modalities have been used to develop empathy in pharmacy learners, with reflection being the most common. A large proportion of studies that assessed empathy development used quasi-experimental or qualitative designs and did not report tests of statistical significance, which would make it difficult to compare the effectiveness of the different learning activities.

IMPLICATIONS

A variety of approaches have been used among pharmacy learners to develop empathy for patients. Due to the high level of variability in approaches, more rigorous studies are needed to assess the effectiveness of these learning activities.

Shifting to Authentic Assessments? A Systematic Review of Student Perceptions of High-Fidelity Assessments in Pharmacy

OBJECTIVE

Despite becoming increasingly popular, there is no comprehensive review on high-fidelity assessments in pharmacy education that has a focus on the perceptions and experiences of students. This systematic review investigates the student acceptability of high-fidelity simulation for summative assessments in pharmacy education and provides recommendations regarding high-fidelity simulation practices.

FINDINGS

The search yielded 37 studies in total. The articles fell into 3 distinct categories: objective structured clinical examinations (N = 25); face-to-face simulation assessments (N = 9), and augmented reality assessments (N = 3). Most high-fidelity assessments were well received with most students agreeing they had a vital role in assessing the application of clinical knowledge, even though they are stressful. Students prefer high-fidelity assessments to be face-to-face rather than online and also prefer when simulated patients whom they are unfamiliar with are used. Students also expressed a need to be well-prepared for the assessment regarding the logistics of the exam and technology use.

SUMMARY

High-fidelity simulation is likely to be increasingly important in the assessment of the knowledge and skills of pharmacy students and student perception is an important factor to consider when developing such assessments. Reducing stress associated with high-fidelity assessments could include familiarizing students with task logistics or technology used prior to the assessment, using external simulated patients, and having face-to-face assessments and practice sessions.

Reevaluating Core Elements of Emotional Intelligence in Professional Identity Formation for Inclusion in Pharmacy Education

OBJECTIVES

The objectives of this review are to (1) analyze the core concepts of emotional intelligence self-perception, self-expression, interpersonal relationships, decision-making skills, and stress management and their role in professional identity formation, and (2) investigate the methods and strategies to incorporate emotional intelligence in pharmacy education.

FINDINGS

A literature review of emotional intelligence in health care education was conducted by searching the electronic databases PubMed, Google Scholar, ProQuest, and ERIC. The following search terms were included: emotional intelligence, emotional quotient, in association with professional identity formation, pharmacy curriculum, pharmacy cocurriculum, entrustable professional activities, medicine, and nursing. Only full-length, free-access, English-text articles were included. Twenty articles addressed the inclusion and/or assessment of core elements of emotional intelligence in pharmacy education. Commonly taught, cultivated, and assessed core elements include self-awareness, empathy, and interdisciplinary relationships. Assessment tools used to evaluate emotional intelligence in pharmacy education are subjective, qualitative, and semiquantitative, and may include pre and postcourse surveys, event surveys, and questionnaires.

SUMMARY

The pharmacy literature is scarce on how best to analyze emotional intelligence and the role it plays in the pharmacist's education and practice. A comprehensive integration of emotional intelligence into the pharmacy curriculum is a challenging task and requires additional in-depth discussions on how best to incorporate it in the pharmacist's professional identity formation. The Academy will benefit from re-engaging its constituents in addressing the gaps of emotional intelligence in the professional curriculum in preparation for the Accreditation Council for Pharmacy Education 2025 standards.

Implementation and evaluation of simulations in a required course to improve empathy of pharmacy students

INTRODUCTION

It is essential for health care professionals to display empathy when communicating with patients. Therefore, empathy is an important skill to teach health care professional students. The objective of this study was to examine the effect of a course enhancement consisting of formal instruction and application-based simulations on empathy in pharmacy students.

METHODS

The Jefferson Scale of Empathy for Health Profession Students (JSE-HPS) was administered at the start of the semester and again at the end of the 16-week required course for third-year pharmacy students. Differences in the mean scores were analyzed using a paired t-test. An inductive conventional content analysis approach was utilized to analyze end of the course reflections about empathy by two investigators.

RESULTS

On the pre-survey (n = 140), the empathy scores ranged from 86 to 140 (mean 113.8). On the postsurvey (n = 73), scores ranged from 93 to 137 (mean 117.5). A statistically significant increase in students' empathy scores on the JSE-HPS was observed following the completion of the course (P = .006). The main themes that emerged from the students' reflections were the impact of empathy on patient-centered care and the importance of patient-provider relationships. Students also discussed the development and use of empathy skills.

CONCLUSIONS

A combination of didactic and skills-based training led to an improvement in empathy in third-year pharmacy students. Student comments highlighted the value of practicing empathy skills in a simulated environment.

The Turkish validity and reliability of the Kiersma-Chen empathy scale

PURPOSE

This study aimed to establish the Turkish validity and reliability of the Kiersma-Chen empathy scale (KCES) and determine its psychometric properties.

DESIGN AND METHODS

This methodological study was carried out with 227 nursing students between April and May 2019.

FINDINGS

The Cronbach's alpha coefficient of the total scale is 0.854, the test-retest coefficient was high for the total scale (r = 0.989), and total-item correlations ranged between 0.398 and 0.712.

PRACTICE IMPLICATIONS

The KCES-TR is a valid and reliable scale to measure empathy in nursing students.

Evaluation and Revision of the Kiersma-Chen Empathy Scale

Objective. This study aimed to provide further validity evidence for the Kiersma-Chen Empathy Scale (KCES) by analyzing data collected from multiple administrations of the scale and conducting cognitive interviews of students in pharmacy and nursing programs to identify needed revisions.Methods. De-identified data from previous administrations of the KCES were used to evaluate the scale. Evidence of response process was enhanced through cognitive interviews with 20 pre-pharmacy and pharmacy students at Cedarville University. After survey revisions, the cognitive interview process was repeated with 10 University of Wyoming nursing students.Results. Based on psychometric data and cognitive interviews, the KCES was revised as follows: key components of cognitive and affective empathy were retained, scaling was changed to reflect necessity and empathy ability, negatively worded items were removed, and the single scale was converted into two parallel subscales.Conclusion. This study used data from thousands of geographically and professionally diverse samples. Based on potential problems identified in quantitative analyses, cognitive interviews with nursing and pharmacy students were conducted, and modifications to the KCES were made. Further psychometric validation is needed regarding the KCES-R.

Improving pharmacy students' empathy and attitudes regarding opioid overdose and substance use disorder in a skills-based learning environment

INTRODUCTION

Using a skills-based learning environment as a launch pad for developing empathy for patients with substance use disorder or at high risk for opioid overdose allows for learning continuity and early intervention. Empathy for this patient population may reduce bias and stigma associated with negative health outcomes. Previous studies have assessed empathy in pharmacy students, but not in the context of substance use disorder and opioid overdose harm reduction among first professional year pharmacy students in skills-based education. This cohort study aimed to measure the change in empathy and opioid overdose-related attitudes before and after a two-part skills-based learning activity that focused on drug diversion and opioid overdose treatment.

METHODS

First professional year pharmacy students were given a pre- and post-survey consisting of empathy and attitudes sections. The Kiersma-Chen Empathy Scale (KCES) and the Opioid Overdose Attitudes Scale (OOAS) were used. The intervention was a skills-based learning activity with two segments, one that focused on naloxone counseling and the other focused on drug diversion.

RESULTS

The aggregate mean change in KCES and OOAS scores of the cohort increased by 1.837 (P = .014) and 2.349 (P = .008), respectively. Of note, students with lower baseline empathy and attitudes scores showed more improvement in both KCES and OOAS scores.

CONCLUSIONS

Students showed improvement in empathy and attitudes regarding opioid overdose and substance use disorder. A larger magnitude of improvement was noted with lower baseline scores.

Effectiveness of simulation-based interventions at improving empathy among healthcare students: A systematic review and meta-analysis

OBJECTIVE

To examine the effectiveness of simulation-based interventions in improving empathy among healthcare students.

DESIGN

A systematic review and meta-analysis of randomized controlled trials and clinical controlled trials.

DATA SOURCES

Studies in English language were sourced from seven electronic databases (PubMed, Embase, CINAHL, PsycINFO, Web of Science, Scopus and ProQuest Dissertations & Theses Global) from their respective inception dates until October 2020.

REVIEW METHODS

This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Random-effect meta-analyses were conducted. Heterogeneity was assessed using the I² statistics and Cochran's Q chi-squared test. Quality appraisal was conducted using the Cochrane risk of bias tool and the Grades of Recommendation, Assessment, Development, and Evaluation approach. Publication bias was assessed using funnel plots.

RESULTS

Sixteen studies were included in this review. Meta-analysis reported statistically significant small, medium and very large effect sizes for empathy reported by healthcare students (SMD = 0.46, 95% CI: 0.25 to 0.66), simulated patients (SMD = 0.65, 95% CI: 0.41 to 0.89) and other personnel (independent observers, faculty members and examiners) (SMD = 1.27, 95% CI: 0.64 to 1.90) respectively, showing the effectiveness of simulation-based interventions in improving empathy among healthcare students. Subgroup analyses found that role-play was more effective than simulated patient and disease-state simulations. Multi-sessional interventions conducted for up to seven months and group-based simulation delivery were found to be more effective.

CONCLUSION

Educational institutions should conduct regular simulation-based interventions to continuously develop healthcare students' empathy during their academic journey. Future trials should involve students from more diverse healthcare disciplines. Empathy should be measured in a standardized manner and rely less on self-reported measures. Role-play segments and group-based simulations could be added to increase interventions' effectiveness. Studies should conduct longer follow-up assessments to determine the sustainability of students' empathy following intervention. Future research is needed to corroborate the current findings.

Walking in a Patient's Shoes: An Evaluation Study of Immersive Learning Using a Digital Training Intervention

Objectives: Evidence suggests that immersive learning increases empathy and understanding of the patient experience of illness. This study evaluated a digital training intervention 'In Their Shoes' which immerses participants in the experience of living with inflammatory bowel disease (IBD), highlighting the biopsychosocial impact. The simulation program uses a mobile application to deliver time-based tasks and challenges over 36 h, supplemented with telephone role-play and 'kit' items to open and use. This study investigated changes in IBD understanding and connection to patients, empathy and perception of job value in a group of pharmaceutical employees. Additionally, it explored experiences and impact of taking part in the intervention. Methods: A mixed methods pre-post design was utilized, with an opportunity sample of employees taking part in the training. 104 participants from sites in 12 countries completed measures at baseline and 97 post-intervention. Measures included the Toronto Empathy Questionnaire, Prosocial Job Characteristics Scale, and structured questions around IBD understanding and connection to patients. Two focus groups (N = 14) were conducted regarding participants experiences of the intervention to complement an open-response question in the questionnaire (N = 75). Qualitative data was analyzed using thematic analysis. Results: Following the intervention, there were statistically significant increases in IBD understanding and connection to patients (p < 0.00025), evaluation of organizational innovation (p < 0.00025), empathy (d = 0.45) and prosocial job perceptions (d = 0.28). Qualitative analysis revealed more fully the transformative personal journey undertaken by participants which provided 'eye opening' insight into the psychosocial impact of living and working with IBD. This insight encouraged patient perspective-taking and a strong desire to promote patient advocacy and reduce stigma around chronic illness. Finally, greater organizational pride and connectivity was evident for some participants. Conclusions: An immersive training program, focussing on the lived experience of illness, led to significant increases in disease understanding and empathy. These findings align with other literature evaluating immersive learning and the potential for increasing knowledge, empathy and motivation. The present study offers opportunities to extend this outside of the body of work focussing on healthcare practitioners and explores the benefits of using this type of learning experience within an organizational setting.