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Cameron K, Cicinelli E, Natsheh C, So M, Tait G, Halapy H. Implementation of Virtual Interactive Cases for Pharmacy Education: A Single-Center Experience. J Pharm Technol 2024; 40:100-107. [PMID: 38525092 PMCID: PMC10959083 DOI: 10.1177/87551225231224627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
Patient case simulation software are described in pharmacy education literature as useful tools to improve skills in patient assessment (including medication history-taking and physical assessment), clinical reasoning and communication, and are typically well-received by students and instructors. The virtual interactive case (VIC) system is a web-based software developed to deliver deliberate practice opportunities in simulated patient encounters across a spectrum of clinical topics. This article describes the implementation and utilization of VIC in the undergraduate curriculum at one Canadian pharmacy school. Methods: At our facility, the use of VIC was integrated across the training spectrum in the curriculum, including core and elective didactic courses and practice labs, experiential learning, interprofessional education, and continuing education. Its use was evaluated through student and instructor surveys and qualitative student interviews). VIC is easy to navigate and created a positive and realistic learning environment. Students identified that it enhanced their ability to identify relevant patient information, accurately simulated hospital pharmacy practice and thereby helped them to prepare for their upcoming experiential courses. The use of VIC has expanded beyond its original intended purpose for individual student practice to become a valuable addition to pharmacy undergraduate education. Future plans include ongoing development of cases and exploration of further uses of VIC within the didactic curriculum, for remediation in experiential courses, and for pharmacist continuing education.
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Affiliation(s)
- Karen Cameron
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Erin Cicinelli
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- University Health Network, Toronto, ON, Canada
| | - Cindy Natsheh
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- University Health Network, Toronto, ON, Canada
| | - Miranda So
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- University Health Network, Toronto, ON, Canada
| | - Gordon Tait
- University Health Network, Toronto, ON, Canada
| | - Henry Halapy
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- St. Michael’s Hospital, Unity Health, Toronto, ON, Canada
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Phanudulkitti C, Puengrung S, Meepong R, Vanderboll K, Farris KB, Vordenberg SE. A systematic review on the use of virtual patient and computer-based simulation for experiential pharmacy education. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 11:100316. [PMID: 37635840 PMCID: PMC10450516 DOI: 10.1016/j.rcsop.2023.100316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/05/2023] [Accepted: 08/05/2023] [Indexed: 08/29/2023] Open
Abstract
Background Simulation use is rapidly expanding, with technologies like virtual patients (VPs) and computer-based simulation (CBS) allowing for educators to equip pharmacy students with the necessary skills that are aligned with the demands and expectations of a practicing pharmacy professional. These technologies enable pharmacy students to be exposed to challenging or infrequent patient case scenarios in an authentic pharmacy setting. This allows for the reinforcing of care processes and for techniques and crucial skills to be applied. Aim of the study To consolidate the existing evidence regarding the utilization of VPs and CBS in preparing and supporting students in pharmacy experiential education and evaluate the effectiveness of these approaches in enhancing student pharmacists' learning outcomes, including knowledge, skills, confidence, enjoyment, and engagement. Methods Five electronic databases were searched using combined keyword and indexing terms (when available) with Boolean operators for the literature search. Studies that reported or investigated the use of VPs and CBS in pharmacy experiential education were included. Data on study design, demographics of participants, information on the interventions, course/skills, primary and secondary outcomes, and qualitative findings were extracted. Results A total of 911 unique articles were initially identified and filtered down to 19 articles fitting within the inclusion criteria. The selected 19 articles involved student pharmacists (Y1-Y5) and pre-registered pharmacists from ten countries. Simulation tools were used in various pharmacy courses, including Advanced Pharmacy Practice Experience (APPE), Advanced Pharmaceutical Care II, and Medication Management. Implementing these tools in pharmacy experiential education demonstrated a statistically significant improvement in student knowledge (p < 0.05). Most students agreed/strongly agreed that practicing with virtual patient cases enhanced their clinical reasoning, counseling skills, confidence in communication, and attitudes toward the courses. Conclusions This systematic review supports the use of VPs and CBS in pharmacy experiential education and provides practical recommendations for educators including selecting suitable tools, implementing them strategically within courses, integrating them with existing activities, and considering financial and IT support.
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Affiliation(s)
- Chamipa Phanudulkitti
- Faculty of Pharmaceutical Sciences, Burapha University, 169 Long Had Bangsaen Rd, Saen Suk, Chon Buri District, Chon Buri 20131, Thailand
| | - Surangkana Puengrung
- Independent Researcher, 502 Charunsanitwong 79, Bangphlat District, Bangkok 10700, Thailand
| | - Rittnarong Meepong
- Faculty of Pharmaceutical Sciences, Burapha University, 169 Long Had Bangsaen Rd, Saen Suk, Chon Buri District, Chon Buri 20131, Thailand
| | - Kathryn Vanderboll
- Taubman Health Sciences Library, University of Michigan, 1135 E Cahterine St, Ann Arbor, MI 48109-5726, United States of America
| | - Karen Bell Farris
- University of Michigan College of Pharmacy, 428 Church St, Ann Arbor, MI 48109-1065, United States of America
| | - Sarah E. Vordenberg
- University of Michigan College of Pharmacy, 428 Church St, Ann Arbor, MI 48109-1065, United States of America
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Kennedy-Malone L, Gontarz J, Monge E, Harlow S, Boles S. Perceived Effectiveness of Nursing Faculty of Clinical Video Simulation for Use in Nurse Practitioner Education. J Nurse Pract 2023; 19:104634. [PMID: 37193015 PMCID: PMC10166652 DOI: 10.1016/j.nurpra.2023.104634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Quality clinical placements for nurse practitioner students are increasingly challenging to locate and sustain, restricting faculty opportunities to assess student clinical competency. With the additional impact of COVID-19 restricting access to in-person clinicals and simulations, faculty began to incorporate virtual clinical simulation experiences. This cross-sectional design study examined nurse practitioner faculty's perception that by including videos with the accompanying faculty guides found at the University of North Carolina at Greensboro School of Nursing Clinical Video Simulation Series site, students' clinical decision making could be enhanced and that video simulation can be used to assess clinical competency.
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Gharib AM, Peterson GM, Bindoff IK, Salahudeen MS. Potential Barriers to the Implementation of Computer-Based Simulation in Pharmacy Education: A Systematic Review. PHARMACY 2023; 11:pharmacy11030086. [PMID: 37218968 DOI: 10.3390/pharmacy11030086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/24/2023] Open
Abstract
Computer-based simulation (CBS) is an interactive pedagogical training method that has seen increased interest, especially in recent years. There is some evidence that CBS in pharmacy education is not as widely adopted compared to other healthcare disciplines. Pharmacy education literature to date has not specifically discussed the potential barriers which may cause this uptake challenge. In this systematic narrative review, we attempted to explore and discuss potential barriers that may impact the integration of CBS in pharmacy practice education and provide our suggestions to overcome them. We searched five major databases and used the AACODS checklist for grey literature assessment. We identified 42 studies and four grey literature reports, published between 1 January 2000 and 31 August 2022, which met the inclusion criteria. Then, the specific approach of Braun and Clarke for thematic analysis was followed. The majority of the included articles were from Europe, North America, and Australasia. Although none of the included articles had a specific focus on barriers to implementation, thematic analysis was used to extract and discuss several potential barriers, such as resistance to change, cost, time, usability of software, meeting accreditation standards, motivating and engaging students, faculty experience, and curriculum constraints. Ad- dressing academic, process, and cultural barriers can be considered the first step in providing guidance for future implementation research for CBS in pharmacy education. The analysis suggests that to effectively overcome any possible barriers to implementing CBS, different stakeholders must engage in careful planning, collaboration, and investment in resources and training. The review indicates that additional research is required to offer evidence-based approach and strategies to prevent overwhelming or disengaging users from either learning or teaching process. It also guides further research into exploring potential barriers in different institutional cultures and regions.
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Affiliation(s)
- Ahmed M Gharib
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS 7005, Australia
| | - Gregory M Peterson
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS 7005, Australia
| | - Ivan K Bindoff
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS 7005, Australia
| | - Mohammed S Salahudeen
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS 7005, Australia
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Taylor B, McLean G, Sim J. Immersive virtual reality for pre-registration computed tomography education of radiographers: A narrative review. J Med Radiat Sci 2023. [PMID: 36657747 DOI: 10.1002/jmrs.657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 01/07/2023] [Indexed: 01/21/2023] Open
Abstract
To be registered as a medical radiation practitioner, The Medical Radiation Practice Board of Australia (MRPBA) requires radiographers to be capable of performing computed tomography (CT) imaging examinations safely and effectively. Universities meet this requirement by offering practical CT training to radiography students on-campus and during clinical placements. However, institutions face challenges when facilitating on-campus CT practicum. Virtual reality (VR) has been suggested as a possible solution for radiography students to gain CT scanning experience. This narrative review explored relevant literature to investigate the potential for immersive VR to be incorporated into CT practicum. Benefits and limitations of this education technology are examined with resultant recommendations made for integration into the CT curriculum. Results found that VR enhances CT learning for students, increases confidence and raises motivation for the simulated CT task. CT simulation provides a viable alternative in the context of pandemic-imposed restrictions and reduced CT placement duration. However, it remains debatable as to whether immersive VR truly enhances student learning compared with other VR modalities, such as computer-based CT simulation. In addition, a lack of staff training, availability of resources and technical problems were flagged as limitations. We concluded that before immersive VR is integrated into CT education, significant optimisation of the simulation is needed. This includes ensuring VR scenarios are based on learning paradigms and feedback is integrated as part of simulation learning. Engaging clinical partners during the CT VR rollout is imperative to ensure successful transition of students from university learning to clinical placement.
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Affiliation(s)
- Bridget Taylor
- Monash Imaging, Monash Health, Berwick, Victoria, Australia
| | - Glenda McLean
- Monash Imaging, Monash Health, Berwick, Victoria, Australia
| | - Jenny Sim
- Department of Medical Imaging and Radiation Sciences, Monash University, Clayton, Victoria, Australia
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Computer-Based Simulators in Pharmacy Practice Education: A Systematic Narrative Review. PHARMACY 2023; 11:pharmacy11010008. [PMID: 36649018 PMCID: PMC9844304 DOI: 10.3390/pharmacy11010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/23/2022] [Accepted: 12/29/2022] [Indexed: 01/05/2023] Open
Abstract
Computer-based simulations may represent an innovative, flexible, and cost-efficient training approach that has been underutilised in pharmacy practice education. This may need to change, with increasing pressure on clinical placement availability, COVID-19 restrictions, and economic pressures to improve teaching efficiency. This systematic narrative review summarises various computer-based simulations described in the pharmacy practice education literature, identifies the currently available products, and highlights key characteristics. Five major databases were searched (Medline, CINAHL, ERIC, Education Source and Embase). Authors also manually reviewed the publication section of major pharmacy simulator websites and performed a citation analysis. We identified 49 studies describing 29 unique simulators, which met the inclusion criteria. Only eight of these simulators were found to be currently available. The characteristics of these eight simulators were examined through the lens of eight main criteria (feedback type, grading, user play mode, cost, operational requirement, community/hospital setting, scenario sharing option, and interaction elements). Although a number of systems have been developed and trialled, relatively few are available on the market, and each comes with benefits and drawbacks. Educators are encouraged to consider their own institutional, professional and curriculum needs, and determine which product best aligns with their teaching goals.
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MacNeil K, Varga D, Gill S, Dahri K. Connecting a simulated virtual patient program with experiential practicums: Perspectives from year three students. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:391-396. [PMID: 33715801 DOI: 10.1016/j.cptl.2020.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 10/18/2020] [Accepted: 11/24/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND PURPOSE Research indicates that the simulated learning tools known as virtual patients (VPs) are valued by pharmacy students and impact students' knowledge and confidence. However, research is needed to understand how students can be supported to make intended connections between VP cases and real-life clinical scenarios. The purpose of this study was to examine whether and how VP cases influence students' clinical reasoning skills, confidence, thought processes, and preparedness for their experiential practicums. EDUCATIONAL ACTIVITY AND SETTING Third-year entry-to-practice doctor of pharmacy students who had completed at least one VP case in second year prior to their experiential practicums were surveyed in fall 2018 after having completed their experiential practicums. Surveys were structured to solicit student perceptions related to how students bridged VP cases and real-life clinical scenarios and were analyzed using a mixed-methods design. FINDINGS Forty-three students completed the survey. Students perceived that VP cases most significantly impacted their clinical reasoning skills due to the opportunity cases afforded them to explore patient data and navigate relevant information. The largest limitation of VP cases to students' learning was that the cases differed from their experiences. Students' suggestions included opportunities for more practice using VP cases and an expanded repertoire of medical conditions offered through case exposure. SUMMARY More research is needed to understand how to help students connect VP cases to their experiential practicums to make them more effective learning tools.
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Affiliation(s)
- Kimberley MacNeil
- Department of Educational & Counselling Psychology, and Special Education, Faculty of Education, University of British Columbia, 2125 Main Mall, Vancouver, BC V6T 1Z4, Canada.
| | - Diana Varga
- University of British Columbia, Pharmaceutical Sciences Building, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada; Faculty of Pharmaceutical Sciences, University of British Columbia, Pharmaceutical Sciences Building, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada
| | - Suki Gill
- University of British Columbia, Pharmaceutical Sciences Building, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada; Faculty of Pharmaceutical Sciences, University of British Columbia, Pharmaceutical Sciences Building, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada
| | - Karen Dahri
- Faculty of Pharmaceutical Sciences, University of British Columbia, Pharmaceutical Sciences Building, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada.
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MartÃn-RodrÃguez F, Castro Villamor MA, López-Izquierdo R, Portillo Rubiales RM, Ortega GJ, Sanz-GarcÃa A. Can anxiety in undergraduate students in a high-fidelity clinical simulation be predicted? A randomized, sham-controlled, blinded trial. NURSE EDUCATION TODAY 2021; 98:104774. [PMID: 33485162 DOI: 10.1016/j.nedt.2021.104774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/10/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION High-fidelity clinical simulation has implied a revolution in health science training. Despite its benefits, some drawbacks could hinder the learning process, especially the anxiety produced during such scenarios. OBJECTIVES The aim of the present work is to develop a predictive model capable of determining which students will present high levels of anxiety. DESIGN We performed a randomized, sham-controlled, blinded trial in which students were randomly assigned to four scenarios and played one of two possible roles. METHODS Before and after the simulation we assessed the anxiety level along with physiological and analytical parameters. The main analyzed outcome was an increase of ≥25% in anxiety compared with baseline. RESULTS The type of scenario or the role played had no effect on anxiety. The predictive model presented an Area Under the Receiver Operating Characteristics of 0.798 (95% CI: 0.69-0.90; p < 0.001), with age and systolic blood pressure being protective factors against anxiety. CONCLUSIONS Our results showed that the anxiety level developed during simulation could be predicted. The application of this predictive model when associated to appropriate techniques to deal with increased anxiety levels could improve the learning process of medical students during simulations.
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Affiliation(s)
- Francisco MartÃn-RodrÃguez
- Faculty of Medicine, Valladolid University, Valladolid, Spain; Advanced Life Support, Emergency Medical Services, Valladolid, Spain
| | - Miguel A Castro Villamor
- Faculty of Medicine, Valladolid University, Valladolid, Spain; Community Health Center, La Cistérniga, Valladolid, Spain
| | - Raúl López-Izquierdo
- Faculty of Medicine, Valladolid University, Valladolid, Spain; Emergency Department, Hospital Universitario Rio Hortega, Valladolid, Spain
| | - Raquel M Portillo Rubiales
- Faculty of Medicine, Valladolid University, Valladolid, Spain; Community Health Center, La Cistérniga, Valladolid, Spain
| | - Guillermo J Ortega
- Data Analysis Unit, Health Research Institute, Hospital de la Princesa, Madrid (IIS-IP), Spain; National Scientific and Technical Research Council, Buenos Aires, Argentina
| | - Ancor Sanz-GarcÃa
- Data Analysis Unit, Health Research Institute, Hospital de la Princesa, Madrid (IIS-IP), Spain.
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Lebdai S, Mauget M, Cousseau P, Granry JC, Martin L. Improving Academic Performance in Medical Students Using Immersive Virtual Patient Simulation: A Randomized Controlled Trial. JOURNAL OF SURGICAL EDUCATION 2021; 78:478-484. [PMID: 32893155 DOI: 10.1016/j.jsurg.2020.08.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 08/06/2020] [Accepted: 08/20/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To determine whether immersive virtual patient simulation (IVPS) on the MedicActiv platform is influential in improving student academic performance in module validation tests. DESIGN In this prospective randomized controlled study a comparison was made between IVPS training combined with regular faculty courses versus courses alone. The primary endpoint was module validation grades. Secondary endpoints were satisfaction scores (overall interest, ergonomics, realism, immersion, and training efficiency). SETTING Angers School of Medicine, France. PARTICIPANTS 2018 to 2019 class of fourth-year students, included on a voluntary basis. In the first semester 51 students were included, of whom 13 were excluded for lack of compliance (6 and 7 from the IVPS and control groups, respectively). In the second semester we included 57 students, of whom 10 were excluded for lack of compliance (2 and 8 from the IVPS and control groups, respectively). RESULTS Mean age was 21 years (±0.8). There were 85 female and 23 male students. In the first semester mean grades were 13.4 ± 1.6 versus 11/.9 ± 2.4 in the IVPS and control groups, respectively (p = 0.038). In the second semester mean grades were 15.3 ± 2.5 versus 11.9 ± 3.6 in the IVPS and control groups, respectively p < 0.001. The entire study population was pooled (n = 85): mean grades were 14.5 ± 2.4 versus 11.9 ± 3 in the IVPS group and the control group, respectively, p < 0.001. The satisfaction questionnaire response rate was 54% (46/85). Score percentages ≥4 regarding overall interest, ergonomics, realism, immersion and training efficiency were 89%, 85%, 100%, 93%, and 93% respectively. CONCLUSIONS Complementing conventional university education with simulation of virtual consultation cases on the MedicActiv platform improved student academic performance as compared with students studying regular courses. Students reported high levels of satisfaction with overall interest, ergonomics, realism, immersion and training efficiency on the MedicActiv platform.
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Affiliation(s)
- Souhil Lebdai
- Urology Department, University Hospital of Angers, Angers, France; AllSims Center for Simulation in Healthcare, University Hospital of Angers, Angers, France.
| | - Matteo Mauget
- AllSims Center for Simulation in Healthcare, University Hospital of Angers, Angers, France
| | - Pierre Cousseau
- AllSims Center for Simulation in Healthcare, University Hospital of Angers, Angers, France
| | - Jean Claude Granry
- AllSims Center for Simulation in Healthcare, University Hospital of Angers, Angers, France
| | - Ludovic Martin
- AllSims Center for Simulation in Healthcare, University Hospital of Angers, Angers, France
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