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Huon JF, Nizet P, Tollec S, Vene E, Fronteau C, Leichnam A, Tching-Sin M, Michelet-Barbotin V, Foucault-Fruchard L, Nativel F. A systematic review of the impact of simulation on students' confidence in performing clinical pharmacy activities. Int J Clin Pharm 2024; 46:795-810. [PMID: 38632204 DOI: 10.1007/s11096-024-01715-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/13/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Although confidence does not automatically imply competence, it does provide pharmacy students with a sense of empowerment to manage a pharmacotherapeutic problem independently. Among the methods used in higher education, there is growing interest in simulation. AIM To evaluate the impact of simulation on pharmacy students' confidence in performing clinical pharmacy activities. METHOD Articles that reported the use of simulation among pharmacy students with fully described outcomes about confidence were included. Studies for which it was impossible to extract data specific to pharmacy students or simulation were excluded. The search was carried out in Medline, Embase, Lissa and PsycInfo from inception to August the 31th, 2022. The results were synthesized into 4 parts: confidence in collecting information, being an expert in a procedure/pathology, counselling and communicating, and other results. The quality assessment of included studies was conducted using the Mixed Methods Appraisal Tool "MMAT" tool. RESULTS Among the 39 included articles, the majority were published in the last 5 years and conducted in the United States. The majority included pharmacy students in years 1 through 3 (69.2%). The most common study design was the pre-post uncontrolled design (66.7%). Studies measuring the effects of human and/or virtual simulation were mainly focused on confidence to counsel and/or communicate with patients and colleagues (n = 20). Evaluations of the effects of these types of simulation on confidence in information gathering by health professionals were also well represented (n = 16). CONCLUSION Simulation-based training generally yielded positive impact on improving pharmacy students' confidence in performing clinical pharmacy activities. Rigorous assessment methods and validated confidence questionnaires should be developed for future studies.
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Affiliation(s)
- Jean-François Huon
- Nantes Université, CHU Nantes, Pharmacie, 5 allée de l'île Gloriette, 44000, Nantes, France.
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France.
| | - Pierre Nizet
- Nantes Université, CHU Nantes, Pharmacie, 5 allée de l'île Gloriette, 44000, Nantes, France
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
| | - Sophie Tollec
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
- CHU Orléans, Orléans, France
| | - Elise Vene
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
- CHU Rennes, Rennes, France
| | - Clémentine Fronteau
- Nantes Université, CHU Nantes, Pharmacie, 5 allée de l'île Gloriette, 44000, Nantes, France
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
| | - Alison Leichnam
- Nantes Université, CHU Nantes, Pharmacie, 5 allée de l'île Gloriette, 44000, Nantes, France
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
| | - Martine Tching-Sin
- Nantes Université, CHU Nantes, Pharmacie, 5 allée de l'île Gloriette, 44000, Nantes, France
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
| | - Vanessa Michelet-Barbotin
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
- CHU Rennes, Rennes, France
| | - Laura Foucault-Fruchard
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
- CHU Tours, Service Pharmacie, Tours, France
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Fabien Nativel
- Nantes Université, Oniris, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, RMeS, UMR 1229, 44000, Nantes, France
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Raafat N, Harbourne AD, Radia K, Woodman MJ, Swales C, Saunders KEA. Virtual patients improve history-taking competence and confidence in medical students. MEDICAL TEACHER 2024; 46:682-688. [PMID: 38084413 DOI: 10.1080/0142159x.2023.2273782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
PURPOSE Klark is a novel online medical education tool (www.klark-cases.com) where students take histories from virtual patients with common presentations from multiple specialities. We investigated whether Klark could enhance student confidence and competence in history-taking, and whether students find Klark helpful. METHODS A single cohort of first-year clinical medical students had access to Klark for three weeks. At both ends of the trial, participants were asked to complete feedback forms and participate in two mock Objective Structured Clinical Examination (OSCE) history stations. Outcome measures included self-reported confidence and competence in history-taking, performance in OSCE stations, and qualitative user experience data. RESULTS Seventy participants successfully completed a case on Klark (mean 18.7), of which 63 (90% user retention) completed ≥ 2 cases. Self-reported competence (p < 0.001) and confidence (p < 0.001) improved. Participants found Klark to be helpful, impactful, and would recommend it to other students. OSCE scores improved for medical (57% vs. 69%, p < 0.001) and surgical (58% vs. 70%, p < 0.001) histories. CONCLUSIONS Klark improved competence and confidence in history-taking. Students found it helpful and chose to continue using the platform. By developing confidence and competence at their own pace in the Klark simulated environment, students can then maximise benefit from in-person clinical opportunities.
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Affiliation(s)
- Nader Raafat
- University of Oxford Medical School, John Radcliffe Hospital, Oxford, United Kingdom
| | - Alexander D Harbourne
- University of Oxford Medical School, John Radcliffe Hospital, Oxford, United Kingdom
| | - Kajal Radia
- University of Oxford Medical School, John Radcliffe Hospital, Oxford, United Kingdom
| | - Myles J Woodman
- University of Oxford Medical School, John Radcliffe Hospital, Oxford, United Kingdom
| | - Catherine Swales
- University of Oxford Medical School, John Radcliffe Hospital, Oxford, United Kingdom
| | - Kate E A Saunders
- University of Oxford Medical School, John Radcliffe Hospital, Oxford, United Kingdom
- Department of Psychiatry, Warneford Hospital, Oxford, United Kingdom
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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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Lippitsch A, Steglich J, Ludwig C, Kellner J, Hempel L, Stoevesandt D, Thews O. Development and evaluation of a software system for medical students to teach and practice anamnestic interviews with virtual patient avatars. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 244:107964. [PMID: 38043500 DOI: 10.1016/j.cmpb.2023.107964] [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: 08/16/2023] [Revised: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND AND OBJECTIVES Taking a medical history is a core competence of the diagnostic process. At the beginning of their study medical students need to learn and practice the necessary techniques, initially focusing on good structuring and completeness. For this purpose, an interactive software system (ViPATalk) was developed in which the student can train to pose questions to virtual patient avatars in free conversation. At the end, the student receives feedback on the completeness of the questioning and an explanation of the essential items. The use of this software was compared to the traditional format of student role play in a randomized trial. METHODS The central component of ViPATalk is a chatbot based on the AI language AIML, which generates an appropriate answer based on keywords in the student's question. To enable a realistic use, the student can enter the question via microphone (speech-to-text) and the answer generated by the chatbot is presented as a short video sequence, where the avatar is generated from a real image. Here, the transition between the sequences is seamless, resulting in a continuous movement of the avatar during the conversation. RESULTS The learning success by practicing with ViPATalk was tested in an anamnestic interview with actors as simulated patients. The completeness of the conversation was evaluated with regard to numerous aspects and also certain behaviors during the conversation. These results were compared with those after practicing using peer role play. CONCLUSIONS It was found that practicing with ViPATalk was mostly equivalent to the students' role play. In the subsequent survey of the students, the wish was expressed that the ViPATalk software should also be used as an online tool for self-study and that there should be more cases for practicing.
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Affiliation(s)
- Antonia Lippitsch
- Dorothea Erxleben Learning Centre Halle (DELH), University of Halle-Wittenberg, Germany
| | - Jonas Steglich
- Dorothea Erxleben Learning Centre Halle (DELH), University of Halle-Wittenberg, Germany
| | - Christiane Ludwig
- Dorothea Erxleben Learning Centre Halle (DELH), University of Halle-Wittenberg, Germany
| | - Juliane Kellner
- Dorothea Erxleben Learning Centre Halle (DELH), University of Halle-Wittenberg, Germany
| | - Linn Hempel
- Dorothea Erxleben Learning Centre Halle (DELH), University of Halle-Wittenberg, Germany
| | - Dietrich Stoevesandt
- Dorothea Erxleben Learning Centre Halle (DELH), University of Halle-Wittenberg, Germany
| | - Oliver Thews
- Julius Bernstein Institute of Physiology, University of Halle-Wittenberg, Magdeburger Str. 6, Halle (Saale) 06112, Germany.
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Sezer B, Sezer TA, Teker GT, Elcin M. Developing a virtual patient: design, usability, and learning effect in communication skills training. BMC MEDICAL EDUCATION 2023; 23:891. [PMID: 37993846 PMCID: PMC10664539 DOI: 10.1186/s12909-023-04860-7] [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: 02/20/2023] [Accepted: 11/09/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Literature shows that Virtual Patients (VPs) find extensive usage in the field of health sciences, especially in the post-pandemic period. VPs are successfully utilized in developing various effective skills like medical interview. However, this technology is quite new in Turkey and has not yet been used in communication skills training in a structured form. This research aimed to develop a virtual patient to improve the communication skills of medical students. METHODS Developmental research method was used in the study. The implementation phase involved the one group posttest quasi-experimental design. The study group comprised of experts in various fields and 213 medical students. Needs Analysis Form, Scenario Building Form, System Validation Form, Communication Skills Assessment Form, and Interview Form were used as data collection tools. The research primarily concentrated on ensuring minimal errors within the system and enhancing students' communication skill scores. RESULTS The study found that VP was effective in teaching communication skills. Communication skills improved from a mean score of 36.74 in the first interview with 15 students to 74.2 in the final application with 198 students. It was determined that the students who practiced repeatedly (n = 26) made 17% more effective interviews than their first practices (score: 89.2). The script matching of the VP was 83%. Other data obtained from the students generally showed that the VP application was developed in accordance with the purpose, that it was user-friendly, and that the scenarios were adequate. CONCLUSION VPs like this have the potential to develop skills such as history taking, clinical reasoning, etc., which are very important in the field of health sciences.
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Affiliation(s)
- Baris Sezer
- Faculty of Medicine, Department of Medical Education and Informatics, Hacettepe University, Altindag, Ankara, Turkey.
| | - Tufan Asli Sezer
- Faculty of Nursing, Department of Pediatric Nursing, Ankara University, Ankara, Turkey
| | - Gulsen Tasdelen Teker
- Faculty of Medicine, Department of Medical Education and Informatics, Hacettepe University, Altindag, Ankara, Turkey
| | - Melih Elcin
- Faculty of Medicine, Department of Medical Education and Informatics, Hacettepe University, Altindag, Ankara, Turkey
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Garza KB, Grabowsky A, Moseley LE, Wright BM, Davis BR, Ford CR. Activities to promote empathy for patients among pharmacy learners: A scoping review. CURRENTS IN PHARMACY TEACHING & LEARNING 2023; 15:911-922. [PMID: 37633755 DOI: 10.1016/j.cptl.2023.08.003] [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: 11/21/2022] [Revised: 07/17/2023] [Accepted: 08/16/2023] [Indexed: 08/28/2023]
Abstract
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.
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Affiliation(s)
- Kimberly B Garza
- Auburn University Harrison College of Pharmacy, 4306b Walker Building, Auburn, AL 36849, United States.
| | - Adelia Grabowsky
- Ralph Brown Draughon Library, 231 Mell Street, Auburn, AL 36849, United States.
| | - Lindsey E Moseley
- Auburn University Harrison College of Pharmacy, 2229 Walker Building, Auburn University, AL 36849, United States.
| | - Bradley M Wright
- Auburn University Harrison College of Pharmacy, 2229 Walker Building, Auburn University, AL 36849, United States.
| | - Brandy R Davis
- Auburn University Harrison College of Pharmacy, 1330 Walker Building, Auburn University, AL 36849, United States.
| | - Channing R Ford
- Jacksonville State University, Graduate School, 700 Pelham Rd., North Jacksonville, AL 36365, United States.
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Qaisar R, Bouzoubaa H, Lajane H, Lamiri A, Benchadlia F, Abidi O, Khyati A. Comparison of Learning Facilitated by Traditional and Virtual Case Studies for Teaching the Nursing Approach to Care. Open Nurs J 2023. [DOI: 10.2174/18744346-v17-230223-2022-151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Aim:
The objective of this study is to investigate the adoption of these two strategies for teaching the steps of the care process to Moroccan nursing students. We attempt to answer the following questions: What is the preference of nursing students between traditional case studies and virtual case studies? What are their suggestions for improving teaching practices? According to their point of view, which of the teaching strategies is more conducive to the appropriation of knowledge and the development of skills related to the care process?
Background:
Case-based learning has long been one of the active teaching strategies widely used by nursing educators. However, the constraints inherent to traditional case study learning have prompted educators to seek alternative teaching practices. Today, virtual case studies are recognised as one of the most recommended and innovative teaching approaches to address these constraints in the nursing context.
Objective:
the present study aims to explore students' perceptions of traditional case studies and virtual case studies as facilitated learning methods for teaching the nursing process.
Methods:
We conducted a questionnaire survey at the Higher Institute of Nursing Professions and Health Techniques Casablanca in 2021 among first-year polyvalent nursing students. The course ‘Conceptualization and Care Planning’ was taught based on these two different pedagogies.
Results:
Comparing the means via a t-test of the paired samples showed that there was a significant difference for all items (p-value<0.005) between learning facilitated by traditional case studies and virtual case studies.
Conclusion:
These results demonstrate that virtual case studies are an innovative and well-received educational tool for nursing students compared to traditional case studies.
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Sikorska K, Gesing M, Olszański R, Roszko-Wysokińska A, Szostakowska B, Van Damme-Ostapowicz K. Misdiagnosis and inappropriate treatment of cutaneous leishmaniasis: a case report. Trop Dis Travel Med Vaccines 2022; 8:18. [PMID: 35909173 PMCID: PMC9341103 DOI: 10.1186/s40794-022-00175-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/06/2022] [Indexed: 11/24/2022] Open
Abstract
Background Leishmaniasis is a widespread disease in tropical and subtropical countries, except for Australia and Oceania. In Poland, tourists, migrants and travellers from leishmaniasis-endemic countries may carry Leishmania. Case presentation We present a case of undiagnosed cutaneous leishmaniasis in a patient who received many weeks of inadequate antibiotic treatment. Ulceration in the right submandibular region was thought to be a purulent complication after laser surgery. Six weeks before the ulcer developed, the patient had visited the jungle (Guatemala). Cutaneous leishmaniasis was finally diagnosed after nine months based on a proper history and a polymerase chain reaction (PCR) assay. Treatment with antimony derivatives was administered. After three months, the ulcer healed but left a scar. Conclusion A lack of knowledge about tropical diseases among doctors and an incomplete medical history were the reasons for many weeks of erroneous treatment of cutaneous leishmaniasis with antibiotics. This is the first reported case of cutaneous leishmaniasis misdiagnosed as a complication after an aesthetic medical procedure.
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The effects of using virtual patients on the history-taking ability of nursing interns: A non-randomized controlled study. Nurse Educ Pract 2022; 59:103289. [DOI: 10.1016/j.nepr.2022.103289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 11/11/2021] [Accepted: 01/08/2022] [Indexed: 11/23/2022]
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Scoular S, Huntsberry A, Patel T, Wettergreen S, Brunner JM. Transitioning Competency-Based Communication Assessments to the Online Platform: Examples and Student Outcomes. PHARMACY 2021; 9:52. [PMID: 33807737 PMCID: PMC8006042 DOI: 10.3390/pharmacy9010052] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/27/2021] [Accepted: 03/04/2021] [Indexed: 11/26/2022] Open
Abstract
In light of the COVID-19 pandemic, pharmacy education has shifted from in-person teaching and assessments to the virtual environment. Many education programs had previously adopted objective structured clinical examinations (OSCEs) to assess communication abilities in-person with standardized patients (SPs). However, comparative student outcome data between virtual and in-person methods as well as guidance on how to conduct communication-based OSCEs in the virtual environment is lacking. The University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences (SSPPS) describes its methods of conducting two types of communication-based OSCEs (patient counseling and gathering a medical history). Student performance data from the two virtual OSCEs in 2020 was compared to results from two 2019 in-person OSCEs using Mann Whitney U Tests. The 2020 cohort scored significantly higher than the 2019 cohort in all variables (i.e., using effective verbal and non-verbal communication, using patient friendly education, organizing the encounter, demonstrating empathy, establishing trust, professionalism) and in overall score. However, the effect size for these findings indicate the differences between performances are generally small and more likely due to changes in grading patterns due to the pandemic.
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Affiliation(s)
- Sarah Scoular
- Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (A.H.); (T.P.); (S.W.); (J.M.B.)
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