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Nicolaou SA, Televantou I, Papageorgiou A, Albert AP, Hitchings AW, McCrorie P, Nicolaou P. Factors affecting pharmacology learning in integrated PBL in diverse medical students: a mixed methods study. BMC MEDICAL EDUCATION 2024; 24:324. [PMID: 38515169 PMCID: PMC10958917 DOI: 10.1186/s12909-024-05289-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/11/2024] [Indexed: 03/23/2024]
Abstract
INTRODUCTION Problem-based learning (PBL) was introduced to address passive teaching limitations. However, it is not fully characterised as a teaching modality in pharmacology. The present study investigated the factors affecting pharmacology learning in an integrated PBL-based curriculum in diverse learners. METHODS Year 1 undergraduate medical students from two cohorts at St. George's University of London and University of Nicosia, participated. Statistical analysis of pharmacology knowledge scores, at the beginning (pre-test) and end of the academic year (post-test), investigated readiness to benefit from PBL based on diverse student characteristics (educational background, age, gender, country of origin, ethnicity, native language, PBL experience). Focus groups/interviews and a survey investigated aspects of integrated PBL impacting learning in depth. RESULTS Pre- and post-test scores were positively correlated. Students with biomedical sciences degrees performed better at the pharmacology pre- and post-tests, while post-graduate degree holders performed better only at the pre-test. Effect size was of moderate magnitude. However, progress in learning (post-test performance after controlling for pre-test scores) was unaffected. Qualitative analysis revealed three major themes: 1) PBL as a learning environment; 2) PBL as a learning environment in pharmacology; and 3) PBL as a learning environment and confidence in prescribing. Under theme one, skill development, knowledge acquisition through collaboration and self-directed learning, group dynamics and preferred teaching methods were discussed. Under theme two, contextual learning, depth of knowledge and material correctness were raised. Under theme 3, students expressed variability in prescribing confidence. They perceived that learning could be improved by better integration, further references earlier on, more lectures and PBL facilitators with greater content expertise. The survey findings were consistent with those from focus groups/interviews. CONCLUSION Pharmacology learning in a PBL-based curriculum is facilitated by constructive, collaborative and contextual learning. While baseline pharmacology knowledge may be advantageous, the other aforementioned characteristics studied may not affect readiness to benefit from PBL. However, further instructional scaffolding is needed, for example through further resources, lectures and self-assessment. The results from our study can inform evidence-based curriculum reform to support student learning further. Addressing learning needs could ultimately contribute to reducing medication errors through effective training of future prescribers.
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Affiliation(s)
- S A Nicolaou
- University of Nicosia Research Foundation, Nicosia, Cyprus
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - I Televantou
- University of Nicosia Research Foundation, Nicosia, Cyprus
- Department of Educational Sciences, European University, Nicosia, Cyprus
| | - A Papageorgiou
- University of Nicosia Research Foundation, Nicosia, Cyprus
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - A P Albert
- Vascular Biology Section, Cardiovascular & Genetics Research Institute, St George's, University of London, London, UK
| | - A W Hitchings
- Institute of Medical, Biomedical and Allied Education, St George's, University of London, London, UK
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - P McCrorie
- University of Nicosia Research Foundation, Nicosia, Cyprus
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, 2417, Nicosia, Cyprus
| | - Persoulla Nicolaou
- University of Nicosia Research Foundation, Nicosia, Cyprus.
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, 2417, Nicosia, Cyprus.
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Fasinu PS, Wilborn TW. Pharmacology education in the medical curriculum: Challenges and opportunities for improvement. Pharmacol Res Perspect 2024; 12:e1178. [PMID: 38361337 PMCID: PMC10869893 DOI: 10.1002/prp2.1178] [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: 11/29/2023] [Revised: 01/19/2024] [Accepted: 01/26/2024] [Indexed: 02/17/2024] Open
Abstract
The knowledge and application of pharmacology is essential for safe prescribing and administration of drugs. In this narrative review, the challenges to pharmacology education in the medical curricula were broadly identified to include issues around content and pedagogies. The increasing number of approved drugs and drug targets, expanding field of pharmacology and the often-changing treatment guidelines and board-defined competencies can make pharmacology education in the medical curriculum daunting. There has been a consensus around the deployment of innovative medical curricula with emphasis on vertical and horizontal integration. This strategy, effective as it has been, presents new challenges to pharmacology education. As a discipline often perceived by students to be hard-to-learn, the future of pharmacology education must include heavy reliance on active learning strategies. The continuing utilization of problem-based, team-based and case-based learning can be complemented with personalized learning which aims to identify the learning gaps in individual students. Technology-inspired student engagement can foster pharmacology learning and retention. Early exposure to pharmacology from premedical preparation through an enduring across-the-level integration can be an effective way to enhance pharmacology learning in the medical curricula.
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Affiliation(s)
- Pius S. Fasinu
- Department of Pharmacology & Toxicology, Heersink School of MedicineThe University of Alabama at BirminghamBirminghamAlabamaUSA
| | - Teresa W. Wilborn
- Department of Pharmacology & Toxicology, Heersink School of MedicineThe University of Alabama at BirminghamBirminghamAlabamaUSA
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Guilding C, Kelly-Laubscher R, White P. The future of pharmacology education: a global outlook. Expert Rev Clin Pharmacol 2024; 17:115-118. [PMID: 38192241 DOI: 10.1080/17512433.2024.2302602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/03/2024] [Indexed: 01/10/2024]
Affiliation(s)
- Clare Guilding
- School of Medicine, Newcastle University, Newcastle Upon Tyne, UK
| | - Roisin Kelly-Laubscher
- Department of Pharmacology & Therapeutics, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Paul White
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
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Aref HAT, Wright BM, Davis BR, Fowlin JM. High-level curricular integration in pharmacy schools: A systematic literature review. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:1724-1734. [PMID: 34895685 DOI: 10.1016/j.cptl.2021.09.046] [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: 12/05/2020] [Revised: 07/23/2021] [Accepted: 09/15/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Pharmacy school accreditors recommend curricular integration. With today's complex health care system, there is also a need for more intentional and seamless blending, characterizing what we propose as "high-level curricular integration" (i.e. intentional "weaving" of multiple disciplines to form a coherent whole). Despite accreditors' recommendations, the practical definition and implementation guidelines of high-level curricular integration are not clear. We aimed to describe high-level curricular integration practices in pharmacy schools by systematically reviewing the literature addressing four elements of high-level curricular integration. These were (1) organizational thread, (2) pedagogies, (3) evaluation strategies, and (4) barriers. METHODS A PRISMA-guided (preferred reporting items for systematic reviews and meta-analyses) literature search strategy was conducted to examine the scientific literature. Inclusion criteria were English written literature related to one or more of the four elements of high-level curricular integration in pharmacy schools. RESULTS After screening titles, abstracts, and full texts, 28 articles were included. The most used organizational thread was disease-oriented (n = 8, 28.5%), and the most reported pedagogy was case studies (n = 11, 39%). Over half of the studies reported how the integration experience was evaluated. Most studies addressed barriers (n = 21, 75%), with the most reported barriers being time (n = 12, 42%) and workload (n = 12, 42%). IMPLICATIONS This review aimed to define and describe high-level integration within schools of pharmacy through four elements. Numerous and diverse trends were identified, and these four elements should be considered when planning, implementing, evaluating, and reporting curriculum integration experiences.
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Affiliation(s)
- Heba A T Aref
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada; Edmonton Clinic Health Academy (ECHA), 3-015, 11405 87 Avenue NW, Edmonton, Alberta, Canada.
| | - Bradley M Wright
- Director of the Professional Program, Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, 301 Governors Drive SW, Huntsville, AL 35801, United States.
| | - Brandy R Davis
- Harrison School of Pharmacy, Auburn University, Auburn, Alabama, Walker Bldg, 2316, Auburn, AL 36849, United States.
| | - Julaine M Fowlin
- Assistant Director for Instructional Design, Center for Teaching, Vanderbilt University, Nashville, TN, United States.
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Khurshid F, Noushad B, Whitehead D. Threshold Concepts in the Discipline of Pharmacology - A Preliminary Qualitative Study of Students’ Reflective Essays. HEALTH PROFESSIONS EDUCATION 2020. [DOI: 10.1016/j.hpe.2019.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Pharmacology education: Reflections and challenges. Eur J Pharmacol 2018; 833:392-395. [PMID: 29935169 DOI: 10.1016/j.ejphar.2018.06.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 06/03/2018] [Accepted: 06/19/2018] [Indexed: 11/23/2022]
Abstract
Pharmacology is one of the cornerstones in health sciences curricula as well as research-oriented biomedical programs in higher education. New educational insights and scientific developments in teaching and learning, as well as exciting discoveries in pharmacology research, must prompt pharmacology teachers to regularly rethink and adjust their teaching. Reflecting on pharmacology education, this paper touches upon some educational issues that might inspire readers of this journal who are involved in pharmacology teaching.
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Lai PSM, Sim SM, Chua SS, Tan CH, Ng CJ, Achike FI, Teng CL. Development and validation of an instrument to assess the prescribing readiness of medical students in Malaysia. BMC MEDICAL EDUCATION 2015; 15:153. [PMID: 26391883 PMCID: PMC4578793 DOI: 10.1186/s12909-015-0433-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 09/04/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Prescribing incompetence is an important factor that contributes to prescribing error, and this is often due to inadequate training during medical schools. We therefore aimed to develop and validate an instrument to assess the prescribing readiness of medical students (PROMS) in Malaysia. METHODS The PROMS comprised of 26 items with four domains: undergraduate learning opportunities; hands-on clinical skills practice; information gathering behaviour; and factors affecting the learning of prescribing skills. The first three domains were adapted from an existing questionnaire, while items from the last domain were formulated based on findings from a nominal group discussion. Face and content validity was determined by an expert panel, pilot tested in a class of final year (Year 5) medical students, and assessed using the Flesch reading ease. To assess the reliability of the PROMS, the internal consistency and test-retest (at baseline and 2 weeks later) were assessed using the Wilcoxon Signed Ranks test and Spearman's rho. The discriminative validity of the PROMS was assessed using the Mann-Whitney U-test (to assess if the PROMS could discriminate between final year medical students from a public and a private university). RESULTS A total of 119 medical students were recruited. Flesch reading ease was 46.9, indicating that the instrument was suitable for use in participants undergoing tertiary education. The overall Cronbach alpha value of the PROMS was 0.695, which was satisfactory. Test-retest showed no difference for 25/26 items, indicating that our instrument was reliable. Responses from the public and private university final year medical students were significantly different in 10/26 items, indicating that the PROMS was able to discriminate between these two groups. Medical students from the private university reported fewer learning opportunities and hands-on practice compared to those from the public university. On the other hand, medical students from the private university reported more frequent use of both web based and non-web-based resources compared to their public university counterparts. CONCLUSIONS The PROMS instrument was found to be a reliable and valid tool for assessing medical students' readiness to prescribe in Malaysia. It may also inform on the adequacy of medical programmes in training prescribing skills.
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Affiliation(s)
- Pauline Siew Mei Lai
- Department of Primary Care Medicine, University of Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Si Mui Sim
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Siew Siang Chua
- Department of Pharmacy, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Choo Hock Tan
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Chirk Jenn Ng
- Department of Primary Care Medicine, University of Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Francis Ifejika Achike
- Division of Clinical Science, School of Medicine and Allied Health Sciences, International Medical University, 57000, Kuala Lumpur, Malaysia.
- Central Michigan University College of Medicine, Mount Pleasant, MI, 48859, USA.
| | - Cheong Lieng Teng
- Division of Clinical Science, School of Medicine and Allied Health Sciences, International Medical University, 57000, Kuala Lumpur, Malaysia.
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Achike FI, Smith J, Leonard S, Williams J, Browning F, Glisson J. Advancing safe drug use through interprofessional learning (IPL): A pilot study. J Clin Pharmacol 2014; 54:832-9. [DOI: 10.1002/jcph.289] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 03/12/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Francis I. Achike
- College of Osteopathic Medicine; William Carey University; Hattiesburg MS USA
| | - John Smith
- College of Osteopathic Medicine; William Carey University; Hattiesburg MS USA
| | - Stuart Leonard
- College of Osteopathic Medicine; William Carey University; Hattiesburg MS USA
| | - Janet Williams
- School of Nursing; William Carey University; Hattiesburg MS USA
| | | | - James Glisson
- College of Osteopathic Medicine; William Carey University; Hattiesburg MS USA
- Wesley Hospital; Hattiesburg MS USA
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Achike FI. The temporal and challenging faces of integration in medical education: The fate of pharmacology. Indian J Pharmacol 2011; 43:227-31. [PMID: 21713082 PMCID: PMC3113370 DOI: 10.4103/0253-7613.81492] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Francis I Achike
- International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia E-mail:
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