Integration of a Virtual Dispensing Simulator "MyDispense" in an Experiential Education Program to Prepare Students for Community Introductory Pharmacy Practice Experience

Developing a framework for MyDispense implementation using the nominal group technique: Perspectives across student progression levels

INTRODUCTION

MyDispense is an online dispensing pharmacy simulation with features such as electronic health records and clinical decision-making. This study aims to develop a framework for integrating MyDispense into pharmacy education programs, and to identify key considerations around its implementation.

METHODS

A nominal group technique with faculty staff and students was employed to gather opinions and experiences with MyDispense, factors to consider during implementation, and perceptions of an ideal framework. A framework for MyDispense implementation was developed based on the input gathered, and common themes from content analysis and considerations for effective integration were identified.

RESULTS

An analysis of discussions on the role of MyDispense in pharmacy student learning revealed that its role depends on how far along students are in their degree and their level of pharmacy knowledge as they progress through their degree. The proposed framework for implementing MyDispense in novice pharmacy education emphasizes the development of fundamental skills, while for students in intermediate year levels, MyDispense can be used in clinical notes. For near-entry to practice students, the focus shifts to refining advanced clinical decision-making skills through authentic virtual training exercises. Valuable insights from former users contributed to shaping a proposed implementation framework, indicating the need for tailored approaches at different student proficiency levels.

CONCLUSION

Our study highlights the versatility of MyDispense as a tool for enhancing pharmacy education. The MyDispense framework, shaped by diverse participant insights, emphasizes the need for tailored implementation based on student proficiency level. The findings offer practical guidance for educators to optimize MyDispense use in fostering clinical skills in pharmacy students.

Online simulation versus traditional classroom learnings in clinical pharmacy education: effect on students' knowledge, satisfaction and self-confidence

BACKGROUND

Over the course of the past few years, the area of medical education has experienced a substantial movement towards the establishment of online learning platforms and resources. This study aimed to to evaluate the efficacy of an online simulation learning intervention, MyDispense®, compared to traditional classroom learning in terms of enhancing knowledge, satisfaction, and self-confidence among participants.

METHODS

A multicentre randomized controlled study was conducted among pharmacy students who were assigned either intervention MyDispense® or control traditional classroom learning groups. They were eligible if they previously had experience with online simulation learning. A previously validated questioner were used to measure the outcome of knowledge, satisfaction and self-confidence.

RESULTS

Both the intervention and control groups revealed significant improvement in knowledge, the P value for pre-post knowledge scores for each group was < 0,001. Despite these internal improvements, this study's findings showed no statistically significant differences (p > 0.05) between the intervention and control groups on knowledge gain, satisfaction, or self-confidence. This represents comparable outcomes irrespective of the group's exposure to intervention.

CONCLUSION

The study evaluated the efficacy of online simulation learning intervention MyDispense® in comparison to traditional classroom learning. While both strategies effectively improved knowledge, satisfaction, and self-confidence, the findings demonstrated that the online simulation yielded equivalent learning benefits. MyDispense® could be an alternative to traditional education in situations where face to face learning is not feasible, with comparable learning outcomes.

CLINICAL TRIAL NUMBER

not applicable.

Evaluating the use of virtual simulation training to support pharmacy students' competency development in conducting dispensing tasks

BACKGROUND

The incorporation of digital health technologies in undergraduate teaching, such as the MyDispense program, provides a simulated opportunity to support students' competency development in dispensing tasks.

OBJECTIVE

This study aimed to evaluate the impact of using MyDispense, an online pharmacy simulation platform, on pharmacy students' self-reported reaction, learning, and accuracy in performing dispensing tasks.

METHODOLOGY

16 MyDispense cases simulating real-practice scenarios from prescription dispensing and verification to patient counseling were created for 55 professional year 1 pharmacy students as part of a professional skills course. A pre-post survey, nestled on Kirkpatrick's Model of Training Evaluation, was conducted on participants in the cohort to evaluate how the incorporation of MyDispense supported their development of dispensing tasks. A virtual formative assessment was also done using MyDispense to compare students' self-reported accuracy with faculty assessment scores to evaluate how MyDispense can support students' knowledge and metacognitive abilities in dispensing.

RESULTS

The study showed an increase in students' confidence after using MyDispense, which led to an increase in the "learning" level of Kirkpatrick's Model. However, small changes were observed in other levels and sublevels of Kirkpatrick's Model. A notable discrepancy was observed between students' self-assessment scores and faculty assessment scores, with students overestimating their performances. Correlation analysis showed a weak relationship between students' self-assessment scores and the learning level of Kirkpatrick's Model.

CONCLUSION

This study highlights the positive impact of MyDispense on pharmacy students' confidence in dispensing. However, virtual simulation training may be best incorporated when students have exposure to experiential training placements, to maximize the learning outcomes and knowledge in dispensing processes.

The effectiveness of a structured validated questionnaire to assess student perception with virtual pharmacy simulation in pharmacy practice experiential education

BACKGROUND AND OBJECTIVE

MyDispense is one of the virtual simulations that has already been established as a suitable alternative for live experiential education in the pharmacy curriculum. However, there are no structured validated questionnaires available to assess the students' perception while integrating MyDispense with pharmacy practice experiential education. Therefore, the present study aimed to validate a structured questionnaire and use the questionnaire to assess the student perception of various pharmacy practice experiential education.

METHODS

Content and construct validity procedure was used to validate the questionnaire. Two hundred students consented to participate in validating the questionnaire. The validated questionnaire assessed the students' perception of integrating MyDispense with Introductory Pharmacy Practice Experience 2 (IPPE2) and Advanced Pharmacy Practice Experience (APPE) courses. The questionnaire was structured with four domains which were: exercise, instructor, technical, and communication. Each domain carried five items; therefore, the whole questionnaire had 20 items that succeeded in content validity. In the survey, 121 fourth-year and 117 fifth-year Pharm.D. students volunteered to convey their perception of integrating MyDispense with IPPE 2 and APPE, respectively. The survey was conducted before and after the MyDispense exam in both the courses.

RESULTS

The Cronbach's α and McDonald's ω coefficients were > 0.8 in all four domains, indicating that the items related to the four domains have good internal consistency. In Exploratory Factor Analysis (EFA), two items were found to cross-load in the exercise domain and removed. Therefore, the EFA proposes 18 items for the confirmatory factor analysis (CFA). In CFA, five fit indices were found to be satisfactory, and this indicates construct was good enough to assess the student perception. In IPPE 2, the pre-test response, the students had significantly higher satisfaction (p < 0.05) with all five items related to the technical domain. In APPE, the students had a significantly (p < 0.05) higher perception of all the items related to the exercise and technical domain in the pre-test compared to the post-test. Therefore, the student's pre-test feedback allowed the instructor to identify and make the necessary corrections in the exercises to improve the quality exercises.

CONCLUSION

This study provides a validated 18-item questionnaire to assess the student perception of integrating MyDispense in experiential education. The integration of MyDispense in experiential education needs to be done carefully by assessing student perception.

A systematic review of the impact of simulation on students' confidence in performing clinical pharmacy activities

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.

Virtual self-care simulations for third-year pharmacy skills laboratory courses in three institutions

BACKGROUND AND PURPOSE

This study was designed to determine whether a virtual, self-care activity improved knowledge and confidence in third-year student pharmacists.

EDUCATIONAL ACTIVITY AND SETTING

Third-year student pharmacists (n = 386) from three institutions participated in the virtual self-care simulation during their respective practice laboratory course. A pre- and post-assessment collected 10 knowledge and five confidence questions, self-reported on 0-100 scale, mapped to learning outcomes and pharmacy standards. Responses for participants who provided consent and had linked assessments were analyzed. Additionally, students participated in a perception assessment following the simulation with the post-assessment. Each knowledge question was scored as binary (correct/incorrect), presented as percentage, and significance identified with a McNemar's test. Total knowledge score and confidence changes were presented as means with standard deviations and significance with a paired t-test. Student perceptions were presented as frequencies and percentages.

FINDINGS

Total knowledge assessment demonstrated a significant improvement (p < 0.001) for the entire cohort of 198 study participants. Upon additional analysis, a single institution led the cohort to significant increase, with variable improvement and significance for each individual question. Confidence improved for the entire cohort of students and at each institution individually. The students perceived the virtual self-care activity favorably.

SUMMARY

The third-year student virtual self-care activity improved knowledge and confidence with varying significance between institutions. Future studies will focus on the impact of continued reinforcement of self-care activities on student growth in knowledge and confidence.

An accelerated dispensing course for grad entry students - Can we teach dispensing skills over a day?

BACKGROUND AND PURPOSE

This study aimed to evaluate an accelerated dispensing course for graduate entry (GE) pharmacy students with prior science-related degrees to join undergraduate (UG) students in year three of the Monash Pharmacy degree.

EDUCATIONAL ACTIVITY AND SETTING

A one day accelerated dispensing course using MyDispense software was delivered to 59 GE students. The accelerated dispensing course was identical to the standard three-week dispensing course delivered to UG students. The same assessment of dispensing skills was conducted after course completion for both UG and GE students and included dispensing four prescriptions of varying difficulty. The assessment scores of the UG and GE students were compared. Perception data from the accelerated course were also collected.

FINDINGS

The accelerated dispensing curriculum was well received by students. They found the simulation relevant to practice, easy to navigate, and helpful for preparing them for assessment. Overall, 5.1% of GE students failed the assessment, which was lower than the 32.6% failure rate in the UG cohort. Comparison of assessment grades between UG and GE students showed no notable disadvantage to attainment of learning outcomes with the accelerated curriculum. However, UG students were more likely to provide unsafe instructions compared to GE students in their labeling for three out of four prescriptions.

SUMMARY

An accelerated dispensing curriculum can be effectively delivered to mature learners with a prior science-related degree as no notable deficiencies were identified when comparing the assessment results of GE students against UG students when both student cohorts undertook the same dispensing assessment.

Using a virtual simulation platform for dispensing pediatric prescriptions in a community-based pharmaceutical skills course

BACKGROUND AND PURPOSE

Safe and accurate dispensing of medications is an essential skill. Pharmacy schools must provide students with the knowledge and practice to enhance special population dispensing skills. The objective of this study is to describe a community pharmacy pediatric simulation completed by first-year pharmacy students and to review student perceptions on confidence and knowledge learned after a MyDispense (Monash University) simulation.

EDUCATIONAL ACTIVITY AND SETTING

First-year Pharmaceutical Skills students participated in a MyDispense simulation to identify errors and omissions of prescription orders with a focus on pediatrics. Although students had limited therapeutic knowledge, the activity emphasized federal and Florida law requirements. Retrieval and direct application of these principles along with new experiences in identifying medication errors afforded students to learn in a low-stake, controlled environment.

FINDINGS

Of the 64 students enrolled in the Pharmaceutical Skills I course, 57 completed the pre-simulation survey and 56 students completed the post-simulation survey (87.5% response rate). Increased confidence and knowledge were found for most questions. The pre-simulation survey had students most frequently answer neutral followed by disagree or strongly disagree for ability to complete the listed task. The post-simulation survey responses shifted with many students responding with agree or strongly agree for the listed task and found MyDispense to be a helpful simulation tool.

SUMMARY

Exposing pharmacy students to pediatric virtual simulations early in the curriculum may increase confidence and knowledge. Future pediatric simulation coursework would benefit longitudinally to further build confidence and enhance retention of knowledge.

Perception of learners on the effectiveness and suitability of MyDispense: a virtual pharmacy simulation and its integration in the clinical pharmacy module in Viet Nam

BACKGROUND

My Dispense is a virtual pharmacy simulation developed for students to train and practice dispensing skills in a safe environment that causes no harm to patients. This study was aimed to investigate learners' perspectives on the effectiveness of MyDispense and its suitability to integrate into the clinical pharmacy module in Viet Nam.

METHODS

A mixed method approach was undertaken. Fourth- and fifth-year pharmacy students at University of Medicine and Pharmacy at Ho Chi Minh city and community pharmacists were invited to complete a survey questionnaire and to participate in semi-structured interviews.

RESULTS

A total of 92/99 participants agreed to take part, of which 75% of participants were students and 65.2% were female. About three-quarters of the participants agreed or strongly agreed that MyDispense improved their dispensing skills, such as patient counselling (70.6%) and collecting patient infomation (85.9%). The majority of the participants (84.8%) considered that MyDispense was suitable to integrate into the clinical pharmacy module. Qualitative analysis from the interviews highlighted the advantages of MyDispense, comprising high interactivity with users, safe environment for practicing medication dispensing, and diversity of common marketed medications. In addition, certain barriers of this programme were also reported, including the complicated process, inconsistent quality of product images, and mixed English-Vietnamese languages.

CONCLUSIONS

From learner's perspectives, MyDispense was an effective tool to enhance dispensing skills and was suitable to integrated into the clinical pharmacy module in Viet Nam.

MyDispense simulation in pharmacy education: a scoping review

BACKGROUND

MyDispense is a free online virtual simulation software developed by Monash University. The software facilitates students to practise, apply and hone the skills of a pharmacist in a realistic environment without the potentially life-threatening consequences of a real-life error. Although the focus of MyDispense was initially on exposure to community pharmacy practice scenarios, its modular build and customizability, indicate that there are a wide range of applications that could be incorporated into pharmacy education. Therefore, this study reviews and appraises the literature on the use of MyDispense within pharmacy education.

METHODS

A scoping review was conducted. The electronic databases (CINAHL, Ovid Embase, Ovid Medline, Google Scholar, and Scopus) were searched to identify scholarly articles related to MyDispense in pharmacy education from January 2011 and August 2022.

RESULTS

Forty-three papers met the inclusion criteria and were analysed in this scoping review. A total of 418 key sentences and segments of text were extracted from the papers and subsequently categorized into 10 subthemes. The 10 subthemes were dispensing skills, communication skills, decision-making/problem-solving skills, student performance, pharmacy law, applying theoretical knowledge, support educators, pharmacy practice, feedback/reflection and practice in a risk-free environment. In total, four overarching themes summarize how MyDispense is supporting pharmacy education: supporting education; skill development; application of knowledge and student outcomes.

CONCLUSION

The scoping review found that MyDispense was mostly used to support education and student skill development. These findings can be used to support pharmacy educators globally on the various uses and applications of MyDispense in their teaching.

Remote extemporaneous compounding lab practical for pharmacy students during the COVID-19 pandemic

BACKGROUND AND PURPOSE

Due to COVID-19 movement restrictions, institutes of higher learning had to deliver pharmacy curricula remotely. One major challenge was teaching practical lab skills, such as extemporaneous compounding, remotely due to the need for hands-on learning and its associated logistical requirements.

EDUCATIONAL ACTIVITY AND SETTING

We present the approach to remote extemporaneous compounding teaching taken by three pharmacy schools: Monash University Malaysia, University of Michigan, and University of Maryland. Prior to delivery, students were either supplied with or asked to procure a set of easily accessible ingredients and equipment to conduct the extemporaneous practicals from home. We conducted lessons remotely using both synchronous and asynchronous delivery, and demonstrated, taught, and assessed practical lab skills using video conferencing modalities.

FINDINGS

We successfully conducted remote teaching of extemporaneous compounding, where similar learning outcomes to the face-to-face implementation were achieved. At Monash University Malaysia, > 90% of students responding to the post-activity surveys found the remote extemporaneous sessions useful for their learning, and qualitative comments supported these views. Mean scores from the remote extemporaneous labs in 2021 were similar to those when conducted physically in 2019, supporting the effectiveness of the approach. The different approaches attempted by the three institutions highlighted the flexibility in implementation that can be considered to achieve similar outcomes.

SUMMARY

Combining technology-based approaches with synchronous and asynchronous teaching and learning methods can successfully deliver extemporaneous compounding skills remotely.

An Introductory Over-the-Counter Simulation for First-Year Pharmacy Students Using a Virtual Pharmacy

Objective. First-year pharmacy students at two institutions were required to complete a virtual over-the-counter (OTC) simulation during their community pharmacy practice skills laboratory course. The simulation was designed to introduce first-year pharmacy students to OTC product selection and consultation prior to didactic coursework and community introductory pharmacy practice experiences. The objective of this study was to assess the impact of the OTC simulation on students' knowledge and confidence of OTC medications and overall perceptions of the activity.Methods. Patient simulation cases in the virtual community pharmacy setting were developed and delivered to students using the MyDispense platform. Students concurrently completed a Google Form that provided directions for the virtual activity, including a combination of didactic and active learning strategies within the online platform. Student surveys assessed knowledge and confidence before and after the activity, with perceptions added to the postsurvey.Results. Total knowledge scores for the 142 students from two institutions who completed both the pre- and postsurvey significantly improved and, when assessed individually, improved for seven out of 10 individual knowledge questions. All five confidence statements significantly increased after students completed the OTC simulation. Student perceptions were overall very positive.Conclusion. Introduction of OTC counseling processes to first-year pharmacy students through a virtual pharmacy simulation resulted in increased student knowledge and confidence in providing OTC recommendations. Students perceived the activity favorably.

Expansion of MyDispense: A Descriptive Report of Simulation Activities and Assessment in a Certified Pharmacy Technician Training Program

BACKGROUND

Yale New Haven Health (YNHH) implemented a pharmacy technician training program in 2016. The curriculum includes 14 weeks of combined didactic and simulation hours (280 h in total), followed by 360 h of experiential learning. MyDispense, an online pharmacy simulation, allows students to develop and practice their dispensing skills in a safe environment with minimal consequences for mistakes. We describe a novel innovation, expanding the functionality of MyDispense to the training of pharmacy technicians.

METHODS

Technician training coordinator, supervisor, faculty members with experience in MyDispense, and experiential pharmacy students created cases within the MyDispense software that were targeted towards pharmacy technician activities. Activities were aligned with current American Society of Health-System Pharmacists (ASHP)-Accreditation Council for Pharmacy Education (ACPE) Accreditation Standards for pharmacy technician education and training programs.

RESULTS

A total of 14 cases were developed to be utilized in student technician training, and account for approximately 14 h of simulation.

CONCLUSIONS

MyDispense is an innovative software that could allow students to access and complete exercises, and to continue developing dispensing skills in a safe, remote environment. We identified similarities between activities performed by student pharmacists and student pharmacy technicians, expanding MyDispense to a new learner group to practice, develop and be assessed on dispensing skills within their scope, as part of a formal technician training program and in preparation for the Pharmacy Technician Certification Examination (PTCE).

Use of the Virtual Simulation Tool 'MyDispense' By Pharmacy Programs in the United States

Objective. Pharmacy programs are increasingly using virtual simulation to provide a safe and realistic environment for students to practice critical patient care skills. The aim of this study was to describe the use of MyDispense, a virtual simulation tool, by pharmacy programs across the United States.Methods. Researchers developed a 16-item survey focused on program characteristics and MyDispense integration in pharmacy curricula. It was sent to MyDispense administrators of pharmacy programs in the United States. Descriptive statistics were used to analyze the results.Results. Administrators from 36 pharmacy programs responded to the survey (72%). MyDispense was most commonly integrated into one or two courses for first- or second-year students. The most common skills that students practiced were medication dispensing, communication with patients, and drug information skills. Validation exercises were most commonly followed by dispensing and over-the-counter exercises. The number of pharmacy schools using MyDispense suggests the potential for collaboration among instructors to increase efficiencies in the delivery of course materials as well as evaluate student learning.Conclusion. Instructors most used MyDispense in courses for first- and second-year students to teach medication dispensing, communication with patients, use of drug information resources, application of pharmacy laws, and how to make recommendations about over-the-counter medications.

Incorporation of MyDispense, a Virtual Pharmacy Simulation, into Extemporaneous Formulation Laboratories

A core competency of Australian Pharmacy graduates is to prepare and compound extemporaneous formulations. Students in our pharmacy course would traditionally formulate extemporaneous products in laboratory classes while simultaneously preparing a handwritten label, with students divorcing this laboratory activity from the entire dispensing process. As a way to incorporate the dispensing process into the preparation of extemporaneous products without adding excessive time to the laboratory, we integrated MyDispense, a virtual pharmacy simulation, in pre-laboratory activities. This meant that students could complete all the dispensing activities for prescribed extemporaneous formulations prior to attending the laboratory. Prescriptions for solutions, suspensions, creams and ointments were developed in MyDispense, including essential components for dispensing an extemporaneous formulation (e.g., formulation name, dosing instructions). These prescriptions were provided to students at least 1 week prior to their laboratory classes, whereas for the laboratory assessments, the prescription was provided at the commencement of the extemporaneous exam. Due to the implementation of dispensing via MyDispense, we found that students demonstrated pre-laboratory engagement as all students presented their printed labels upon entering the laboratory. We also observed an increase in interaction between students and laboratory facilitators, mainly focused on the principles of formulation integrated around patient outcomes. Virtual simulations such as MyDispense can therefore provide a guided realistic learning experience, whilst overcoming time pressures associated with laboratory timetabling. This approach also encourages students to engage in the dispensing process prior to extemporaneous laboratories providing more opportunity to discuss higher-level formulation principles and patient-centred outcomes during laboratory classes.

Simulation-Based Education Implementation in Pharmacy Curriculum: A Review of the Current Status

Simulation-based education (SBE) is a fundamental teaching method that complements traditional teaching modalities. SBE has improved students' knowledge, understanding, and numerous essential skills within undergraduate pharmacy education, similar to traditional teaching methods. However, SBE has become crucial for developing students' teamwork, decision-making, and communication skills. Even though the Accreditation Council for Pharmacy Education (ACPE) has acknowledged the benefit of SBE in interprofessional education (IPE) and the introductory pharmacy practice experience (IPPE). This article provides evidence that SBE can be effective beyond that. This narrative review is focused on the literature related to SBE modalities and the assessment methods of student learning outcomes in the undergraduate pharmacy curriculum. The review illustrates that SBE is an effective teaching method that could be utilized within the pharmacy curriculum. The review also could help pharmacy educators decide on the best modality and placement of integrating patient simulation within the pharmacy curriculum. Combining multiple simulation techniques may be the best way to achieve the desired student learning outcomes.

Using Technology to Enhance Teaching and Learning in Pharmacy Education

It was a privilege to serve as guest editors in Pharmacy for the Special Issue 'Technology-Enhanced Pharmacy Teaching and Learning Strategies' [...].