A case-based toxicology elective course to enhance student learning in pharmacotherapy

Perceptions of Australian and Malaysian Educators in an Undergraduate Pharmacy Program on Case-based Learning

Objective. To determine the perceptions of lecturers toward case-based learning (CBL) and to elicit their feedback and opinions regarding the design of CBL sessions within the pharmacy curricula. Methods. One-on-one interviews were conducted with 10 academic staff members involved in teaching an undergraduate Bachelor of Pharmacy (BPharm) program. All sessions were audio-recorded and field notes were compiled. The recordings were transcribed, and thematic analysis of responses was performed. Results. Four key themes were identified: perceived benefits of CBL, challenges in implementing CBL within the curricula, characteristics of effective and engaging CBL, and relevance and implementation of CBL within the curriculum. Some of the specific benefits of CBL identified by participants included the applicability of knowledge learned to students' future role as pharmacists. Participants also identified challenges such as the design of CBL cases and course time constraints. Respondents also emphasized the need for more training for facilitators in how to design cases and facilitate sessions. Conclusion. While participants identified numerous benefits of CBL, they also identified challenges to implementing this learning method within the pharmacy school curriculum. Paying careful attention to selecting facilitators and providing appropriate facilitator training, in terms of facilitation and case design, is paramount in effectively implementing CBL sessions.

Comparing Pharmacotherapy Instruction to the 2009 and 2016 ACCP Toolkit Recommendations

Objective. To compare pharmacotherapy instruction in Doctor of Pharmacy (PharmD) programs with the 2009 and 2016 American College of Clinical Pharmacy (ACCP) pharmacotherapy toolkits. Methods. A survey was sent to representatives at US schools and colleges with PharmD programs. The survey consisted of questions pertaining to pharmacotherapy credit-hours, contact time spent for each therapeutic subject area, and pedagogical methods used. Data were analyzed using descriptive statistics. Results. Representatives from 75 of 129 PharmD programs responded (response rate 58%). A median of 23 credit-hours were devoted to required pharmacotherapy. Infectious diseases and cardiology were taught with the most number of contact hours. Lecture was the most popular principal method of instruction delivery but the incorporation of case-based learning was also common. Conclusion. Devoted curricular time to pharmacotherapy is adequate to provide coverage of tier 1 and 2 topics from the ACCP toolkit. PharmD programs should continue to review their pharmacotherapy coursework to adjust topic coverage as needed to incorporate active learning strategies whenever possible.

Integration of a Community Pharmacy Simulation Program into a Therapeutics Course

Objective. To demonstrate the feasibility of integrating the computer simulation, MyDispense, into a therapeutics course and to measure its effects on student perception and learning. Methods. We conducted a prospective study with an experimental phase and an implementation phase. In the first phase, students were randomized to complete a therapeutics case using MyDispense or traditional paper methods in class. In the second phase, all students completed two therapeutic cases using MyDispense in class with the option to complete four additional outside-of-class cases using MyDispense. Students completed pre- and post-tests in class and three surveys. Results. In the experimental phase, mean test scores increased from pre- to post-test for both MyDispense and traditional paper groups, but the difference between the groups was not statistically significant. Students in the traditional paper group reported statistically significant gains in confidence compared to the MyDispense group. In the implementation phase, mean test scores again increased, however, student perception of the use of MyDispense for therapeutics was negative. Completing the optional outside-of-class cases, however, was positively and significantly correlated with the midterm and final examination scores. Conclusion. Implementation of MyDispense in therapeutics may be feasible and has positive effects (eg, correlation with exam scores, capacity for immediate feedback, and potential for effective self-study). With short-term use and in the absence of assessment methods that also require seeking information from patients, students prefer to learn via traditional paper cases.

Process oriented guided inquiry learning (POGIL®) marginally effects student achievement measures but substantially increases the odds of passing a course

While the inquiry approach to science teaching has been widely recommended as an epistemic mechanism to promote deep content understanding, there is also increased expectation that process and other transferable skills should be integral part of science pedagogy. To test the hypothesis that coupling process skills to content teaching impacts academic success measures, we meta-analyzed twenty-one studies (n = 21) involving 7876 students that compared Process Oriented Guided Inquiry Learning (POGIL), a pedagogy that provides opportunities for improving process skills during content learning through guided-inquiry activities, to standard lecture conditions. Based on conventional measures of class performance, POGIL had a small effect on achievement outcomes (effect size = 0.29, [95% CI = 0.15-0.43]) but substantially improved the odds of passing a class (odds ratio = 2.02, [95% CI: 1.45-2.83]). That is, participants in the POGIL pedagogy had higher odds of passing a course and roughly performed 0.3 standard deviations higher on achievement measures than participants in standard lectures. In relative risk terms, POGIL reduced the risk of failing a course by 38%. These findings suggest providing opportunities to improve process skills during class instruction does not inhibit content learning but enhances conventional success measures. We compare these findings with those of recent large meta-analysis that examined the effects of global active learning methods on achievement outcomes and course failure rates in science, technology, engineering, and mathematics (STEM) fields.

Assessing a traditional case-based application exercise and a student question creation exercise on student performance and perceptions

BACKGROUND AND PURPOSE

To compare the impact of a traditional case-based application exercise with a student question creation exercise on a) student exam performance, b) student perceptions of enjoyment, competence, understanding, effort, interest in continuing participation, and interest in the subject.

EDUCATIONAL ACTIVITY AND SETTING

Subjects were 84 second-year pharmacy students in a pharmacotherapy course. The research focus was active learning involving the topic of chronic kidney disease-mineral bone disorder. Student teams were randomly assigned to either case-based or student question creation exercises using PeerWise. Student performance was assessed by a pre- and posttest and on block and final exams. After completion, an online survey assessed student perceptions of both exercises.

FINDINGS

Statistically significant differences were revealed in favor of the student question creation group on enjoyment and interest in the subject matter. No statistically differences were found between the traditional case-based group and the student question creation group on gain score from pre-test to posttest. The student question creation group performed slightly better than the case-based application group on two of the five questions on the block exam but none of these differences reached statistical significance.

DISCUSSION AND CONCLUSIONS

Students randomly assigned to groups that created and reviewed questions exhibited slightly improved summative exam performance and reported significantly more positive perceptions than students engaging in a more traditional case-based learning activity. Student question creation has demonstrated potential as a useful learning activity. Despite inherent difficulties in designing studies involving educational research in a controlled environment, students who have submitted, created, rated, and answered peers' questions have overall performed well.

Educational Games as a Teaching Tool in Pharmacy Curriculum

The shift in the pharmacist's role from simply dispensing medications to effective delivery of pharmaceutical care interventions and drug therapy management has influenced pharmacy education.(1-3) The educational focus has shifted from basic sciences to clinical and integrated courses that require incorporating active-learning strategies to provide pharmacy graduates with higher levels of competencies and specialized skills. As opposed to passive didactic lectures, active-learning strategies address the educational content in an interactive learning environment to develop interpersonal, communication, and problem-solving skills needed by pharmacists to function effectively in their new roles.(4-6) One such strategy is using educational games. The aim of this paper is to review educational games adopted in different pharmacy schools and to aid educators in replicating the successfully implemented games and overcoming deficiencies in educational games. This review also highlights the main pitfalls within this research area.

Impact of abbreviated lecture with interactive mini-cases vs traditional lecture on student performance in the large classroom

OBJECTIVE

To compare the impact of 2 different teaching and learning methods on student mastery of learning objectives in a pharmacotherapy module in the large classroom setting.

DESIGN

Two teaching and learning methods were implemented and compared in a required pharmacotherapy module for 2 years. The first year, multiple interactive mini-cases with inclass individual assessment and an abbreviated lecture were used to teach osteoarthritis; a traditional lecture with 1 inclass case discussion was used to teach gout. In the second year, the same topics were used but the methods were flipped. Student performance on pre/post individual readiness assessment tests (iRATs), case questions, and subsequent examinations were compared each year by the teaching and learning method and then between years by topic for each method. Students also voluntarily completed a 20-item evaluation of the teaching and learning methods.

ASSESSMENT

Postpresentation iRATs were significantly higher than prepresentation iRATs for each topic each year with the interactive mini-cases; there was no significant difference in iRATs before and after traditional lecture. For osteoarthritis, postpresentation iRATs after interactive mini-cases in year 1 were significantly higher than postpresentation iRATs after traditional lecture in year 2; the difference in iRATs for gout per learning method was not significant. The difference between examination performance for osteoarthritis and gout was not significant when the teaching and learning methods were compared. On the student evaluations, 2 items were significant both years when answers were compared by teaching and learning method. Each year, students ranked their class participation higher with interactive cases than with traditional lecture, but both years they reported enjoying the traditional lecture format more.

CONCLUSION

Multiple interactive mini-cases with an abbreviated lecture improved immediate mastery of learning objectives compared to a traditional lecture format, regardless of therapeutic topic, but did not improve student performance on subsequent examinations.

A solid organ transplant elective course for pharmacy students

OBJECTIVE

To develop and implement a solid organ transplant elective course for second- and third-year pharmacy students, and assess its impact on students' knowledge in the management of medications, adverse effects, and complications in organ transplantation patients.

DESIGN

Topics related to the care of solid organ transplant patients were covered in depth. Students were required to complete a group presentation focusing on common infectious disease topics encountered in solid organ transplant patients.

ASSESSMENT

Students' solid organ transplantation knowledge was assessed using examinations quizzes, a group presentation, and class participation. With an average class grade of 87%, students demonstrated knowledge of the course material. Most students felt that their knowledge increased significantly with regard to the course objectives.

CONCLUSION

Students who completed the elective course significantly improved their confidence and knowledge regarding solid organ transplantation, felt more prepared than their peers who did not complete the course, and became open to exploring careers or residencies in this area.

Developing health literacy knowledge and skills through case-based learning

OBJECTIVE

To evaluate the efficacy of case-based learning to teach pharmacy students health literacy concepts and skills in managing patients with limited health literacy.

DESIGN

A health literacy patient case was developed and incorporated into a case-based learning laboratory. The case involved a patient with limited health literacy and required students to evaluate and formulate a care plan.

ASSESSMENT

A comparison of pretest and posttest scores demonstrated that students gained health literacy knowledge and skills through completion of the patient case. Students believed that the case-based exercise was successful in meeting specific learning objectives for the course.

CONCLUSIONS

Addition of a case-based learning was effective in teaching pharmacy students health literacy concepts and skills.

A case-based toxicology module on agricultural- and mining-related occupational exposures

OBJECTIVE

To develop and assess a toxicology module to teach pharmacy students about farming- and mining-related occupational exposures in the context of an existing toxicology elective course.

DESIGN

A teaching unit that included lectures and case studies was developed to address the unique occupational exposures of patients working in agricultural and mining environments. Upon completion of this 4-hour (2 class periods) module, students were expected to recognize the clinical signs and symptoms associated with these occupational exposures and propose acceptable therapeutic plans.

ASSESSMENT

After completing the module, students scored significantly higher on a patient case involving suicide resulting from pesticide consumption. Seventy-three percent of the students scored higher than 90% on a 33-item multiple-choice examination. Eighty-two percent of students were able to correctly read a product label to determine the type of pesticide involved in an occupational exposure.

CONCLUSION

Pharmacy students who completed a module on occupation exposure demonstrated competence in distinguishing occupational exposures from each other and from exposure to prescription and nonprescription drugs. This module can be used to educate future pharmacists about occupational health issues, some of which may be more prevalent in a rural setting.

A model for curricular quality assessment and improvement

The article describes a systematic assessment model and its potential application to a college's ongoing curricular assessment activities. Each component of the continuous quality improvement model is discussed, including (1) the definition of a competent practitioner, (2) development of the core curricular competencies and course objectives, (3) students' baseline characteristics and educational attainment, (4) implementation of the curriculum, (5) data collection about the students' actual performance on the curriculum, and (6) reassessment of the model and curricular outcomes. Over time, faculty members involved in curricular assessment should routinely reassess the rationale for selecting outcomes; continually explore reliable and valid methods of assessing whether students have reached their learning goals; get legitimate support for assessment activities from faculty members and administration; routinely review curricular content related to attitudinal, behavioral, and knowledge-learning outcomes; and determine what to do with the collected assessment data.