An assessment model for multidisciplinary, team-taught integrated pharmacy courses

Reducing Student Workload Through Curricular Efficiency

OBJECTIVE

This integrative review will examine the current literature assessing student workload, outcomes of increased workload and cognitive load, and approaches to evaluate and reduce student workload. Recommendations to better inform curriculum planning efforts will be presented along with a call to action to address the dilemma of student workload and curricular efficiency efforts.

FINDINGS

Literature supports that perceptions of heavy workload can influence students' approach to learning and lead to the adoption of surface learning rather than a deep approach that involves higher-order processing and critical thinking. Additionally, ongoing evidence suggests that workload expansion affects student well-being and potential burnout in professional programs, and specifically that students perceive workload as directly related to their well-being and satisfaction. Intentional planning by faculty and programs can address this issue through streamlining classroom content, reducing lecture time, and modifying preclass work to allow for efficient learning. Even if the curriculum is lecture-based, workload perceptions can be affected by developing clearer guidance to set expectations for learners, intentionality in classroom design, and creating opportunities for student engagement.

SUMMARY

Cognitive overload is multifactorial and complicated, given the increased standards of professional education accreditation and licensure requirements. As the Academy deliberately considers methods to improve curricular efficiency, there is an opportunity to focus on curriculum delivery with an appropriate balance of breadth and depth of instruction to ensure effective assessment and cognitive load.

An overview of Instructional approaches and decision-making strategies to curtail curricular overload

OBJECTIVES

Curriculum overload often occurs when content is kept in the curriculum that may no longer be necessary to prepare students for professional practice. The overload becomes compounded by the addition of new content from the ever-changing professional practice needs and updates to accreditation standards. Challenges may occur when programs must first determine the "level" of proficiency a new graduate should attain and then determine the appropriate breadth and depth of educational outcomes in relation to proficiency, while examining what content should be retained from past curricula. Thus, the purpose of this manuscript is to summarize institutional approaches for making content delivery more effective and efficient with the goal of curtailing curriculum expansion.

FINDINGS

Four key elements were consistently identified in the literature as important considerations to address curriculum overload - 1) communication and coordination among faculty, 2) incorporation of active learning strategies, 3) effective utilization of technology, and 4) minimizing faculty and student workload and cognitive burden.

SUMMARY

Each pharmacy program will need to take an individualized approach in addressing curriculum overload; however, consideration of the aforementioned key elements can assist in making these decisions. With increased student engagement in the classroom, intentional design to reduce content and student workload, enhanced communication among faculty, and appropriate technology utilization, curriculum overload can be addressed at every level of pharmacy education.

High-level curricular integration in pharmacy schools: A systematic literature review

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.

Student and faculty perceptions of integrated therapeutics courses in a doctor of pharmacy program

INTRODUCTION

There has been a movement in clinical education towards integrating foundational and applied course content. It remains unclear what best practices are for integration or how meaningful integration is for improving learning. We assessed the impact and perceptions of different degrees of integration in Integrated Pharmacy Care and Patient Management (IPC) courses.

METHODS

Students and faculty of one four-year doctor of pharmacy program were asked to complete surveys upon conclusion of the last of twelve integrated courses. Three degrees of integration (first degree, second degree, complete Integration) were defined for respondents. The student questionnaire included items on perceived value of integrated education as well as used and preferred levels of integration throughout the course series. Perceived estimated integration levels were then correlated with mean grade point averages (GPAs) for the courses. The faculty survey assessed experience with, and perceptions of, integrated teaching.

RESULTS

Sixty-five students (100% response) and 10 faculty (50% response) completed the surveys. Students preferred complete integration for all IPC courses and indicated that they were better able to retain and understand information with higher levels of integration. Supporting this, mean course GPAs positively correlated with estimated levels of integration. Faculty remained neutral on whether integration helps students to better understand course material and highlighted barriers to implementing higher levels of integration, including lack of time.

CONCLUSIONS

Our results suggest that a team approach to complete integration is most beneficial for pharmacy students. Faculty may require additional institutional support to accomplish such integration.

Scholastic synergy: A team prototype for pharmacy faculty engagement in education, research, and service

INTRODUCTION

Many clinical faculty members are challenged by competing factors of scholarly productivity, education, service obligations, and patient care. A team-based approach has the potential to synergistically increase productivity and mitigate factors associated with burnout.

METHODS

The purpose of this report is to discuss a prototype for a small, team-based, practice-oriented collaborative approach to advancing critical care pharmacy practice through research and education. Productivity was evaluated in the areas of scholarship and teaching.

RESULTS

This team was formed in 2017 and includes five critical care faculty across four campuses from a single academic institution. This collaborative has published peer-reviewed articles, secured grant funding, and developed novel teaching modalities.

CONCLUSIONS

Challenges encountered include timeline adherence, development of uniform data collection processes, clarifying roles and expectations for different projects, and authorship. This team may act as a prototype for clinical faculty teams to enhance engagement and scholarship productivity in a practice-based setting.

Development of Professional Attributes through Integration of Science and Practice at First-Year Pharmacy Level

The design, implementation and evaluation of a year 1 pharmacy-integrated learning component, using the World Health Organisation’s (WHO) analgesic ladder as a scaffold for case-based learning, is described. A novel aspect of the integrated component is the mapping of the cases to the national Core Competency Framework (CCF) for Pharmacists in Ireland and to the school’s own cross-cutting curricular integration themes. The integrated cases were student led and delivered through peer-to-peer teaching for 68 first-year pharmacy students. The integrated cases mapped strongly to three of the CCF’s domains, namely, personal skills, organisation and management skills and supply of medicines. With regard to the school’s curricular integrative themes, the cases mapped strongly to the curricular integration themes of professionalism and communications; medicines sourcing, production and use; and safe and rational use of medicines. Highlights from an anonymous online student survey were the recognition by students of the importance of core science knowledge for practice, the enabling of integrated learning and the suitability of the integrated component for entry-level. While a majority of students were found to favour individual work over group work, future iterations will need to consider a greater degree of group work with a view to reducing the volume of content and time required to complete the cases.

Design and Implementation of an Integrated Competency-Focused Pharmacy Programme: A Case Report

This paper describes the design and implementation of elements of an integrated competency-focused pharmacy programme in the School of Pharmacy and Pharmaceutical Sciences (SoPPS), Trinity College Dublin (TCD), Ireland. Following a national review of pharmacy education and training in Ireland in 2010, and subsequent publication of legislation in 2014, the School has implemented a five-year integrated programme of pharmacy education and training, leading to the award of a Master's degree in Pharmacy (M. Pharm.). Curricular integration has been achieved by underpinning the new programme with a national competency framework for pharmacists and through the utilisation of curricular integration themes. Programme integration also encompasses embedded experiential learning placements in Years 2, 4 and 5 of the five-year programme. The new five-year integrated pharmacy programme, which commenced in 2015, replaced the 4 + 1 model of education and training where a four-year Bachelor's degree was followed by a one-year internship, which was a distinct and separate element of the students' training.

The Need to Strengthen the Role of the Pharmacist in Sri Lanka: Perspectives

The role of the pharmacist in healthcare has evolved greatly over the last half-century, from dispensing to providing direct patient-oriented activities not associated with dispensing. However, pharmacist-led healthcare services in Sri Lanka must undergo reform to fully take advantage of their expertise and training in medicine management and related outcomes in Sri Lankan patients. As befits a profession's role development and value, professional and educational standards for pharmacists need ongoing development and growth. Currently, university curricula and continuing professional education in Sri Lanka require further development and optimisation to provide the theoretical and practical knowledge and skills regarding quality use of medicines and patient-oriented care. Furthermore, pharmacists' roles in Sri Lankan hospital and community pharmacist settings need to be recognised and should include the pharmacist as an integral part of the multidisciplinary healthcare team in Sri Lanka. Studies from developed countries and some developing countries have demonstrated that expanded pharmacists' roles have had a significant positive cost-effective impact on the population's health. Therefore, the availability of qualified Sri Lankan pharmacists trained to deliver expanded professional services accompanied by greater pharmacist integration into healthcare delivery is crucially important to ensure quality use of medicines within the Sri Lankan healthcare system and optimise the medication-related needs of Sri Lankans.

Faculty perception of team-based learning over multiple semesters

INTRODUCTION

Perspectives from faculty regarding team-based learning (TBL) are not well understood. Previous studies describe faculty preference for TBL due to increased student interaction despite requiring increased time for design. The perception of changes in faculty workload over multiple semesters has not been measured. This research evaluates faculty workload and perceived student engagement after implementing TBL in a required non-prescription medication course over multiple semesters.

METHODS

TBL was implemented in the non-prescription medication course and continued for three consecutive semesters. Faculty members' perception of TBL was captured using an anonymous survey. The survey was an 11 item questionnaire with five Likert-type response options to identify changes in workload, training, and student interaction using TBL.

RESULTS

Twenty-eight total responses were collected from 10 faculty members who taught in at least one of the four semesters. Results were aggregated based on the number of semesters faculty continually taught in the course. More respondents agreed than disagreed that participation from and interactions with students increased with the TBL course compared to traditional lectures. However, more respondents believed the TBL course approach was more difficult and reported increased workload in the initial semester taught. Enjoyment of teaching increased for a majority of respondents.

DISCUSSION AND CONCLUSIONS

This is the first study to explore the impact of TBL implementation over multiple semesters. These data can be used to help implement TBL in pharmacy school curricula.

Structured academic discussions through an online education-specific platform to improve Pharm.D. students learning outcomes

OBJECTIVE

To facilitate active academic discussions using an online, education-centered platform and reinforce concepts, in order to improve overall course outcomes.

MATERIALS AND METHODS

A third year integrated pharmacotherapy course was enrolled on an online searchable platform, Piazza®, to facilitate academic discussions. Students could ask, answer, and explore content, and build on submitted answers in wiki style in collaboration. Instructor posted learning objectives, endorsed student responses with correct answers and led follow-up discussions. Review sessions were conducted on this platform before all major exams. A student t-test was used to compare class performance with those of previous years.

RESULTS

In a post-activity qualitative survey, most students appreciated the less stressful, online interaction with peers and faculty. For 15 medicinal chemistry course hours, there were 83 posts on Piazza® with 303 total contributions, 107 student responses, and 546min of group discussion time. 94% of questions received student responses and 89% of those were endorsed by the instructor. Students enjoyed pre-exam discussions, organization of the page, and reinforcing material on complex learning objectives. This discussion forum fostered personal exploration of content by the students, which led to better performance on examinations.

CONCLUSIONS

Involving the use of an online, education-centered platform for student discussions was an effective means of increasing class engagement with the course material. Student performance on exams was significantly improved in both cohorts that utilized active learning compared to the cohort without active learning (p=0.001 and p= 0.002 respectively). Piazza® can be utilized for any course and across disciplines.

Survey of Pharmacy Schools' Approaches and Attitudes toward Curricular Integration

Objective. To identify ways in which curricular integration is addressed in US pharmacy schools, the structure of therapeutics and foundational science courses, and perceptions of the effects current curricular integration methods have on student learning. Methods. An electronic survey was sent to academic leaders representing 131 pharmacy schools in the United States. Frequency data was tabulated and demographic analysis was performed. Results. Respondent data represents 94 schools of pharmacy. Arranging similar content from various disciplines in a course, a skills laboratory and pharmacy practice experiences were the most common methods for achieving curricular integration. More than one half of the schools indicated that foundational sciences were integrated with therapeutics. The most common reported challenge to curricular integration was logistics. Conclusion. Pharmacy education in the United States has evolved in addressing curricular integration in the curricula, which is consistent with changes in accreditation standards. Most pharmacy schools reported a variety of methods for achieving the intent of curricular integration.

Integrating a new medicinal chemistry and pharmacology course sequence into the PharmD curriculum

OBJECTIVE

To evaluate the implementation of an integrated medicinal chemistry/pharmacology course sequence and its alignment with a therapeutics series.

DESIGN

Each topic was divided into modules consisting of 2-hour blocks, and the content was integrated and aligned with the therapeutics series. Recitation sessions emphasizing application skills in an interactive environment followed each of three 2-hour blocks. To ensure that students achieved competency in each unit, students failing any unit examination were encouraged to undergo remediation.

ASSESSMENT

Student feedback was collected by an independent researcher through social media and focus groups and relayed anonymously to course directors for midcourse improvements. Responses from surveys, interviews, and student ratings of faculty members and of courses were used to implement changes for future editions of the courses.

CONCLUSION

The majority of students and faculty members felt the integration and alignment processes were beneficial changes to the curriculum. Elements of the new sequence, including remediation, were viewed positively by students and faculty members as well.