Using debate to teach pharmacy students about ethical issues

A Scoping Review for Debate-Style Journal Clubs in Health Professional Education

OBJECTIVES

The objectives of this scoping review are to (1) describe the available literature regarding the utility of the debate-style journal club for health professional learners on literature evaluation skills and (2) report the themes found within debate-style journal club research and assessments in the context of professional education.

FINDINGS

A total of 27 articles written in the English language were included in this scoping review. Published evaluations of debate-style journal clubs have been predominantly based in the pharmacy profession (48%, n = 13), but are reported in other health professions, such as medicine (22%, n = 6), dentistry (15%, n = 4), nursing (7%, n = 2), occupational therapy (4%, n = 1), and physical therapy (4%, n = 1), as well. The skills assessed in these studies often included critical literature evaluation, application of literature to patient care, critical thinking, knowledge retention, use of supporting literature, and debate-specific skills. Learners typically reported better understanding and application of the literature, and enjoying the experience more than traditional journal clubs, but note the increased assessor and learner time requirement for debating. Pharmacy learner-specific articles more often utilized a traditional, team-based debate format, incorporated grading rubrics for skill assessment and debate performance, and included a grading component for the debate in the course.

SUMMARY

Debate-style journal clubs are well-received by learners but require an additional time commitment. Debate platforms, format, rubric use and validation, and outcome assessment vary across published reports.

An Online, Multi-institutional Debate on Diabetes Medications by Advanced Pharmacy Practice Experience Students

Objective. The purpose of this study was to evaluate changes in advanced pharmacy practice experience (APPE) students' knowledge and to measure student perceptions of an online, multi-institutional debate curriculum as an alternative to a journal club to improve critical thinking skills related to diabetes medications.Methods. All APPE students assigned to four faculty (n=37) at three different colleges during the 2020-2021 academic year received instruction on diabetes medication classes and their cardiovascular outcome trials. Students debated via the Lincoln-Douglas format whether the preferred second-line therapies for patients with type 2 diabetes mellitus are either glucagon-like peptide-1 receptor agonists or sodium-glucose cotransporter-2 inhibitors. Matched pre- and post-APPE knowledge scores were measured using a seven-item assessment tool. A 22-item post-debate survey measured student perceptions of the activity.Results. Pre- and post-APPE knowledge scores were compared in 32 students, yielding an 86% response rate. Knowledge scores improved 32% (59% pre vs 87% post). Thirty-three students completed the perceptions survey, yielding an 89% response rate. Students reported that the debate activity was beneficial (100%) and rated it more effective than a journal club at improving critical thinking skills and knowledge retention.Conclusion. Preliminary results suggest that incorporating an online, multi-institutional debate as an alternative to journal clubs during APPE rotations was well received. Further research is warranted on the impact of the multi-institutional debate and how to best deliver it during the APPEs of a pharmacy curriculum.

Promoting professional judgement through peer debate in radiation therapy undergraduate curriculum

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Professional judgements require RTs to make morally justifiable decisions.

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Peer debate supports development of decision-making skills about moral dilemmas.

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Students will discuss moral dilemmas in safe and appropriately structured learning environments.

Radiation therapists (RTs) are often required to exercise professional judgement when faced with the ambiguity inherent in professional dilemmas not comprehensively accommodated by the professional Code of Conduct. Clinical educators therefore need to design curriculum that motivates students to apply professional judgement in ambiguous situations. Role play and peer debate enables development of competencies related to professional judgement. The aim of this short communication is to report on the rationale for and integration of peer teaching resources that prompt students to justify, through discussion and debate, the basis of their own judgement and those of their peers.

Evaluating the Group Debate Activity as a Student-Centered Approach in Microbiology Course for PharmD Students: An Observational Study

BACKGROUND

Group debate is an educational strategy meant to equip undergraduate students with enhanced communication skills as well as the understanding of complex topics. Many controversial topics in the microbiological field pose challenges to the pharmacist's ability to attribute a specific opinion to its supported clinical evidence and to discuss these topics with confidence.

METHODS

A total of 76 second-year pharmacy students who enrolled in a PharmD program participated in the group debate as part of the student assessment in microbiology course. The students prepared selected topics on controversial issues in microbiology, which were presented as a debate. Post-debate questionnaire was distributed to the students and used to measure student perceptions.

RESULTS

The majority of the students (82.89%) demonstrated an improvement in their understanding of the topics after the debate. The highest percentage was recorded from one topic group (97.37%) which stated that they had improved understanding after the debate. About a third of the total students reported great improvement in their communication skills.

CONCLUSION

This debate group clearly provided the students with high confidence in presenting their arguments from relevant scientific information gathered from existing literature. It also enhanced their understanding of complex and controversial microbiology topics that will be needed during their pharmacy education.

Exploring the Effects of Argument Map-Supported Online Group Debate Activities on College Students’ Critical Thinking

Debate has been warranted as a meaningful activity to promote students’ higher-level thinking, such as critical thinking. However, traditional debate activities which are typically carried out in the physical classroom may meet some obstructions of limited time and space, which would result in the phenomenon that many participants act as silent watchers rather than mind exchangers. Moreover, it is hard to make a visualized record about the whole process and contents of the traditional debate activity. The current study aimed to explore the effects of argument map (AM)-supported online group debate activities on college students’ critical thinking, including their depth and phases of critical thinking, and the relationship between students’ depth of critical thinking and their number of speeches. In the study, an innovative argumentation construction way was designed. All students enrolled in a course could have a chance to attend the AM-supported online group debate activities and the whole process and outcomes of online group debate could be visualized by AM. At the same time, the effectiveness of the innovative activities was evaluated by content analysis of AM. A total of 42 sophomores in the undergraduate course named “Learning Sciences and Technology” were recruited to attend online group debate activities assisted by a web-based visualization tool named “ZJU Yuque” in 5 weeks. Newman’s framework about the depth of critical thinking and Murthy’s instrument of critical thinking phases were employed as guidelines. We found that 42 students’ overall depth of critical thinking was gradually improved in an obvious way during the five online debate activities. The most frequent phases for students in the first and second team in online group debate activities include Understand→Understand (U→U), Recognize→Understand (R→U), and Understand→Evaluate (U→E). However, students’ creating behaviors were not significantly generated. Teachers’ real-time feedback was helpful for students’ improvements of high-level thinking skills and their preparation for the next debate activity. Students’ interviews found that students highly valued such online group debate activities because every student could have a chance to express their thoughts and they had enough time to prepare debate contents. Based on the findings, some implications were proposed for the better design and implementation of online group debate activities.

Undergraduate pharmacy students' perceived learning using a team-based debate approach

INTRODUCTION

Currently, teaching and learning in higher institutions is moving away from traditional didactic lecture-based learning towards student-centered learning. The objectives of this study were to implement a team debate as a method of teaching and learning about pharmacy regulatory issues, and evaluate students' perceptions of a team debate.

METHODS

This was a pre-and post-study with a validated 11-item online questionnaire. Data were summarized using descriptive statistics (frequencies, means, standard deviations, and percentages), while paired sample t-test was used to compare pre- and post-study mean scores of the survey items. P values < .05 were taken to be statistically significant.

RESULTS

One hundred and forty-two students enrolled in a mandatory "Pharmacy Regulation and Control" course at a Nigerian University during the 2020 academic year participated in the study. The average age of the participants was 25.56 ± 2.96 years (Range = 20-38 years), and the majority were males (n = 99, 69.7%). All the questionnaire items and the total score improved significantly (P < .05) after the group debate exercise.

CONCLUSION

The study shows that team debate was well received by the participants and demonstrates that incorporation of team-based debate into a didactic style course improved student's self-perceived learning. Thus, it is recommended that pharmacy educators in Nigeria should consider incorporating team debate to complement didactic teaching to enhance learning.

The Importance of Teaching Ethics in Pharmacy Education

All pharmacy faculty members should have a general understanding of the field of ethics, regardless of whether they have received any formal training, since instruction and training in ethical decision-making is an accreditation expectation. Additionally, whether they recognize it or not, pharmacy faculty members are involved in ethical decision-making on an almost daily basis. The aims of the current commentary are to expand on a basic approach to ethical decision-making using examples involving students or faculty members in each of the triad areas of teaching, research, and service, and serve as a starting point to enable all faculty to teach students how to work through an ethical dilemma. This commentary will focus on the initial steps involved in determining whether an ethical dilemma exists, determining the facts related to the dilemma by identifying technical facts and legal constraints, and identifying the principles and values that play a role in the situation and decide which are in conflict. References are provided for more in-depth review of ethics subject matter beyond the scope of this commentary.

Implementing and evaluating a course in professional ethics for an undergraduate pharmacy curriculum: A feasibility study

BACKGROUND

Pharmacy practice today mandates "patient-centered care", thereby assigning higher levels of professional responsibility for pharmacists leading to ethical challenges. These challenges often involve ethical principles, institutional, personal, or other constraints that can pull practitioners in incompatible opposite directions, creating "ethical dilemmas" in many circumstances. Pharmacists are expected to handle challenges competently and in the best interest of patients. Literature underlines the positive impact of educational interventions focusing on ethical awareness and competence, and that "gaps" existed in pharmacy training/curricula for Jordanian pharmacists. The objective of this study was to develop, implement, and evaluate the utility of a tailored ethics education component in the pharmacy curriculum for students enrolled at a well-ranked Jordanian university.

EDUCATIONAL ACTIVITY AND SETTING

Fifth-year pharmacy students attending summer school at a university in Jordan from July to September 2020 were invited to participate in an educational intervention (suite of didactic online lectures and skills-based workshops). This study was delivered in four parts, with a pretest administered immediately before and a posttest survey immediately after the educational intervention, the educational intervention (three phases), and focus-group discussions to elicit students' feedback.

FINDINGS

Findings indicated enhanced levels of confidence in students' decision-making. The development of students' moral reasoning and decision-making skills were also observed to be improved.

SUMMARY

This study highlighted the importance of the implementation of an ethics course in pharmacy undergraduate curricula. It emphasized the positive impact this course made on the students' learning experiences and provided a strong environment for discussion and group learning.

Critical Psychiatry Debates; A Neglected Tool in Undergraduate Medical Education

This article was migrated. The article was marked as recommended. Background: Healthcare professionals must adapt to everyday clinical controversies using their critical thinking and communication skills. Educational debates nurture these skills producing a well-rounded clinician. Their value is well established in healthcare education, yet they are not commonly employed, and there is no literature on their use in undergraduate Psychiatry teaching. Methods: We planned and implemented a one-off educational debate lesson as part of the teaching program of fourth-year medical students on their Psychiatry clinical placements. We collected and analyzed the students' feedback. Results: Although most students had no experience of debates, 79% found the learning event positive. The students also reported improvement in their confidence (58%), oral presentation skills (37%), critical thinking skills (71%) and the ability to cope with conflict (54%). In addition, there was a positive shift in their attitude towards Psychiatry (71%) and the chances of choosing it as a future speciality (33%). Conclusion: Our results showcase the benefit of using debates in shaping future doctors' non-clinical skills and practice attitudes. In this paper, we discuss a thematic analysis of students' feedback comments and reflect on several points in the planning and delivering educational debates. We also include practical recommendations for future applications.

Encouraging Undergraduate Marketing Students to Reflect on Critical Thinking and the Digital Gender Divide

In today’s society where there is an abundance of accessible, complex, and often false information, critical thinking (CT) is an essential skill so that citizens in general and students in particular can make complex decisions based on scientific evidence, rather than on prejudices, biases, and pre-established beliefs. In this context, the purpose of this study is to discover whether Active Learning (AL) methodology, using different technologies, contributes to improving the CT of the student body, applying it to the Digital Gender Divide (DGD). Three questionnaires were used to collect information, using both a quantitative and a qualitative approach. Open-ended questions are included for fuller answers, which are complemented by content analysis of the recordings and virtual presentations made. The results show that the AL methodology favours the development of CT in the DGD in a remarkable way. Likewise, the various technologies implemented in the methodology (e.g., the Google Applications Site, online round table discussions, role-plays, virtual presentations, and forms) are relevant to improving CT in DGD. It concludes by recommending the implementation of AL with CT as in the one carried out, to help prepare better professionals and raise awareness of how to reduce the DGD.

Use of Debate as a Pedagogical Tool in Psychiatry Residency Teaching: A Cross-Sectional Study

PURPOSE

Despite the potential benefits of the use of debate as a teaching tool in promoting active self-directed and reflective learning, there are few studies examining its use within postgraduate training including psychiatry residency training. We aim to study this pedagogical tool and hypothesize that within psychiatry residency training, preference for the use of debates during teaching of a common topic is associated with better learning processes and outcomes such as better motivation, engagement of the learners, promotion of critical thinking and understanding of the subject content.

SUBJECTS AND METHODS

All second-year psychiatry residents from 2015 to 2019 who underwent a specific teaching session on "Neurobiology of Psychosis" (which was conducted using debate) were administered a study questionnaire following the session. Between-group comparisons, correlational and path analyses were conducted to examine the relationship between use of debate and specific learning processes and outcome.

RESULTS

Overall, 66 out of 80 (82.5%) residents participated in the survey. The preferred use of debate was associated with better motivation, engagement, facilitation of critical thinking, understanding, equipping and better overall rating of the teaching session. Path analyses found that the relationship between preference for debate as a teaching tool and overall rating of the teaching was partially mediated by better engagement, felt relevance to the learning needs and better understanding.

CONCLUSION

The effectiveness of debate as perceived by psychiatry residents is consistent with self-determination and related learning theories and extant literature on its use as a pedagogical tool. This behoves the need to consider more of its use alone or in combination with other teaching methods in enhancing learning outcomes within psychiatry residency teaching and other training programmes.

Effect of Interprofessional Clinical Debates on Attitudes of Interprofessional Teams

Introduction

Current evidence supports the notion of debates as a pedagogical method to teach literature evaluation skills in health care education; however, there are no reports of this method as an interprofessional approach and its potential benefits. The aim of this study was to assess the impact of interprofessional clinical debates on attitudes toward interprofessional teamwork and perceived literature evaluation skills.

Methods

We invited third-year family medicine residents and fourth-year pharmacy students to complete a survey before and after participating in an interprofessional clinical debate. The anonymous survey was composed of the Students' Perceptions of Interprofessional Clinical Education-Revised (SPICE-R2) instrument to evaluate perceptions of interprofessional teamwork, literature evaluation, and other skills gained through the process. We evaluated matched responses for change in attitudes toward interprofessional teams.

Results

We evaluated 41 matched responses, which indicated improvement in attitudes toward interprofessional teams and was statistically significant ( P<.001). This finding held true for subscales of roles/responsibilities for collaborative practice and patient outcomes from collaborative practice (P<.001). Participants also perceived improvements in literature evaluation, problem-solving, critical thinking, teamwork, and communication skills.

Conclusion

The interprofessional clinical debate activity positively impacted medical residents and pharmacy students, and improved attitudes toward interprofessional teams.

[Evaluation of the ethics of pharmaceutical practice: A literature review]

INTRODUCTION

Ethics are at the heart of pharmacy practice.

METHOD

This is a literature review. The main objective is to carry out a review of studies relating on the evaluation of ethics in pharmacy practice. Documentary research on Pubmed was carried out from 1990 to 2020. All studies relating to pharmaceutical ethics that may be applied to the pharmacy practice in pharmacies or in health establishments and that conducted a qualitative or quantitative evaluation of pharmaceutical ethics (e.g. surveying pharmacists or pharmacy students, using a measurement tool, quantifying or qualifying a perception or behaviour) were included.

RESULTS

The studies come mainly from Anglo-Saxon countries (29/38). Studies related to pharmacy practice, mainly target pharmacists (n=27) and pharmacy students (n=16), and more often have a quantitative component of (n=28). The main ethical dilemmas observed dealt with emergency oral contraception (EOC), voluntary termination of pregnancy with drugs, euthanasia, commercial practices of the pharmaceutical industry, refusal to dispense a prescription in a broader context and plagiarism or dishonesty in academic settings.

CONCLUSION

Few studies have been conducted on the review of ethics of pharmacy practices from 1990 to 2020. Pharmacy students and practicing pharmacists are regularly exposed to ethical dilemmas and respond to these dilemmas with due consideration, taking into account six principles, eight values and other factors. Exposure to these dilemmas creates inaction, stress and distress. A few possible solutions have been identified.

Teaching Research Ethics to Pharmacists: The Practice of Participatory Learning

The research history of community pharmacists in Japan is short, and ethical responses may not be mature. Therefore, the Japan Pharmaceutical Association and universities are working on research ethics education to help pharmacists make appropriate ethical responses. In this study, we evaluated whether an educational program using participatory learning was effective in research ethics education for pharmacists. Regarding the educational effects of our workshop, the score for motivation to learn about research ethics was high, and that for judgment and applied skills related to research ethics was low. Overall, participants’ assessment of the program contents was extremely favorable, indicating their satisfaction. Participatory learning was widely accepted and suggested to be effective in improving learning motivation. Additionally, to be able to apply the knowledge of research ethics to own research, it was considered necessary to continue learning through participatory learning. This will help pharmacists gain judgment and applied skills related to research ethics.

Status of Pharmacy Ethics Education in Australia and New Zealand

Objective. To explore models of teaching in, resources available to, and delivery of a standardized course in pharmacy ethics. Methods. An email invitation was sent to the educator responsible for teaching pharmacy ethics at each of 19 institutions in Australia and New Zealand. Over a six- to eight-week period, semi-structured interviews were conducted in person, by email, or by phone, and were audio-recorded where possible, transcribed verbatim, and entered into data analysis software. Using an inductive analysis approach, themes related to the topics and issues discussed in the interview process were identified. Results. Of the educators invited to participate, 17 completed an interview and were included in this study. Participants reported a paucity of resources available for teaching pharmacy ethics at schools in Australia and New Zealand. Compounding this issue was the lack of expertise and ad-hoc process educators used to create their courses. Assessment methods varied between institutions. Participants felt schools needed to move toward a more standardized pharmacy ethics course with clear and defined guidelines. Conclusion. This study identified many areas in pharmacy ethics that need improvement and revealed the need to develop resources and course structure that adhere to the highest level of Miller's pyramid, while using known frameworks to evaluate ethical competency.

Perspectives of Pharmacy Graduates Toward an Undergraduate Ethics Course and Its Potential Impact on Their Professional Practice

PURPOSE

The aim of this study was to gauge the opinions and attitudes of pharmacy graduates toward an undergraduate ethics course they received and to explore if the ethics course was relevant to their practice.

SAMPLE AND METHODS

This online questionnaire-based study involved pharmacy college graduates (alumni) who, at the time of the study, were practicing in different practice settings and who had all graduated from the same college of pharmacy in Qatar. An online questionnaire comprising 27 items related to attitudes, perceptions, and impact of the undergraduate ethics course on professional practice was distributed through email to all eligible alumni. Both descriptive and inferential statistics were performed for data analyses, with a p-value <0.05 considered statistically significant.

RESULTS

Of 119 invited graduates, 62 (52.1%) responded to the survey. About 73% of the respondents were satisfied with the ethics course received and 77.5% agreed that the course helped them in applying ethical principles in practice. Over 57% of the respondents discussed ethical issues in practice and 84.2% of these reported that the discussions were influenced by having had the ethics course. Barriers to applying ethical principles and discussing ethical issues in practice included lack of time (41%) and lack of reliable resources (23.1%). Participants' years of experience did not influence their attitudes toward the ethics course and its impact on professional practice (p>0.05 for both). However, practicing in a hospital setting or completing postgraduate education had a significant influence on the perception of the impact of the course on professional practice (p=0.036 and p=0.035, respectively).

CONCLUSION

A large proportion of pharmacy graduates value the ethics course received during their undergraduate program in pharmacy. The course appeared to have a positive influence on graduates' professional practice. Future studies should investigate specific areas that need to be reinforced in the curriculum and reliable reference resources should be developed and/or identified.

Students' perceptions of debating as a learning strategy: A qualitative study

Debate has been shown to develop critical thinking skills, enhance communication, and encourage teamwork in a range of different disciplines, including nursing. The objective of this study was to explore students' perceptions of the educational value of debate. A semi-structured focus group was conducted with 13 undergraduate Operating Department Practice students following a debate on the opt-out system of organ donation. Transcripts were analysed thematically, identifying three main themes that described the students' perceptions of the debate. These were: (1) openness to diverse viewpoints; (2) developing non-technical skills, and (3) encouraging deep learning. The analysis showed participants perceived debate to be a valuable educational method that enhanced their learning. Engaging in debate encouraged students to critically reflect on their prior beliefs about organ donation-in some cases leading them to reconsider their original position. The findings from this study suggest that debate can be a valuable pedagogical tool to incorporate into healthcare education. Future research should consider the use of debate to develop non-technical skills that have utility in healthcare.

Using debates as the primary pedagogy to teach critical care in a PharmD curriculum elective course

BACKGROUND AND PURPOSE

Debate is a pedagogy that incorporates deeper learning and has been used in many areas of healthcare and higher education. Debates have primarily been described within a course, but not as the predominant pedagogy for a course, particularly in pharmacy education or critical care instruction.

EDUCATIONAL ACTIVITY AND SETTING

Debating the Evidence was a two-credit hour course taught by debate-style pedagogy on an extended campus to third year pharmacy students in a four-year curricular program. The class met weekly for two hours over 15 weeks, and students came prepared to debate preselected topics. Focus groups for students enrolled over two years were conducted to gauge students' perceptions of this course structure.

FINDINGS

The debate-dominant course structure seemed to increase accountability of learning, pre-class preparation, and in-class engagement. Students had difficulty debating with lower quality evidence, but were able to use physiologic reason and adverse effect profiles when robust literature was lacking. All students enrolled over two course offerings consented and participated in the focus groups. Themes identified across both semesters included: 1) efficiency with accessing and evaluating drug literature, 2) increased understanding of an individualized patient-centered approach, and 3) an appreciation for patient care in the acute setting.

SUMMARY

An entirely debate-style critical care elective course was perceived to be beneficial to students. Scalability and impact on student learning requires further assessment.

Systematic review of the use of debates in health professions education - does it work?

Background: It is unavoidable for learners undergoing health professions training to encounter different complex clinical scenarios related to diagnoses, treatment and ethical dilemmas. The lack of standard answers to such clinical challenges can cause uncertainty in the process of teaching, learning and assessment as learners grapple with the need to critically appraise the specific context, past practices and extant literature to arrive at a thoughtful decision. In this aspect, debate can be a useful pedagogical tool to consider multiple, different perspectives regarding these issues. As the use of debate within the health professions education has not been reviewed, we conducted a systematic review of the current literature on the adoption of debate as a pedagogical tool to clarify the specific context of use as well as its effectiveness in the learning of skills and content within the health professions education. Methods: A systematic review was conducted on relevant published literature in English within journal databases until September 2018 that employed debate as a pedagogical tool within health professions education. Results: Out of 626 screened articles, 12 studies were finally included based on inclusion/exclusion criteria. The 12 studies (9 undergraduate, 3 postgraduate) covered a diverse range of disciplines and debate in health professions education was adopted for acquisition of skills (such as critical thinking, communication skills, teamwork), or learning of specific topics (such as patient safety, ethical issues, teaching of new topics) as well as to examine evidence based practice. In the majority of studies (10 of 12 studies, 83.3%), debate has been deemed by the learners to be effective in facilitating the learning of new content and skills such as communication and critical thinking, which are related to processes aligned with adult learning, motivational, reflective and social learning theories. Conclusion: Overall, sparse studies to date with relatively low risk of bias found debate to be effective in enabling the learning of skills and content within health professions education. Future studies may want to incorporate more objective measures of the learning outcomes of learners following the adoption of debate as a teaching tool as well as to examine the combinatorial use of debate with other pedagogical tools and their longitudinal impact on learners and learning.

Development of a teaching model to advance skills in industrial pharmaceutical formulation and regulatory aspects

BACKGROUND AND PURPOSE

To design and critically evaluate a laboratory-scale pharmaceutical formulation practical that enables pharmaceutical science students to develop work-based skills relating to industrial pharmacy such as problem solving, pharmaceutical calculations, research, legal checking, communication, practical aptitude, handling of medicinal products, record keeping, and ability to interpret, analyze and report data.

EDUCATIONAL ACTIVITY AND SETTING

Nine laboratory practical sessions were designed whereby students formulated a range of dosage forms and conducted corrective and preventative actions (CAPAs) exercises. A master batch formula outlined the specifications for each product and a practical sheet was provided for the students to record their activities. Student evaluation of the exercise was performed via a self-administered 17-item questionnaire in the final week.

FINDINGS

Twenty-four students completed the workshops over two year groups (2015 year group n = 11, 2016 year group n = 13). The mean score across both groups was 15.6 out of 20.

DISCUSSION

The questionnaire had a 100% response rate and the majority of students agreed that the classes were a useful teaching method and that they fostered key skills required for pharmaceutical formulation and regulation.

SUMMARY

Laboratory classes effectively delivered course content relating to industrial-based pharmaceutical formulation and helped to develop relevant skills.

Implementation and lessons learned from a mock trial as a teaching-learning and assessment activity

BACKGROUND AND PURPOSE

To describe implementation and lessons learned from use of a mock trial as a teaching-learning and assessment activity in a required evidence-based practice course. This innovative self-directed learning strategy reinforced evidence-based skills and affective domain competencies in Center for the Advancement of Pharmaceutical Education (CAPE) 2013 Outcomes and Accreditation Council for Pharmacy Education (ACPE) Standards 2016.

EDUCATIONAL ACTIVITY AND SETTING

During spring semesters 2015 and 2016, first professional year (P1) cohorts were divided into teams and assigned controversial topics to research and debate in mock trials. The activity provided opportunities for teaching-learning and assessment. Statistical analysis included inter-rater reliability (IRR), comparison of faculty-judge and student-juror evaluation of trial performance.

FINDINGS

Two cohorts were divided into eight teams (four per cohort) to debate four issues. Students within each team were assigned individual scores. Mean individual scores are reported by trial/topic. Faculty-judges and student-jurors rated eight criteria including content/knowledge, critical thinking, application/discussion of federal/state law, citations/references, visual aids, delivery/style, and active listening. Analysis indicated students met competency expectations with overall judges' and jurors' mean scores above 54/60 points (90%) in 2015 and above 51/60 points (85%) in 2016. Judges' scores showed a wider distribution than jurors' scores. Peer evaluation mean scores were above 55/60 points in all four trials. Intra-class correlation was calculated. Judges' scores had excellent IRR in two trials, and good IRR in a third trial, whereas jurors had good IRR in one trial.

SUMMARY

Evaluation scores demonstrated students successfully applied knowledge and skills from this and prior P1 courses, and met competency expectations for the mock trial.

Evaluating the Effectiveness of a Focused Debate on the Development of Ethical Reasoning Skills in Pharmacy Technician Students

Objective. To evaluate the effectiveness of debating an ethical dilemma on the development of ethical reasoning skills in pharmacy technician students. Methods. A mixture of qualitative and quantitative methods was used. This included analysis of before and after 5-minute papers, a sentiment survey, thematic analysis of student reflective writing and a qualitative questionnaire by an independent observer. Results. Twenty-five students participated in the study. The 5-minute papers showed improvement in student learning. In the sentiment survey, 83% of students agreed or strongly agreed that they had a better understanding of ethical dilemmas following the debate. The main theme identified from student blogs was the variety of different opinions expressed during the debate. Conclusion. Debating was an effective means of exploring ethics with pharmacy technician students.

Teaching and assessing clinical ethics through group reading experience and student-led discussion

BACKGROUND AND PURPOSE

Ethical decision-making is one of the foundational elements of responsible patient care, yet traditional didactic coursework often misses the nuances of specific situational aspects of ethics as well as the impact of individual patient experiences on their perspective related to health care. The purpose of this study was to assess the impact of a clinical research ethics elective course involving a group reading experience and facilitated discussion on student decision-making and perspective on questions related to ethics.

EDUCATIONAL ACTIVITY AND SETTING

The elective was offered to second-year pharmacy students and was designed to teach ethical concepts within the framework of a group reading experience employing active learning through facilitated student-led group discussion. The book chosen was The Immortal Life of Henrietta Lacks by Rebecca Skloot. Students were assessed pre- and post-course using ethical scenarios (framed as "yes/no" questions) covering a wide range of topics, as well as over their familiarity with and confidence in making decisions related to ethical topics using a five-point Likert scale.

FINDINGS

Sixteen students were enrolled in the course, with 14 (87.5%) completing all pre- and post-course assessments. There were no statistically significant changes in the proportion of students answering "yes" or "no" to the scenarios from pre- to post-course, though there were several items in which responses "shifted," meaning students switched answers from pre- to post-course. Overall, students showed significantly more familiarity with the topics covered after the course versus before (p < 0.05), also reporting improved confidence (p < 0.05) in making decisions related to the topics. The per-student analysis also showed significant changes in overall confidence and familiarity (p < 0.05).

SUMMARY

Through the course, students showed increased familiarity with the history of clinical research and ethical topics discussed as well as improved confidence in making decisions related to clinical ethics. This type of course design provided a strong environment for discussion and group learning.

Evaluation of a Modified Debate Exercise Adapted to the Pedagogy of Team-Based Learning

Objective. To assess the impact of a debate exercise on self-reported evidence of student learning in literature evaluation, evidence-based decision making, and oral presentation. Methods. Third-year pharmacy students in a required infectious disease therapeutics course participated in a modified debate exercise that included a reading assignment and readiness assessment tests consistent with team-based learning (TBL) pedagogy. Peer and faculty assessment of student learning was accomplished with a standardized rubric. A pre- and post-debate survey was used to assess self-reported perceptions of abilities to perform skills outlined by the learning objectives. Results. The average individual readiness assessment score was 93.5% and all teams scored 100% on their team readiness assessments. Overall student performance on the debates was also high with an average score of 88.2% prior to extra credit points. Of the 95 students, 88 completed both pre- and post-surveys (93% participation rate). All learning objectives were associated with a statistically significant difference between pre- and post-debate surveys with the majority of students reporting an improvement in self-perceived abilities. Approximately two-thirds of students enjoyed the debates exercise and believed it improved their ability to make and defend clinical decisions. Conclusion. A debate format adapted to the pedagogy of TBL was well-received by students, documented high achievement in assessment of skills, and improved students' self-reported perceptions of abilities to evaluate the literature, develop evidence-based clinical decisions, and deliver an effective oral presentation.

It's no debate, debates are great

INTRODUCTION

A debate can be a pedagogical method used to instill essential functions in pharmacy students. This non-traditional teaching method may help to further develop a number of skills that are highlighted in the current Accreditation Council for Pharmacy Education Standards 2016 and Center for the Advancement of Pharmacy Education Educational Outcomes 2013.

COMMENTARY

Debates have also been used as an educational tool in other health disciplines. Current pharmacy literature does illustrate the use of debates in various areas within the pharmacy curriculum in both required and elective courses; however, the current body of literature would suggest that debates are an underutilized teaching tool in pharmacy experiential education.

IMPLICATIONS

With all potential benefits of debates as a teaching tool, pharmacy experiential preceptors should further explore their use in the experiential setting.

Teaching Health Care Policy: Using Panel Debate to Teach Residents About the Patient Protection and Affordable Care Act

INTRODUCTION

The debate format has been infrequently used in resident education. We used the panel debate format as a tool to improve health care professionals' knowledge of the Patient Protection and Affordable Care Act (PPACA).

METHODS

Six physical medicine and rehabilitation resident physician debaters led a 60-minute panel debate about the PPACA. Outcome measures included a survey of the spectators with validated questions on physician attitudes towards health care reform in the US and open-ended questions regarding Americans' views on the US health care system.

RESULTS

Twenty-nine physician and nonphysician faculty and staff participated as spectators. Responses to the questions on attitudes toward reform of the health care system indicated that zero spectators rated the current US health care system (i.e., the PPACA) as "Excellent," 25% rated it as "Good," 42% "Average," 25% "Poor," and 8% "Failing." Half of the respondents indicated they support a US president who advocates making the US health care system more like those of other countries. The majority of respondents (89%) expressed the idea that the US does not have the best health care system in the world.

DISCUSSION

Approaching a topic as broad as health care reform with the debate format promoted knowledge, reflection, and interaction with both the opposing debaters and audience.

Implementation of an online ethics course into a pharmacy curriculum

BACKGROUND AND PURPOSE

To evaluate students' ethical reasoning skills after implementation of a series of online modules containing ethical content.

EDUCATIONAL ACTIVITY AND SETTING

A four-module online ethics series was created and embedded in the learning management system of a second-year pharmacy skills lab course. The Defining Issues Test Version 2 (DIT-2) was administered before and after completion of the ethics module series. Results of the DIT-2 were used to evaluate the impact of the modules on students' ethical thinking ability. An optional written survey utilizing Likert-scale questions was administered at the end of the study to assess students' perceptions of the course.

FINDINGS

A total of 134 students were enrolled in this study. After removal of voluntary exclusions and unreliable data, 107 DIT-2 tests were evaluated. The study failed to demonstrate a statistically significant increase in pre- and posttest DIT-2 scores. Student scores were higher than other pharmacy students' scores that were previously reported in the literature. Thirty-four (26.1%) students participated in the optional survey. The results demonstrated perceived value of the online ethics series, with students indicating improved understanding, confidence, and ability to consider other perspectives when dealing with medical ethical dilemmas.

SUMMARY

Implementing an online ethics series into a pharmacy curriculum failed to produce statistically significant increases in ethical thinking ability as measured by the DIT-2. However, students indicated a benefit from participating in the course as evidenced by responses to a post-course survey.

Learning through debate during problem-based learning: an active learning strategy

We explored medical student's views and perceptions of a series of debates conducted during problem-based learning (PBL) practiced as a part of the Spiral curriculum at the Imam Abdulrahman Bin Faisal University, Saudi Arabia. A series of debates were employed during PBL sessions for second-year female medical students, over the period 2014-2016. Each cohort of students was randomly split into 10 small PBL groups and exposed to weekly PBL activity. Within each group, the students were divided into a proposition half and an opposition half. Students were given 1 wk for debate preparation. The students' responses were recorded on a formulated questionnaire. Descriptive statistics were used to analyze quantitative data, and results are presented as percentages. The usefulness of debate in alleviating potential difficulties in communicating with patients was agreed to by 69% (n = 126) of participants. That these sessions evoked critical thinking among students was reported by 78% (n = 142). This series of debates helped 61% (n = 111) of students to learn effectively about controversial issues. Seventy-one percent (n = 130) considered that debate promoted argument generation and interpretation skills. Enhanced ability to analyze and research evidence was reported by 59% (n = 108) of students. One hundred and thirteen students (62%) agreed that debate helped them to improve clinical decision-making, and 75% of students agreed that debates encouraged tolerance toward diverse viewpoints/convincing strategies. The majority of our medical students found debating enhanced analytic decision-making, communication, and critical thinking skills.

Bioethics: a challenge and an opportunity for hospital pharmacists

Objectives

Traditionally, pharmacy ethics in Europe has held an insignificant place in the scheme of pharmaceutical education. We embraced the idea that bioethics should be an integral part of a pharmacist's education and professional practice, especially in hospital pharmacy where the concept of 'pharmaceutical care' should be revitalised to strengthen the broad-based and patient-oriented responsibilities of the clinical pharmacist.

Methods

We decided to structure a bioethics course tailored to pharmacists who are specialising in hospital pharmacy. We first created a training network partnership between a university and a research hospital to integrate classroom teaching with skill-specific practical experience. Our course pilot project introduces, in two of the four years of the national specialty programme, general topics and practical bioethical issues.

Results

A pilot course on ethics for the School of Specialisation in Hospital Pharmacy began at the Padua University in 2014. in February 2017 we contacted the same students again, asking them further questions about their experience. Several students asked to examine more cases and to deal with the few arguments that questioned them on an ethical level. On the whole, through the comments of trainees, the needs of those who are facing an unfamiliar subject, which is perceived as important, emerge.

Conclusion

Even if we are aware that this is a pilot project and requires more data, dissemination of this experience into a wider network will help us to define an effective educational pathway in collaboration with other Specialty Schools of Hospital Pharmacy.

Developing competencies among health professions students related to the care of people with disabilities: a pilot study

This is a two-phase study, the first was a literature review that aimed to identify a set of competencies for professional practice that would be relevant for the health care of People with disabilities (PwD). These competencies were then used to plan a thirty-hour multidisciplinary course for undergraduate health care students. The educational intervention led to improvements in the students’ learning experiences, including the development of empathy and knowledge related to the care of PwD, improved knowledge around accessibility, and an awareness of the need to humanize the care of PwD. Students reported enhanced learning experiences and an increase in knowledge related to the care of PwD, and also highlighted the need to humanize the care.

An investigation of final year pharmacy students' moral reasoning ability, and their views on professionalism and fitness to practice panel determinations: A questionnaire study

BACKGROUND AND PURPOSE

The aim was to establish pharmacy students' moral reasoning ability and obtain their views on professionalism and fitness to practice (FtP) determinations involving pharmacists.

EDUCATIONAL ACTIVITY AND SETTING

Following ethical approval and piloting, final year pharmacy students at Queen's University Belfast (QUB) (n=119) were invited to participate in a questionnaire study. Section A was a validated moral reasoning assessment tool [Defining Issues Test (DIT2); five moral dilemmas], Section B was FtP cases and professionalism. Distribution occurred at a compulsory class. DIT2 data were scored by the University of Alabama. Descriptive statistics and non-parametric tests were used with significance level set at 0.05 a priori.

FINDINGS

The response rate was 94.1% (112/119) and the 'DIT2 P score mean' (postconventional schema) was 25.21±14.10. Almost all [(98.2% (110/112)] fully understood the term "professionalism" and 83.9% (94/112) considered it reasonable for a professional code to apply always (within university and out socializing). Differences in opinions existed depending on what the FtP case related to. Students were significantly more likely to consider a 12-month suspension 'very lenient' or 'lenient' for a pharmacist's personal use of illicit drugs compared with theft of money/cosmetics (42.0% versus 64.3%; p=0.031). There were no significant differences between male and female responses/scores and no strong correlations between DIT2 scores and FtP/professionalism responses.

DISCUSSION AND SUMMARY

Pharmacy students appeared to understand professionalism and accepted being bound by a code. A level of discrimination between the FtP cases was evident. Moral reasoning ability was lower than expected for future healthcare professionals (see manuscript) requiring attention.

The use of debates as an active learning tool in a college of pharmacy healthcare delivery course

BACKGROUND AND PURPOSE

To describe the use of debates, and to evaluate student performance and perceptions, when student debates are incorporated as an active learning tool in a required pharmacy healthcare delivery course.

EDUCATIONAL ACTIVITY AND SETTING

Student live debates replaced 15% of a traditional lecture-based course. Twelve healthcare controversies were debated by student teams each year. Student perception of debate utility and opinion on topics, pre- and post-debate, were measured via a voluntary survey. Both peer and instructor's assessments of team performances, as well as individual student performance on the debate-based questions on course exams, contributed to course grade.

FINDINGS

The average survey response rates were 76% (2014) and 86% (2015). Fifteen-54% of student respondents changed their opinion on individual debate topics due to the debates. Although exam performance on debate-based questions was no better than on lecture-based questions, respondents who found the debates useful or very useful in mastering course material increased by 19% post versus pre-debate surveys.

SUMMARY

Debates are an effective active learning tool for engaging students in controversial subjects. Assessment of student performance should include student and instructor evaluations, and can be incorporated into the course grade.

Debate as an alternative method for medical literature evaluation

BACKGROUND AND PURPOSE

To determine the student impression of utilizing a debate style journal club as an alternative approach for preceptors to teach medical literature evaluation skills to pharmacy students undergoing Advance Pharmacy Practice Experiences (APPE) in both acute care and ambulatory care.

EDUCATIONAL ACTIVITY AND SETTING

Students were asked to debate on a controversial topic or two drugs with similar indications. Each side had to research supporting evidence based medicine and use literature appraisal skills to incorporate the information logically into an oral debate style format. Approximately fifteen minutes were allotted for each debate, allowing five minutes for each opening argument, three minutes for each rebuttal, and two minutes for each closing argument. Students were then asked to complete a post-debate survey using a Likert Scale to evaluate their perception of the debate style journal club.

FINDINGS

Following implementation of the debate style journal club, students reported being more confident with their ability to find, compare, and retain information from primary literature with a mean of 4.1, 4.2, and 4.4 respectively on a Likert Scale. Students also reported overall enjoyment and satisfaction with a mean of 4.0.

SUMMARY

Debate style journal clubs have the capability to teach pharmacy students vital literature appraisal skills, and are a well-liked alternative to the traditional style journal club. Incorporating this method improved student interest as well as increased their ability to find, compare, and retain the information gathered from primary literature.

Utilizing Team Debate to Increase Student Abilities for Mentoring and Critical Appraisal of Global Health Care in Doctor of Nursing Practice Programs

Although graduates of doctor of nursing practice (DNP) programs are expected to demonstrate competence in advanced clinical scholarship, mentoring, and leadership, little is published about how team debate on a global health care topic supports DNP student learning and skill development.

PURPOSE

This article reports on an illuminative evaluation of DNP student learning experiences of team debate in the context of a 2-week international school program in Ireland.

METHOD

A focused illuminative evaluation approach involving a cohort of seven DNP students, who had participated in an international school team debate, was used. Data were collected using a Web-based qualitative questionnaire designed to elicit in-depth reflective accounts of DNP students' learning experiences.

RESULTS

Content analysis revealed that team debate on a global health care topic enhanced learning in relation to fostering critical thinking and critical appraisal skills; encouraging teamwork; providing opportunities for mentoring, relationship building, and socialization into profession; and, from the DNP student perspective, increasing knowledge and global understanding of health care.

CONCLUSION

This evaluation provides insights for nurse educators into the benefits of introducing team debate as a group activity to enhancing scholarly inquiry and mentoring skills of DNP students. Further research to evaluate team debate in other nurse education programs is needed.

Developing Entrepreneurial Skills in Pharmacy Students

Objective. To create, implement, and evaluate a workshop that teaches undergraduate pharmacy students about entrepreneurship. Design. Workshops with 3 hours of contact time and 2 hours of self-study time were developed for final-year students. Faculty members and students evaluated peer assessment, peer development, communication, critical evaluation, creative thinking, problem solving, and numeracy skills, as well as topic understanding. Student evaluation of the workshops was done primarily via a self-administered, 9-item questionnaire. Assessment. One hundred thirty-four students completed the workshops. The mean score was 50.9 out of 65. Scores ranged from 45.9 to 54.1. The questionnaire had a 100% response rate. Many students agreed that workshops about entrepreneurship were a useful teaching method and that key skills were fostered. Conclusion. Workshops effectively delivered course content about entrepreneurship and helped develop relevant skills. This work suggests students value instruction on entrepreneurship.