Enhancing application and long-term retention of clinical knowledge using an extracurricular non-credit course

BACKGROUND AND PURPOSE

Curricular overload in doctor of pharmacy (PharmD) programs is necessitating innovative approaches to support student learning. The purpose of this study was to describe the design, delivery, and assessment of a non-credit extracurricular course that reinforced foundational concepts through the application of learning in case-based activities.

EDUCATIONAL ACTIVITY AND SETTING

A 14-week extracurricular course, designed using principles of spaced repetition and interleaving in the context of case-based exercises, was offered to third-year PharmD students. Content focused on Top 300 and over-the-counter medications, brown bag sessions/drug utilization review, and medication therapy management. Short-term course effectiveness was assessed through post-course focus groups. Longitudinal effectiveness was assessed nine months post-course using an online survey. Qualitative data were analyzed using a content analysis process with overarching themes identified. Clinical interventions identified in the post-course survey were analyzed descriptively.

FINDINGS

Twenty-four students completed the course and all assessments. Focus group themes were: (1) making connections to prior learning; (2) moving beyond memorizing facts; and (3) benefit from a low-stakes course. Students identified 162 course-linked clinical interventions during advanced pharmacy practice experiences (APPEs) in 16 different settings.

SUMMARY

Student learning can be enhanced through integration of evidence-based teaching strategies both within and across the curriculum. This can be accomplished not only through introduction of an extracurricular course but through modification of existing courses. Providing additional opportunities for reinforcing core clinical knowledge and applying clinical decision-making in a low-stakes environment was well-received by students and helped them make clinical interventions during APPEs.

Early skills laboratory warnings: Laboratory faculty perspectives on student barriers for progression to experiential education

INTRODUCTION

This study characterized faculty perceptions of student barriers to achieving an Entrustable Professional Activities (EPA) level 2 or higher in the Patient Care Provider domain.

METHODS

Pharmacy skills laboratory faculty participated in a nominal group technique (NGT) session. Participants reflected on two questions: "What behaviors would result in a student not achieving a rank of EPA readiness level 2 or higher?" and "What knowledge and skills would result in a student not achieving a rank of EPA readiness level 2 or higher?" Participants developed a ranked list using silent brainstorming, idea generation, clarification, and discussion.

RESULTS

Two NGT sessions were conducted. Group 1 reported (lack of) professionalism, (inability to perform) physical skills, (lack of) critical thinking and interpreting data gathered during physical skills, and (inability to achieve) programmatic outcomes and mile makers exams as barriers. Group 2 ranked behaviors as lack of independence, not taking roles and responsibilities seriously, inability to follow instructions, lack of classroom engagement, and disorganized and unable to prioritize. Group 2 ranked knowledge and skills of significant errors when making medication recommendations, inability to identify accurate medication history, inability to perform tasks with time constraints, poor patient communication, and inability to identify resources.

CONCLUSIONS

Pharmacy skills laboratory faculty can identify behaviors, knowledge, or skills that may prevent a student from achieving an EPA readiness level 2 or higher such as lack of professionalism and poor critical thinking skills and should be empowered to identify early warning signs for students' success and progression to experiential education.

Student Perceptions of an Interprofessional Short Course Designed to Increase Awareness of Human Trafficking

Human trafficking is a global problem with significant impacts on victims' physical and emotional health. Many health care professionals lack human trafficking knowledge, leading to missed opportunities for intervention. This cross-sectional study used evaluation data from a short course on human trafficking to evaluate the course's perceived impact on students. Closed-ended questions were analyzed descriptively while open-ended questions were analyzed using qualitative content analysis. A total of 241 students across eight professions/disciplines completed the evaluation. The vast majority indicated course content was valuable, applicable to their future practice, and recognized interprofessional teamwork is needed to address human trafficking. Despite course effectiveness, there remains a need to continue expanding interprofessional engagement and examining the longitudinal impact of this educational effort.

A Pharmacist's Role in a Dental Clinic: Establishing a Collaborative and Interprofessional Education Site

Background:

Dental patients often have comorbidities and take multiple medications, some of which could impact their dental health and treatment. A pharmacist in a dental clinic can assist with the gathering, documentation and evaluation of a dental patient's medication history as it pertains to their dental visit and overall health.

Purpose:

To develop and implement a collaborative and interprofessional education program with a pharmacist providing services in a dental school clinic.

Summary:

Creighton University School of Dentistry, a student-operated dental clinic located in Omaha, Nebraska, provides dental care by student dentists, faculty and staff to the surrounding community in a learning-focused environment. A pharmacist was incorporated into the dental clinic to create and establish an interprofessional relationship with both dental students and faculty beginning August 2014. Pharmacy students on an ambulatory care advanced pharmacy practice experience rotation were eventually added to the team. The pharmacy team provided medication therapy management services including disease state and medication counseling, medication reconciliation, identifying drug-related problems and dental implications of medications, and recommendations for prescribed medications.

Conclusion:

The pharmacy team's presence was largely accepted by dental faculty, staff, dental students, and patients. Pharmacists can play an important role in a dental clinic by performing thorough health and medication histories and communicating with dental and medical providers involved in a patient's care.

Technology in the Pharmacy Learning Environment: Surveys of Use and Misuse

The use of technology in the classroom may have positive and negative effects on learning. The purpose of this investigation was twofold: to identify the effect technology is having on the pharmacy learning environment; and, to assess students' use of technology during class time for non-academic purposes. This study included a national cross-sectional survey as well as a single, college-specific survey. The national survey had a faculty response rate of 71.2%. Of the responders, approximately 61% identified significant problems related to students' use of technology in the pharmacy learning environment. Cell phones were a recognized concern and more than 90% of programs have chosen to restrict cell phone use in the classroom. The single college survey examining technology use during class for non-academic purposes had a student response rate of 87% and faculty response rate of 100%. Students and faculty members disagreed regarding the negative effects of technology use during class for non-academic purposes. Notably, 16% of students acknowledged their in-class use of technology for non-academic purposes had been disruptive to their learning, as compared to 95.7% of faculty. According to students, common reasons for off-task technology use included checking e-mail/text messages (75.1%), lack of engagement (58.1%), multitasking (56.2%), and accessing social media sites (33%). Faculty and students were asked about enforcement of technology policy. More faculty than students supported policy enforcement by faculty (65.2% versus 22.8%, respectively; p<0.001) as well as policy enforcement by students (78.3% versus 31.9%, respectively; p<0.001). Overall, technology use during class for non-academic purposes was common. Many schools and colleges of pharmacy are developing approaches to address these evolving issues by revising their technology use policies.   Type: Original Research

Role of pharmacists in the treatment of excessive daytime sleepiness

The focus of this case is a 78-year-old female who is being referred to an assisted living community following several episodes of excessive daytime sleepiness (EDS). EDS in the geriatric patient is widespread and is often underdiagnosed and inadequately treated. It can affect an older patient?s quality of life, as well as increasing physical, psychological, cognitive, and mortality risks. There are many different etiologies for EDS including coexisting medical conditions, circadian misalignment, medications affecting the sleep/wake cycle, and psychiatric or psychosocial circumstances. This case illustrates how the pharmacist can help patients with EDS by recognizing symptoms; performing a targeted medical history, sleep history, and medication review; and offering screening with validated tools to refer patients to sleep specialists. There are both pharmacological and nonpharmacological treatment options. The consultant pharmacist is a vital member of the interprofessional health care team and can play a major role in the education, monitoring, and management of EDS.

An advanced pharmacy practice experience in community engagement

OBJECTIVE

To implement a 5-week advanced pharmacy practice experience (APPE) in community engagement and assess the impact of the APPE on students' confidence and ability to provide community-based services.

DESIGN

Working with community partners, students provided medication reconciliation, attended interprofessional healthcare meetings, developed health-promotion activities, and conducted medication-therapy reviews.

ASSESSMENT

Responses to pre- and post-APPE 10-item surveys, preceptor and practice-experience evaluations, and the documented number of pharmacy student recommendations were determined.

CONCLUSION

This APPE provides students opportunities in nontraditional community settings to increase their confidence and enhance their skills in health-promotion activities, medication-therapy management, and interprofessional care of patients, all of which are essential to the practice of pharmacy.

Medication therapy management training using case studies and the MirixaPro platform

OBJECTIVE

To implement and assess a medication therapy management (MTM) training program for pharmacy students using the MirixaPro (Mirixa Corporation, Reston, VA) platform and case studies.

DESIGN

Students received lectures introducing MTM and were given a demonstration of the MirixaPro platform. They were divided into teams and assigned cases and times to interview patients portrayed by faculty members. Using the MirixaPro system, students performed 2 comprehensive medication reviews during the semester, recording the patient's current medications, indications, side effects, allergies, health conditions, and laboratory test recommendations and developed a personal medication record and medication action plan.

ASSESSMENT

Based on a rubric with a rating scale of 0-10, campus and distance pathway students received mean scores ranging from 6.3-7.4 for their performance on the second MTM exercise, an increase of 47%-54% over the first MTM exercise. In qualitative assessments, the majority of students believed that their confidence in providing MTM was enhanced by the activity, while faculty members recognized the advantage of using MirixaPro, which allowed students to experience what is required in processing a pharmacist led, billable MTM encounter.

CONCLUSIONS

Use of the MirixaPro system and patient cases provides students with a "hands-on" experience that may encourage them to promote MTM during their APPEs and provide MTM services as practicing pharmacists.