Incorporating age-related special populations into a pharmacy skills laboratory course sequence

Case mapping of geriatrics: Looking beyond age in skills laboratories

BACKGROUND AND PURPOSE

Development of competencies related to care of older adults is necessary in pharmacy education. Skills laboratories as an essential part of the curriculum represent an important setting to teach geriatrics. The purpose of this research was to describe geriatrics cases in skills/simulation activities of an undergraduate pharmacy program.

EDUCATIONAL ACTIVITY AND SETTING

A retrospective review of one academic year of skills laboratories from the pharmacy program at the Faculty of Pharmacy of University of Montreal was performed. Sessions including cases aged ≥65 years were selected. Content was extracted for characteristics relating to the patient, health, medications, and care context. A framework including geriatric considerations such as geriatric syndromes, frailty status, and potentially inappropriate medications was developed for data collection.

FINDINGS

In total, 210 patient cases were extracted. Older adults (≥ 65 years) were represented in 51 cases (24%), with 8 cases (4%) aged ≥80 years. Geriatric syndromes were documented in 8%, functional status in 10%, and mobility in 12% of the cases. The median number of comorbidities and medications were 4 and 7, respectively. Regarding polypharmacy, only 10 cases had >10 medications, and none had >15 medications. Potentially inappropriate medications were found in 47% (n = 24) of the cases but were addressed in only 14% (n = 7) cases.

SUMMARY

This mapping of skills laboratories highlights gaps in geriatrics content. Inclusion of the oldest patients and geriatrics issues were incorporated in a minority of cases and lacked many characteristics essential for geriatrics care.

Change in Student Pharmacists' Perceptions and Confidence of Pediatric Related Topics After Participation in Pediatric Pharmacy-Focused Skills Laboratory

OBJECTIVE

The objective of this study was to assess the impact of a pediatric pharmacy-focused skills laboratory on student pharmacist confidence and comfort with pediatric topics.

METHODS

This study compared student responses on a questionnaire completed both pre- and post-lab. The lab activities included pre-readings, a pre-lab lecture, and a 2-hour laboratory session. The questionnaire assessed perceptions related to counseling pediatric patients and confidence in communicating with children and caregivers. Wilcoxon rank sum tests compared the differences in the preand post-lab questionnaire results. The McNemar test was used to test for conversion.

RESULTS

A total of 187 of 221 pharmacy students completed the pre-lab questionnaire (85% response rate) and 116 completed the post-lab questionnaire (52% response rate). Significantly higher confidence levels were reported in the post-lab questionnaire for 5 of the 7 questionnaire items. Specifically, concerning level of confidence in measuring oral solutions, 17.5% of students' pre-lab, compared with 42.6% post-lab felt completely confident in being able to determine the appropriate measuring devices for liquid medications. No statistically significant differences were noted regarding comfort level or knowledge.

CONCLUSIONS

Although an increase in confidence was seen in several areas, some students still lacked confidence after the lab session, suggesting that more pediatric-focused activities may be needed in the curriculum to reinforce pediatric concepts.

Joint Statement on Pediatric Education at Schools of Pharmacy

Providing health care for children is a unique specialty, and pediatric patients represent approximately 25% of the population. Education of pharmacy students on patients across the lifespan is required by current Accreditation Council for Pharmacy Education standards and outcomes; thus, it is essential that pharmacy students gain a proficiency in caring for children. A collaborative panel of pediatric faculty members from schools and colleges of pharmacy was established to review the current literature regarding pediatric education in Doctor of Pharmacy curricula and establish updated recommendations for the provision of pediatric pharmacy education. This statement outlines five recommendations supporting inclusion of pediatric content and skills in Doctor of Pharmacy curricula.