Combining rhetoric and role-play to introduce and develop patient presentation skills in third year pharmacy students

Instrument development to determine student self-efficacy to present a patient to a pharmacy p receptor (4P)

INTRODUCTION

Effective patient assessment is often supported through simulated experiences where students identify potential drug-related problems (DRPs) through evaluation of the patient's electronic health record and verbally present their assessment and proposed resolutions for DRPs. This research aimed to initiate validation of a Patient Presentation to a Pharmacy Preceptor (4P) tool using exploratory factor analysis (EFA) to examine underlying constructs, refine items, and improve tool conciseness. The 4P tool was designed to assess student self-efficacy to identify, assess, resolve, and verbally present DRPs to a pharmacy preceptor.

METHODS

The 4P instrument was administered to third-year doctor of pharmacy students in a performance-based skills laboratory course. EFA was conducted on student confidence data to examine underlying 4P constructs and improve survey conciseness. Laboratory faculty evaluated EFA results and came to consensus on factor extraction, item reduction and revision, and a finalized version of the 4P tool.

RESULTS

Faculty interpretation of EFA results suggested elimination of two constructs resulting in a four-factor solution. Item evaluation further led to renaming the four constructs based on underlying factor themes. Out of the original 34-item tool, 13 items were eliminated, eight items were revised, and 1 new item was generated to retain relevant concepts. The refined 4P instrument contained four factors and 22 items.

CONCLUSIONS

Use of EFA was useful to determine core 4P tool constructs and improved tool conciseness. This final four-factor model including 22 items will be used for a future confirmatory factor analysis.

Determining presentation skills gaps among healthcare professionals

Healthcare professionals frequently communicate complex medical information among colleagues and students. This paper aims to determine gaps in healthcare professionals' presentation skills and identify barriers to improving. Eighty-eight individuals at a Midwest Academic Medical Center completed a survey that consisted of three parts: (1) respondents' current presentation slide deck, (2) respondents' perceptions of their current presentation skills, and (3) barriers to and motivations for improving their presentation skills. A mixed-methods approach was used to collect and analyze data. Respondents used bullet points and text the most (74%), and videos the least in their presentations (51%). When assessing respondents' perceptions of their current presentation skills, they rated themselves the lowest as a storyteller (median = 6/10) and as an overall presenter (median = 6/10). The biggest barrier reported was "lack of training on best practices" (58%). Respondents reported "interested in improving" and "enhance opportunities" as their main motivations for improving presentation skills. Four themes emerged from the open-ended survey items: Practical tips and best practices, Ability to communicate effectively, Professional development, and Practice opportunities. Effective presentation skills should be included in every healthcare professionals faculty development curriculum. This is especially crucial for junior faculty members to ensure their continued success.

Simulation-Based Education Implementation in Pharmacy Curriculum: A Review of the Current Status

Simulation-based education (SBE) is a fundamental teaching method that complements traditional teaching modalities. SBE has improved students' knowledge, understanding, and numerous essential skills within undergraduate pharmacy education, similar to traditional teaching methods. However, SBE has become crucial for developing students' teamwork, decision-making, and communication skills. Even though the Accreditation Council for Pharmacy Education (ACPE) has acknowledged the benefit of SBE in interprofessional education (IPE) and the introductory pharmacy practice experience (IPPE). This article provides evidence that SBE can be effective beyond that. This narrative review is focused on the literature related to SBE modalities and the assessment methods of student learning outcomes in the undergraduate pharmacy curriculum. The review illustrates that SBE is an effective teaching method that could be utilized within the pharmacy curriculum. The review also could help pharmacy educators decide on the best modality and placement of integrating patient simulation within the pharmacy curriculum. Combining multiple simulation techniques may be the best way to achieve the desired student learning outcomes.

Revisions to a patient presentations curricula informed by longitudinal evaluation of student confidence

BACKGROUND AND PURPOSE

Presentation of patient cases to a preceptor is a complex skill taught throughout the pharmacy curriculum. However, published literature to guide instruction on this skill is lacking. The objective of this project was to inform revisions to a patient presentations curriculum through measurement and evaluation of student confidence to perform skills necessary to effectively present a patient case to a preceptor.

EDUCATIONAL ACTIVITY AND SETTING

A patient presentations to pharmacy preceptor curriculum was implemented into a pharmacotherapy skills laboratory course. Students were invited to complete three surveys over the course of the semester to evaluate areas for improvement in the teaching of this skill. Surveys measured student confidence in ability to identify and present relevant components within an electronic health record, identify and resolve drug-related problems, and communicate effectively during a patient presentation (34 items, 7-point Likert type scale). Survey results were analyzed, and instructional interventions were identified and designed.

FINDINGS

Student confidence to present a patient to a pharmacy preceptor improved over the semester. Four interventions were designed and implemented to address five low self-reported student confidence items. Interventions included creation of large-group discussions, standardization of student feedback, and revision of a lab to limit student preparation time. Survey data revealed students understood the importance of evaluating patient cases and agreed these skills are applicable to multiple practice settings.

SUMMARY

Based on student confidence data, areas for improvement in a patient presentations curriculum were identified, allowing for implementation of instructional interventions that targeted specific performance items.

Implementation and assessment patient cases using the SBAR method to teach patient quality of life issues

BACKGROUND AND PURPOSE

Quality of life (QoL) preferences are an important consideration with respect to the Pharmacists' Patient Care Process (PPCP) and should be assessed prior to implementing a patient-centered plan. The objectives of this intervention were to determine if the design of a QoL activity impacts student performance, and to discern student perceptions of an innovative, case-based activity.

EDUCATIONAL ACTIVITY AND SETTING

Two cohorts of students in their second professional year were asked to present an article that included a QoL consideration. The two student cohorts were asked to complete the activity using a case report and modified SBAR (Situation, Background, Assessment, Recommendation) format. Presentations were graded using a rubric, and scores were assessed retrospectively. An unpaired t-test was used to examine differences. The final cohort of students was also asked to complete a survey to gather their perspectives. Results were described using descriptive statistics; thematic analyses were also performed.

FINDINGS

Students who completed the SBAR activity (N = 71) performed significantly better than those who completed the article (N = 98) presentation (95.62 ± 5.47 vs. 86.30 ± 16.54, P < .001). Those who completed the survey (N = 22) felt they made moderate to excellent progress explaining QoL (86%) and that the activity was helpful (68%). Overall, students reported an improved understanding of the patient's perspective.

SUMMARY

The PPCP requires that students must consider the patient's QoL in order to develop an optimal patient-centered plan. Activities such as this may improve student understanding of QoL implications.

Feedback for Learning in Pharmacy Education: A Scoping Review

Feedback is an effective pedagogy aimed to create cognitive dissonance and reinforce learning as a key component of clinical training programs. Pharmacy learners receive constant feedback. However, there is limited understanding of how feedback is utilized in pharmacy education. This scoping review sought to summarize the breadth and depth of the use of feedback within pharmacy education and identify areas for future research. PubMed, Embase, Scopus, and Web of Science were searched for English articles since January 2000 to identify studies related to feedback in pharmacy education. Sixty-four articles were included for analysis, stratified by moderate and major theory talk, where moderate theory talk explicitly included feedback into study design and major theory talk included feedback into both study design and analysis. Feedback was provided in Bachelor (14%), Master (15.6%), Doctor of Pharmacy (67.2%) and post-graduate programs (4.7%) on a variety of curricular objectives including communication and patient work up in didactic, objective structured clinical examination (OSCE), and experiential settings, and career/interview preparation in the co-curriculum. Feedback comments were mostly written in didactic courses, and both written and verbal in OSCE, experiential, and co-curricular settings. The pharmacy education feedback literature lacks depth beyond student perceptions, especially with respect to assessing the effectiveness and quality of feedback for learning. While feedback has been utilized throughout pharmacy education across myriad outcomes, several areas for inquiry exist which can inform the design of faculty and preceptor development programs, ensuring provision of effective, quality feedback to pharmacy learners.

Use of a novel videotaped presentation to improve pharmacy student confidence in presenting evidence-based medicine

INTRODUCTION

We assessed the use of a novel videotaped presentation on pharmacy student confidence in presenting an evidence-based recommendation to theoretical healthcare professionals from various disciplines.

METHODS

Students in a required drug literature evaluation course prepared a three-min videotaped presentation critiquing an assigned journal article with the goal of providing a patient care recommendation to a fictional physician. To determine change in confidence, students completed a pre-/post-survey on a 5-point scale. Survey questions explored confidence in presenting and discussing article evidence with both peers and licensed healthcare providers as well as making verbal recommendations for medication use. The survey also included open-ended questions to assess perceptions of the assignment and suggestions for assignment improvement.

RESULTS

Over two years, 208 students completed both surveys (75.9%). Student confidence significantly increased for all items from the pre- to the post-survey. Items with the largest increase in confidence were presenting medical literature to peers, pharmacists, and other healthcare professionals (range 0.72 to 0.89 mean increase for these items). Students reported increased preparedness in presenting, improved conciseness in presenting, and increased self-awareness as a result of the assignment. The majority of students had no suggestions for assignment improvements.

CONCLUSIONS

Use of a videotaped assignment is a novel, low-resource option for assessing student skills. This video presentation activity allowed students to gain additional communication practice without additional administrative resources. The activity resulted in increased pharmacy student confidence in discussing medical literature and making evidence-based recommendations for medication use.