The impact of team-based learning on the critical thinking skills of pharmacy students

The impact of critical thinking skills on student pharmacist GPA at a historically Black university

INTRODUCTION

Limited information is available regarding whether malleable factors such as critical thinking skills are associated with academic performance among underrepresented minority pharmacy students. This study assessed the relationship between critical thinking skills and grade point average (GPA) among pharmacy students attending a Historically Black College.

METHODS

A cross sectional study design was utilized to evaluate the association between student's GPA and critical thinking skills. Demographic data and GPA were abstracted from student records. The health sciences reasoning test with numeracy was administered to pharmacy students at Howard University during the 2017 to 2018 academic year. Critical thinking scores were classified as weak, moderate, or strong/superior. A one way analysis of variance was conducted to ascertain if the average GPA differed based on critical thinking skills category. A multiple linear regression analysis was conducted to determine whether student's critical thinking skill category was associated with the cumulative GPA after accounting for other factors.

RESULTS

Among 217 students, the mean GPA among students with a weak critical thinking skills score (3.22 ± 0.40) was lower compared to students with a strong/superior score (3.39 ± 0.33) with a p-value of 0.029. After adjusting for other factors, a strong/superior critical thinking skills score was associated with a higher GPA (p-value = 0.024) in comparison to weak critical thinking skills.

CONCLUSION

Stronger critical thinking skills scores are associated with better academic performance among underrepresented minority pharmacy students.

Pharmacology education in the medical curriculum: Challenges and opportunities for improvement

The knowledge and application of pharmacology is essential for safe prescribing and administration of drugs. In this narrative review, the challenges to pharmacology education in the medical curricula were broadly identified to include issues around content and pedagogies. The increasing number of approved drugs and drug targets, expanding field of pharmacology and the often-changing treatment guidelines and board-defined competencies can make pharmacology education in the medical curriculum daunting. There has been a consensus around the deployment of innovative medical curricula with emphasis on vertical and horizontal integration. This strategy, effective as it has been, presents new challenges to pharmacology education. As a discipline often perceived by students to be hard-to-learn, the future of pharmacology education must include heavy reliance on active learning strategies. The continuing utilization of problem-based, team-based and case-based learning can be complemented with personalized learning which aims to identify the learning gaps in individual students. Technology-inspired student engagement can foster pharmacology learning and retention. Early exposure to pharmacology from premedical preparation through an enduring across-the-level integration can be an effective way to enhance pharmacology learning in the medical curricula.

Critical thinking disposition of medical students in Anhui Province, China: a cross-sectional investigation

OBJECTIVE

To investigate the critical thinking disposition of medical undergraduates.

METHODS

This cross-sectional study was performed on 426 students from four majors, including preventive medicine, maternal and children's health care medicine, health inspection and quarantine, and food quality and safety. The survey was completed in May 2019 using the California Critical Thinking Dispositions Inventory-Chinese version (CTDI-CV).

RESULTS

A total of 435 questionnaires were distributed and 426 valid questionnaires were collected, with an effective rate of 97.93%. The CTDI-CV overall average score was 262.02 ± 34.74 points indicating an ambivalent disposition in medical undergraduate students. Only one of the subscales (maturity in judgment) had mean scores of 43.35 ± 8.23 indicating the positive disposition of students. Among them, males scored 257.42 ± 35.06 lower than females' 264.82 ± 34.32, the difference was statistically significant. The target scores of preventive medicine, maternal and children's health medicine, health inspection and quarantine, and food quality and safety were 265.17 ± 30.10, 260.26 ± 37.05, 271.73 ± 33.55, and 252.11 ± 39.87, respectively. The difference was statistically significant. Among the three dimensions of seeking truth, open mind, and cognitive maturity, the scores of males were 38.26 ± 7.48, 38.78 ± 6.46 and 41.03 ± 8.69, which were lower than females' 39.97 ± 7.11, 40.48 ± 6.48 and 44.91 ± 7.60, respectively. The scores of food quality and safety students were 37.23 ± 7.08, 36.61 ± 7.41 and 40.57 ± 8.60, respectively, which were lower than the preventive medicine (39.98 ± 7.07, 40.60 ± 5.96 and 44.44 ± 6.97, respectively).

CONCLUSION

Most medical students were found to have an ambivalent disposition which meant they were not disposed toward critical thinking. These findings suggested that more effective teaching methods should be taken to facilitate critical thinking disposition and problem-solving ability.

Team-based learning complemented by interactive response system: Application of a strategy on the course of human growth and development for nursing students

OBJECTIVE

Lecture-based learning (LBL) strategy cannot stimulate learners' ability to think and learn independently. Recently team-based learning (TBL), a learner-centered strategy, gained popularity in health education. An interactive response system (IRS) assists educators in providing instant feedback on classroom activities. This study was to evaluate the TBL strategy supplemented by IRS (TBL/IRS) on the learning effects of the core course, the human growth and development (HGD), in nursing education.

MATERIALS AND METHODS

A quasi-experimental study design with two-group, pretests and posttests was employed with year-one students enrolled in two HGD classes in the nursing department of a university in central Taiwan. Both HGD classes employed the LBL method at the beginning of a semester. TBL/IRS strategy was introduced to the experimental class 6 weeks later. Three scales were used to measure self-directed learning, classroom engagement, and team learning. Individual and group readiness assurance tests (IRATs and GRATs) were administered. Final exams were also compared between the groups. For thematic analysis, learners' experience with TBL/IRS was collected from learner reports and a semi-structured questionnaire designed for the study.

RESULTS

A total of 105 learners-48 in TBL/IRS and 55 in LBL-were recruited. Self-directed learning, classroom engagement and team learning were improved significantly in TBL/IRS whereas only self-directed learning was improved in LBL. In the TBL/IRS group, GRAT scores were significantly higher than IRAT. However, the difference in final exams between the groups was non-significant. Four themes emerged from learners' experiences with TBL/IRS: stimulate self-learning; a diverse and flexible learning method; promote high-level thinking and deepen learning results; and, cultivate teamwork and application.

CONCLUSIONS

This study confirmed that TBL/IRS was effective in enhancing learners' abilities to integrate concepts and skills, thereby cultivating competence in problem-solving and teamwork. The TBL/IRS strategy was cost-effective in promoting active learning of HGD in nursing students.

Evaluating and comparing critical thinking skills of residents of Tehran University of Medical Sciences

BACKGROUND

Today's complexities and diversity in the clinical setting have revealed the need to pay attention to strengthening critical thinking (CT) skills. The present study aimed to evaluate and compare CT skills in the residents of the Tehran University of Medical Sciences.

METHODS

This is a cross-sectional study. The study's statistical population included 284 residents in orthopedic, internal medicine, and surgery groups studying in the PGY1 to PGY4 years of residency. The data collection tool was the California Critical Thinking Skills Test (CCTST) form B. The collected data were entered into SPSS-16 software and analyzed using descriptive (mean and standard deviation) and inferential (one-way ANOVA) statistics. The significant level in all tests was considered at P < 0.05.

RESULTS

189 out of 284 residents completed and returned the questionnaire, and the response rate was 66%. The mean CT skill score of residents (M = 13.81, SD = 3.52) was lower than the optimal level (M = 17.1 SD = 5.0). Comparing the mean CT skill scores of the residents separately for the residency year revealed a significant decrease in CT scores in the 4 years. A significant difference was found between the CT skill scores in the three groups (internal medicine, general surgery, and orthopedic surgery).

CONCLUSION

The CT skills of the residents of Tehran University of Medical Sciences were generally below the optimal level. The CT score of the residents show an increase in PGY2, but a decrease in PGY3 and PGY4. Due to the emphasis of accreditation institutions, the World Federation for Medical Education, and other international educational institutions on the importance of critical thinking, it is recommended to pay more attention to the factors related to the promotion and development of CT skills in residency programs.

Brazilian undergraduate nursing students’ critical thinking need to be increased: a cross-sectional study

ABSTRACT Objectives: to map Brazilian undergraduate nursing students’ critical thinking level and investigate the correlation between selected sociodemographic data and critical thinking domains. Methods: in this descriptive cross-sectional study, participants’ (N=89) critical thinking was assessed using the Health Science Reasoning Test. Correlation between critical thinking domains and sociodemographic data was assessed using the Pearson correlation coefficient. Results: the overall results showed a moderate level of participants’ critical thinking (mean = 70.7; standard deviation 5.7). A poor performance was identified in 5 of the 8 critical thinking domains. A significant positive correlation was found between education period and critical thinking (p<.001). Conclusions: poor level in students critical thinking domains may lead to negative consequences for their learning outcomes. Further studies should be carried out to confirm our results, in addition to investigation of teaching methods that encourage and ensure the development of students’ critical thinking skills during nursing education.

Effectiveness of an Advanced Naloxone Training, Simulation, and Assessment of Second-Year Pharmacy Students

Background: Opioid overdoses continue to be one of the most urgent public health priorities. In 2020, reported overdose deaths in the United States reached a high of over 93,000 cases. As the COVID-19 pandemic and opioid crisis continues to be addressed, life-saving agents must be more widely accessible to those with a high overdose risk. An essential step to increasing access is to train student pharmacists to dispense naloxone. Once licensed, the number of personnel authorized to dispense naloxone can increase. Objectives: To design a training program to educate second-year pharmacy (P2) students on furnishing naloxone under a state protocol. Methods: A multi-phased curriculum-based naloxone training program was delivered to P2 students and included lecture-based education, team-based learning (TBL) applications, case-based scenarios, and summative assessments to improve student knowledge and confidence in furnishing naloxone. Students were surveyed on their knowledge and confidence with naloxone prior to training, after the in-class training and TBL applications and after three assessments. Assessments included simulated patient counseling, case-based scenarios, and proper dispensing of naloxone in a community pharmacy simulation lab. Results: A total of 185 student pharmacists completed the naloxone training program and 68 completed all three surveys. Average scores for naloxone assessments were 83% for the APPS lab patient case, 90.5% for the prescription label typed for the naloxone product, and 88.5% for patient counseling. Statistically significant increases in knowledge-based quiz-like scores (42.1% after training vs. 7.2% after assessment) and in the proportion of students affirmatively answering survey questions after training and assessment was observed. Conclusion: Multi-phase curriculum-based naloxone training program improved pharmacy student knowledge and confidence in furnishing naloxone under a state BOP protocol.

Enhanced numeracy skills following team-based learning in United States pharmacy students: a longitudinal cohort study

PURPOSE

The literature suggests that the ability to numerate cannot be fully understood without accounting for the social context in which mathematical activity is represented. Team-based learning (TBL) is an andragogical approach with theoretical links to sociocultural and community-of-practice learning. This study aimed to quantitatively explore the impact of TBL instruction on numeracy development in 2 cohorts of pharmacy students and identify the impact of TBL instruction on numeracy development from a social perspective for healthcare education.

METHODS

Two cohorts of students were administered the Health Science Reasoning Test-Numeracy (HSRT-N) before beginning pharmacy school. Two years after using TBL as the primary method of instruction, both comprehensive and domain data from the HSRT-N were analyzed.

RESULTS

In total, 163 pharmacy student scores met the inclusion criteria. The students’ numeracy skills measured by HSRT-N improved after 2 years of TBL instruction.

CONCLUSION

Numeracy was the most significantly improved HSRT-N domain in pharmacy students following two years of TBL instruction. Although a closer examination of numeracy development in TBL is warranted, initial data suggest that TBL instruction may be an adequate proxy for advancing numeracy in a cohort of pharmacy students. TBL may encourage a social practice of mathematics to improve pharmacy students’ ability to numerate critically.

A Practical Review for Implementing Peer Assessments Within Teams

Objective. The objective of this review is to maximize the benefit of peer assessments in teamwork settings in professional pharmacy curricula.Findings. Best practices do not exist for using peer assessments in academic settings. The studies on peer assessments that we reviewed applied various conditions: Some studies used peer assessments of teams for formative assessments, while others used them for summative assessments; some assessed teamwork at a limited number of time points, while some assessed multiple time points; some attached student names to the assessments, while some were anonymous; and some explained why the tool was being used, while others offered no explanation.Conclusion. To use peer assessments most beneficially, instructors must define the purpose for their use, explain the purpose of teamwork, orient students to the tool being used, assess teamwork over time, provide feedback, minimize grades associated with the assessment, and use partial anonymity when collecting feedback.

The Student Engagement Effect of Team-Based Learning on Student Pharmacists

Objective. To expand our understanding of student engagement by qualitatively examining how student pharmacists experienced the psychological state of engagement when applying team-based learning (TBL) pedagogy.Methods. A qualitative case study was conducted. Data were obtained through semi-structured interviews with a purposeful and convenience sample of student pharmacists (n=14). Our initial data analysis identified common themes for student engagement in TBL. We then characterized each common theme by deductively coding the themes into predetermined focal concepts of engagement based upon Kearsley and Shneiderman's 1 previous characterization of student engagement as either relate, create, or donate components.Results. Seven common themes arose from this research: accountability, communication, conflict, learning, preparation, purpose, and teamwork. Results indicated that student pharmacists engaged in TBL pedagogy mostly experience the psychological state of student engagement through a relate (41%) component by drawing on team support and trust, followed by the donate (32%) and create (27%) components.Conclusion. Findings in this study are consistent with other research on TBL pedagogy which concluded that, at least in part, this type of learning was a conduit for building student pharmacists' engagement skills. The novelty of this research is that it deductively characterized how student pharmacists perceive, comprehend, and interpret the psychological state of engagement in TBL. Specifically, our findings concluded student pharmacists mostly identify with a relate component of engagement by drawing on team support and trust developed from TBL tenets that encourage communication, conflict resolution, and teamwork.

Revisiting the Socratic method of teaching to improve third-year pharmacy students critical thinking and advanced pharmacy practice experience readiness in a critical care elective

BACKGROUND

One of the most important abilities we look to nurture and develop in pharmacy students is critical thinking. A critical care elective course was re-designed to optimize high-pressure situations to engage and target critical thinking, clinical reasoning, and advanced pharmacy practice experience (APPE) readiness using the Socratic method of teaching.

EDUCATIONAL ACTIVITY

Pharmacy students at Loma Linda University School of Pharmacy were selected and exposed to a high-pressure classroom environment with each day structured around the Socratic method of teaching. Pass/fail grades were earned daily based solely on verbal responses and discussions. The assessment tools used were: Health Sciences and Reasoning Test (HSRT) to measure critical thinking, an APPE-readiness survey of the entire third-year class for peer comparison, and a survey of the style and pedagogies used.

CRITICAL ANALYSIS OF THE EDUCATIONAL ACTIVITY

The elective students showed noteworthy gains on their HSRT results in an eight-week critical care elective course. They also had significantly more positive responses on the APPE-readiness survey relative to their classmates and rated this teaching style higher than a typical course. Revisiting and applying the Socratic method of teaching in a high-pressure course is an effective way to engage pharmacy students, producing substantial improvements in critical thinking, clinical reasoning, and APPE readiness in a short time. Lastly, it offers one way to incorporate a validated tool to measure critical thinking in pharmacy students for institutional assessment and accreditation that is widely available, easy to use, and cost friendly.

Use of Team-Based Learning Pedagogy to Prepare for a Pharmacy School Accreditation Self-Study

Ensuring adequate engagement and preparation of all stakeholders in an accreditation self-study can be challenging for many reasons, including lack of motivation and inadequate understanding of expectations and procedures. The goal of this exploratory study was to determine whether using team-based learning (TBL) pedagogy to deliver an accreditation preparation workshop could effectively prepare and engage participants. A Likert-scale questionnaire was administered to workshop attendees (n = 52) to determine whether they found TBL-based training helpful and whether it promoted engagement. Twenty-four attendees completed the survey (46%). More than 80% of participants strongly agreed or agreed with 12 statements relating to perceptions of self and participant engagement within team activities and the usefulness of team activities. More than 65% of participants strongly agreed or agreed with statements relating to the helpfulness of the TBL approach in preparing for the self-study (five questions). Subgroup analysis showed no significant difference in responses based on whether on not participants had previously been involved in an accreditation self study. Our data indicate that a TBL approach can be an effective way to engage and prepare stakeholders for an accreditation self-study, and that TBL pedagogy has utility outside of the classroom setting.