An interprofessional activity using standardized patients

In-Person or Online? Exploring Student Pharmacists' Perceived Change in Interprofessional Skills between Two Delivery Formats

The COVID-19 pandemic drastically changed how education is delivered. Many academic programs quickly transformed their curriculum to online distance learning. This rapid transition may have compromised the rigor and fidelity of these activities. The Interprofessional Standardized Patient Experience (ISPE) is an interprofessional education activity (IPE) involving a team of students from six different healthcare professions that switched to an online delivery format. This manuscript compares pharmacy students' perceived change in interprofessional skills between the two formats. Following the ISPE, second-year pharmacy students completed the revised Interprofessional Collaborative Competencies Attainment Survey (ICCAS-R). The ICCAS-R assesses the change in interprofessional collaboration-related competencies in healthcare students before and after IPE training using a retrospective pre-post approach. For each ICCAS-R item and each delivery format (44 in-person and 51 online), paired Student's t-test on pre- and post-ISPE scores, and Cohen's d were calculated. Every item of the ICCAS-R was significant (p < 0.001), regardless of delivery format. Nearly all ICCAS-R items had a large effect size, and the remaining items had a medium effect size. The amount of change pre- and post-ISPE for each ICCAS-R item was calculated. Student's t-test was used to compare the magnitude of change in interprofessional skills between the two delivery formats. Only one difference was noted between the two delivery formats-ICCAS-R item 16, which measured actively listening to interprofessional team members (p = 0.0321). When switching to an online format, the high-fidelity dimension of the ISPE was retained. The ISPE is an effective IPE activity at increasing pharmacy students' self-perceived interprofessional collaboration skills regardless of delivery format. Even though students reported the ISPE increased their ability to actively listen to the perspectives of interprofessional team members in both formats, the magnitude of the benefit was more profound in the in-person group.

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.

Pharmacy Students' Perspectives on Interprofessional Learning in a Simulated Patient Care Ward Environment

Objective. To assess pharmacy students' opinions of an interprofessional learning (IPL) course in their final year of the Bachelor of Pharmacy program at The University of Auckland. Methods. Pharmacy students participated in the second day of a two-day simulation-based course, WardSim, alongside medical and nursing students in an acute care, hospital ward setting. After finishing the course, all students were asked to complete a questionnaire. The responses of pharmacy, nursing, and medical students on the scaled questions were compared. An in-depth thematic analysis of the pharmacy students' responses to the open-ended questions was completed using an iterative process. Results. Significant differences were found among the students' responses regarding the prioritization of care, systematic assessment of patients, and communication strategies. Pharmacy students had less favourable responses regarding the IPL experience than medical and nursing students. However, overall responses were positive. Some of the themes that emerged among the pharmacy students' responses included: learning communication tools, being assertive in communicating with other health care professionals, and understanding their own and others' roles in the health care team. Furthermore, some pharmacy students reported feeling underprepared for and underutilized during patient care scenarios. Conclusion. An IPL experience in an acute patient care setting demonstrated clear and beneficial learning outcomes for pharmacy students, especially in regards to communicating and understanding their roles and those of others on their team. Tailoring the pre-work or scenarios for the IPL experience to be more pharmacy orientated and having pharmacy students participate on both days may improve the preparedness for IPL.

Impact of an interprofessional medication error workshop on healthcare student perceptions

BACKGROUND

The integration of interprofessional education (IPE) into health professional curricula is critical to ensuring safe and efficient delivery of patient care. The intent of this manuscript is to describe the results of a pilot study designed to evaluate the impact of a large-scale interprofessional medication error prevention workshop on student perceptions of team-based patient care in the prevention of medication errors.

INTERPROFESSIONAL EDUCATION ACTIVITY

Pharmacy, medical, and physician assistant students' perceptions of the role of multidisciplinary patient care teams in preventing medication errors were evaluated before and after participating in a three-hour interprofessional medication errors prevention workshop utilizing a modified version of the validated Attitudes Towards Health Care Teams Scale.

DISCUSSION

When comparing student attitudes among the three schools, statistically significant differences in student perceptions across the items and subscales (e.g., quality of care/process and physician centrality) captured in the instrument utilized were identified. Additionally, differences in the responses of pharmacy, medical, and physician-assistant students were found, highlighting the areas where healthcare education can be targeted to bridge the gap in opinion.

IMPLICATIONS

We demonstrated an overall positive impact of an interprofessional medication errors prevention-themed workshop on the attitudes of the participating healthcare students. Future directions and research initiatives focusing on the role of IPE and the influence of IPE workshops on team-based performance are indicated to validate the influence of this method of education on the attitudes of post-graduate healthcare trainees and healthcare practitioners.

Quality assurance processes for standardized patient programs

OUR PROBLEM

As the pharmacy profession evolves to include non-dispensing services and collaborative care, greater emphasis is placed on communication skills building through standardized patient programs. Best practices for assuring the quality of standardized patient (SP) programs, however, remains unclear. The objective of this manuscript is to summarize quality assurance processes for standardized patient programs from health professions education literature.

METHODOLOGICAL LITERATURE REVIEW

A search of PubMed and Scopus between 2011 and 2016 was conducted and 22 articles were retained for thematic analysis. Articles were screened for relevance to quality assurance.

OUR RECOMMENDATIONS AND THEIR APPLICATIONS

The thematic analysis revealed four themes: (1) enhanced SP training programs, (2) structured feedback to students, (3) statistical measurements to ensure inter-rater reliability, and (4) observation and evaluation of the SP to improve SP performance. Specific methods to assure the quality of an SP program were identified, including training program content and feedback techniques.

POTENTIAL IMPACT

Although SP programs varied widely in their implementation, there were several common strategies used to evaluate the consistency of performance, effectiveness of feedback to students, and reliability of grading. Additional research is necessary to establish standards for SP programs across professional healthcare disciplines.

Description and assessment of a pilot interprofessional education case competition activity

BACKGROUND AND PURPOSE

A case competition involving pharmacy and nursing students was designed as a pilot project to determine if this would be an effective way to implement interprofessional education (IPE) within the College of Health and Pharmaceutical Sciences at the University of Louisiana at Monroe.

EDUCATIONAL ACTIVITY AND SETTING

Level 5 nursing students and third-year pharmacy students were invited to participate in a patient case competition activity as interprofessional teams. A modified version of the Interprofessional Education Collaborative (IPEC) Competency Survey and the Readiness for Interprofessional Learning Scale (RIPLS) Questionnaire were administered before and after the activity.

FINDINGS AND DISCUSSION

Nineteen students (nine nursing, 10 pharmacy) participated in the case competition and completed both the pre- and post-survey. Responses to questions in the IPEC Competency Self-Assessment Tool suggest improved self-reported competence in the interaction and values/ethics domains.

SUMMARY

Participation in this IPE case competition demonstrated improved engagement with other healthcare professional students as assessed by the IPEC Competency Survey and the RIPLS Questionnaire. This activity could serve as a way for other schools of pharmacy to implement IPE in their curriculum.

Design and Validation of Patient-Centered Communication Tools (PaCT) to Measure Students' Communication Skills

Objective. To develop a comprehensive instrument specific to student pharmacist-patient communication skills, and to determine face, content, construct, concurrent, and predictive validity and reliability of the instrument. Methods. A multi-step approach was used to create and validate an instrument, including the use of external experts for face and content validity, students for construct validity, comparisons to other rubrics for concurrent validity, comparisons to other coursework for predictive validity, and extensive reliability and inter-rater reliability testing with trained faculty assessors. Results. Patient-centered Communication Tools (PaCT) achieved face and content validity and performed well with multiple correlation tests with significant findings for reliability testing and when compared to an alternate rubric. Conclusion. PaCT is a useful instrument for assessing student pharmacist communication skills with patients.

Development and delivery of an interdisciplinary course in mobile health (mHealth)

BACKGROUND

Interdisciplinary practice is a primary focus within the United States health care system. Despite the existence of interdisciplinary educational efforts in pharmacy for many years, the practice only recently entered mainstream health care education. Informatics offers interdisciplinary educational opportunities. Mobile health (mHealth), an informatics sub-discipline, is the use of mobile devices for health and wellness activities. We used the mHealth domain as the context for an interdisciplinary learning experience for pharmacy and computer science and software engineering (CSSE) students.

EDUCATIONAL ACTIVITY

Educational activities focused on creating an mHealth course sequence and an mHealth application (app). Students worked in teams to complete various assignments, including developing and presenting a course proposal, building a purchase plan for mHealth equipment, developing an mHealth app prototype, delivering a disease state presentation (pharmacy students only), developing use case scenarios (CSSE students only), and completing peer evaluations.

CRITICAL ANALYSIS OF THE EDUCATIONAL ACTIVITY

Course evaluations were only available from pharmacy students. They indicated an overall favorable rating (mean 3.27-3.55; 4=strongly agree). Survey data collected after students entered the workforce indicated that students felt better prepared than their colleagues to work with individuals from other disciplines (mean 4.82; 5=strongly agree). Students also indicated using the knowledge from course proposal development in their careers (mean 4.27; 5=strongly agree). Through team interactions, students learned from each other while overcoming challenges related to terminology and content areas. Skills learned through team interactions reflect real-world processes and are expected to support students' future professional responsibilities.

Prelicensure Simulation-Enhanced Interprofessional Education: A Critical Review of the Research Literature

STATEMENT

This review explores the state of prelicensure interprofessional education (IPE) using simulation-based education (SBE) by examining studies that use SBE for prelicensure IPE through a critical review of the research literature. We focus particularly on studies that included experiential SBE with reported measures and formal IPE with prelicensure participants from at least 2 health care professions. Fifty-four studies met criteria. We explore these studies, providing a compilation of information (e.g., educational, simulation, and research methods used; outcome measures reported; and demographics of learner groups), identifying themes that may affect learning, as well as surfacing challenges and gaps in the field. The quality and rigor of the existing literature is inadequate to confidently determine factors that affect learning through simulation-enhanced IPE. We suggest that more rigorous research criteria be included in future studies and a list of reporting items be provided, where future publications can enhance knowledge to guide best practice in simulation-enhanced IPE.

Interprofessional Education (IPE) and Pharmacy in the UK. A Study on IPE Activities across Different Schools of Pharmacy

Interprofessional education (IPE) has been recognised internationally as a way to improve healthcare professional interactions and team working in order to enhance patient care. Since pharmacists are increasingly part of multi-professional healthcare teams and are expanding their clinical roles, many pharmacy regulators have stipulated IPE must be included in educational curricula. This study aimed to examine how different Schools of Pharmacy (SOPs) in the UK implement IPE within their pharmacy course. Information about IPE was mainly obtained through interviews with staff from various SOPs. Nine telephone interviews were conducted which were analysed using a thematic analysis approach in order to derive common categories. These were identified as students, activities, barriers and facilitators and benefits of IPE. It was found that teaching methods used for IPE varied across SOPs. No standard strategy to deliver IPE was identified. Students were thought to value the IPE experience, especially the interaction with other professionals. The main barriers to implementing IPE arose from limited financial and organisational support. In general, many SOPs in the UK are undertaking IPE but challenges remain in establishing it as a routine part of the course, something which seems to echo difficulties in implementation of IPE both nationally and internationally.

Use of Baby Isao Simulator and Standardized Parents in Hearing Screening and Parent Counseling Education

PURPOSE

The primary purpose of this study was to test the effect of the combined use of trained standardized parents and a baby simulator on students' hearing screening and parental counseling knowledge and skills.

METHOD

A one-group pretest-posttest quasi-experimental study design was used to assess self-ratings of confidence in knowledge and skills and satisfaction of the educational experience with standardized parents and a baby simulator. The mean age of the 14 audiology students participating in this study was 24.79 years (SD = 1.58). Participants completed a pre- and postevent questionnaire in which they rated their level of confidence for specific knowledge and skills. Six students (2 students in each scenario) volunteered to participate in the infant hearing screening and counseling scenarios, whereas others participated as observers. All participants participated in the briefing and debriefing sessions immediately before and after each of 3 scenarios. After the last scenario, participants were asked to complete a satisfaction survey of their learning experience using simulation and standardized parents.

RESULTS

Overall, the pre- and post-simulation event questionnaire revealed a significant improvement in the participants' self-rated confidence levels regarding knowledge and skills. The mean difference between pre- and postevent scores was 0.52 (p < .01). The mean satisfaction level was 4.71 (range = 3.91-5.00; SD = 0.30) based on a Likert scale, where 1 = not satisfied and 5 = very satisfied.

CONCLUSIONS

The results of this novel educational activity demonstrate the value of using infant hearing screening and parental counseling simulation sessions to enhance student learning. In addition, this study demonstrates the use of simulation and standardized parents as an important pedagogical tool for audiology students. Students experienced a high level of satisfaction with the learning experience.

Multidisciplinary team working in an adult male prison establishment in the UK

The first two articles in this series exploring the oral and dental health of male prisoners in the UK demonstrated how the general and oral health of prisoners is compromised compared to those of a similar age who are not prisoners. In caring for the oral health needs of this group the high demand for emergency dental services often precludes the delivery of preventive and routine care. Comprehensive oral care for this population requires a level of training to gain the skills and knowledge to manage prisoners' complex medical, dental and social needs and the heightened dental anxiety that prisoners exhibit. The type of training that might be required for prison dentistry will be discussed in the final article. This article will describe a number of cases selected to demonstrate the complex problems presented by male prisoners in Her Majesty's Prison (HMP), Brixton. This article will also discuss the establishment of a primary care inter-professional relationship network (IRN) developed within a prison setting involving a dentist and other healthcare professionals. After informal discussions between the dentist and other prison healthcare professionals, it became apparent that vulnerable patients were not accessing dental services. These patients also cancel/fail to attend their dental appointments more frequently. In order to improve access and provision of dental care for this group of prisoners, an IRN was developed between the dentist, diabetic nurse, forensic psychology team, communicable disease lead, general medical practitioner (GMP), prison officers and healthcare manager within HMP Brixton. The nature of the IRN is presented along with reviews with relevant patient cases. The IRN allowed information sharing between professionals and an open care culture. The network was valued by prisoners. Prison populations show higher rates of general and oral disease, therefore an IRN can help to identify vulnerable groups and allow healthcare providers to give appropriate, targeted and focused care in a timely fashion.

Incorporating Standardized Colleague Simulations in a Clinical Assessment Course and Evaluating the Impact on Interprofessional Communication

OBJECTIVE

To determine the impact of incorporating standardized colleague simulations on pharmacy students' confidence and interprofessional communication skills.

DESIGN

Four simulations using standardized colleagues portraying attending physicians in inpatient and outpatient settings were integrated into a required course. Pharmacy students interacted with the standardized colleagues using the Situation, Background, Assessment, Request/Recommendation (SBAR) communication technique and were evaluated on providing recommendations while on simulated inpatient rounds and in an outpatient clinic. Additionally, changes in student attitudes and confidence toward interprofessional communication were assessed with a survey before and after the standardized colleague simulations.

ASSESSMENT

One hundred seventy-one pharmacy students participated in the simulations. Student interprofessional communication skills improved after each simulation. Student confidence with interprofessional communication in both inpatient and outpatient settings significantly improved.

CONCLUSION

Incorporation of simulations using standardized colleagues improves interprofessional communication skills and self-confidence of pharmacy students.

Developing pharmacy student communication skills through role-playing and active learning

OBJECTIVE

To evaluate the impact on pharmacy students of a communication course, which used role-playing to develop active-learning skills.

DESIGN

Students role-playing pharmacists in patient care scenarios were critiqued by students and pharmacist faculty members. Grading was performed using the rubric inspired by Bruce Berger's Communication Skills for Pharmacists. Written skills were evaluated using student written critique questionnaires. Students completed precourse and postcourse self-assessment surveys. Preceptor evaluations were analyzed for course impact.

ASSESSMENT

Students demonstrated improvement in oral skills based on role-play scores (45.87/50) after practice sessions. The average score based on the student questionnaire was 9.31/10. Gain was demonstrated in all defined course objectives. Impact on introductory pharmacy practice experience (IPPE) communication objectives was insignificant. Student evaluations for course and teaching strategy reflected a high average.

CONCLUSION

Study results demonstrated improvement in oral and written communication skills that may help improve interprofessional teamwork between pharmacists and other health care providers.

Perceived benefits and challenges of interprofessional education based on a multidisciplinary faculty member survey

OBJECTIVE

To identify differences among faculty members in various health professional training programs in perceived benefits and challenges of implementing interprofessional education (IPE).

METHODS

A 19-item survey using a 5-point Likert scale was administered to faculty members across different health disciplines at a west coast, multicollege university with osteopathic medicine, pharmacy, and physician assistant programs.

RESULTS

Sixty-two of 103 surveys (60.2%) were included in the study. Faculty members generally agreed that there were benefits of IPE on patient outcomes and that implementing IPE was feasible. However, group differences existed in belief that IPE improves care efficiency (p=0.001) and promotes team-based learning (p=0.001). Program divergence was also seen in frequency of stressing importance of IPE (p=0.009), preference for more IPE opportunities (p=0.041), and support (p=0.002) within respective college for IPE.

CONCLUSIONS

Despite consensus among faculty members from 3 disciplines that IPE is invaluable to their curricula and training of health care students, important program level differences existed that would likely need to be addressed in advance IPE initiatives.

Interprofessional education among student health professionals using human patient simulation

OBJECTIVE

To describe the planning, implementation, and outcomes of an interprofessional education clinical laboratory facilitated through human patient simulation.

DESIGN

An interprofessional education clinical laboratory was developed with a patient-care scenario of acute exacerbation of heart failure that incorporated the use of a high-fidelity patient simulator. Pharmacy and nursing students assumed clinical roles in this realistic scenario and collaborated to diagnose and treat the patient.

ASSESSMENT

Student attitudes toward and readiness to participate in interprofessional education improved following participation in the laboratory. Students reported that the greatest benefit of the experience was in their communication skills.

CONCLUSION

Students' ability to participate in interprofessional education experiences and their attitudes toward them improved following participation in this curricular initiative. Further evaluation of the impact of interprofessional education on student learning outcomes and changes in practice is warranted.

High-fidelity simulation training in advanced resuscitation for pharmacy residents

OBJECTIVE

To assess the impact of high-fidelity patient simulation on pharmacy resident knowledge, confidence, and competency with advanced resuscitation algorithms and interventions.

DESIGN

An overview of the institutional cardiopulmonary arrest algorithm and a review of pertinent medications and calculations were presented to postgraduate year 1 (PGY1) pharmacy residents, followed by participation in 3 simulated clinical scenarios using a high-fidelity mannequin.

ASSESSMENT

An improvement of pharmacy resident knowledge, confidence, and competency with advanced resuscitation skills was observed. In addition, pharmacy residents demonstrated high performance levels with skills requiring advanced competency and proactive interactions with the cardiac arrest team.

CONCLUSION

Incorporating high-fidelity patient simulation into an advanced resuscitation training program can help pharmacy residents achieve competency through the active learning of practical skills.

Standardized patient and standardized interdisciplinary team meeting: validation of a new performance-based assessment tool

The interdisciplinary team (IDT) approach is critical in the care of elderly adults. Performance-based tools to assess IDT skills have not been well validated. A novel assessment tool, the standardized patient (SP) and standardized interdisciplinary team meeting (SIDTM), consisting of two stations, was developed. First, trainees evaluate a SP hospitalized after a fall. Second, trainees play the role of the physician in a standardized IDT meeting with a standardized registered nurse (SRN) and standardized medical social worker (SMSW) for discharge planning. The SP-SIDTM was administered to 52 fourth-year medical students (MS4s) and six geriatric medicine fellows (GMFs) in 2011/12. The SP, SRN, and SMSW scored trainee performance on dichotomous checklists of clinical tasks and Likert scales of communication skills, which were compared according to level of training using t-tests. Trainees rated the SP-SIDTM experience as moderately difficult, length of time about right, and believability moderate to high. Reliability was high for both cases (Cronbach α = 0.73-0.87). Interobserver correlation between SRN and SMSW checklist scores (correlation coefficient (r) = 0.82, P < .001) and total scores (r = 0.69, P < .001) were high. The overall score on the SP-SIDTM case was significantly higher for GMF (75) than for MS4 (65, P = .002). These observations support the validity of this novel assessment tool.

A virtual patient software program to improve pharmacy student learning in a comprehensive disease management course

OBJECTIVE

To implement and assess the impact of a virtual patient pilot program on pharmacy students' clinical competence skills.

DESIGN

Pharmacy students completed interactive software-based patient case scenarios embedded with drug-therapy problems as part of a course requirement at the end of their third year.

ASSESSMENT

Assessments included drug-therapy problem competency achievement, performance on a pretest and posttest, and pilot evaluation survey instrument. Significant improvements in students' posttest scores demonstrated advancement of clinical skills involving drug-therapy problem solving. Students agreed that completing the pilot program improved their chronic disease management skills and the program summarized the course series well.

CONCLUSION

Using virtual patient technology allowed for assessment of student competencies and improved learning outcomes.

Assessing pharmacy students' ability to accurately measure blood pressure using a blood pressure simulator arm

OBJECTIVE

To compare student accuracy in measuring normal and high blood pressures using a simulator arm.

METHODS

In this prospective, single-blind, study involving third-year pharmacy students, simulator arms were programmed with prespecified normal and high blood pressures. Students measured preset normal and high diastolic and systolic blood pressure using a crossover design.

RESULTS

One hundred sixteen students completed both blood pressure measurements. There was a significant difference between the accuracy of high systolic blood pressure (HSBP) measurement and normal systolic blood pressure (NSBP) measurement (mean HSBP difference 8.4 ± 10.9 mmHg vs NSBP 3.6 ± 6.4 mmHg; p<0.001). However, there was no difference between the accuracy of high diastolic blood pressure (HDBP) measurement and normal diastolic blood pressure (NDBP) measurement (mean HDBP difference 6.8 ± 9.6 mmHg vs. mean NDBP difference 4.6 ± 4.5 mmHg; p=0.089).

CONCLUSIONS

Pharmacy students may need additional instruction and experience with taking high blood pressure measurements to ensure they are able to accurately assess this important vital sign.

Use of simulation-based teaching methodologies in US colleges and schools of pharmacy

OBJECTIVES. To characterize the use of high-fidelity mannequins and standardized patients in US pharmacy colleges and schools. METHODS. A survey instrument was sent to 105 doctor of pharmacy (PharmD) programs to collect data on the use of simulation and to identify barriers to using simulation-based teaching methods. RESULTS. Eighty-eight colleges and schools completed the survey instrument (response rate 84%). Of these, 14 did not use high-fidelity mannequins or standardized patients within the curriculum. Top barriers were logistical constraints and high resource cost. Twenty-three colleges and schools used simulation for introductory pharmacy practice experiences (IPPEs), 34 for interprofessional education, and 68 for evaluation of at least 1 core competency prior to advanced pharmacy practice experiences (APPEs). CONCLUSIONS. Although the majority of US colleges and schools of pharmacy use simulation-based teaching methodologies to some extent in the pharmacy curricula, the role of simulation in IPPEs, interprofessional education, and assessment of competency-based skills could be expanded.

Communications training in pharmacy education, 1995-2010

The role of the pharmacist as a "communicator" of information and advice between patients, other healthcare practitioners, and the community is recognized as a vital component of the responsibilities of a practicing pharmacist. Pharmacy education is changing to reflect this, although the difficulty is in designing a curriculum that is capable of equipping students with the necessary knowledge and skills, using activities that are effective in promoting communication competency. The objective of this review was to identify published, peer-reviewed articles concerning communication training in pharmacy education programs, and describe which communication skills the structured learning activities aimed to improve and how these learning activities were assessed. A systematic literature search was conducted and the articles found were analyzed and divided into categories based on specific communication skills taught and type of learning activity used. Oral interpersonal communication skills targeted at patients were the most common skill-type described, followed by clinical writing skills. Common teaching methods included simulated and standardized patient interactions and pharmacy practice experience courses. Most educational interventions were assessed by subjective measures. Many interventions were described as fragments, in isolation of other learning activities that took place in a course, which impedes complete analysis of study results. To succeed in communication training, integration between different learning activities and progression within pharmacy educations are important.

Physical assessment experience in a problem-based learning course

OBJECTIVE

To evaluate the impact of a physical-assessment learning experience implemented in the problem-based learning (PBL) format of the third year of a doctor of pharmacy (PharmD) program.

DESIGN

Students enrolled in a PBL course completed survey instruments to measure knowledge and confidence before and after participating in the learning experience. A simulation stethoscope was used to teach students abnormal pulmonary and cardiovascular sounds in 1-hour sessions for each of 12 PBL groups.

ASSESSMENT

The 92 students enrolled in the PBL course completed pre- and post-experience survey instruments. Students' scores on knowledge questions increased significantly (p < 0.0001) from 40.4% ± 11.4% at baseline to 62.5% ± 13.7% and 63.1 ± 11.6%, respectively, on the 2 sets of post-experience questions. Students scored a median of 3 or 4 on a 5-point Likert scale after a learning experience on questions measuring confidence.

CONCLUSION

Use of a simulation stethoscope in a physical-assessment learning experience increased pharmacy students' knowledge in performing pulmonary and cardiovascular assessment techniques.

A regional model of interprofessional education

This paper describes the innovative features of the first regional model of interprofessional education (IPE) in the US, developed by The Commonwealth Medical College, Scranton, PA, USA, as a new, independent, community-based medical school in northeastern Pennsylvania. Essential educational components include collaborative care seminars, interprofessional sessions, simulations, live web-based seminars and newly innovative virtual environment interactive exercises. All of these elements are being integrated into the curricula of 14 undergraduate and allied professional schools, and three graduate medical education programs located in the region. Activities incorporate simulation, standardized patients, student leadership, and faculty and student facilitation. As this new regional model of interprofessional education is fully implemented, its impact will be assessed using both quantitative and qualitative outcomes measurements. Appropriate ongoing modifications to the model will be made to ensure improvement and further applicability to collaborative learning.

Assessing Student Attitudes as a Result of Participating in an Interprofessional Healthcare Elective Associated with a Student-Run Free Clinic

BACKGROUND: An interprofessional elective using a student-run clinic can introduce students to professional roles, collaborative patient care, and health disparities. METHODS AND FINDINGS: Students from four professions (pharmacy, medicine, physician assistant, and physical therapy) participated in a service-learning elective where they received weekly didactic lectures and provided healthcare in a student-run free clinic. Additional interprofessional activities included a quality improvement project and a case presentation. Students were administered anonymous surveys before and after the elective to assess changes in their attitudes toward interprofessional teamwork. A total of 93 and 74 students completed the pre-survey and post-survey, respectively. After participating in the elective, significantly more students reported working in interprofessional teams and understood the role of physician assistants. The majority of other attitudes about interprofessional collaboration and professional roles were sustained or improved after the elective. CONCLUSION: An interprofessional service-learning elective using didactic and experiential learning in an interprofessional, student-run free clinic sustained or improved student attitudes toward interprofessional teamwork. The elective had a significant impact on increased student experience working in interprofessional healthcare teams and increased understanding of health professions' roles. Continued assessment of the impact on student behaviours and patient outcomes is warranted.

Human simulators and standardized patients to teach difficult conversations to interprofessional health care teams

OBJECTIVE

To design and implement a demonstration project to teach interprofessional teams how to recognize and engage in difficult conversations with patients.

DESIGN

Interdisciplinary teams consisting of pharmacy students and residents, student nurses, and medical residents responded to preliminary questions regarding difficult conversations, listened to a brief discussion on difficult conversations; formed ad hoc teams and interacted with a standardized patient (mother) and a human simulator (child), discussing the infant's health issues, intimate partner violence, and suicidal thinking; and underwent debriefing.

ASSESSMENT

Participants evaluated the learning methods positively and a majority demonstrated knowledge gains. The project team also learned lessons that will help better design future programs, including an emphasis on simulations over lecture and the importance of debriefing on student learning. Drawbacks included the major time commitment for design and implementation, sustainability, and the lack of resources to replicate the program for all students.

CONCLUSION

Simulation is an effective technique to teach interprofessional teams how to engage in difficult conversations with patients.

Preparing pharmacy graduates for traditional and emerging career opportunities

Educational programs in pharmacy must focus on educating pharmacists of the future who are prepared to serve as competent and confident health care "providers" whose "practice" can occur in any number of current and future settings; and whose expertise is essential to an interprofessional health care team. Graduates must be able to incorporate a scholarly approach to their practice in identifying patient care problems; practicing in an evidence-based manner; and ensuring safe, effective, and appropriate use of medications. It is time for colleges and schools of pharmacy to implement contemporary teaching and assessment strategies that facilitate effective and efficient student learning that is focused at the graduate professional level, to evolve the content around which the curriculum is organized, and clearly articulate the abilities graduates must have to function effectively in the myriad professional roles in which they may find themselves.

An interprofessional education session for first-year health science students

OBJECTIVE

To implement and evaluate the effectiveness and short-term impact of an interprofessional education (IPE) session in the first year for health sciences students representing 9 health professions.

DESIGN

An interprofessional faculty committee created a 2(1/2) hour introductory interprofessional education session focusing on a single patient case and 2 possible discharge scenarios. A mixed method pretest/posttest research design was used to examine changes in students' perceptions of and attitudes toward IPE. Six follow-up focus groups also were held with students from the participating professions.

ASSESSMENT

Of 1197 health professions students enrolled, 914 students (76%) attended the IPE session. Two hundred thirty-two of 240 pharmacy students (97%) attended. Forty-three (18.5%) pharmacy students responded to the open-ended questions on the survey instrument. The most frequently reported gains from attending the session were recognition of teamwork importance to benefit the patient (30%) and understanding of other professionals' roles (29%). Shortfalls reported by students related to the content/style of presentation (26%) and technical/organizational (23%) aspects of the session. Pharmacy students who participated in one of the focus groups stated the session demonstrated the benefits as well as facilitators and barriers to collaborative care.

CONCLUSION

The session served as an effective introduction to IPE; debriefing and integration with uniprofessional curricula should occur. Students need additional small group interaction with other health professional students, and can contribute as members of the planning committee.

Interprofessional education: definitions, student competencies, and guidelines for implementation

Interprofessional education (IPE) is an important step in advancing health professional education for many years and has been endorsed by the Institute of Medicine as a mechanism to improve the overall quality of health care. IPE has also become an area of focus for the American Association of Colleges of Pharmacy (AACP), with several groups, including these authors from the AACP Interprofessional Education Task Force, working on developing resources to promote and support IPE planning and development. This review provides background on the definition of IPE, evidence to support IPE, the need for IPE, student competencies and objectives for IPE, barriers to implementation of IPE, and elements critical for successfully implementing IPE.

Interprofessional continuing health education for diabetic patients in an urban underserved community

The CPD(iQ) Saskatchewan Project (ICEC(4)) is directed by the Inter-Professional Continuing Education for Collaborative Client Centered Care Committee, representing the disciplines of medicine, nursing, physical therapy, pharmacy, kinesiology and dentistry at the University of Saskatchewan. It was designed to serve two target audiences: the urban underserved community that would access services at the West Winds Primary Care Centre; and health professionals at the West Winds who would deliver educational modules to those in need. The main objectives were to identify the learning needs of health professionals related to working collaboratively in urban underserved community settings; identify and develop relevant educational modules to address needs identified, implement the program, and evaluate participants' experience with the educational modules. Evaluation consisted of debriefing after each educational session and the completion of a self administered questionnaire. Findings from this pilot study. The results of the study suggest the modules as a useful approach to addressing some of the barriers to effective inter-professional collaborative care. Common themes from the evaluation included satisfaction with learning other professionals' contributions to patient care. The module format may serve useful in an inter-professional case-based clinical educational setting.

Integrating forensic nursing into the undergraduate nursing curriculum: a solution for a disconnect

Violence occurring in the home and community, and its resultant negative effects on public health, is of critical concern to health care professionals. The aim of this article is to underscore the importance of the role of nurse educators in preventing and reducing the consequences of domestic violence and abuse. A viable solution for the disconnect that exists between violence reduction strategies and their effective implementation is proposed, including an integration of forensic nursing concepts and skills into the undergraduate nursing curriculum. Doing so will enable nurse educators to prepare practitioners who can help break the cycle of violence and close the gap that exists in health care delivery for individuals affected by violence. Related issues and challenges are presented, including the need to prepare culturally competent health care professionals, to examine and revise overloaded curricula on the basis of empirical research and societal trends, and to address faculty competence.

Using a human patient simulation mannequin to teach interdisciplinary team skills to pharmacy students

OBJECTIVES

To determine the effectiveness and student acceptance of using a human patient simulation (HPS) training module focused on interdisciplinary teamwork skills.

DESIGN

During their second-professional year, all pharmacy students were in enrolled in Principles of Pharmacotherapy 4: Cardiovascular Diseases and Patient Care Lab IV, a problem-based learning course. As part of the patient care laboratory, students participated in a simulated case of an acutely ill patient with a hypertensive emergency. During the simulation, students performed a history and physical examination. They then worked as a team to make treatment recommendations to the nursing and physician staff members. Following the exercise, a facilitated debriefing session was conducted. Students completed satisfaction surveys to assess the quality and effectiveness of the session.

ASSESSMENT

Over 98% of students agreed or strongly agreed that they learned material relevant to their current studies. When compared to student lectures, 90% of students felt that they learned clinical patient care better when using a HPS mannequin in simulated patient scenarios.

CONCLUSION

HPS-based learning offers a realistic training experience through which clinical knowledge and interpersonal teamwork skills can be taught. Students enjoy the experience and find it relevant to their future practice. Simulation-based training may teach certain topics better than traditional lecture formats and as such could help to fill gaps in the current pharmacy curriculum.

Community-based collaboration with high school theater students as standardized patients

OBJECTIVES

To describe a collaborative undertaking between a private school of pharmacy (Bernard J. Dunn School of Pharmacy) and a public high school (John Handley High School) in the development, and implementation of a partnership utilizing high school theater students as standardized patients.

METHODS

High school theater students were trained to portray patients within the Standardized Patient Assessment Laboratory. The patient encounters were videotaped and evaluated by both peer and faculty members. Quantitative and qualitative analyses of semi-structured interviews, focus groups, post-encounter surveys of students and faculty members, and encounter grades were used to evaluate the outcomes.

RESULTS

Pharmacy students exhibited competence in clinical assessment skills as evidenced by high encounter grades (91.5% +/- 6.8%) and 100% positive faculty feedback. The high school theater students self-reported that their improvisational skills improved through learning patient conditions and behaviors. Both schools met their mission statement and accreditation goals, including increased collaboration with the community.

CONCLUSION

This model for collaboration between a school of pharmacy and a high school using adolescents as simulated patients was successful in creating a beneficial learning experience for both the theater and pharmacy students.