Integrating medical humanities into a pharmaceutical care seminar on dementia

Assessing Person-Centered Care in Pharmacy Education

OBJECTIVES

The ability to provide person-centered care is an important aspect of the Pharmacists' Patient Care Process (PPCP); therefore, the assessment of students' skills in this area is essential in pharmacy curricula. The objectives of this article were to: (1) review literature on the assessment of student pharmacists' ability to provide person-centered care, (2) describe trends in assessment practices relevant to this skill, and (3) provide recommendations for pharmacy educators on the assessment of this skill and further research.

FINDINGS

A total of 62 sources were included in the analysis for this review. Results were characterized by the educational setting in which the assessment took place (ie, didactic, skills, and/or experiential), assessment strategies (eg, self-evaluations, simulations, knowledge-based quizzes, reflections, objective structured clinical exams), and themes observed for commonly assessed skill areas (eg, empathy, communication, interprofessional teamwork, and social determinants of health). Gaps in the assessment of person-centered care, particularly regarding specific steps of the PPCP (follow-up and documentation) were identified in the sources reviewed.

SUMMARY

Assessment practices of students' ability to provide person-centered care within the context of the PPCP were reviewed, and key findings relevant to pharmacy education were described. More holistic person-centered care assessment strategies that encompass the full PPCP are recommended.

Pharmacists' empathy after a postgraduate course in narrative medicine: an observational study

BACKGROUND

Narrative medicine is a recent cross-disciplinary approach which through aesthetic activities such as reading fiction and creative writing aims to encourage empathy, reflection, professionalism, and trustworthiness in the encounter between patients and health care professionals.

AIM

The aim of this study was to evaluate changes in level of empathy after a postgraduate course in narrative medicine among pharmacists conducting medication counselling.

METHOD

During 2020-2021, three courses in narrative medicine among pharmacists with the aim to enhance empathy were held in Odense, Denmark. The primary outcome was the pharmacists' self-reported level of empathy before and after the course measured with Jefferson Scale of Empathy (JSE), which is a validated 20 item scale with higher scores indicating higher levels of cognitive empathy.

RESULTS

A total of 33 community and hospital pharmacists participated in the three courses. The pharmacists' median age was 41 years, 91% were female, 76% were working in community pharmacy, and 47% were, according to themselves, rare readers. The pharmacists completed the JSE scale before and after the course. A statistically significant increase was found in mean total JSE score from 109.9 ± 17.1 before the course to 115.7 ± 14.6 after the course (p = 0.0362).

CONCLUSION

Following the course in narrative medicine the level of empathy for the pharmacists according to JSE was enhanced. We recommend that future studies also use patient-reported outcomes to explore if the self-experienced enhanced empathy among pharmacists affects the patients' experience of their encounters.

Pharmaceutical Humanities and Narrative Pharmacy: An Emerging New Concept in Pharmacy

The complexity of our life experiences and the rapid progress in science and technology clearly necessitate reflections from the humanities. The ever-growing intersection between science and society fosters the emergence of novel interdisciplinary fields of research. During the past decade, Medical Humanities arose to meet the need to unravel hidden information beyond technology-driven and fact-based medicine. In the present paper, we put forward the hypothesis that there is a similar requirement to develop Pharmaceutical Humanities as an academic discipline within pharmacy and pharmaceutical biology. Based on Thomas Kuhn's epistemological theory on the structure of scientific revolutions, one may argue that a paradigm change for Pharmaceutical Humanities might open new levels of insight. Many complex diseases (e.g., cancer, neurological diseases, and mental disorders) remain uncurable for many patients by current pharmacotherapies, and the old beaten paths in our therapeutic thinking may at least partly have to be left behind. By taking examples from Pharmaceutical Biology, we attempt to illustrate that the transdisciplinary dialogue with the humanities is fertile ground not only for enlarging our understanding of disease-related conditions but also for exploring new ways of combatting diseases. In this context, we discuss aspects related to traditional herbal medicine, fair access and benefit sharing of indigenous knowledge about medicinal plants, post-traumatic stress syndrome, the opioid crisis, stress myocardiopathy (broken heart syndrome), and global environmental pollution with microplastics. We also explore possibilities for a narrative turn in pharmacy. The urgent need for inter- and transdisciplinary solutions to pressing health-related problems in our society may create a scholarly atmosphere for the establishment of Pharmaceutical Humanities as a fruitful terrain to respond to the current demands of both science and society.

Curricular Assessment Blueprint and Needs Analysis for the Social, Administrative, and Behavioral Foundational Sciences

OBJECTIVES

The objective of this integrative review is to analyze conceptual topics, applied content, teaching and learning strategies, and assessment methods within social, administrative, and behavioral sciences (SAS) syllabi and literature. The goal is to evaluate opportunities for enhancing the adoption and implementation of Curricular Outcomes and Entrustable Professional Activities 2022. Recommendations to better inform curriculum and assessment planning efforts are presented for programs and faculty seeking to optimize the integration of SAS content.

FINDINGS

Our search yielded 69 SAS-related syllabi from the American Association of Colleges of Pharmacy Connect repository and 296 publications from pharmacy journals focused on education. Most SAS literature was published in the didactic setting, which represents an opportunity to interweave and apply SAS knowledge concepts through the experiential, cocurricular, and interprofessional settings. In the future, it would be prudent to thoughtfully design assessment measures that encompass both summative and formative evaluations. The literature findings offer valuable insights and examples regarding content, teaching strategies, and assessment methods. These findings can serve as a practical framework, providing ideas and guidance for programs and faculty aiming to enhance the integration of SAS content into their curricula.

SUMMARY

In response to the recent guidelines from Curricular Outcomes and Entrustable Professional Activities 2022 and the release of the Accreditation Council for Pharmacy Education Standards 2025, programs and faculty have the responsibility to thoughtfully revise and improve the delivery and assessment of SAS content. The intentional integration of SAS knowledge, skills, and attitudes should be guided by a collaborative effort to develop pharmacists who deliver effective person-centered care and are well-equipped to navigate the complexities of health care.

Activities to promote empathy for patients among pharmacy learners: A scoping review

BACKGROUND

Provider empathy has been shown to be directly linked to improved patient outcomes. The objective of this scoping review of the literature was to identify and describe learning activities that promote empathy for patients among pharmacy learners.

METHODS

This scoping review was conducted using the following inclusion criteria: publication in English, activities conducted in any academic pharmacy training program (professional degree program, experiential, residency, or fellowship), description of the learning activity(ies) provided, and focus on the experience of empathy/caring/compassion for patients, either human or animal. Articles were excluded if they focused only on skills such as empathic responding or if they did not describe the learning experience. All study designs other than reviews were included.

RESULTS

The scoping review revealed 89 full-text articles that met the inclusion criteria. Included studies demonstrated a wide variety of approaches to the design of learning experiences as well as methods of measurement of empathy. Various types of learning modalities have been used to develop empathy in pharmacy learners, with reflection being the most common. A large proportion of studies that assessed empathy development used quasi-experimental or qualitative designs and did not report tests of statistical significance, which would make it difficult to compare the effectiveness of the different learning activities.

IMPLICATIONS

A variety of approaches have been used among pharmacy learners to develop empathy for patients. Due to the high level of variability in approaches, more rigorous studies are needed to assess the effectiveness of these learning activities.

Comparison of the University Pharmacy Education Programs in Germany and Vietnam

During the global COVID pandemic, the importance of professionals in the health care sector has been put in a new light, including pharmacists. In this context, the focus is also on how pharmacists are trained in different countries. Through an exchange of pharmacy teaching staff from a German to a Vietnamese university, the pharmacy education programs in both countries were compared. Aspects such as access to studies, structure of studies, and further training opportunities were considered. Differences and similarities emerged. In both countries, students first acquire basic knowledge and then delve deeper into pharmaceutical content in main studies. There is, expectedly, a great overlap in the content of the courses. Overall, the education at Vietnamese universities seems to be more practice-oriented due to a large number of placements. This also allows a specialization, which can be pursued in Germany with self-interest after graduation. There, the preparation for everyday work in the community pharmacy is separated from the university by a mandatory practical year. For the future, efforts are being made in both countries to strengthen the importance of clinical pharmacy in the curriculum. To this end, the Vietnamese are taking their inspiration from abroad in many cases, including Germany.

Teaching with madness/'mental illness' autobiographies in postsecondary education: ethical and epistemological implications

This paper presents a critical interpretive synthesis of 53 articles describing the pedagogical use of madness/'mental illness' autobiographical narratives in postsecondary education. Focusing on instructor intentions and representations of student learning outcomes, findings indicate that narratives are most commonly used as 'learning material' to engage students in active learning, cultivate students' empathy, complement dominant academic/professional knowledges, illustrate abstract concepts and provide 'real'-life connections to course content. This paper contributes to a conversation across the intellectual traditions of Mad studies, medical humanities, educational research, stigma reduction and service user involvement to interrogate pedagogical uses of autobiographical narratives that remain in uncritical educational terms rather than as a matter of justice for Mad communities. While teaching with narratives will not inevitably result in social justice outcomes, thoughtful engagement with the ethical and epistemological considerations raised throughout this review may increase this possibility by shifting when, why and how we teach with autobiography.

A Systematic Review of Palliative Care Content in the Doctor of Pharmacy Curriculum

Objective. To describe the methods of teaching and evaluating palliative care experiences for pharmacy students.Findings. A literature search retrieved 971 reports, from which 26 studies met all of study criteria. Educational interventions concerning palliative care included didactic courses, flipped classrooms, advanced pharmacy practice experiences (APPEs), workshops, and seminars. Total direct hours of education in palliative care ranged from 1-200. Seven (27%) focused experiences were reported as required, while nine (35%) were reported as elective. The majority (n=14, 54%) of studies measured pharmacy students' confidence, attitudes, or perceptions as the main outcome, and of those most studies reported an improvement. Five (19%) studies reported on interprofessional experiences in palliative care conducted in the United States, and four (15%) studies reported on similar experiences conducted outside the United States. When reported, most experiences were developed for students to complete prior to beginning their APPE year. All of the included studies used a non-randomized design.Summary. This review suggests a palliative care experience for pharmacy students should be interprofessional, occur during the year prior to APPEs, and measure skills-based outcomes.

The Contribution of the Humanities and Social Sciences to Pharmacy Education: Literature Review and Perspectives

Background: Healthcare systems worldwide adapt to patients’ needs and expectations, following social evolutions. Pharmaceutical practice has shifted towards activities such as therapeutic education. Such new missions require to prioritize human and social sciences, which now play a predominant role in training. Objective: This work consists of assessing the contribution of human and social sciences to the field of pharmacy, with a twofold focus on practice and training. Method: A literature review was carried out according to the PRISMA guidelines focusing on the last 10 years. Selected full texts were read and analyzed to elicit the contribution of human and social sciences to pharmacy. Results: Overall 36 articles were included. Three specific topics were identified during an inductive process of full text analysis: public health policy, patient care, and interprofessional collaboration. Conclusions: Although human and social sciences are essential to the evolution of the pharmacist profession, their impact on health care costs remains difficult to evaluate. Moreover, teaching human and social sciences can prove difficult to standardize. Such approaches must be supported and organized by governments and universities with a view of upscaling practices.

'Never forget': fictionalising the Holocaust survivor with dementia

This article asks what the reasons are for the frequent linking of the image of the Holocaust with that of dementia in contemporary discursive and representational practice. In doing so, it analyses some of the numerous 21st-century examples of fiction, drama and film in which the figure of a Holocaust survivor living with dementia takes centre stage. It explores the contradictory cultural effects that arise from making such a connection, in contexts that include expressions of fear at the spectacle of dementia, as well as comparisons between the person living with that condition and the inmate of a concentration camp. Detailed consideration of novels by Jillian Cantor and Harriet Scott Chessman as well as a play by Michel Wallenstein and a film by Josh Appignanesi suggests that the fictions of this kind can appear to provide solace for the impending loss of the eyewitness generation, yet also offer potential for a model for caregiving practice to those living with dementia in broader terms.

Use of mixed-methods approach to assess the impact of a pre-professional health humanities honors course on developing interpersonal skills

INTRODUCTION

The purpose of this study was to use a mixed-methods approach to provide evidence for growth in empathy, respect for patient autonomy, ability to relate to others, and self-awareness as a result of participating in a health humanities course.

METHODS

The mixed-methods approach gathered quantitative data using a quasi-experimental design of a pre/post course survey and qualitative data from reflective writings and student papers. The reflective writings and student papers were evaluated using an adapted rubric to assess the quality of the reflections on measures of empathy, respect for patient autonomy, ability to relate to others, and self-awareness.

RESULTS

Twenty-five students were enrolled in the course. Matched pair data was available from 22 students (88% response rate) for the quantitative survey data. Qualitative data was available from all 25 participants. The pre- and post-course surveys revealed a statistically significant increase in empathy (p < 0.001) as a result of completing the health humanities course. The final written report contained the highest quality of reflections compared to all other reflective writing assignments. Evidence for understanding empathy was prominent in the final written report.

CONCLUSIONS

The evaluation of development of interpersonal skills through use of health humanities resources may be reproduced by using a mixed-methods assessment approach. The quantitative and qualitative data presented provide some evidence for enhancing awareness and understanding of empathy, particularly by utilizing health humanities resources in an undergraduate interdisciplinary seminar course.

Qualitative evaluation of how a virtual dementia experience impacts medical and pharmacy students' self-reported knowledge and attitudes towards people with dementia

Objectives

It is important for healthcare professional students to understand the experience of people with dementia, their family, and their carers. Despite person-centred educational policies, current curriculums may not adequately prepare students to meet the needs of people with dementia. This study qualitatively evaluated the impact of a virtual dementia experience on medical and pharmacy students’ self-reported knowledge and attitudes towards people with dementia.

Methods

Ten focus groups were conducted with 29 medical and 24 pharmacy students in September and October 2016. All students had undertaken a multisensory virtual dementia experience designed to simulate the cognitive and perceptual difficulties faced by people with dementia. Focus groups were used to evaluate the virtual dementia experience in terms of perceived usefulness, suggestions for improvement, and ability to inform students’ understanding of dementia-friendly environments. Focus groups were audio-recorded and analysed via a thematic approach.

Results

The virtual dementia experience was described as useful and impactful, and students suggested how it could be more tailored towards their learning needs, such as via incorporating hospital, medical, and pharmacy-specific scenarios and opportunities for role play. Additionally, students explained how dementia-friendly communication techniques could be used in their future practice and provided strategies to optimise dementia-friendly characteristics of current work environments.

Conclusion

A virtual dementia experience improved student self-reported knowledge and attitudes towards people with dementia.

Pharmaceutical care as narrative practice? Rethinking patient-centered care through a pharmacist's perspective

Illness is a disruptive experience that requires high-quality care. The best evidence-based medical treatment risks losing some of its efficacy, however, when patients feel misunderstood when faced with the complexity of their experiences. They might stop treatment, refuse to disclose relevant information or seek unsound alternatives. A narrative-based approach to health care understands the patient's case history as a narrative that can be read or analyzed like a story. In other words, this approach honors individual illness experiences through the stories that patients tell. While programs that train 'narrative competence' have been successfully implemented in medical education, an application to pharmaceutical training is missing so far. We argue for the necessity to complement evidence-based pharmaceutical practice with narrative-based approaches to ensure high-quality care. Using the perspective of a pharmacist in a case scenario, we exemplify the centrality of "narrative pharmacy" for improving the quality and safety of pharmaceutical health care.