Evaluation of Clinical and Communication Skills of Pharmacy Students and Pharmacists with an Objective Structured Clinical Examination

Predictors of student preparedness for advanced pharmacy practice experiences

BACKGROUND

A capstone course often serves as the final checkpoint of student readiness before the commencement of experiential training. The purpose of this study was to determine if the assessment components from the capstone course can serve as predictors of student performance during their Advanced Pharmacy Practice Experiences (APPEs).

METHODS

Student data was analyzed to observe the correlation between performance in the Pharmacy Curriculum Outcomes Assessment (PCOA), student performance in the capstone course, and the overall grade point average (GPA) earned during APPEs. Spearman rank correlation analysis, multiple linear regression, and Mann-Whitney U test were used for statistical analysis.

RESULTS

A statistically significant positive correlation was observed between the overall APPE GPA and students' capstone course grade, top drug competency exam score, pharmacy calculation competency exam score, and PCOA exam score. A significant regression equation was obtained during the analysis: (F(5, 97) = 5.62, p < 0.001), with an R2 = 0.225 (adjusted R2 = 0.185). In the linear regression model, capstone GPA emerged as a significant predictor (β = 0.155; p = 0.019) of APPE GPA amongst the tested variables. Additionally, students scoring < 73% on the top drug competency exam in the capstone course or less than the reference group in the PCOA exam were found to have significantly lower GPA during their APPEs compared to other students.

CONCLUSION

Performance on the top drug competency exam and the PCOA exam can serve as potential predictors of success during APPEs.

Evaluation of Clinical Communication in Pharmacy Undergraduates in Brazil: A Multicentric Study

OBJECTIVE

To assess the clinical communication characteristics of pharmacy undergraduates, estimate differences in this specific competency, and produce recommendations for further education and training.

METHODS

Analysis of communication competence between 110 pharmacy students in the last graduation year from each of the 5 Brazilian regions and a simulated patient with complaints of mild allergic rhinitis passive of resolution with non-prescription medicines. The simulated appointment was recorded, and the video was analyzed using the 2 main elements: biomedical/task-focused and socio-emotional exchange of the Roter Interaction Analysis System.

RESULTS

The total of utterances/speech from the pharmacist to the patient was 183.4; there was a statistically significant difference according to the Brazilian region. In the consultation, the frequency with which pharmacy students returned to the segment was evaluated, with a total mean clinical history segment 2 of mean 5.60; in segment 4, which is the counseling phase, an average of 4.80. In the task codes and the socio-emotional codes, there was a statistically significant difference between the codes when compared by region. We compare by sex because it is said that women talk more than men. There was a statistically significant difference in socio-emotional code and biomedical/focused and task being higher for women.

CONCLUSION

The level of communication competence of students should be that desired for graduation, in all regions. There seems to be a difference between training and level of competence. Considering gender, although the consultation time is similar, it appears that the quality of communication is higher for women.

Work readiness of pharmacy graduates: An exploratory study

Introduction

The recent global pandemic of Covid-19 caused various disruptions. Among them were face-to-face teaching and learning activities being switched to virtual sessions in accordance with health authorities recommendations. The impact of these changes on work readiness of pharmacy graduates is unknown.

Aim

This study aims to determine the impact of pharmacy graduate's work readiness, particularly those that had their studies disrupted from the pandemic.

Methods

Practicing pharmacists with supervisory experience were interviewed on their opinions on work readiness of early career and intern pharmacists. Specifically, they were asked to comment on work readiness of pharmacy graduates who had their later stage of pharmacy education impacted by the pandemic. Data was transcribed verbatim and thematically analysed. This was also supplemented with quantitative data from graduating students in 2020 and 2021 using the Work Readiness Scale.

Results

Qualitative feedback showed four themes related to workforce readiness: work competence, social intelligence, personal characteristics, and organizational acumen. Preceptors interviewed noted differences in communication abilities when interacting with patients. However, this improved with time. Quantitative data collected from graduates via the validated Work-Readiness Scale also showed a more positive agreement towards perceived work readiness. These graduates were comfortable with using technology as they had used these extensively in their learning during the pandemic and thus was comfortable in adopting digital health tools in their practice.

Conclusion

Although graduates reported to be work ready, there were gaps in communication skills and confidence levels when interacting with patients, as reported by supervising preceptors. Graduates also described this sense of 'missing out' from not having the opportunity to attend face-to-face activities like their originally planned hospital placements and how it impacted their choice of career. As pharmacists continue to play vital roles as members of the broader healthcare workforce, both in clinical and nonclinical settings, learnings from this study should be considered in designing educational activities to train and develop the workforce of the future.

Exploring the problems and coping strategies of pharmacy internship in large general hospitals in China: from the perspective of preceptors

OBJECTIVE

The role of the Hospital Pharmacy Preceptor (HPP) is pivotal in upholding the excellence of experiential training and fostering the professional growth of pharmacy interns. However, there is a lack of studies that provide an overview of pharmacy internships from the perspective of HPP. This study explores the experience and expectations of HPPs regarding existing problems and possible coping strategies in intern teaching.

METHODS

This is a qualitative study that was conducted through individual interviews and focus group discussions. HPPs were invited as participants from large-scale tertiary hospitals in representative provinces of mainland China. Interview and focus group discussion data were analyzed using thematic analysis to see emerging themes from the data. Nvivo 12 was utilized for data management and processing.

RESULTS

Eight individual interviews and two focus group discussions were conducted, involving 14 HPPs as participants. Upon the examination of the interviews and focus group data, four themes were summarized regarding HPPs' perceptions: 1) current presenting problems; 2) possible coping strategies; 3) something HPPs should do; 4) something interns should do.

CONCLUSION

This study found that from the HPPs' perspective, the hospital-based pharmacy internship still has some problems from policy to practice, which need to be addressed by the joint efforts of the state, schools, internship bases, pharmacy preceptors, and students.

An Exploration of Diversity, Equity, Inclusion, and Antiracism in Standardized Patient Simulations

A trending topic in pharmacy education is the importance of educating and exposing student pharmacists to topics of diversity, equity, inclusion, and antiracism (DEIA). Incorporation of diverse patient populations is one emerging learning opportunity for students in the DEIA space. This commentary presents the findings of seven pharmacy programs reporting similarities and differences in standardized patient (SP) recruitment and training, and their use in DEIA simulation learning activities. Common barriers of DEIA-centric SP activities in pharmacy programs were also identified and included recruitment of diverse SPs, lack of faculty knowledge for implementation of DEIA-focused simulations, and emotional protection of SPs involved. While no best practices or standardized processes exist, the authors provide suggestions for addressing barriers, and make a call to action for further research to determine best practices related to recruitment, training, and utilization of diverse SPs in simulation activities in pharmacy education.

Shifting to Authentic Assessments? A Systematic Review of Student Perceptions of High-Fidelity Assessments in Pharmacy

OBJECTIVE

Despite becoming increasingly popular, there is no comprehensive review on high-fidelity assessments in pharmacy education that has a focus on the perceptions and experiences of students. This systematic review investigates the student acceptability of high-fidelity simulation for summative assessments in pharmacy education and provides recommendations regarding high-fidelity simulation practices.

FINDINGS

The search yielded 37 studies in total. The articles fell into 3 distinct categories: objective structured clinical examinations (N = 25); face-to-face simulation assessments (N = 9), and augmented reality assessments (N = 3). Most high-fidelity assessments were well received with most students agreeing they had a vital role in assessing the application of clinical knowledge, even though they are stressful. Students prefer high-fidelity assessments to be face-to-face rather than online and also prefer when simulated patients whom they are unfamiliar with are used. Students also expressed a need to be well-prepared for the assessment regarding the logistics of the exam and technology use.

SUMMARY

High-fidelity simulation is likely to be increasingly important in the assessment of the knowledge and skills of pharmacy students and student perception is an important factor to consider when developing such assessments. Reducing stress associated with high-fidelity assessments could include familiarizing students with task logistics or technology used prior to the assessment, using external simulated patients, and having face-to-face assessments and practice sessions.

Development, Validation, and Reliability of a P1 Objective Structured Clinical Examination Assessing the National EPAs

OBJECTIVE

To document the performance of first-year pharmacy students on a revised objective structured clinical examination (OSCE) based on national entrustable professional activities, identify risk factors for poor performance, and assess its validity and reliability.

METHODS

A working group developed the OSCE to verify students' progress toward readiness for advanced pharmacy practice experiences at the L1 level of entrustment (ready for thoughtful observation) on the national entrustable professional activities, with stations cross-mapped to the Accreditation Council for Pharmacy Education educational outcomes. Baseline characteristics and academic performance were used to investigate risk factors for poor performance and validity, respectively, by comparing students who were successful on the first attempt with those who were not. Reliability was evaluated using re-grading by a blinded, independent grader, and analyzed using Cohen's kappa.

RESULTS

A total of 65 students completed the OSCE. Of these, 33 (50.8%) successfully completed all stations on first attempt, and 32 (49.2%) had to re-attempt at least 1 station. Successful students had higher Health Sciences Reasoning Test scores (mean difference 5, 95% CI 2-9). First professional year grade point average was higher for students who passed all stations on first attempt (mean difference 0.4 on a 4-point scale, 95% CI 0.1-0.7). When evaluated in a multiple logistic regression, no differences were statistically significant between groups. Most kappa values were above 0.4 (range 0.404-0.708), suggesting moderate to substantial reliability.

CONCLUSION

Though predictors of poor performance were not identified when accounting for covariates, the OSCE was found to have good validity and reliability.

Evidence for commonly used teaching, learning and assessment methods in contact lens clinical skills education

INTRODUCTION

Evidence based practice is now an important part of healthcare education. The aim of this narrative literature review was to determine what evidence exists on the efficacy of commonly used teaching and learning and assessment methods in the realm of contact lens skills education (CLE) in order to provide insights into best practice. A summary of the global regulation and provision of postgraduate learning and continuing professional development in CLE is included.

METHOD

An expert panel of educators was recruited and completed a literature review of current evidence of teaching and learning and assessment methods in healthcare training, with an emphasis on health care, general optometry and CLE.

RESULTS

No direct evidence of benefit of teaching and learning and assessment methods in CLE were found. There was evidence for the benefit of some teaching and learning and assessment methods in other disciplines that could be transferable to CLE and could help students meet the intended learning outcomes. There was evidence that the following teaching and learning methods helped health-care and general optometry students meet the intended learning outcomes; clinical teaching and learning, flipped classrooms, clinical skills videos and clerkships. For assessment these methods were; essays, case presentations, objective structured clinical examinations, self-assessment and formative assessment. There was no evidence that the following teaching and learning methods helped health-care and general optometry students meet the intended learning outcomes; journal clubs and case discussions. Nor was any evidence found for the following assessment methods; multiple-choice questions, oral examinations, objective structured practical examinations, holistic assessment, and summative assessment.

CONCLUSION

Investigation into the efficacy of common teaching and learning and assessment methods in CLE are required and would be beneficial for the entire community of contact lens educators, and other disciplines that wish to adapt this approach of evidence-based teaching.

Nailed it! Doctor of pharmacy learners' self-awareness of performance on authentic assessments

INTRODUCTION

The primary objective of this pilot study was to determine the reliability and validity of an objective structured clinical examination (OSCE) self-awareness survey. A secondary objective was to assess learner self-awareness in OSCE performance.

METHODS

A retrospective review of OSCE data from a single cohort in a three-year accelerated doctor of pharmacy program occurred. The cohort completed four OSCEs with a total of 23 discrete cases. At the end of each case, before receiving feedback, learners completed an evaluation of their skills, communication, overall performance, and identified if they believed the patient/provider would return ("nailed or failed"). These self-evaluations were then compared with respective learner performance scores for each case. Content validity was assessed for the self-awareness survey via the Lawshe method. Reliability of the OSCE cases and self-awareness survey were conducted utilizing Cronbach's alpha and the Spearman-Brown formula, respectively.

RESULTS

The OSCE self-awareness survey was found to be face valid and reliable for the overall survey. The subsections of return to pharmacist and overall learner performance were also found to be valid and reliable. A statistical relationship was found between learner self-assessment of pass/fail and their actual grade for overall performance and return to pharmacist.

CONCLUSIONS

Results from this study may guide remediation plans related to OSCE performance and development of other self-awareness activities in practice settings. Further studies are needed to evaluate the broader application and use of self-awareness tools.

Quality management of objective structured clinical examinations: An integrative literature review

BACKGROUND

Objective Structured Clinical Examinations are widely adopted as a clinical assessment method in nurse education. Quality is an integral aspect of the design and implementation of OSCEs, facilitating their credibility and rigour. However, there is a dearth of literature regarding the management of the quality of Objective Structured Clinical Examinations.

OBJECTIVE

To summarise existing literature regarding best practices on the management of the quality of Objective Structured Clinical Examinations in health science education.

DESIGN

An integrative literature review.

DATA SOURCES

EBSCOhost, including CINAHL, eBook Collection, E-journals, ERIC, Health Source-Consumer Edition, Health Source-Nursing/Academic Edition, Humanities International Complete and MEDLINE, together with Cochrane Online, PubMed, Taylor & Francis Online and ScienceDirect, were searched, followed by hand searching of references as well as a manual search for grey literature, using Google.

REVIEW METHODS

Using predetermined inclusion and exclusion criteria, research documents (experimental, non-experimental, descriptive and qualitative studies), non-research documents (editorials, opinion letters), including grey literature, published between January 2010 and March 2021.

RESULTS

A total of thirteen (n = 13) studies were included in the review. A total of 22 quality measures were identified, which should be applied in the preparation and planning, implementation and evaluation phases of Objective Structured Clinical Examinations. The preparation and planning phase is crucial for the quality of Objective Structured Clinical Examinations, as more than half (n = 12) of the 22 quality measures were identified in this phase.

CONCLUSIONS

There is limited available recorded evidence that defines and describes the management of the quality of Objective Structured Clinical Examinations. Future research should focus on the context-specific use of psychometric analysis to ensure generation of valid, objective and consistent assessment during Objective Structured Clinical Examinations. More rigorous large-scale studies (such as quantitative or randomised controlled trials) regarding management of variances amongst examiner scores, impact of moderation on Objective Structured Clinical Examinations, and virtual Objective Structured Clinical Examinations should be conducted.

Predictors of student pharmacist success on an advanced pharmacy practice experience-readiness performance-based assessment

INTRODUCTION

The study objective was determining the relationship of certain predictor variables with student performance on an advanced pharmacy practice experience (APPE)-readiness performance-based assessment (PBA) in the third professional year (P3).

METHODS

This retrospective study aimed to identify if student predictors and/or curricular-related predictor variables correlate with student performance on a patient interview and documentation activity (PIDA), an APPE-readiness assessment. Student predictors included Pharmacy College Admission Test score, pre-pharmacy cumulative grade point average (GPA), end of first professional year (P1) GPA, end of second professional year GPA, end of fall P3 GPA, and elective Pharmacists' Patient Care Process (PPCP) score. Curricular-related predictor variables comprised specific activities with emphasis on patient care skill development in P1 through P3 years. Adjusted and unadjusted linear regression models assessed correlations between PIDA score and student predictors as well as curricular variables.

RESULTS

Students from the Classes of 2018 through 2020 at Southern Illinois University Edwardsville School of Pharmacy (N = 231) were included. Two student predictors, P3 GPA and PPCP elective score, showed statistically significant correlations with PIDA performance. One curriculum-related variable, P3 activity with an emphasis on medication reconciliation, demonstrated a statistically significant correlation with student performance on the PIDA.

CONCLUSIONS

Student performance on a cumulative PBA may be predictive from prior curricular learning experiences that assess similar patient care skills. The predictive impact of the elective PPCP score on a PBA needs additional research. Recent implementation of a new curriculum may lead to identification of other predictors of student success on PBAs.

The utilization of simulated patients for teaching and learning in the pharmacy curriculum: exploring pharmacy students' and recent alumni's perceptions using mixed-methods approach

BACKGROUND

The use of simulated patients (SPs) is considered a significant resource for teaching and assessing clinical and communication skills in health professional education. We conducted this study to explore pharmacy students' perspective towards the utilization of SPs in Qatar and to identify areas that require improvement.

METHODS

An explanatory sequential mixed-methods design was used among students and recent graduates of the College of Pharmacy at Qatar University (QU-CPH). First, their perspectives toward the current utilization of SPs at QU-CPH was explored using a quantitative cross-sectional study design. Following this, we conducted six focus group discussions based on the analysis of the questionnaire results. The findings of the two phases were interpreted through integration of the quantitative and qualitative phases.

RESULTS

The majority of the participants (> 90%) reported that interactions with SPs are important in building good communication and counseling skills during professional skills course activities. Similarly, most of the respondents (80%) indicated that interactions with SPs prepared them to apply the clinical skills gained during professional skills and patient assessment sessions in real-life. In addition, they reported that interactions with SPs during competency-based assessments were good experiences. The participants disagreed with the notion that interaction with SPs of opposite gender was uncomfortable for them. Themes identified from the focus groups include: interactions with trained SPs compared to faculty SPs, standardization and consistency of SPs' roles, communication and language barriers, simulations of real-life case scenarios, SPs' competence and preparedness, psychological impact associated with interaction with SPs, proposed strategies for improving the SP program. Identified areas for improvement include the need for strengthening the SP training and orientation program as well as the SP selection criteria.

CONCLUSION

This study showed a positive impact of the utilization of SPs in this pharmacy curriculum as perceived by students and alumni. However, the SP program needs to be optimized in terms of the training and orientation of SPs.

Use of Face-to-Face Assessment Methods in E-Learning-An Example of an Objective Structured Clinical Examination (OSCE) Test

The spread of COVID-19 and social-distancing rules have increased the need for alternative learning environments with a focus on e-learning platforms. The objective of this study was to assess whether and to what extent the transition from traditional learning and assessment environment to the e-setting impacts the knowledge and skills acquired by students and their satisfaction with new e-solutions of taking the OSCE test. The study compared the results of three face-to-face (2018-2019) and one electronically conducted (2021) OSCE tests, as well as students' feedback on the content and organization of the tests. For data analysis the one-way ANOVA test and post hoc multiple comparisons were used. The results demonstrated the feasibility and effectiveness of and students' satisfaction with OSCE tests in the Zoom environment. However, more focus on communication techniques is required in a remote communication environment to better cover all patient health-related and drug communication aspects. There were identified differences between undergraduate students and practicing assistant pharmacists in assessing patients' health problems and providing corresponding counseling. This result points to the need to implement the continuous development of patient-centered counseling techniques in the lifelong learning of pharmacists and the need to use innovative digital solutions, if applicable.

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.

Transitioning Competency-Based Communication Assessments to the Online Platform: Examples and Student Outcomes

In light of the COVID-19 pandemic, pharmacy education has shifted from in-person teaching and assessments to the virtual environment. Many education programs had previously adopted objective structured clinical examinations (OSCEs) to assess communication abilities in-person with standardized patients (SPs). However, comparative student outcome data between virtual and in-person methods as well as guidance on how to conduct communication-based OSCEs in the virtual environment is lacking. The University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences (SSPPS) describes its methods of conducting two types of communication-based OSCEs (patient counseling and gathering a medical history). Student performance data from the two virtual OSCEs in 2020 was compared to results from two 2019 in-person OSCEs using Mann Whitney U Tests. The 2020 cohort scored significantly higher than the 2019 cohort in all variables (i.e., using effective verbal and non-verbal communication, using patient friendly education, organizing the encounter, demonstrating empathy, establishing trust, professionalism) and in overall score. However, the effect size for these findings indicate the differences between performances are generally small and more likely due to changes in grading patterns due to the pandemic.

Assessing communication skills in student pharmacists-Psychometric validation of Global Communication Rubric

ASSESSING COMMUNICATION SKILLS IN STUDENT PHARMACISTS

Psychometric validation of the Global Communication Rubric.

OBJECTIVE

The objective of this study was to perform psychometric validation of the Global Communication (GC) rubric.

METHODS

The GC rubric was developed and used for the past 10 years at the institution to assess level of communication skills in Objective Structured Clinical Examinations (OSCE) in the PharmD program. The rubric consisted of 6 questions with the scoring criteria of 0 (failure), 1 (needs improvement), 2 (satisfactory), and 3 (excellent). Data from GC rubric scores for Classes 2010 to 2020 (1,100 students) was used to perform psychometric validation by assessing the following properties: scale reliability; face, content, construct, and predictive validity; and responsiveness.

RESULTS

Internal consistency reliability was acceptable at Cronbach's alpha of 0.78. Construct validity showed that all six items loaded highly onto one component. Responsiveness was demonstrated using uptrend of the score improvement as the students advance in the curriculum from P1 to P3 levels.

CONCLUSION

The result of this study confirmed reliability and validity of the GC rubric in evaluating communication skills of student pharmacists.

PRACTICE IMPLICATIONS

The GC rubric is valuable in evaluating short encounters in an easy and expedited manner.

Evolving to Objective Structured Clinical Exams (OSCE): Transitional experience in an undergraduate pharmacy program in Kuwait

BACKGROUND

Objective Structured Clinical Exams (OSCEs) can assess professional competencies in a structured manner and facilitate objective evaluation of clinical performance. With limited data from the Eastern Mediterranean region, this study aims to describe the development, implementation, and evaluation of OSCEs for final year pharmacy students in Kuwait. The study also aims to compare students' performance in two academic years (2015-2016 and 2016-2017).

METHODS

The design, implementation, and evaluation of the competency-based OSCE followed a 3-phase systematic evidence-based approach. The development phase involved establishing an OSCE working group to develop a blueprint and scoring rubrics and to organise assessors and standardised patient/physician training. The implementation phase involved conducting formative and summative OSCEs. The evaluation phase involved undertaking student and staff perception surveys.

RESULTS

The overall students' OSCE scores for the academic years 2015-2016 and 2016-2017 were (median (interquartile range)) (71.6%, 32.2) and (60.0% (30.7)) and respectively (p < 0.0001). The average students' performance score was high in stations covering 'patient consultation and diagnosis' competency (71.4% (95% CI: 66.7-73.3)) and lower in stations covering 'monitoring of medicine therapy' competency (50.0% (95% CI: 33.3-66.7)). Students perceived stations covering 'monitoring medicines therapy' and 'assessment of medicine' as difficult. However, staff perceived stations related to 'patient consultation and diagnosis' competency as the easiest. Students reported that the OSCE was a positive experience as it provided them an opportunity to practice real life scenarios in a safe learning environment.

CONCLUSION

The OSCE helped to identify the level of competency of students prior to graduation and areas to improve in the curriculum.

Blended learning: Improving the diabetes mellitus counseling skills of German pharmacy students

INTRODUCTION

Pharmacists have the responsibility to conduct medication therapy management and appropriately counsel patients and physicians on medicines. Blended learning and objective structured clinical examinations (OSCEs) may have the potential to address these skills. This study aimed to assess whether a blended learning program consisting of e-learning and OSCEs could enhance pharmacy students' abilities to conduct pharmaceutical consultations with type 2 diabetes mellitus patients.

METHODS

The blended learning program consisted of e-learning, formative OSCEs, and summative OSCEs. The e-learning aimed to bring the students to the same level of diabetes knowledge. The students' baseline consultation skills were measured by a summative pre-training OSCE. After the formative OSCEs, a summative post-training OSCE quantified the change in performance. During the pre- and post-training OSCEs, analytical checklists were used to assess consultation skills and a global rating scale assessed communication skills. Surveys were used to measure students' self-assessment and satisfaction.

RESULTS

The study demonstrated significant improvement in students' pharmaceutical knowledge of diabetes mellitus, consultation performances on diabetes mellitus, and self-assessment scores. Most students responded positively on the satisfaction survey.

CONCLUSIONS

This study demonstrated that a blended learning approach with e-learning and OSCEs can improve students' diabetes consultations and communication skills. These results support the use of this instructional technique for teaching patient counseling. Further studies should consider a control group to assess whether the improvement of the consultation performance is a result of the training or solely a learning effect due to the repetition of summative OSCEs.

Use of active learning and simulation to teach pharmacy students order verification and patient education best practices with oral oncolytic therapies

INTRODUCTION

The primary objective of this study was to describe the incorporation of the flipped classroom model and use of real-life oncology patients to facilitate student learning of oral oncolytic best safety practices and patient counseling. The secondary objective was to assess the impact of the flipped classroom learning activity on students' perceived confidence.

METHODS

This study was a prospective, single center, flipped classroom learning activity and pre/post assessment survey administered to third year doctor of pharmacy students enrolled in the Oncology Pharmacotherapy didactic elective in 2016 and 2017. A pre/post survey was used to assess student's perceived confidence with oral oncolytic best practice competencies.

RESULTS

Ten students participated in the flipped classroom learning activity and survey. Five students completed both the pre- and postsurvey. The overall change in student's mean scores for their confidence of oral oncolytic competencies improved significantly from 3 to 4.1 on a 6-point Likert Scale (p = 0.03) following the learning activity. Students perceived confidence in performing oral oncolytic order verification increased following the implementation of a flipped classroom learning activity and use of real-life cancer oncology patients.

CONCLUSION

This study describes the development and implementation of a flipped classroom learning activity and use of real-life patients with cancer that can be implemented at other institutions of higher education in a didactic or experiential learning environment. Additionally, this study demonstrated a potential benefit in student learning.

An Objective Structured Clinical Examination to Assess Competency Acquired During an Introductory Pharmacy Practice Experience

Objective. To evaluate the use of an objective structured clinical examinations (OSCE) to assess clinical competency acquired during an off-campus introductory pharmacy practice experience (IPPE). Methods. Third-year pharmacy students completed an IPPE in transitions of care and completed 24 experiential contact hours at one of 17 practice sites. Students were assessed using two OSCEs, the first occurring prior to beginning an off-site IPPE (pre-experience OSCE) and the second occurring after completion of the off-site IPPE (post-experience OSCE). Each OSCE consisted of 10 stations and covered five graded competency domains. The primary outcome was the degree of change in student performance from the pre-experience OSCE to the post-experience OSCE. Secondary outcomes included changes in each graded domain, OSCE pass rate, and failure conversion rate. Results. Of 111 students, 109 completed both the pre- and post-experience OSCE. Significant improvements were observed in overall score and cohort pass rate. Overall scores improved from 80 for the pre-experience OSCE to 87 for the post-experience OSCE. The OSCE pass rate also improved from 47% to 84%. Conclusion. Although preceptor evaluations have traditionally served as the primary summative assessment for IPPE and APPE, this study indicates that OSCEs may be a reliable alternative to assess clinical competency acquired from off-site practice experiences.

Evaluation of a Situational Judgement Test to Develop Non-Academic Skills in Pharmacy Students

Objective. To design, implement, and psychometrically evaluate a situational judgement test (SJT) to use as a formative assessment of pharmacy students' non-academic skills in an Australian-based university. Methods. An SJT was developed using a previously validated design process including involvement of subject matter experts. The first phase included design of a blueprint through stakeholder consultation and the development of bespoke attribute definitions and a tool specification. Following on from this, SJT items were developed through subject matter expert interviews and in-depth review process. Results. Students (702) from four different cohorts (first through fourth years) of a Bachelor of Pharmacy degree program completed the situational judgment test. Data from 648 students was eligible for inclusion in the analysis. The SJT demonstrated good reliability, appropriateness for use (difficulty and quality), fairness, and face validity. The variability in students' scores suggested that the SJT may be a useful metric to identify students most in need of additional support. Conclusion. Evaluation of the SJT demonstrated that the tool was valid, reliable, fair and appropriate to use as a formative assessment. Through implementing an SJT such as this, pharmacy students are provided the opportunity to receive feedback on their non-academic skills and consider how to approach challenging or unfamiliar situations before entering the profession.

Implementation of objective structured clinical examinations (OSCEs) in a doctor of pharmacy program

BACKGROUND AND PURPOSE

Objective structured clinical examinations (OSCEs) are an assessment solution that can be adapted in multiple ways within the doctor of pharmacy (PharmD) curriculum to assess clinical and communication skills and to improve teaching and learning across the curriculum.

EDUCATIONAL ACTIVITY AND SETTING

The University of Florida College of Pharmacy formed an OSCE Assessment Committee, wrote blueprints for the OSCEs aligned with Entrustable Professional Activities (EPAs), and delivered OSCEs in the first and third professional years of the PharmD program.

FINDINGS

Overall, students performed well on both the first year OSCE and third year OSCE (96 to 97% pass rate on first attempt).

SUMMARY

OSCEs provide a number of benefits to students, faculty, and preceptors. Students are afforded the opportunity to demonstrate the knowledge and skills they have acquired during pharmacy school. Likewise, faculty are able to determine if the skills they are teaching are being retained by students. Faculty are also able to assess if students are ready for pharmacy practice rotations. OSCEs also identify areas within the curriculum which may need reinforcement or review. In order for OSCEs to provide benefit to students and to the college, thought should be given as to what skills OSCEs will assess, how they will be developed and administered, and how they will be graded and used to determine progression through the curriculum.

Student pharmacists' performance and perceptions on an evidence-based medicine objective structured clinical examination

BACKGROUND AND PURPOSE

Studies have examined evidence-based medicine (EBM) focused objective structured clinical examinations (OSCEs) in medical training, but data are lacking in pharmacy trainees. This study sought to assess student pharmacists' performance on and perceptions of a novel EBM OSCE.

EDUCATIONAL ACTIVITY AND SETTING

This EBM OSCE included answering a drug-information inquiry, researching background questions, calling a simulated provider to acquire specific patient information, developing a foreground clinical question, reviewing pre-appraised trial synopses, and applying evidence to write a recommendation. Pharmacy faculty served as simulated providers and assessed students on knowledge/analytical (AC) and global communication (GC) skills. Students completed a worksheet (WS) that included developing a patient, intervention, comparison, outcome (PICO) statement, trial selection, and clinical recommendation. After OSCE completion, students were surveyed regarding perceptions of their performance and OSCE applicability. Outcomes assessed were performance scores (AC, GC, WS) and student perceptions.

FINDINGS

One-hundred twenty-nine students completed the survey and were included in analysis. AC, WS, and GC performance [median (IQR)] were 75.0 (37.8), 86.4 (36.9), and 88.9 (22.2), respectively, on a 100-point scale. On the WS, 89% of students developed a suitable searchable clinical question and 61% selected the correct trial synopsis to apply to the case. Students felt literature application and WS development were most challenging. A majority of students felt this OSCE increased comfort in engaging with providers (74%) and that these skills correlate with real clinical scenarios (77%).

SUMMARY

OSCEs can be a valuable tool for simulating clinical scenarios and assessing student pharmacists' EBM skills.

Impact of a teaching objective structured clinical examination (TOSCE) on student confidence in a pharmacy skills laboratory

OBJECTIVE

To describe the relationship between the use of a teaching objective structured clinical examination (TOSCE) and student confidence in a pharmacy skills laboratory.

METHODS

To develop students' abilities in providing recommendations and patient education on selected drug products, third-year pharmacy students participated in a TOSCE in a men's and women's health laboratory. A 19-item, 5-point Likert scale survey was administered longitudinally to assess student confidence (1 = not all confident to 5 = extremely confident). An additional seven items (1 = strongly disagree to 5 = strongly agree) were added to the original 19-item survey to measure changes in confidence and attitude before and after a problem-based assessment.

RESULTS

Seventy-two students completed all five surveys administered throughout the semester. Students' confidence improved in multiple areas within the clinical skills and interpersonal communication skills categories. Students also indicated their confidence in using primary literature, electronic drug references, and package inserts to answer medication-related questions improved after the TOSCE implementation. Students agreed that the feedback they received from the TOSCE was beneficial to their performance on a problem-based assessment.

CONCLUSIONS

A TOSCE is a formative assessment that has the potential to improve student confidence in core competency areas immediately after an activity. However, its benefit may be short-term when a time gap exists. Further study is needed to assess long-term sustainability in student confidence over multiple laboratory activities throughout a semester.

A Simulation-Based Workshop to Improve Dermatologists' Communication Skills: A Pilot for Continuing Medical Education

INTRODUCTION

Communication skills influence the quality of health care and patient experience; both may affect provider reimbursement. There are few opportunities available for practicing physicians to receive direct feedback on communication in patient encounters. The purpose of this simulation-based patient encounter workshop was for dermatologists to practice and obtain feedback on their communication skills.

METHODS

In March 2016, dermatologists participated in a workshop with four simulated patient encounters. Cases were developed based on a prior needs assessment. Standardized patient educators evaluated participants' communication using the Master Interview Rating Scale and provided verbal feedback. Physicians rated the usefulness of the simulation and the feedback received through a survey upon workshop completion.

RESULTS

Of the 170 physicians who registered, 103 participated in the simulation. The workshop was highly rated in meeting its three learning objectives (score of 4.5-4.6 out of a maximum score of 5). The lowest-rated communication skills were as follows: allowing the patient to share their narrative thread (3.1), summarizing the patient's history from the provider (3.8), and assessing patient understanding (3.8).

CONCLUSIONS

Participants reported that this communication workshop effectively satisfied its learning objectives. Opportunities to practice and improve communication skills as part of continuing medical education will benefit the clinical experience of patients and physicians alike, and the workshop may be formatted to serve physicians of other specialties. The lowest-scoring communication areas identified in this study present an opportunity to develop a tailored curriculum for physician-patient communication in the future.

Implementation of a skills practical to first-year pharmacy students

BACKGROUND AND PURPOSE

Objective structured clinical examinations (OSCEs) are being implemented in pharmacy schools across the country. As part of a new curriculum, a practical with an OSCE component was implemented for the first time at the West Virginia University School of Pharmacy.

EDUCATIONAL ACTIVITY AND SETTING

A practical with an OSCE component was developed for first-year professional pharmacy students in a foundational pharmacy skills course. The OSCE component assessed insulin and inhaler counseling and blood pressure skills. A written exam covered material from throughout the semester.

FINDINGS

A total of 76 students completed the practical. The average grade was a 27.8 out of 30 points. A total of 62 faculty hours were needed for the implementation of this OSCE.

DISCUSSION AND SUMMARY

An OSCE that assessed a variety of foundational pharmacy skills was designed and implemented to first year pharmacy students using limited faculty time and resources.