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Logan LD, Johnson BR, Grout K, Gyamfi K, Fulford M. Developing Confidence in Engaging in Diversity, Equity, and Inclusion and Social Determinants of Health Topics Through Self-Authorship. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100746. [PMID: 38944281 DOI: 10.1016/j.ajpe.2024.100746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 02/22/2023] [Accepted: 06/22/2024] [Indexed: 07/01/2024]
Abstract
OBJECTIVE This study used a self-authorship framework to explore if diversity, equity, and inclusion (DEI) and social determinants of health (SDoH)-focused laboratories and learning activities increase student confidence in understanding aspects of implicit bias and SDoH, and how these activities impact student comfort in discussing and confidence in initiating conversations on DEI/SDoH topics with colleagues, faculty, supervisors, and patients. METHODS First-year PharmD students engaged in 3 learning activities across 2 courses. Students were challenged to evaluate their biases and incorporate DEI/SDoH into their professional identity formation. This study used a mixed-methods, embedded approach to analyze assessment data collected via a questionnaire and assignments administered at 3 points during the fall semester. Quantitative analysis used a quasi-experimental, between-participants, pretest-posttest design. The qualitative component used open-ended questions to gain additional insight into participant experiences, gathered detail on perceptions, and provided context. RESULTS A 1-way analysis of variance showed statistically significant increases between assessment points for all items related to confidence in understanding implicit bias and SDoH. Comfort in discussing DEI/SDoH topics with supervisors/faculty and patients increased over time. Comfort in discussing DEI/SDoH topics with colleagues did not increase. Three salient themes emerged from qualitative analyses: bias and privilege awareness, education, and professionalism. CONCLUSION This study found that students started evaluating their own knowledge, beliefs, and claims in social and professional settings as defined by the self-authorship framework. Student comfort and confidence in discussing DEI/SDoH topics increased over time. Findings support that engaging students in multimodal programming may support incorporation of DEI/SDoH into professional identity formation.
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Affiliation(s)
- Linda D Logan
- University of Georgia College of Pharmacy, Athens, GA, USA.
| | | | - Kaitlin Grout
- University of Georgia College of Pharmacy, Athens, GA, USA
| | - Konadu Gyamfi
- University of Georgia College of Pharmacy, Athens, GA, USA
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Jarrar R, Lim R, Richardson CL, Naqvi AA, Rathbone AP, Lau WM. How cultural competence is conceptualised, developed and delivered in pharmacy education: a systematic review. Int J Clin Pharm 2024; 46:40-55. [PMID: 37755644 PMCID: PMC10830822 DOI: 10.1007/s11096-023-01644-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND It is important to have a pharmacy workforce that is culturally competent to recognise a patient's health beliefs to improve medication adherence and reduce poor treatment outcomes. AIM This systematic review aimed to identify, critically appraise and summarise how cultural competency is conceptualised, developed and embedded in pre-qualification pharmacy education. METHOD Medline, Scopus, PsychInfo, Web of Knowledge, CINAHL, and Embase databases were searched for relevant papers published in English between January 2012 and December 2021, following PRISMA guidelines. Data from included papers were thematically analysed. Educational quality of papers was appraised using the GREET criteria. This systematic review was registered on PROSPERO, CRD42021295875. RESULTS The review included 47 papers (46 studies) with 18 papers meeting ≥ 9 points on the GREET criteria thus considered of good educational quality. Forty papers focused on educational interventions implemented to pharmacy students only, the remaining included students from different health disciplines. Half of the educational interventions focused on cultural competence in general. Most educational interventions lasted over a week and 21 were compulsory. Cultural competence conceptualisation varied; a focus on knowledge about different cultures or on culturally competent behaviours or a continuum with knowledge at one end and behaviour at the other. CONCLUSION There is variation in how cultural competence is embedded in pharmacy programmes, which could be a reflection of the differences in how educators conceptualised cultural competence. Further research is needed to develop a unified understanding of the meaning of cultural competence and how it can be embedded in pharmacy education.
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Affiliation(s)
- Rawand Jarrar
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, King George VI Building, Newcastle upon Tyne, NE1 7RU, UK
| | - Rosemary Lim
- Reading School of Pharmacy, University of Reading, Whiteknights, Reading, RG6 6AP, UK
| | - Charlotte Lucy Richardson
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, King George VI Building, Newcastle upon Tyne, NE1 7RU, UK
| | - Atta Abbas Naqvi
- Reading School of Pharmacy, University of Reading, Whiteknights, Reading, RG6 6AP, UK
| | - Adam Pattison Rathbone
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, King George VI Building, Newcastle upon Tyne, NE1 7RU, UK
| | - Wing Man Lau
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, King George VI Building, Newcastle upon Tyne, NE1 7RU, UK.
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Clarke CL, Bayne S, Martin A. Impact of a Simulation Exercise on Student Perceptions of Poverty and Interprofessional Socialization. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100035. [PMID: 37714662 DOI: 10.1016/j.ajpe.2022.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 08/22/2022] [Accepted: 10/04/2022] [Indexed: 09/17/2023]
Abstract
OBJECTIVE This study aimed to evaluate the impact of an interprofessional poverty simulation exercise by determining if participating students demonstrated changes in attitude toward poverty (ATP) and perceptions of interprofessional socialization. METHODS The Community Action Poverty Simulation from the Missouri Community Action Network was provided to 512 interprofessional health care students during 9 simulation exercises over a 3-year period. Primary participating professions were pharmacy, occupational therapy, and nursing. Student simulation roles were assigned to ensure a mix of professions in simulated families and debriefing groups. Debriefing sessions included questions related to interprofessional interactions. Students completed surveys before and following participation in the simulation, which included the ATP Short Form scale and the Interprofessional Socialization and Valuing Scale-9A. RESULTS Statistically significant improvements in ATP were demonstrated for the overall score and 15 items of the 21-item ATP Short Form scale. The domains of stigma and structural perspective showed statistically significant improvement, while the personal deficiency domain did not. Statistically significant improvements in student perceptions related to interprofessional socialization were demonstrated for the overall score and 7 items of the 9-item Interprofessional Socialization and Valuing Scale-9A scale. CONCLUSION This interprofessional poverty simulation positively altered student ATP and enhanced interprofessional socialization. The Community Action Poverty Simulation augmented with debriefing questions related to interprofessional interactions served as an effective interprofessional education experience for pharmacy, occupational therapy, and nursing students.
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Affiliation(s)
- Cheryl L Clarke
- Drake University, College of Pharmacy and Health Sciences, Des Moines, IA, USA.
| | - Sarah Bayne
- Drake University, College of Pharmacy and Health Sciences, Des Moines, IA, USA
| | - Amanda Martin
- Community Engaged Learning, Drake University, Des Moines, IA, USA
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Kelsch MP, Thompson S, Skoy E. Impact of a Co-curricular Poverty Simulation on Pharmacy Students' Socioeconomic and Patient Advocacy Attitudes and Beliefs. J Pharm Technol 2023; 39:110-116. [PMID: 37323763 PMCID: PMC10268040 DOI: 10.1177/87551225231167294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
Background: Pharmacists are well-positioned to assist patients facing poverty with financial and well-being resource navigation. Pharmacy educators must find avenues for students that foster awareness of applicable challenges encountered by economically disadvantaged patients. Objective: This study examines the impact of a poverty simulation on pharmacy students' socioeconomic and patient advocacy attitudes and beliefs. Methods: Third year professional pharmacy students participated in the Community Action Poverty Simulation (CAPS). Students were asked to voluntarily complete a survey prior to and following their participation. The survey was based upon a combination of 3 previously validated survey tools: Attitudes Toward Poverty (ATP) scale, Medical Student Attitudes Toward the Underserved (MSATU), and the Locus of Control Scale (LCS). Students also responded to open-ended questions postsimulation. Results: Forty of the 74 students completed both the presimulation and postsimulation surveys. Significant changes were seen in a matched sample analysis for 17 of 49 survey questions. Prominent differences (decreasing agreement) came from the statements: "An able-bodied person collecting welfare is ripping off the system" and "Welfare makes people lazy"; and increasing agreement that "I feel personally responsible for providing medical care to the needy." Open-ended survey responses reflected a greater understanding of time and effort needed to locate and navigate available resources, and challenges such as adhering to medication regimens due to inability to pay. Conclusion: A poverty simulation, such as CAPS, is an effective method to encourage pharmacy students to reflect on their future impact toward patients facing the challenges of poverty. The shift in students' attitudes and beliefs on various measures revealed that the simulation had an impact on altering perceptions for those with low socioeconomic status.
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Affiliation(s)
| | - Sara Thompson
- Department of Pharmacy, Mayo Clinic, Rochester, MN, USA
| | - Elizabeth Skoy
- School of Pharmacy, North Dakota State University, Fargo, ND, USA
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Garnier A, Vanherp R, Bonnabry P, Bouchoud L. Use of simulation for education in hospital pharmaceutical technologies: a systematic review. Eur J Hosp Pharm 2023; 30:70-76. [PMID: 34949651 PMCID: PMC9986932 DOI: 10.1136/ejhpharm-2021-003034] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/30/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Because of the inherent risks facing pharmacy technicians, and consequently also patients, initial and continuing education on hospital pharmaceutical technologies is essential. Simulation is a pedagogical tool now widely used in healthcare education. This study's objectives are to provide an overview of simulation's current place in the field of hospital pharmaceutical technology education, to classify these uses, and to discuss how simulation technologies could be better used in the future. DATA SOURCES Two pharmacists independently searched PubMed, Embase, and Web of Science on 21 July 2020 and included studies in English or French that used simulation as an educational tool in the field of hospital pharmaceutical technologies, whether in academic teaching or professional practice. DATA SUMMARY Our search criteria resulted in 6248 articles, of which 24 were assessed for eligibility and 13 included in the qualitative synthesis. Simulation in hospital pharmaceutical technology education is used in three different ways: first, as a playful pedagogical tool, with error-based simulations (cleanrooms and preparation sheets with errors), or game-based simulations (escape games, role-plays, and board games); second, as an electronic tool with virtual reality (virtual cleanrooms and serious games), or augmented reality (3D glasses); finally, to evaluate chemical contamination (fluorescein and quinine tests) and microbiological contamination (media-fill tests) during compounding to periodically requalify pharmacy technicians. CONCLUSION Further studies, including non-technical skills evaluations, are needed to confirm the usefulness of this innovative technique in training as efficiently as possible actual and future pharmacy professionals.
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Affiliation(s)
- Alexandra Garnier
- Department of Pharmacy, Geneva University Hospitals, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
| | - Romain Vanherp
- Department of Pharmacy, Geneva University Hospitals, Geneva, Switzerland
| | - Pascal Bonnabry
- Department of Pharmacy, Geneva University Hospitals, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
| | - Lucie Bouchoud
- Department of Pharmacy, Geneva University Hospitals, Geneva, Switzerland
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Rahman H, Maerten-Rivera JL, Woodruff AE, Prescott GM. Students' knowledge and perceptions of social determinants of health utilizing interactive computer simulation-based learning. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:847-853. [PMID: 35914845 DOI: 10.1016/j.cptl.2022.06.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 05/06/2022] [Accepted: 06/16/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The purpose of this study was to assess if using computer simulations as a supplemental tool for teaching social determinants of health (SDoH) would impact first-year pharmacy students' knowledge and perceptions of SDoH. METHODS A brief lecture and online poverty game were followed by completion of two, in-class, computer-simulated SDoH clinical scenarios and corresponding case discussion. Students completed a pre- and post-quiz and perception survey with two open-ended questions. Qualitative analysis of the open-ended questions and quantitative analyses of the poverty game choices, quiz, and perception survey were conducted. RESULTS In total, 132 students were enrolled in this study. Thematic analysis of the open-ended question asking students what they learned included empathy (42%), general SDoH knowledge (30%), culture/religion (18%), and economic impact (15%). Student perceptions for all teaching modalities had a mean score of 4. Mean quiz scores on the pre- and post-class quizzes were 2.31 (SD 0.93) and 2.51 (SD 0.89), respectively. CONCLUSIONS Computer simulations can be utilized as a supplemental tool to teach and apply clinical patient cases focused on SDoH. Strategically threading SDoH throughout the pharmacy curriculum is recommended to further develop SDoH knowledge and clinical skills.
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Affiliation(s)
- Habibur Rahman
- University at Buffalo School of Pharmacy & Pharmaceutical Sciences, 201 Pharmacy Building, Buffalo, NY 14214, United States.
| | - Jaime L Maerten-Rivera
- University at Buffalo School of Pharmacy & Pharmaceutical Sciences, 280 Pharmacy Building, Buffalo, NY 14214, United States.
| | - Ashley E Woodruff
- University at Buffalo School of Pharmacy & Pharmaceutical Sciences, 205 Pharmacy Building, United States.
| | - Gina M Prescott
- University at Buffalo School of Pharmacy & Pharmaceutical Sciences, 215 Pharmacy Building, Buffalo, NY 14214, United States.
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Murray PM, Sepulveda A, Baird J. Longitudinal impact of a poverty simulation on healthcare practitioners' attitudes towards poverty. J Pediatr Nurs 2022; 64:24-30. [PMID: 35131716 DOI: 10.1016/j.pedn.2022.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Many clinicians have limited knowledge about the challenges of living in poverty, leading to stigma and differential treatment in healthcare settings. A poverty simulation event may help clinicians gain empathy and knowledge about the ways that poverty impacts health and well-being. PURPOSE This study evaluated the impact of a poverty simulation and the effect of personal characteristics on clinicians' attitudes towards poverty. METHODS Using a prospective longitudinal mixed-methods study design, a convenience sampling of clinicians from a freestanding children's hospital was recruited to participate in a poverty simulation event. The 21-item Attitudes Towards Poverty (ATP) tool was administered pre- and post-simulation and at 3 follow-up time points. Multiple linear regression analysis and linear mixed effects models were used to analyze ATP data. Qualitative data were analyzed to identify broad themes. RESULTS Mean scores in the ATP domains of stigma and structural perspective increased post-simulation, but only stigma scores demonstrated sustained improvement. Scores in the personal deficiency domain remained unchanged. Being male, White, and having Liberal political views were associated with lower ATP scores in our data. Qualitative data show participants felt the simulation generated feelings of compassion and empathy. DISCUSSION Simulation participation improved ATP scores in two domains immediately post-event, suggesting the simulation positively impacted clinicians' attitudes towards poverty. Follow-up data suggest the impact of the simulation may be temporary. TRANSLATION TO HEALTH EDUCATION PRACTICE Experiential learning activities, like poverty simulations, help foster awareness and empathy among clinicians but may not have long-term impact. Ongoing education is needed to create a workforce sensitized and equipped to care for families from all backgrounds.
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Affiliation(s)
- Paula M Murray
- Institute for Nursing and Interprofessional Research, Children's Hospital Los Angeles, Los Angeles, USA
| | - Aviril Sepulveda
- Division of Rehabilitation Medicine, Children's Hospital Los Angeles, Los Angeles, USA
| | - Jennifer Baird
- Institute for Nursing and Interprofessional Research, Children's Hospital Los Angeles, Los Angeles, USA.
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Bawazeer G, Sales I, Albogami H, Aldemerdash A, Mahmoud M, Aljohani MA, Alhammad A. Crossword puzzle as a learning tool to enhance learning about anticoagulant therapeutics. BMC MEDICAL EDUCATION 2022; 22:267. [PMID: 35410242 PMCID: PMC8995885 DOI: 10.1186/s12909-022-03348-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 04/06/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Educational games make the learning process more enjoyable, fun, and create a competitive classroom environment that can positively affect learning. The purpose of this study was to evaluate pharmacy students' perceptions of crossword puzzles (CWPs) as a learning tool in the pharmacotherapy cardiovascular module focusing on anticoagulants' therapeutics and assessing if students' preference of learning style influenced their perception. METHODS Clues for the puzzle were developed, validated, and piloted by course faculty. A free internet puzzle generator was used to create puzzles with 10 to 20 clues. Students were given 30 min to solve the puzzle following six hours of didactic lectures about the topic. An 8-item survey instrument and Pharmacists' Inventory of Learning Styles (PILS) questionnaire were administered to examine students' perceptions of the game and their learning style preference, respectively. RESULTS Two hundred sixty-seven students participated in the activity from both undergraduate programs (BPharm and PharmD) over three consecutive course offerings. Most students expressed favorable perceptions of the puzzle. Female and BPharm students had significantly more favorable perceptions than male and PharmD students on several perception items. The dominant preferred learning style (PLS) was converger (35.6%), followed by assimilator (25.3%), while 15.1% had mixed learning styles. The study did not find a significant association between PLS and students' perceptions toward the CWP. CONCLUSIONS The CWP game presented an innovative, creative, and easy active learning tool to enhance information recall, retention, and class engagement while accommodating all learning style preferences.
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Affiliation(s)
- Ghada Bawazeer
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 89885, Riyadh, 11692 Saudi Arabia
| | - Ibrahim Sales
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 89885, Riyadh, 11692 Saudi Arabia
| | - Huda Albogami
- Pharmaceutical Care Services, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Ahmed Aldemerdash
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 89885, Riyadh, 11692 Saudi Arabia
| | - Mansour Mahmoud
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | | | - Abdullah Alhammad
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 89885, Riyadh, 11692 Saudi Arabia
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Westrick SC, Harris T, Hastings T, Zhao Y, Diggs K, Shah R. Evaluation of a poverty-focused educational program and simulation for pharmacists. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:344-351. [PMID: 35307095 DOI: 10.1016/j.cptl.2022.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 11/24/2021] [Accepted: 01/13/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND PURPOSE Limited literature explores the impact that poverty-focused educational simulations can have on practicing clinicians. This study used a poverty simulation, specifically created to resemble the lives of Medicare patients, to sensitize practicing pharmacists to the situations faced by people living in poverty. The study evaluated how a poverty-focused educational program impacted practicing pharmacists' actual knowledge gain, intention to assist patients with limited income, and satisfaction with the educational program. EDUCATIONAL ACTIVITY AND SETTING A quasi-experimental one-group pre-/posttest design of practicing pharmacists was utilized. The intervention was a live continuing educational (CE) program at a pharmacy alumni event and a pharmacy convention. The CE program was delivered in person and included a Medicare poverty simulation and a 75-min didactic lecture. Pre- and posttests were used to assess outcomes. The primary outcome was change in knowledge as measured by test scores. Secondary outcomes included intention to assist future low-income patients and participant satisfaction with the educational program. FINDINGS Eighty-nine pharmacists participated in the educational program. Participants' mean knowledge increased from 2.76 (SD = 0.97) to 3.61 (SD = 1.21) (P < .001) out of 5. The majority (88.3%) agreed they were interested in assisting patients with limited income in the future. Most participants strongly agreed that the program was satisfactory and contributed to their learning. SUMMARY This is the first identifiable study that incorporated a poverty simulation into an educational program for practicing pharmacists. The study may help inform the development of future educational programs for practicing pharmacists.
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Affiliation(s)
- Salisa C Westrick
- Health Outcomes Research and Policy Department, Harrison School of Pharmacy Auburn University, 2316 Walker Building, Auburn University, AL 36849, United States.
| | - Tinia Harris
- PGY1 Pharmacy Practice Resident, Regional One Health, 877 Jefferson Avenue, Memphis, TN, United States.
| | - Tessa Hastings
- Clinical Pharmacy and Outcomes Sciences, University of South Carolina College of Pharmacy, 715 Sumter Street - CLS 311E, Columbia, SC 29208, United States.
| | - Yi Zhao
- Health Outcomes Research and Policy Department, Harrison School of Pharmacy Auburn University, 2316 Walker Building, Auburn University, AL 36849, United States.
| | - Kavon Diggs
- Harrison School of Pharmacy Auburn University, 2316 Walker Building, Auburn University, AL 36849, United States.
| | - Ritu Shah
- EVERSANA, Mumbai, Maharashtra, India
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Fliesher S, Neumann L, Curtis MP. School Nurse Poverty Education: Why It Is Important to Your Practice. NASN Sch Nurse 2021; 36:323-327. [PMID: 33853444 DOI: 10.1177/1942602x211006434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
School nurses are seeing increased numbers of children who are living in poverty. The Missouri Community Action Program Poverty Simulation was presented to school nurses to increase their awareness of what it might be like to live in poverty and the related healthcare barriers. Participants shared their reactions and knowledge gained in the simulation in a postparticipation survey with the simulation facilitators. Some participants shared practice changes that they made as a result of their participation in the simulation, which included use of additional referral resources, being less judgmental, and increased empathy.
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Affiliation(s)
- Susan Fliesher
- Assistant Professor Nursing, Goldfarb School of Nursing at Barnes-Jewish College, St. Louis, MO
| | | | - Mary P Curtis
- Professor and Director of the Adult Primary Care Nurse Practitioner Program, Goldfarb School of Nursing at Barnes-Jewish College, St. Louis, MO
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Hitchcock LI, Timmons McKenzie C, Shipman S, Varley A, Pollio W, Peterson DT, King DM, Lee White M. Interprofessional Simulation for Understanding Poverty. Clin Simul Nurs 2021. [DOI: 10.1016/j.ecns.2020.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Abstract
ABSTRACT The purpose of this study was to evaluate the influence of a poverty simulation on the attitudes of baccalaureate nursing students toward those living in poverty. A single-group pretest-posttest design was used. Participants' attitudes were measured using the Attitude Toward Poverty Scale-Short Form. Results indicated significant improvement in 11 out of 21 items, along with the subscales for stigma and structural perspectives. However, four items, along with the overall personal deficiency domain score, indicated a significant worsening of attitudes. Results of this study are mixed and suggest that valid concerns exist regarding the administration of the simulation.
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An Authentic Poverty Simulation for Health Care Profession Students Using Community Volunteers Experiencing Poverty. Nurse Educ 2020; 45:93-96. [PMID: 31033874 DOI: 10.1097/nne.0000000000000679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Poverty is a harsh reality for more than 40 million Americans, which can lead to detrimental health outcomes. PROBLEM Considering health professionals encounter clients of low-income status, increasing awareness and empathy toward this population is essential. APPROACH This article describes a novel approach to conducting poverty simulations by using community volunteers that are currently living or have recently lived in poverty, lending to a more authentic experience for students. The community volunteers acted as resource workers during the simulation. OUTCOMES Five lessons were learned as part of this authentic approach including the importance of orientation, consistent volunteer recruitment, volunteer appreciation, simulation role ownership, and importance of incentives. CONCLUSION This approach is an effective initial step in increasing awareness and empathy among health care profession students toward individuals living in poverty. Use of community volunteers with personal experience with poverty enhances the realism of this experience for students.
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Kiles T, Jasmin H, Nichols B, Haddad R, Renfro CP. A Scoping Review of Active-Learning Strategies for Teaching Social Determinants of Health in Pharmacy. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2020; 84:8241. [PMID: 34283757 PMCID: PMC7712738 DOI: 10.5688/ajpe8241] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/12/2020] [Indexed: 05/10/2023]
Abstract
Objective. To review current conceptualizations and measurements of active-learning education within Doctor of Pharmacy degree programs as it pertains to social determinants of health (SDOH) and to determine the gaps and limitations in available literature. A secondary objective was to assess simulation-based educational methods related to SDOH in pharmacy.Findings. Sixteen articles were eligible for inclusion. Many simulation-based and non-simulation-based teaching strategies are described. The majority of articles included active-learning activities related to social/community context and health/health care, the other three 3 social determinants of health domains: education, economic stability, and neighborhood/built community, were not equally addressed. In the studies included in this review, schools and colleges of pharmacy did not appear to not be integrating all five components of SDOH into active learning curricula. The sparsity of literature and lack of diversity in published types of simulated experiences and assessments may suggest there is room for innovation in this area.Summary. More research is needed in order to fully characterize conceptualizations of social determinants of health in Doctor of Pharmacy degree programs in order to ensure students are provided with a full understanding of the SDOH factors that affect patient outcomes.
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Affiliation(s)
- Tyler Kiles
- University of Tennessee Health Science Center, College of Pharmacy, Memphis, Tennessee
| | - Hilary Jasmin
- University of Tennessee Health Science Center, College of Pharmacy, Memphis, Tennessee
| | - Brittany Nichols
- University of Tennessee Health Science Center, College of Pharmacy, Memphis, Tennessee
| | - Romena Haddad
- University of Tennessee Health Science Center, College of Pharmacy, Memphis, Tennessee
| | - Chelsea P Renfro
- University of Tennessee Health Science Center, College of Pharmacy, Memphis, Tennessee
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Ehmke M, Sanner-Stiehr E. Improving attitudes toward poverty among DNP students: Implementing a Community Action Poverty Simulation©. J Am Assoc Nurse Pract 2020; 33:150-157. [PMID: 32039961 DOI: 10.1097/jxx.0000000000000361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 10/18/2019] [Indexed: 11/25/2022]
Abstract
ABSTRACT Poverty has detrimental effects on health outcomes. Doctorally prepared nurse practitioners are in a position to promote health for patients and communities experiencing poverty. To do so, they must be aware of their own attitudes and to have empathy toward the condition of poverty. Specialized poverty simulations have been successfully used to improve attitudes toward poverty among prelicensure nursing students, but there is a paucity of evidence exploring the effects of poverty simulations among Students in a Doctor of Nurse Practice (DNP) program. The purpose of this study was to evaluate the impact of a poverty simulation for students enrolled in a DNP program on their attitudes toward poverty. A quasi-experimental, pre-test and post-test survey design was used in this curriculum improvement project. A total of 29 DNP students participated in a 1-time, 4-hour Community Action Poverty Simulation© (CAPS). The simulations presented various challenges faced during 1 month of living in poverty. The Attitudes toward Poverty Scale-Short Form (ATPS-SF) was used to measure attitudes toward poverty both before and after the CAPS© experience. Descriptive statistics and paired t-tests were used to describe the participant group and measure the impact of the simulation on attitudes toward poverty. Attitudes toward poverty improved overall on all dimensions of the ATPS-SF after the CAPS© experience as compared to the pre-test, with particular improvement regarding stigmas related to poverty. Statistically significant improvements were detected on four items, and the overall favorable shift in attitudes presents clinically significant results. This poverty simulation experience should be considered for adoption into DNP curricula.
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Affiliation(s)
- Melissa Ehmke
- College of Nursing, University of Missouri- St. Louis, St. Louis, Missouri
| | - Ericka Sanner-Stiehr
- College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, North Dakota
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Abstract
Introduction: Cultural sensitivity training among pharmacy students is required by the Accreditation Council for Pharmacy Education, but little data exists on effective practices for teaching these concepts. The goal of this case study was to describe the process and determine if integration of a patient-led Cultural Sensitivity Panel into the required didactic curriculum impacts pharmacy student perceptions of their own cultural competence. Description of case: A special population was defined based on the CAPE competencies requiring students demonstrate sensitivity and responsiveness to culture, race/ethnicity, socioeconomic status, gender, sexual orientation, spirituality, disability, and other aspects of diversity and identity. Patients representing various special populations, such as veterans, the Deaf and hard of hearing population, the LGBT community, were invited to participate in a Cultural Sensitivity Panel for two consecutive years. Panelists shared information they wish future healthcare professionals understood about the population they represented and participated in a question and answer session. Pre- and post-surveys were conducted to assess the impact of the panel on student perceptions of cultural competence. Results: Over two years, 138 students completed surveys. More than 95% of students agreed or strongly agreed that a cultural sensitivity panel is a worthwhile experience, and that the panel would help them change behaviors that may be culturally insensitive. Student perceptions of their own cultural competence significantly improved between the pre- and post- surveys; ethnicity, age and gender significantly impacted responses (p<.05). Key themes of responses to open-ended questions included learning about effective communication (64%), new resources for diverse patient populations (28%), addressing barriers to care (21%), the importance of patience and empathy (18%), and incorporating a patient’s background into their care (18%). Exploration of case impact: Use of a cultural sensitivity panel provides patients with their own voice in discussing barriers to the provision of health care and thus mitigates the inherent bias and limitations of faculty members teaching about cultures and populations they do not represent. Conclusion: This novel approach of integrating a Cultural Sensitivity Panel into the didactic curriculum positively impacted student perceptions of their own cultural competence and may improve culturally competent provision of care among pharmacy students.
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Affiliation(s)
| | - Annesha White
- University of North Texas System College of Pharmacy
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17
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Turk MT, Colbert AM. Using simulation to help beginning nursing students learn about the experience of poverty: A descriptive study. NURSE EDUCATION TODAY 2018; 71:174-179. [PMID: 30292059 DOI: 10.1016/j.nedt.2018.09.035] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 09/04/2018] [Accepted: 09/25/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Increased numbers of individuals and families in the United States are living below the poverty level. Beginning nursing students must start to develop an understanding of the constraints of living in poverty and its relationship with health. OBJECTIVES To describe the effects of a poverty simulation implemented in a freshman-level course as a beginning preparation for working with patients who face financial hardship. DESIGN Descriptive study with a pre-test and post-test design. SETTING School of Nursing within a private, religiously-affiliated university in the northeastern United States. PARTICIPANTS 170 freshman-level Bachelor of Science in Nursing (BSN) students. METHODS Students participated in a poverty simulation designed to sensitize participants to the experience and realities of living in a typical low-income family. Using the Undergraduate Perceptions of Poverty Tracking Survey, data were collected on students' general attitudes toward poverty, empathy for those living in poverty, and commitment to addressing poverty, two weeks prior to and one week after the poverty simulation experience. RESULTS A significant decrease was noted in total scores from pre-simulation to post-simulation with a mean decrease of 7.9 ± 10.1 points (±standard deviation), p < .001. Significant decreases were also noted in four of the six subscales, including the Welfare Attitudes, Poor are Different, Equal Opportunity and Lack of Resources subscales, ps < .001. Changes represent improvements in the students' attitudes toward poverty, empathy for those faced with poverty, and recognition of societal and structural barriers encountered by individuals living in poverty. CONCLUSIONS This poverty simulation contributed to building empathy among freshman, BSN students and preparing them, early on, to provide more sensitive care to economically-disadvantaged populations. Nursing programs should include similar learning experiences at the beginning of curricula, so that this knowledge becomes an integral part of the care students provide throughout their clinical experiences.
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Affiliation(s)
- Melanie T Turk
- Duquesne University, 518 Fisher Hall, 600 Forbes Ave., Pittsburgh, PA 15282, United States of America.
| | - Alison M Colbert
- Duquesne University, 524C Fisher Hall, 600 Forbes Ave., Pittsburgh, PA 15282, United States of America.
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18
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Parker KW, DiPietro Mager NA, Aronson BD, Hart C. Using a mock board of pharmacy disciplinary hearing to teach concepts related to administrative law, addiction, empathy, and professionalism. CURRENTS IN PHARMACY TEACHING & LEARNING 2018; 10:1512-1517. [PMID: 30514543 DOI: 10.1016/j.cptl.2018.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 06/22/2018] [Accepted: 08/03/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND AND PURPOSE The purpose of this project was to impact pharmacy students' personal and professional development through simulation of a board of pharmacy disciplinary hearing regarding addiction. EDUCATIONAL ACTIVITY AND SETTING The mock board hearing was conducted as part of the required curriculum. Faculty obtained materials from a prior board hearing. The actual respondent, lawyer, former executive director, and a board agent participated. Students served as board members and president, asked questions of the witnesses, and deliberated per board procedure. After the event, student learning and perceptions were assessed through knowledge-based, opinion-based questions, and open-ended questions. FINDINGS Of the 141 students who attended the event, 97% completed the assessment. The average score on the knowledge-based questions was 95%. Ratings of perceptions and reflections of the experience were used in tandem to understand the experience. In general, students indicated the experience was positive and impactful towards their education. Students indicated they felt that the experience allowed them to better understand addiction and empathize with someone called before the board. In fact, there were fundamental differences in perceptions regarding the "addicted person," going from a penalizing and stigmatized perspective to one of caring and compassion. SUMMARY Students were knowledgeable about the board and its regulatory process after the event. More than knowledge, students indicated fundamental changes in their views of addiction. Other institutions may consider implementing similar exercises to engender empathy and professionalism regarding drug addiction and regulatory compliance.
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Affiliation(s)
- Kyle W Parker
- Ohio Northern University Raabe College of Pharmacy, 525 S. Main St., Ada, OH 45810, United States.
| | - Natalie A DiPietro Mager
- Ohio Northern University Raabe College of Pharmacy, 525 S. Main St., Ada, OH 45810, United States.
| | - Benjamin D Aronson
- Ohio Northern University Raabe College of Pharmacy, 525 S. Main St., Ada, OH 45810, United States.
| | - Christopher Hart
- Ohio Northern University Raabe College of Pharmacy, 525 S. Main St., Ada, OH 45810, United States.
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Bellottie GD, Kirwin J, Allen RA, Anksorus HN, Bartelme KM, Bottenberg MM, Dula CC, Kane TH, Lee PH, McMillan A, Riley BL, Waghel R. Suggested pharmacy practice laboratory activities to align with pre-APPE domains in the Doctor of Pharmacy curriculum. CURRENTS IN PHARMACY TEACHING & LEARNING 2018; 10:1303-1320. [PMID: 30497635 DOI: 10.1016/j.cptl.2018.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 02/26/2018] [Accepted: 06/06/2018] [Indexed: 06/09/2023]
Abstract
OUR SITUATION The Accreditation Council for Pharmacy Education outlines ability statements that pharmacy students should be able to demonstrate prior to beginning their Advanced Pharmacy Practice Experiences (APPEs). Practice laboratory courses offer extensive opportunities for students to participate in activities and assessments that enable them to meet the objectives outlined in the Pre-APPE Core Domains in Standards 2016. This review identifies selected published literature, activities, and assessment methods that can be adapted and implemented in practice laboratory courses to help achieve the abilities outlined within the Pre-APPE Core Domains. METHODOLOGICAL LITERATURE REVIEW The Medline database and journals related to pharmacy education were searched to identify activities and assessments for each domain. Search terms for each core domain were extracted from the domain titles, ability statements, and performance competencies and coupled with "laboratory" or "lab." "Pharmacy" was also added as a search term when searching the Medline database. Preference was given to example activities published in the last 15 years. Abstracts and activities based on author experience were also included. OUR RECOMMENDATIONS AND THEIR APPLICATIONS Specific examples of how activities and assessments can be included in practice laboratories to develop or refresh skills identified in the pre-APPE core domains were described. POTENTIAL IMPACT The practice laboratory setting is an ideal place for students to learn and practice the skills necessary to demonstrate readiness for APPEs. This paper serves as a resource for instructors, curriculum committees, or pharmacy programs looking for ideas to expand specific training or develop particular skill areas.
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Affiliation(s)
- Gina DeSevo Bellottie
- Department of Pharmacy Practice, Jefferson College of Pharmacy, Thomas Jefferson University, 901 Walnut Street, Suite 901, Philadelphia, PA 19107, United States.
| | - Jennifer Kirwin
- Department of Pharmacy and Health Systems Sciences, Northeastern University School of Pharmacy, Mail Stop - R218, 360 Huntington Avenue, Boston, MA 02115, United States.
| | - Rachel A Allen
- University of Washington School of Pharmacy, HSB H-375, Box 357630, Seattle, WA 98195-7630, United States.
| | - Heidi N Anksorus
- Division of Practice Advancement and Clinical Education, University of North Carolina Eshelman School of Pharmacy, CB #7574, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7574, United States.
| | - Kassandra M Bartelme
- Concordia University Wisconsin School of Pharmacy, 12800 N Lake Shore Drive, Mequon, WI, United States.
| | - Michelle M Bottenberg
- Drake University College of Pharmacy and Health Sciences, 2507 University Avenue, Des Moines, IA 50311, United States.
| | - Colleen Clark Dula
- The Ohio State University, 500 West 12th Avenue, Columbus, OH 43210, United States.
| | - Teresa H Kane
- Albany College of Pharmacy and Health Sciences, 106 New Scotland Avenue, Albany, NY 12208, United States.
| | - Phillip H Lee
- Belmont University College of Pharmacy, McWhorter Hall, 309, 1900 Belmont Boulevard, Nashville, TN 37212, United States.
| | - Ashlee McMillan
- West Virginia University, PO Box 9520, Morgantown, WV 26506, United States.
| | - Brittany L Riley
- Department of Pharmacy Practice, Administration and Research, Marshall University School of Pharmacy, 1 John Marshall Drive, Huntington, WV 25755, United States.
| | - Rashi Waghel
- Wingate University School of Pharmacy, 515 N. Main Street, Wingate, NC 28174, United States.
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20
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Smith C, Ryder P, Blais M, Schneck R. Evaluation of two different poverty simulations with professional phase pharmacy students. CURRENTS IN PHARMACY TEACHING & LEARNING 2017; 9:903-910. [PMID: 29233323 DOI: 10.1016/j.cptl.2017.05.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 02/02/2017] [Accepted: 05/20/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND AND PURPOSE Pharmacy students will interact with patients who struggle to receive the health care they need. Since attitudes can influence behavior, exposure to these struggles may positively improve patient care. This study evaluates a group of student responses to two different interventions approximately 9 months apart. The primary objectives of this study were to: (1) identify if SPENT, an online game, could alone improve students' attitudes towards those living in poverty, (2) determine if changes imparted by SPENT were retained for nine months, and (3) identify if CAPS, a live simulation, has an additional benefit. EDUCATIONAL ACTIVITY AND SETTING Student participants completed both the SPENT online game and the CAPS simulation. Students were asked to complete the Undergraduate Perceptions of Poverty Tracking Survey (UPPTS) before and after each simulation FINDINGS: Ninety-nine first year and second year professional phase pharmacy students completed both interventions and all surveys. The average pre-survey and post survey "scores" for the SPENT game were 133.52 and 135.54, a statistically significant improvement (p=0.046). When comparing the SPENT post "score" and the pre-survey score of CAPS (136.45) there was no significant difference (p=0.423). The average pre-survey and post survey "scores" for CAPS were 136.45 and 139.18, a statistically significant improvement (p=0.001). An analysis of the overall change showed a statistically significant improvement of 5.6667 (p<0.001). DISCUSSION Both the online SPENT game and CAPS live simulation interventions had positive effects on the students' empathy towards people living in poverty.
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Affiliation(s)
- Carriann Smith
- Butler University, College of Pharmacy and Health Sciences, 4600 Sunset Avenue Indianapolis, IN 46208 United States.
| | - Priscilla Ryder
- Butler University, College of Pharmacy and Health Sciences, 4600 Sunset Avenue Indianapolis, IN 46208 United States.
| | - Meghan Blais
- Butler University, College of Pharmacy and Health Sciences, 4600 Sunset Avenue Indianapolis, IN 46208 United States.
| | - Ryan Schneck
- Butler University, College of Pharmacy and Health Sciences, 4600 Sunset Avenue Indianapolis, IN 46208 United States.
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