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

Geriatric education for pharmacy students: A scoping review

BACKGROUND

Comprehensive medication management for older adults requires specific knowledge and skills. Therefore, pharmacy curricula should include appropriate strategies to prepare students for care of this population. This scoping review aimed to identify how geriatric concepts, such as geriatric topics and competencies, are included in pharmacy curricula, and to map current literature on preferred teaching and assessment methods related to geriatric pharmacy education.

METHODS

Four databases were searched to identify papers involving pharmacy learners, education, and geriatrics. Selection process was a two-step approach, involving independent title/abstract screening by two reviewers, then full-text retrieval for eligibility assessment. All types of articles were considered except opinion papers. Data extraction included details on methodology, participants, setting, educational activity, teaching method, and outcomes assessed.

RESULTS

A total of 2537 articles were identified from which 189 met the inclusion criteria: 221 documents after citation and gray literature searching. Articles were grouped for analysis as education-related intervention articles (studies, n = 100 or descriptive articles/case reports, n = 49), studies not including an education-related intervention (n = 49), and others (e.g., reviews, position papers/statements, n = 23). Various teaching methods were reported including experiential, didactic, interprofessional, or simulation. Most articles reported positive outcomes on skills, knowledge, or attitudes, but few articles used a validated assessment tool. Curricula and student's surveys were consistent with suboptimal geriatric education, with few programs offering mandatory dedicated geriatric courses or rotations.

CONCLUSIONS

Gaps remain regarding geriatric inclusion in pharmacy curricula despite decades of evidence, advocacy, and frameworks to guide its development. A wide diversity of teaching methods has been described and their combination may be considered for skills and competency development. There is a need for the scholarship of teaching and learning to be applied to pharmacy programs in order to prepare future pharmacists for an aging society.

Development and validation of a performance-based palliative care assessment tool for student pharmacists

INTRODUCTION

Integration of hospice and palliative care principles within pharmacy curricula is essential to fill the need of pharmacist training in this growing specialty. A formalized assessment tool to evaluate skill development does not exist for student pharmacists specific to palliative care. The objective of this study was to develop a valid and reliable, palliative care-focused, performance-based assessment tool for student pharmacists.

METHODS

Eight academic palliative care (PC) pharmacists were recruited for the workgroup to perform domain development, validation, tool creation, and reliability testing for this performance-based assessment tool. Hospice and palliative care clinical pharmacist entrustable professional activities (EPAs) served as the framework. Content validity testing utilized content validity index and scale universal agreement (S-CVI/UA) to determine level of agreement for activities included in the tool. Student volunteers completed a standardized patient case and workgroup members served as raters during the reliability testing phase. Interrater reliability was measured through calculation of Fleiss Kappa scores for each activity.

RESULTS

Out of 14 EPAs, nine were deemed "essential" to include in the tool. Thirty-four supporting activities for the nine essential EPAs were drafted. Two rounds of content validity testing were necessary to achieve S-CVI/UA of 0.9593. Consensus was reached from workgroup members for activities deemed necessary to include in the tool after questionnaire distribution utilizing a Fleiss Kappa cutoff >0.6.

CONCLUSIONS

This validated tool will afford colleges and schools of pharmacy with PC curricula an opportunity to assess student achievement of PC-specific skills and evaluate curricular effectiveness.

Palliative care education in an Australian undergraduate pharmacy curriculum: an exploratory descriptive study

Objectives

To examine the self-perceived knowledge, confidence and preparedness of undergraduate pharmacy students to provide palliative care.

Methods

A descriptive exploratory analysis was conducted in 2021 at an Australian university involving final-year pharmacy students (n = 200) who were provided with the opportunity to complete a survey on self-perceived knowledge, confidence and preparedness overall and with respect to a range of graduate capabilities which are essential to provide care in palliative care settings. Key capability areas include: communication, showing empathy, making clinical judgements and self-reflection. This was measured using the Palliative Care Curriculum for Undergraduates Questionnaire which was distributed electronically. Descriptive statistics were undertaken and Mann–Whitney U tests were used to explore any differences in outcomes with respect to factors related to demographics, personal experience and education. Thematic analysis was utilised for qualitative data.

Key findings

Forty-five percent of the student cohort (n = 89) responded, 70% of whom were female, and the median age for students was 22 years. Median scores (interquartile range) were modest for overall self-perceived knowledge: 5.0 (3.0–5.0), confidence: 4.0 (3.0–5.0) and preparedness: 4.0 (2.5–5.0). Students who had participated in learning about palliative care through clinical placements (n = 25, 28%), self-directed learning activities (n = 18, 20%) or case-/problem-based learning (n = 14, 16%) demonstrated a statistically significant increase in overall preparedness (P = 0.017), confidence with specific capabilities including evidence-based practice (P = 0.013), responding to medication queries (P < 0.05) and managing symptoms other than pain (P = 0.018).

Conclusions

Findings suggest students were confident to manage symptoms and medication-related issues but less confident to address distress or discuss sensitive matters with patients and their families. There may be a need for greater exposure and practical experience in palliative care settings.