Use of the Virtual Simulation Tool 'MyDispense' By Pharmacy Programs in the United States

Teaching and Assessing Pharmacy Students in Medication-Use Process Stewardship

OBJECTIVE

The medication use system is a complex process of medication prescribing, order processing, dispensing, administration, and effects monitoring. Objectives of this review are to describe the available literature and identify resources for educating and assessing pharmacy students in Medication-use Process Stewardship.

FINDINGS

In 2013, the Center for the Advancement of Pharmacy Education (CAPE) published educational outcomes (EOs) including Medication-use Systems Management (CAPE 2.2, Manager). In 2022, the EOs for pharmacy education were updated and integrated with Entrustable Practice Activities (EPAs) as Curriculum Outcomes and Entrustable Practice Activities (COEPA). During this evolution the revised Medication-use Process Stewardship (COEPA 2.6, Steward) de-emphasized process management while focusing more on stewardship of the Pharmacists' Patient Care Process (PPCP), person-centered care and optimizing patient outcomes, and environmental impact of medication-use systems. A literature review identified 41 articles relevant to pharmacy education and assessment of medication-use concepts. Most available literature is aligned with CAPE 2013 domain 2.2 Manager, not COEPA 2.6 Steward. Many articles reported innovations in teaching and assessment, such as simulation in prescription verification and Objective Structured Clinical Examinations (OSCEs). Few articles reported on prescription verification and dispensing in non-community settings.

SUMMARY

The change from management to stewardship in COEPA 2.6 has significant curricular implications with the emphasis moving from process- to person-centered care. However, continued integration of process-centered activities throughout the curriculum is essential to fully prepare graduates for entry level practice. Future research is needed to identify approaches for teaching and assessing stewardship and the environmental impact of medication use systems.

Evaluating the use of virtual simulation training to support pharmacy students' competency development in conducting dispensing tasks

BACKGROUND

The incorporation of digital health technologies in undergraduate teaching, such as the MyDispense program, provides a simulated opportunity to support students' competency development in dispensing tasks.

OBJECTIVE

This study aimed to evaluate the impact of using MyDispense, an online pharmacy simulation platform, on pharmacy students' self-reported reaction, learning, and accuracy in performing dispensing tasks.

METHODOLOGY

16 MyDispense cases simulating real-practice scenarios from prescription dispensing and verification to patient counseling were created for 55 professional year 1 pharmacy students as part of a professional skills course. A pre-post survey, nestled on Kirkpatrick's Model of Training Evaluation, was conducted on participants in the cohort to evaluate how the incorporation of MyDispense supported their development of dispensing tasks. A virtual formative assessment was also done using MyDispense to compare students' self-reported accuracy with faculty assessment scores to evaluate how MyDispense can support students' knowledge and metacognitive abilities in dispensing.

RESULTS

The study showed an increase in students' confidence after using MyDispense, which led to an increase in the "learning" level of Kirkpatrick's Model. However, small changes were observed in other levels and sublevels of Kirkpatrick's Model. A notable discrepancy was observed between students' self-assessment scores and faculty assessment scores, with students overestimating their performances. Correlation analysis showed a weak relationship between students' self-assessment scores and the learning level of Kirkpatrick's Model.

CONCLUSION

This study highlights the positive impact of MyDispense on pharmacy students' confidence in dispensing. However, virtual simulation training may be best incorporated when students have exposure to experiential training placements, to maximize the learning outcomes and knowledge in dispensing processes.

Virtual self-care simulations for third-year pharmacy skills laboratory courses in three institutions

BACKGROUND AND PURPOSE

This study was designed to determine whether a virtual, self-care activity improved knowledge and confidence in third-year student pharmacists.

EDUCATIONAL ACTIVITY AND SETTING

Third-year student pharmacists (n = 386) from three institutions participated in the virtual self-care simulation during their respective practice laboratory course. A pre- and post-assessment collected 10 knowledge and five confidence questions, self-reported on 0-100 scale, mapped to learning outcomes and pharmacy standards. Responses for participants who provided consent and had linked assessments were analyzed. Additionally, students participated in a perception assessment following the simulation with the post-assessment. Each knowledge question was scored as binary (correct/incorrect), presented as percentage, and significance identified with a McNemar's test. Total knowledge score and confidence changes were presented as means with standard deviations and significance with a paired t-test. Student perceptions were presented as frequencies and percentages.

FINDINGS

Total knowledge assessment demonstrated a significant improvement (p < 0.001) for the entire cohort of 198 study participants. Upon additional analysis, a single institution led the cohort to significant increase, with variable improvement and significance for each individual question. Confidence improved for the entire cohort of students and at each institution individually. The students perceived the virtual self-care activity favorably.

SUMMARY

The third-year student virtual self-care activity improved knowledge and confidence with varying significance between institutions. Future studies will focus on the impact of continued reinforcement of self-care activities on student growth in knowledge and confidence.

A comparison of in-person vs. asynchronous learning with self-care patient cases

BACKGROUND AND PURPOSE

To evaluate the effectiveness of a live laboratory setting compared to an asynchronous session in a crossover teaching design on knowledge and confidence in self-care review topics.

EDUCATIONAL ACTIVITY AND SETTING

Pharmacy students (n = 88) participated in a crossover designed laboratory session where they either attended a live, active-learning laboratory session on self-care review topics, followed by a virtual, asynchronous self-care simulation or vice versa. Sessions were held one week apart. Pre- and post-assessments were administered that contained knowledge and confidence questions as well as student perceptions on the teaching modalities.

FINDINGS

Of the 88 students who participated in the study, 67 (76.1%) were included in the study findings. Post-assessment knowledge and confidence significantly increased after both the live, active-learning session and the asynchronous simulation. The majority of students (85%) indicated that they preferred the in-person activity.

SUMMARY

Students preferred the live, active-learning laboratory for reviewing self-care concepts. However, knowledge and confidence improved using either teaching modality, therefore, in institutions where resources are limited, the virtual, asynchronous activity may be useful especially if facilitators and/or budget are limited.

An accelerated dispensing course for grad entry students - Can we teach dispensing skills over a day?

BACKGROUND AND PURPOSE

This study aimed to evaluate an accelerated dispensing course for graduate entry (GE) pharmacy students with prior science-related degrees to join undergraduate (UG) students in year three of the Monash Pharmacy degree.

EDUCATIONAL ACTIVITY AND SETTING

A one day accelerated dispensing course using MyDispense software was delivered to 59 GE students. The accelerated dispensing course was identical to the standard three-week dispensing course delivered to UG students. The same assessment of dispensing skills was conducted after course completion for both UG and GE students and included dispensing four prescriptions of varying difficulty. The assessment scores of the UG and GE students were compared. Perception data from the accelerated course were also collected.

FINDINGS

The accelerated dispensing curriculum was well received by students. They found the simulation relevant to practice, easy to navigate, and helpful for preparing them for assessment. Overall, 5.1% of GE students failed the assessment, which was lower than the 32.6% failure rate in the UG cohort. Comparison of assessment grades between UG and GE students showed no notable disadvantage to attainment of learning outcomes with the accelerated curriculum. However, UG students were more likely to provide unsafe instructions compared to GE students in their labeling for three out of four prescriptions.

SUMMARY

An accelerated dispensing curriculum can be effectively delivered to mature learners with a prior science-related degree as no notable deficiencies were identified when comparing the assessment results of GE students against UG students when both student cohorts undertook the same dispensing assessment.

A systematic review on the use of virtual patient and computer-based simulation for experiential pharmacy education

Background

Simulation use is rapidly expanding, with technologies like virtual patients (VPs) and computer-based simulation (CBS) allowing for educators to equip pharmacy students with the necessary skills that are aligned with the demands and expectations of a practicing pharmacy professional. These technologies enable pharmacy students to be exposed to challenging or infrequent patient case scenarios in an authentic pharmacy setting. This allows for the reinforcing of care processes and for techniques and crucial skills to be applied.

Aim of the study

To consolidate the existing evidence regarding the utilization of VPs and CBS in preparing and supporting students in pharmacy experiential education and evaluate the effectiveness of these approaches in enhancing student pharmacists' learning outcomes, including knowledge, skills, confidence, enjoyment, and engagement.

Methods

Five electronic databases were searched using combined keyword and indexing terms (when available) with Boolean operators for the literature search. Studies that reported or investigated the use of VPs and CBS in pharmacy experiential education were included. Data on study design, demographics of participants, information on the interventions, course/skills, primary and secondary outcomes, and qualitative findings were extracted.

Results

A total of 911 unique articles were initially identified and filtered down to 19 articles fitting within the inclusion criteria. The selected 19 articles involved student pharmacists (Y1-Y5) and pre-registered pharmacists from ten countries. Simulation tools were used in various pharmacy courses, including Advanced Pharmacy Practice Experience (APPE), Advanced Pharmaceutical Care II, and Medication Management. Implementing these tools in pharmacy experiential education demonstrated a statistically significant improvement in student knowledge (p < 0.05). Most students agreed/strongly agreed that practicing with virtual patient cases enhanced their clinical reasoning, counseling skills, confidence in communication, and attitudes toward the courses.

Conclusions

This systematic review supports the use of VPs and CBS in pharmacy experiential education and provides practical recommendations for educators including selecting suitable tools, implementing them strategically within courses, integrating them with existing activities, and considering financial and IT support.

Expansion of MyDispense: A Descriptive Report of Simulation Activities and Assessment in a Certified Pharmacy Technician Training Program

BACKGROUND

Yale New Haven Health (YNHH) implemented a pharmacy technician training program in 2016. The curriculum includes 14 weeks of combined didactic and simulation hours (280 h in total), followed by 360 h of experiential learning. MyDispense, an online pharmacy simulation, allows students to develop and practice their dispensing skills in a safe environment with minimal consequences for mistakes. We describe a novel innovation, expanding the functionality of MyDispense to the training of pharmacy technicians.

METHODS

Technician training coordinator, supervisor, faculty members with experience in MyDispense, and experiential pharmacy students created cases within the MyDispense software that were targeted towards pharmacy technician activities. Activities were aligned with current American Society of Health-System Pharmacists (ASHP)-Accreditation Council for Pharmacy Education (ACPE) Accreditation Standards for pharmacy technician education and training programs.

RESULTS

A total of 14 cases were developed to be utilized in student technician training, and account for approximately 14 h of simulation.

CONCLUSIONS

MyDispense is an innovative software that could allow students to access and complete exercises, and to continue developing dispensing skills in a safe, remote environment. We identified similarities between activities performed by student pharmacists and student pharmacy technicians, expanding MyDispense to a new learner group to practice, develop and be assessed on dispensing skills within their scope, as part of a formal technician training program and in preparation for the Pharmacy Technician Certification Examination (PTCE).

Incorporation of MyDispense, a Virtual Pharmacy Simulation, into Extemporaneous Formulation Laboratories

A core competency of Australian Pharmacy graduates is to prepare and compound extemporaneous formulations. Students in our pharmacy course would traditionally formulate extemporaneous products in laboratory classes while simultaneously preparing a handwritten label, with students divorcing this laboratory activity from the entire dispensing process. As a way to incorporate the dispensing process into the preparation of extemporaneous products without adding excessive time to the laboratory, we integrated MyDispense, a virtual pharmacy simulation, in pre-laboratory activities. This meant that students could complete all the dispensing activities for prescribed extemporaneous formulations prior to attending the laboratory. Prescriptions for solutions, suspensions, creams and ointments were developed in MyDispense, including essential components for dispensing an extemporaneous formulation (e.g., formulation name, dosing instructions). These prescriptions were provided to students at least 1 week prior to their laboratory classes, whereas for the laboratory assessments, the prescription was provided at the commencement of the extemporaneous exam. Due to the implementation of dispensing via MyDispense, we found that students demonstrated pre-laboratory engagement as all students presented their printed labels upon entering the laboratory. We also observed an increase in interaction between students and laboratory facilitators, mainly focused on the principles of formulation integrated around patient outcomes. Virtual simulations such as MyDispense can therefore provide a guided realistic learning experience, whilst overcoming time pressures associated with laboratory timetabling. This approach also encourages students to engage in the dispensing process prior to extemporaneous laboratories providing more opportunity to discuss higher-level formulation principles and patient-centred outcomes during laboratory classes.