Long-Term Retention of Advanced Cardiovascular Life Support Knowledge and Confidence in Doctor of Pharmacy Students

OBJECTIVE

This study aimed to evaluate the impact of American Heart Association (AHA) advanced cardiovascular life support (ACLS) education and training on long-term retention of ACLS knowledge and confidence in Doctor of Pharmacy (PharmD) students.

METHODS

This multicenter study included PharmD students who received ACLS training through different means: 1-hour didactic lecture (didactic), 1-hour didactic lecture with 2-hour skills practice (didactic + skills), and comprehensive AHA ACLS certification through an elective course (elective-certification). Students completed a survey before training, immediately after training, and at least 6-12 months after training to assess demographics and ACLS confidence and knowledge. The primary outcome was a passing score, defined as ≥ 84% on the long-term knowledge assessment. Secondary outcomes included overall knowledge score and perceived confidence, assessed using the Dreyfus model.

RESULTS

The long-term assessment was completed by 160 students in the didactic group, 66 in the didactic + skills group, and 62 in the elective-certification group. Six (4%), 8 (12%), and 14 (23%) received a passing score on the long-term knowledge assessment in the didactic, didactic + skills, and elective-certification groups, respectively. The median (IQR) scores on the long-term knowledge assessment were 50% (40-60), 60% (50-70), and 65% (40-80) in the 3 groups. On the long-term assessment, confidence was higher in the elective-certification group, demonstrated by more self-ratings of competent, proficient, and expert, and fewer self-ratings of novice and advanced beginner.

CONCLUSION

Long-term retention of ACLS knowledge was low in all groups, but was higher in students who received AHA ACLS certification through an ACLS elective course.

The impact of synchronous hybrid instruction on students’ engagement in a pharmacotherapy course

Background:

Synchronous hybrid instruction offers flexible learning opportunities by allowing a portion of students to attend class sessions on campus while simultaneously allowing the remaining students to attend remotely. Although such flexibility may offer a number of advantages for pharmacy students, one area of concern is whether online participation options within synchronous hybrid courses can promote similar levels of engagement as courses that are designed entirely for face-to-face (FTF) participation.

Objectives:

The objective of this study was to evaluate the impact of synchronous hybrid instruction on pharmacy students’ engagement in a pharmacotherapy course. An evaluation was completed to determine if students were more likely to actively engage in class when they were participating remotely via teleconferencing technology or when FTF. Additionally, students’ perspectives were evaluated to determine their views of the benefits and challenges of the hybrid model for engagement in learning.

Methods:

The course utilizes team-based learning to apply critical thinking skills and develop a comprehensive care plan. A mixed methods approach was used to examine students’ engagement in the hybrid learning environment by quantitatively analyzing students’ responses to likert-scale survey items and qualitatively analyzing their responses to open-ended survey questions.

Results:

Students reported they were more likely to actively listen (p=0.004), avoid distractions (p=0.008), and react emotionally to a topic or instruction (p=0.045) when FTF. There were no significant differences found in student reported note taking, asking questions, responding to questions, or engaging in group work between the two modes of participation. Content analysis identified other benefits that supported student engagement, including perceived flexibility and enhanced ability to interact during class via the teleconferencing technology. For some students, challenges that negatively impacted engagement included difficulties with internet connectivity and a sense of dislocation or isolation in the course.

Conclusion:

This study demonstrated that when participating in a synchronous hybrid course, students participating remotely were less likely (compared to in-person attendance) to pay close attention and react emotionally, but were just as likely to take notes and communicate with teachers and groups. Key benefits of the hybrid approach were increased flexibility and the usefulness of online communication tools, while key challenges focused on technical and psychological isolation from others. The principles of flexible learning environments and self-regulated learning provide opportunities for pharmacy educators who are interested in improving hybrid instruction in the future.

Doctor of pharmacy student preferences for computer-based vs. paper-and-pencil testing in a, social and administrative pharmacy course

INTRODUCTION

The use of online learning and subsequent online testing has expanded rapidly in pharmacy programs across the United States. Numerous published studies have compared online learning with traditional methods in pharmacy. However, no such studies have been published in pharmacy. This study's objective is to compare first-professional year student preferences for computer-based vs. traditional paper-and-pencil testing for a required social and administrative pharmacy class.

METHODS

All students enrolled in the class were invited to complete one brief survey at the end of the semester to determine their testing preference.

RESULTS

Of the 138 first-professional year students completing the survey, 79% (109 of 138) preferred computer-based testing, 9% had no preference, 6% (8 of 138) preferred paper-and-pencil testing, and the remainder (8 of 138) stated it depended on what was being tested. Ninety-one percent of students did not perceive the testing method to impact their grades. Students preferred computer-based testing over traditional paper-and-pencil as a convenient testing method (mean 4.73 vs. 3.4, P < .001), providing immediate feedback (mean 4.87 vs. 1.91, P < .001), and as a more effective testing method (mean 4.57 vs. 3.96, P < .001).

CONCLUSIONS

First-professional year students preferred computer-based over traditional paper-and-pencil testing for a social and administrative science class, with the method of testing not perceived to impact grade. This finding is timely, given the recent required transitioning of all pharmacy classes and subsequent testing to an online format due to the coronavirus disease of 2019 pandemic.

Pharmacist perceptions of CliftonStrengths® themes important for success in advanced cardiovascular life support

WHAT IS KNOWN AND OBJECTIVE

Advanced Cardiovascular Life Support (ACLS) is an integrated, team-based approach to optimizing patient outcomes during acute cardiovascular events. Due to the fast-paced, high-stress environment, inherent strengths may impact performance and confidence with ACLS skills. The objective of this study was to assess pharmacist perceptions regarding strengths deemed important during emergency cardiovascular response.

METHODS

An electronic survey was administered to members of the American College of Clinical Pharmacists Critical Care, Cardiology, Internal Medicine, Emergency Medicine and Pediatrics Practice and Research Network listservs. The survey assessed the top 5 strengths deemed important for being part of an emergency response team, a pharmacist's role in ACLS and a team leader's role in ACLS. The primary outcome was top strengths required for pharmacist involvement in ACLS. Descriptive statistics were used to present survey results.

RESULTS

Of the 359 responses included, nearly all respondents had been certified by the American Heart Association in ACLS and/or Pediatric Advanced Life Support (PALS). The top CliftonStrengths^® themes considered important for a pharmacist's role in ACLS were communication, adaptability, analytical, focus and responsibility. The top CliftonStrengths^® themes considered important for the team leader's role in ACLS were communication, command, analytical, focus and adaptability. The top CliftonStrengths^® themes important for an emergency response team were communication, adaptability, focus, analytical and command.

WHAT IS NEW AND CONCLUSIONS

By determining the personality traits perceived to be associated with high performance in ACLS, approaches can be taken to personalize student learning in order to train "practice-ready" pharmacists that can be integral members of the ACLS team.

Self-perceived knowledge and confidence regarding infectious diseases of advanced pharmacy practice experience students

INTRODUCTION

Knowledge in infectious diseases (ID) pharmacotherapy and antimicrobial stewardship is becoming increasingly important for pharmacists. Pharmacy schools utilize multiple methods to teach ID pharmacotherapy including advanced pharmacy practice experiences (APPEs).

METHODS

An internet-based survey was sent to students currently on APPEs at four colleges/schools of pharmacy. The primary study objective was a comparison of self-perceived ID knowledge and confidence prior to starting and during APPEs. The secondary objectives were to determine the level of self-perceived knowledge and confidence of students who have completed an ID APPE to those who have not, as well as the level of interest in postgraduate year 1 (PGY-1) and ID-specific postgraduate year 2 (PGY-2) residencies.

RESULTS

All statements revealed a statistically significant increase in self-perceived ID knowledge and confidence for students during APPEs compared to before starting rotations (p-values < 0.001). Students who completed an ID APPE had an overall increase in both self-perceived knowledge and confidence for all aspects. Completion of an ID APPE enhanced self-perceived knowledge in basic microbiology fundamentals, antimicrobial stewardship principles, and overall ID knowledge. Completion of an ID APPE created a higher level of confidence regarding selecting appropriate antimicrobial therapy, interpreting cultures and susceptibilities to de-escalate, and communicating with other healthcare professionals.

CONCLUSIONS

Students who completed an ID APPE had a higher level of self-perceived knowledge and confidence than those who had not. Recent increases in demand for antimicrobial stewardship positions warrants maximization of ID and non-ID APPEs to enhance students' knowledge and confidence in infectious diseases.

Using debates as the primary pedagogy to teach critical care in a PharmD curriculum elective course

BACKGROUND AND PURPOSE

Debate is a pedagogy that incorporates deeper learning and has been used in many areas of healthcare and higher education. Debates have primarily been described within a course, but not as the predominant pedagogy for a course, particularly in pharmacy education or critical care instruction.

EDUCATIONAL ACTIVITY AND SETTING

Debating the Evidence was a two-credit hour course taught by debate-style pedagogy on an extended campus to third year pharmacy students in a four-year curricular program. The class met weekly for two hours over 15 weeks, and students came prepared to debate preselected topics. Focus groups for students enrolled over two years were conducted to gauge students' perceptions of this course structure.

FINDINGS

The debate-dominant course structure seemed to increase accountability of learning, pre-class preparation, and in-class engagement. Students had difficulty debating with lower quality evidence, but were able to use physiologic reason and adverse effect profiles when robust literature was lacking. All students enrolled over two course offerings consented and participated in the focus groups. Themes identified across both semesters included: 1) efficiency with accessing and evaluating drug literature, 2) increased understanding of an individualized patient-centered approach, and 3) an appreciation for patient care in the acute setting.

SUMMARY

An entirely debate-style critical care elective course was perceived to be beneficial to students. Scalability and impact on student learning requires further assessment.

Evaluation of affective domain elements in a new pharmacy practice course

INTRODUCTION

In 2016, new Accreditation Standards were implemented that required integration of affective domain elements (ADEs) into the Doctor of Pharmacy (PharmD) curriculum and admissions interview process. The purpose of this study is to analyze the relationship between admissions variables and performance in a new course, and to analyze the relationship between student self-assessment and faculty evaluation of their development and performance in ADEs.

METHODS

Pre-pharmacy admission variables were evaluated for correlations with student performance in ADEs. Student self-assessments and faculty evaluations of performance in ADEs were also analyzed.

RESULTS

Statistically significant positive correlations were found between student age and completion of at least a bachelor's degree with student self-assessment in communication and leadership. When evaluating faculty assessment, significant positive correlations were found for female performance in the areas of leadership and team readiness. There was a positive association between the Pharmacy College Admission Test (PCAT) quantitative score and performance in professionalism; while negative associations were seen between the PCAT comprehensive score and student self-assessment in self-awareness and professionalism, and between the PCAT quantitative score and student self-assessment in self-awareness (p < 0.05 for all). Median evaluation ranks by faculty members were significantly lower than the median self-evaluation ranks done by students.

DISCUSSION AND CONCLUSION

This study suggests careful analysis of admissions variables in relation to ADEs may offer PharmD programs insight into how they design educational activities related to the affective domain. Additionally, evaluating multiple observations by both students and faculty members may identify patterns of growth and development in ADEs.

Medicine Pharmacy Interprofessional Exercise Pilot: Lessons Learned

This article was migrated. The article was marked as recommended. The Association of American Medical Colleges and the American Association of Colleges of Pharmacy with leaders of other health professions formed the Interprofessional Education Collaborative (IPEC) in 2009. Interprofessional education (IPE) is now a component of accreditation standards for academic programs in both medicine and pharmacy. While geographically separated, the Medical College of Georgia (Augusta University) and the College of Pharmacy (University of Georgia) have over 40 year history of collaboration but never intentionally added joint curricular offerings.To address IPE competencies, we developed and evaluated a medicine pharmacy collaborative exercise. Specifically, to compare the attitudes and perception toward interprofessional education and practice of students from two disciplines. An observational cross sectional study with 208 third year medical (M3) students and 108 third year pharmacy (P3) students was conducted in two consecutive academic years. Groups consisted of 6-8 M3 and 3-4 P3 students from all campuses across the state. The M3 student was to choose a patient they had seen who was taking at least 3 prescription medications. Objectives for students were to discuss the case (medications, side effects, cost, pharmacogenetics, drug-drug interactions, and cost effectiveness). A report of M3-P3 findings was to be submitted for grading by the Pharmacy faculty. Once the exercises were completed surveys were distributed and the de-identified data was analyzed in relation to IPEC competencies. The study was conducted in one academic year and 316 responses were obtained. Within medical students 48.2 % agreed and 21.2 % strongly agreed to consult with Pharm D in the future. Perception of leadership in the groups was shifted more toward pharmacy students (56.5% vs. 27.4%, p<0.0001). Students confidence in working with other professionals was improved more for pharmacy students than medical students (50.0% in P3 and 30.2% in M3 p =0.0014). Communication skills improved more in P3 than M3 (48.2% in P3 and 28.3% in M3, p=0.0043). More research is needed on equal adoption of IPE by medical and pharmacy students. Emphasis should be made on equal state of training (theory vs. clinical) on both sides with focus on working as a team and value of each team member. More direct involvement in patient care is needed with both M3 and P3 having face to face contact with patients and each other.

Evaluating the Effects of Flexible Learning about Aseptic Compounding on First-year Students in a Pharmacy Skills Laboratory

OBJECTIVE

To evaluate how flexible learning via online video review affects the ability and confidence of first-year (P1) pharmacy students to accurately compound aseptic preparations.

DESIGN

Customary instructions and assignments for aseptic compounding were provided to students, who were given unlimited access to 5 short review videos in addition to customary instruction. Student self-confidence was assessed online, and faculty members evaluated students' aseptic technique at the conclusion of the semester.

ASSESSMENT

No significant difference on final assessment scores was observed between those who viewed videos and those who did not. Student self-confidence scores increased significantly from baseline, but were not significantly higher for those who viewed videos than for those who did not.

CONCLUSION

First-year students performed well on final aseptic compounding assessments, and those who viewed videos had a slight advantage. Student self-confidence improved over the semester regardless of whether or not students accessed review videos.

A novel NGFB point mutation: a phenotype study of heterozygous patients

OBJECTIVE

A family with neurological findings similar to hereditary sensory and autonomic neuropathy type V having a point mutation in the nerve growth factor beta (NGFB) gene was recently described. The homozygous genotype gives disabling symptoms. The purpose of the present study was to evaluate the symptoms in heterozygous patients.

METHODS

26 patients heterozygous for the NGFB mutation (12 men, mean age 50 (13-90) years) were examined clinically and answered a health status questionnaire, including the Michigan Neuropathy Screening Instrument (MNSI). 28 relatives (15 men, mean age 44 (15-86) years) without the mutation served as controls in the clinical examination part. 23 of the heterozygotes were examined neurophysiologically and six heterozygous patients underwent a sural nerve biopsy.

RESULTS

The heterozygous phenotype ranged from eight patients with Charcot arthropathy starting in adult age and associated with variable symptoms of neuropathy but without complete insensitivity to pain, anhidrosis or mental retardation, to 10 symptom free patients. There was no difference in MNSI between the young heterozygous cases (<55 years old) and the controls. Six of 23 heterozygous patients had impaired cutaneous thermal perception and 11 of 23 had signs of carpal tunnel syndrome. Sural nerve biopsies showed a moderate reduction of both small myelinated (Adelta) and unmyelinated (C) fibres. No apparent correlation of small fibre reduction to symptoms was found.

CONCLUSIONS

The NGFB mutation in its heterozygous form results in a milder disease than in homozygotes, with a variable clinical picture, ranging from asymptomatic cases to those with Charcot arthropathy appearing in adult age. Particularly age, but perhaps lifestyle factors also, may influence the development of clinical polyneuropathy.

Guidelines for the prevention of endocarditis: report of the Working Party of the British Society for Antimicrobial Chemotherapy

These guidelines have been produced following a literature review of the requirement for prophylaxis to prevent bacterial endocarditis following dental and surgical interventions. Recommendations are made based on the quality of available evidence and the consequent risk of morbidity and mortality for "at risk" patients.

Hospital versus home care for the acutely mentally ill? Preferences of caregivers who have experienced both forms of service

OBJECTIVE

Demonstration studies of community treatment as an alternative to hospitalization have reported high degrees of satisfaction by family carers. We aimed to determine the extent of carer preference for hospital versus community treatment for acute mental illness in a routine setting where carers had experienced both service types.

METHOD

Patients who had contact with both a hospital inpatient service and a Crisis Assessment and Treatment (CAT) team within the previous 5 years were identified. Seventy-seven family carers of these patients completed a questionnaire which identified their preference for services, and psychological and demographic variables likely to be predictive of their choice.

RESULTS

Only half the carers preferred a CAT service to treat their relative in the event of a future relapse. Psychological variables were better predictors of choice than were demographic variables.

CONCLUSIONS

The proportion of caregivers who prefer community treatment for acute psychosis may be smaller than previously thought. The lower carer satisfaction found here may be associated with the short-term interventions of Victoria's CAT teams, the severity of acute relapses and the duration of the patient's mental health problem.