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 The University of Charleston School of Pharmacy (UCSOP), located in Charleston, West Virginia, began admitting students in 2006 and graduated its first.

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Presentation on theme: " The University of Charleston School of Pharmacy (UCSOP), located in Charleston, West Virginia, began admitting students in 2006 and graduated its first."— Presentation transcript:

1  The University of Charleston School of Pharmacy (UCSOP), located in Charleston, West Virginia, began admitting students in 2006 and graduated its first class in May 2010. The program is fully accredited by the Accreditation Council for Pharmacy Education (ACPE).  The school’s original curriculum was organized around a series of modules that integrated content from pathophysiology, pharmacokinetics, pharmacology, medicinal chemistry, and pharmacotherapy. These topics related to a particular body system, a concept such as self-care, or a specific patient population.  After two years of teaching the module curriculum, the design was modified to reflect a more traditional, sequential approach to content delivery, with discrete courses representing each discipline. This modification necessitated expansion and/or consolidation of previously offered courses and raised the question as to whether or not students were successfully integrating the didactic content.  Current P4 students (2011-2012) were the first to complete the reconfigured curriculum. Faculty initiated this study to validate that students were able to apply knowledge and skills attained in the first two years of the curriculum to experiential education activities in the P3 year. This study represents a faculty group’s effort to demonstrate that integration is occurring and to substantiate the effectiveness of the revised curriculum. The purpose of this study was to determine if students exposed to a traditional non-integrated course curriculum are able to integrate and apply P1 and P2 basic science, clinical and communication skills to selected patient activities in a P3 clinical rotation.  In PHAR 716L P3 IPPE, students were assigned to work with Professor Barbara Smith, a UCSOP faculty member, at Roane General Hospital (RGH), a small community hospital. Half of the class was assigned to the fall semester and the other half to the spring semester; students were further divided into three groups, with each group traveling to the site three times to work seven hours each trip. Over the semester, students provided pharmaceutical care to patients in the RGH Diabetes Management Program, Roane General Medical Clinic, the RGH Fitness Complex, Roane County Committee on Aging, and the Miletree Center (a long-term care facility).  In this study, students were involved in seven activities, including: carrying out patient interviews to obtain a medical history, measurement of blood pressure, obtaining a blood glucose reading, completion of a Brown Bag medication review, interpretation of findings and explanation to patient, presentation of a patient case to faculty and students, and preparation of patient education materials.  Student Survey: Students completed a 35 question survey to determine retrospectively their use of information gained from P1 and P2 courses (Table 1) as they worked with patients in the P3 IPPE course. Students were asked to respond to four questions as these pertained to the 7 competencies listed above. For each activity, students were asked to respond to four questions: 1.Review the Pharmacy curriculum and identify in which courses in your P1 and P2 years (list attached) you learned either the knowledge and/or skills necessary to conduct this activity, i.e. interview, blood pressure, etc. 2.In preparing to conduct this activity (interview, blood pressure, etc.) did you refer back to materials from courses in your P1 or P2 curriculum? If so, please identify these: 3.Please identify any resources other than information presented in (P1 or P2) Pharmacy courses that you consulted to be able to conduce this activity (interview, blood pressure, etc.) 4.What other information would have been helpful for you to have had in the Pharmacy curriculum to be better prepared to conduct this interview? Be as specific as possible: As part of the survey, students were asked to respond to a short series of questions to determine their confidence levels in the above activities. Surveys were administered using Constant Contact software. Students who took the P3 IPPE in the spring semester were allowed time in class to complete the survey if they chose to participate in the study, or they could take it later outside class. Students who were enrolled in the course in the fall semester were allowed to take the survey during the same time period that the spring students took the survey, but those students were sent an email with a link to the survey.  Syllabus analysis: Syllabi were collected from all courses that the students were required to take during their P1 and P2 years. Syllabi were analyzed to determine which content directly related to the seven competencies highlighted in this study. The content was identified from both topical lists of lectures and from assignments in the course. For example, if a course had an oral presentation assignment, then that course was identified as related to preparing students to present case studies.  Student responses to these questions were tabulated and compared with syllabi content analysis as depicted in the Results section of this poster.  This project was approved by the University of Charleston Institutional Review Board (IRB): #11-0021. FROM CLASSROOM TO CLINICAL AND BEYOND. Barbara D. Smith, RPh, CDE, Michelle L. Herdman, PhD, Sandra S. Bowles, EdD, RN, CNE, University of Charleston School of Pharmacy, Charleston, WV. BACKGROUNDOBJECTIVEMETHODOLOGYDISCUSSION & CONCLUSIONSRESULTSACKNOWLEDGEMENTS The faculty member working with these students made direct observations of student interactions, patients completed questionnaires related to their experience, and students completed a self-report of their experience. From the student self-report tool, it was apparent that students enjoyed this experience and viewed it as a valuable learning opportunity as they shared the following comments: “... we were able to apply our knowledge and skills as well as get more hands on practice with blood pressure and blood glucose readings.” “A patient said we made her day by taking her B/P and glucose and the value was within goal.” “... it was gratifying for me to talk to an actual patient who needs help.” “I became more comfortable in reviewing patient’s charts and finding pertinent information.” “... it was helpful to let people know what the glucometer readings actually meant. It was also helpful to review charts and put practical use to knowledge learned in class.” “Applied what I’ve learned and love interacting with patients.” “Definitely got to practice what I learned in class.” Roane General Hospital Roane General Medical Clinic Dr. Maria Kessell Dr. Grant Parkins Dr. Kenneth Seen Roane County Committee on Aging The Fitness Complex Miletree Center Class of 2012 students that participated in the study UCSOP faculty members that shared syllabi for the study STUDENT COMMENTS RESULTS  A majority of students reported increased confidence levels in conducting patient interviews, taking an accurate blood pressure, performing a blood glucose screening, presenting a patient case to their peers, and preparing patient education materials. Only one quarter of the students indicated that their confidence levels had increased in conducting Brown Bag medication reviews.  In analyzing syllabi, faculty found that many courses contained relevant content or assignments/activities that prepared students for the P3 IPPE course, with the exception of taking blood pressures and performing a blood glucose test. These skills are learned in specific courses, and are not referred to in most other courses. Students listed similar courses as those identified in the syllabus analysis. In the case of four competencies (1-3, 5), students identified more courses than were apparent from syllabi content, but with the remaining three competencies, the students listed few courses. In general, the courses that the majority of students listed as containing relevant information were also identified by the syllabus analysis.  While some students indicated that they referred to information from previous courses, most students indicated that they did not refer back to materials from previous courses.  Students cited a variety of materials and resources that were referred to during PHAR 716L. Some of the sources were reliable standard resources that are introduced in courses, such as JNC7 Guidelines, but other sources were less specific, such as relatives or Google searches. Still others cited personal experiences outside of course work, such as working as a pharmacy intern. The lists were lengthy and varied, indicating that students are integrating a variety of experiences from coursework, outside resources, and personal experiences.  While many students indicated that no other prior preparation could have helped them achieve success in PHAR 716L, others indicated that having more introductory experiences and more practice in the individual activities prior to the course would have been helpful. Others students indicated more specific needs, such as a course in Microsoft PowerPoint and Publisher. CURRICULUM STUDENT CONFIDENCE SURVEY RESPONSES First Professional Year FallSpring Credit Hrs PHAR 501L Prof. Awareness Prep. Seminar1PHAR 520 Pathophysiology4 PHAR 510 Intro. To Pharmacy Pr. & Law3PHAR 522 Pharmaceutics II 3 PHAR 511 Drug Literature Evaluation3PHAR 523L Pharmaceutical Compounding1 PHAR 512 Immunology3PHAR 524 Clinical Research Methods 2 PHAR 513 Biochemistry3PHAR 525L Intro. Practice Experience I*1 PHAR 514 Pharmaceutics I (Calculations)2PHAR 527 Lifestyle Mod. & Dx Prevention2 PHAR 515L Pharmaceutical Science Lab1 Elective 3 PHAR 525L Intro. Practice Experience I1 Semester Total 16(17) 16(15) Second Professional Year FallSpring Credit Hrs PHAR 610 Pharmacokinetic Principles3PHAR 643 Strat for Positive Hlth Outcomes3 PHAR 611L Pharmacy Skills Laboratory1PHAR 626L Intro. Practice Experience III3 PHAR 612 Pharmacology I4PHAR 629 HC Communications & Ethics3 PHAR 614 Medicinal Chemistry3PHAR 640 Pharmacotherapy I8 PHAR 615L Intro. Practice Experience II3PHAR 641 Pharmacology II4 PHAR 617L Patient Assessment Skills Lab1 Elective3 Semester Total 18 Semester Total 21 Table 1 1 = Strongly Disagree; 2 = Disagree; 3 = Neither Agree nor Disagree; 4 = Agree; 5 = Strongly Agree 1.My confidence level in conducting a patient interview has increased as a result of my experiences in PHAR 716L. Rating score 4.3 - 90% agree or strongly agree 2.My confidence level in taking an accurate blood pressure has increased as a result of my experiences in PHAR 716L. Rating score 4.0 – 80% agree or strongly agree 3.My confidence level in performing a blood glucose screening and interpreting the results has increased as a result of my experiences in PHAR 716L. Rating score 4.4 – 92% agree or strongly agree 4.My confidence level in conducting a Brown Bag medication review has increased as a result of my experiences in PHAR 716L. Rating score 3.1 – 25% agree or strongly agree* 5.My confidence level in presenting a patient case to my peers has increased as a result of my experiences in PHAR 716L. Rating score 4.3 – 92% agree or strongly agree 1.My confidence level in creating a display board or flier appropriate for patient education has increased as a result of my experiences in PHAR 716L. Rating score 3.7 – 60% agree or strongly agree* Responses: n = 31. *Not all students were able to participate in this activity. Figure 1  Most students reported that their confidence levels increased in the indicated patient care areas, but only 25% indicated that their confidence increased in the area of Brown Bag Medication reviews, with 58% indicating neither agree nor disagree. Not all students were able to participate in this activity, and those that did may have only participated one time, perhaps explaining the low numbers in this category. While more experience may be needed in the medication review area, the other activities appear sufficient to increase the confidence levels of most students responding to the survey.  The courses that the majority of students listed as containing relevant information were also identified by the syllabus analysis. However, in the case of four competencies, students listed more courses as containing relevant content than were identified in the syllabus analysis. This discrepancy may be due to individual variation in student experiences within a particular course. For example, if a student had an early experiential course in the P1 or P2 year that focuses on a diabetes-related area, such as working in the dialysis center, or a community pharmacy that does diabetes education, then that student may have indicated that course as relevant, whereas another student at a site focused on substance abuse may not have found the course relevant to the P3 course. Additionally, some activities may not be evident in the syllabus, and, therefore, were not identified in the syllabus analysis. On the other hand, for three of the competencies, students identified few courses than were listed in the syllabus analysis. A variety of explanations are possible for this discrepancy. In one case, many of the courses were P1 courses, and students may have not remembered all of the relevant content at the time of the survey because a long time had elapsed since students took the course.  Many students reported that they did not refer to materials from previous courses, and some indicated that they felt prepared and did not need to. However, others did not indicate the reason, so the study is limited in the ability to determine the reason why students are not referring back to information from previous courses.  While many students felt prepared for the course, some students provided suggestions that faculty members may find useful in preparation of future courses, and these lists will be provided to faculty members.  In analyzing the information, most students appear to recognize that information from previous courses carries forward to experiential courses and are using this information in the daily activities in the P3 IPPE. IMPLICATIONS Table 2 Analysis of Syllabi from P1 and P2 Courses and Student Survey Responses to Determine Content Relevant to PHAR 716L P3 IPPE – Courses with relevant content identified in the syllabi are listed in the left-hand column, and those courses with relevant content identified by students, with response numbers, are listed in the right- hand column under each competency heading. Courses identified by both syllabi and students are highlighted in yellow. SYLLABUS ANALYSIS AND STUDENT IDENTIFICATION OF RELEVANT COURSES Patient Interview/ Medical History Taking Blood Pressure Blood Glucose Brown Bag Medication Review Interpret Findings/ Explain to Patient Case Presentation Patient Education Materials SyllabusStudentSyllabusStudentSyllabusStudentSyllabusStudentSyllabusStudentSyllabusStudentSyllabusStudent 525L511 (3)520611L (7)617L523L (1) 511 511 (1) 525L 511 (1) 501L 511 (1) 510 510 (1) 527525L (7)617L614 (1)640611L (9) 514 525L (1) 520 512 (1) 510 611L (10) 511 512 (6) 611L520 (1)640615L (1)614 (1) 525L 527 (1) 527 525L (1) 511 612 (1) 512 525L (1) 615L527 (7)617L (32)615L (2) 522 611L (12) 611L 520 (3) 514 615L (2) 513 524 (5) 617L611L (23)626L (2)617L (29) 527 612 (5) 615L 527 (3) 525L 617L (1) 514 527 (1) 626L612 (2)640 (2)640 (1) 610 614 (1) 617L 611L (14) 522 626L (2) 525L 611L (1) 629615L (6) 611L 617L (6) 643 612 (6) 523L 640 (13) 520 617L (1) 643617L (18) 612 640 (9) 640 614 (2) 524 641 (1) 524 643 (1) 512L**626L (5) 614 641 (4) 521 615L (1) 527 629 (5) 629 (2) 615L512L** 617L (22) 610612 640 (2) 640 (5) 643 640 (17) 612643 641 (2) 640 641 (6) 614629 641615L640 617L641 643513L** 626L 629 640 641 512L** ** Course no longer offered Patient Interview/Medical History Teach Drug Lit later in curriculum (1) More drill on correct B/P, glucose, lipid values (1) Taking Blood Pressure Need more practice (8) Need opportunity to take in quiet place (3) How to select cuff size (1) Require re-certification annually (2) None-N/A (22) Blood Glucose More participation in health fairs/practice (4) Treating hyper- & hypoglycemia (1) Drilling us on correct glucose values/goals (1) None-N/A (28) Brown Bag Medication Review Simulation of a Brown Bag Event in Pharmacotherapy (1) Drug references on hand would have been helpful (1) Practice in Class (7) Actually performing a Brown Bag Event (2) None-N/A (21) Interpret Findings/Explain to Patient Not sure (2) Felt prepared (8) More opportunity for practice (1) Mote handouts, drug references (2) None-N/A (19) Case Presentation Journal club (1) Not sure (3) More opportunity for practice (1) Maybe some info on how to present a patient case (1) Incorporate presenting pt cases into one of the labs (1) Possibly one more assessment-based class (1) Presenting pt cases in pharmacotherapy (1) None-N/A (23) Patient Education Materials More info on poster creation (4) Course on Microsoft Publisher & PowerPoint (1) No/None (26) Patient Interview / Medical History Taking Blood Pressure Blood Glucose Brown Bag Medicatio n Review Interpret Findings/ Explain to Patient Case Presentation Patient Education Materials 511 (2)617L (1)617L (5)520 (1)512 (1)611L (1)629 (1) 527 (1)640 (1)527 (1)611L (3)617L (1)512 (1) 611L (10)611L (1)612 (1)640 (7)524 (1) 617L (4)612 (1)643 (4)640 (2) 614 (1)640 (7) 617L (1)641 (1) 640 (2) 641 (2) None-N/A (20) None-N/A (33) None-N/A (25) None – N/A (29) None-N/A (16) All lectures/textbooks (2) None-N/A (21) Yes, textbook (not specified) Yes, from all of the courses stated previously. Yes, lab materials (patient communication) None-N/A (25) Past newsletter/pos ter projects Patient Interview/ Medical History Blood Glucose Interpret Findings/ Explain to Patient Case Presentation Patient Education Materials Previous experience (4) Micromedex (3) LexiComp (3) Database on iPhone (2) Clinical Pharmacology (1) ADA Guidelines (2) AACE Guidelines (1) JNC 7 Guidelines (1) Personal experience (4) ACEE Guidelines (1) ADA Guidelines (1) Ms. Smith (1) Website of glucometer (1) None (26) Lexicomp (5) Clinical Pharmacology (5) Facts and Comparisons (1) Epocrates (2) Internet/Online Resources (2) WebMD (1) Wikipedia (1) Micromedex (1) Google (1) Medscape (1) Lab values (2) Pharmacy Journals (1) Outside Professors (1) Pharmacists in the community (1) ADA Guidelines (3) JNC 7 Guidelines (1) Websites for guidelines (1) Drug References (1) Doing Cases (1) Working in a pharmacy as an intern (1) None (15) Micromedex (1) Lexicomp (3) Clinical Pharmacology (3) Epocrates (2) Online resources (1) Skills lab notes (1) All was presented in class (1) JNC Guidelines (1) ADA Guidelines (1) Life experience with presentations (1) All pharmacy resources (1) Working in the pharmacy (2) Example care plans (1) lab (1) Peers (1) Pharmacotherapy cases (1) None (17) Lexicomp (1) Clinical Pharmacology (1) Looked up needed resources (1) Internet (3) Microsoft Publisher (1) Powerpoint (1) JNC7 (1) ADA (2) mypyramid.gov (1) Life experience (2) Example posters (1) AHA (1) AMA (1) Pharmacotherapy text (1) No/None (16) Taking Blood Pressure Brown Bag Medication Review JNC7 Guidelines (5) Am Heart Asso (1) Googled it (1) Past experience (2) Pharmacotherapy I (2) Mother a RN (1) No/None (24) Lexicomp (7) Accumulation of Courses (1) Pharmacotherapy I notes (1) Epocrates (2) Facts & Comparisons (1) Clinical Pharmacology (2) Class would be fine (1) Personal experience / Intern (2) Micromedex (1) None (19) Table 3 A. Student Reported Previous Course Materials Referenced During PHAR 716L B. Student Reported Other Materials Referenced During PHAR 716L C. Student Reported Prior Information or Experience That Could Have Aided Their Success in PHAR 716L Findings of this study appear to validate that those students participating in the survey are able to integrate and apply knowledge and skills obtained though successful completion of courses in the current P1 and P2 years of the UCSOP curriculum. A follow-up study with students in the P3 year during the 2011-2012 academic year may further support this assumption. It may be helpful for faculty teaching in the P1 and P2 courses to further analyze results of this study to identify indications for further curriculum revision, particularly as related to comments in which students identified need for further hands on experience or didactic exposure to specific concepts needed to carry out the seven activities included in this study. Students Conducting Blood Pressure Screening Students Conducting Medication Review and Blood Pressure Screening


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