Evaluation of the effectiveness of educational medical informatics tutorial on improving pharmacy students’ knowledge and skills about the clinical problem-solving process
Main Article Content
Keywords
Clinical problem-solving process, Pharmacy, Informatics, Online learning
Abstract
Objective: To investigate the effectiveness of an online tutorial and its impact on improving knowledge and skills of pharmacy students in the clinical problem-solving process that is necessary to implement pharmaceutical care. Methods: This is a prospective interventional study conducted during the COVID-19 pandemic restrictions using four novel templates. The first two levels of Kirkpatrick’s Model (Reaction and Learning) were used. Results: 129 participants completed all of the online training parts. The findings indicated a significant improvement in the students’ knowledge and skills. The participants achieved higher score following the tutorial than the baseline, with a statistically significant difference (p < 0.001). There was a significant improvement in the number of detected treatment-related problems. The majority of students were satisfied with the overall training process and stated a high evaluation score out of 10 (mean = 7.93 ± 1.42, median = 8.00). Conclusion: The educational intervention achieved a substantial positive impact on decision-making skills of participating students and was considered effective in helping them attain basic skills such as teamwork, peer assessment, communication and critical evaluation. Healthcare providers must work together to ensure accurate medication use during care transitions. Pharmacists, as medication experts, play an important role in the implementation process. Pharmacy educators must prepare pharmacy student to use pharmaceutical care in their future practice.
References
2. Toklu HZ, Hussain AJJoYP. The changing face of pharmacy practice and the need for a new model of pharmacy education. JYoung Pharm. 2013;5(2):38-40. https://doi.org/10.1016/j.jyp.2012.09.001
3. Roughead E, Semple SJ, Vitry AJIJoPP. Pharmaceutical care services: a systematic review of published studies, 1990 to 2003,examining effectiveness in improving patient outcomes. 2005;13:53-70.
4. Hepler CDJPTJoHP, Therapy D. Clinical pharmacy, pharmaceutical care, and the quality of drug therapy. Pharmacotherapy.2004;24(11):1491-1498. https://doi.org/10.1592/phco.24.16.1491.50950
5. Aburuz S. The case for evidence-based pharmaceutical care. Res. Social Adm. Pharm. 2015;11(3):e146-147. https://doi.org/10.1016/j.sapharm.2009.06.001
6. Alsayed A, El Hajji FD, Al-Najjar MA, et al. Patterns of antibiotic use, knowledge, and perceptions among different populationcategories: A comprehensive study based in Arabic countries. Saudi Pharmaceutical Journal. 2022.
7. Khader H, Hasoun LZ, Alsayed A, et al. Potentially inappropriate medications use and its associated factors among geriatric
patients: a cross-sectional study based on 2019 Beers Criteria. Pharmacia. 2021;68:789-795.
8. Kruijtbosch M, Göttgens-Jansen W, Floor-Schreudering A, et al. Moral dilemmas of community pharmacists: a narrative studyIn J Clin Pharm. 2018;40(1):74-83. https://doi.org/10.1007/s11096-017-0561-0
9. Alsayed AR, Hasoun L, Alnatour D, et al. Perspectives of the community in the developing countries toward telemedicine and pharmaceutical care during the COVID-19 pandemic. Pharm Pract. 2022;20(1):2618. https://doi.org/10.18549/ PharmPract.2022.1.2618
10. Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47(3):533-543.
11. Allemann SS, van Mil JF, Botermann L, et al. Pharmaceutical care: the PCNE definition 2013. Int J Clin Pharm. 2014;36(3):544-555. https://doi.org/10.1007/s11096-014-9933-x
12. Shao H, Chen G, Zhu C, et al. Effect of pharmaceutical care on clinical outcomes of outpatients with type 2 diabetes mellitus.Patient Prefer Adherence. 2017;11:897. https://doi.org/10.2147/PPA.S92533
13. Parajuli DR, Franzon J, McKinnon RA, et al. Role of the pharmacist for improving self-care and outcomes in heart failure. CurrHeart Fail Rep. 2017;14(2):78-86. https://doi.org/10.1007/s11897-017-0323-2
14. Shanmugam S, Varughese J, Nair MAS, et al. Pharmaceutical care for asthma patients: A Developing Country’s Experience. JResp Pharm Pract. 2012;1(2):66. https://doi.org/10.4103/2279-042X.108373
15. Cazarim MdS, de Freitas O, Penaforte TR, et al. Impact assessment of pharmaceutical care in the management of hypertensionand coronary risk factors after discharge. PloS One. 2016;11(6):e0155204. https://doi.org/10.1371/journal.pone.0155204
16. Liekweg A, Westfeld M, Braun M, et al. Pharmaceutical care for patients with breast and ovarian cancer. Support Care Cancer.2012;20(11):2669-2677. https://doi.org/10.1007/s00520-012-1385-z
17. Kousar R, Murtaza G, Azhar S, et al. Randomized controlled trials covering pharmaceutical care and medicines management:a systematic review of literature. Res Social Adm Pharm. 2018;14(6):521-539. https://doi.org/10.1016/j.sapharm.2017.06.008
18. Poudel RS, Piryani RM, Shrestha S, et al. Benefit of hospital pharmacy intervention on the current status of dry powder inhalertechnique in patients with asthma and COPD: a study from the Central Development Region, Nepal. Integr Pharm Res Pract.2017;6:7-13. https://doi.org/10.2147/IPRP.S119202
19. Berenguer B, La Casa C, de la Matta MJ, et al. Pharmaceutical care: past, present and future. Curr Pharm Des. 2004;10(31):3931-3946. https://doi.org/10.2174/1381612043382521
20. Obreli-Neto PR, Guidoni CM, de Oliveira Baldoni A, et al. Effect of a 36-month pharmaceutical care program on pharmacotherapyadherence in elderly diabetic and hypertensive patients. Int J Clin Pharm. 2011;33(4):642-649. https://doi.org/10.1007/ s11096-011-9518-x
21. Clifford RM, Davis WA, Batty KT, et al. Effect of a pharmaceutical care program on vascular risk factors in type 2 diabetes: theFremantle Diabetes Study. Diabetes Care. 2005;28(4):771-776. https://doi.org/10.2337/diacare.28.4.771
22. Bunting BA, Cranor CWJJotAPA. The Asheville Project: long-term clinical, humanistic, and economic outcomes of acommunity-based medication therapy management program for asthma. J Am Pharm Assoc. 2006;46(2):133-147. https://doi.org/10.1331/154434506776180658
23. Cranor CW, Bunting BA, Christensen DB. The Asheville Project: long-term clinical and economic outcomes of a community pharmacy diabetes care program. J Am Pharm Assoc. 2003;43(2):173-184. https://doi.org/10.1331/108658003321480713
24. May JRJAJoHP. Barriers to pharmaceutical care in the acute care setting. 1993;50:1608-1611.
25. Roberts AS, Benrimoj SI, Chen TF, et al. Practice change in community pharmacy: quantification of facilitators. Ann Pharmacother. 2008;42(6):861-868. https://doi.org/10.1345/aph.1K617
26. McDonough RP, Rovers JP, Currie JD, et al. Obstacles to the implementation of pharmaceutical care in the community setting.1998;38:87-95.
27. Ngorsuraches S, Li SCJAjoh-sp. Thai pharmacists’ understanding, attitudes, and perceived barriers related to providing
pharmaceutical care. Am J Health Syst Pharm. 2006;63(21):2144-2150. https://doi.org/10.2146/ajhp060054
28. Uema SA, Vega EM, Armando PD, et al. Barriers to pharmaceutical care in Argentina. Pharm World Sci. 2008;30(3):211-215.https://doi.org/10.1007/s11096-007-9167-2
29. Fang Y, Yang S, Feng B, et al. Pharmacists’ perception of pharmaceutical care in community pharmacy: a questionnaire surveyin Northwest China. Health Soc Care Community. 2011;19(2):189-197. https://doi.org/10.1111/j.1365-2524.2010.00959.x
30. Education TACfP. Accreditation Standards and Key Elements for the Professional Program in Pharmacy Leading to the Doctorof Pharmacy Degree. Standards 2016. Vol 2020: Accreditation Council for Pharmacy Education. 2016.
31. Medina MS, Plaza CM, Stowe CD, et al. Center for the Advancement of Pharmacy Education 2013 educational outcomes. Am.J. Pharm. Educ. 2013;77(8):162-162. https://doi.org/10.5688/ajpe778162
32. Accreditation Standards and Key Elements for the Professional Program in Pharmacy Leading to the Doctor of PharmacyDegree. Standards 2016. Vol 2019: Accreditation Council for Pharmacy Education. 2016.
33. Hatwig C, Crane V, Hayman JJTihpm. A pharmaceutical care challenge: recruiting, training, and retaining pharmaceutical carepractitioners. Top Hosp Pharm Manage. 1993;13:1-10.
34. Kane MPJAJoPE. Solving Drug-Related Problems in the Professional Experience Program. 1993;57:347-351.
35. Briceland LL, Hamilton RAJAJHP. Skk. 1993;50:294-296.
36. Chisholm MA, Hawkins DWJJoPT. Analysis of pharmacotherapy recommendations provided by doctor of pharmacy clerkshipstudents. 1996;5:3-12.
37. Chisholm MA, Wade WEJAjoh-sp. Factors influencing students’ attitudes toward pharmaceutical care. Am J Health Syst pharm.1999;56:2330-2335. https://doi.org/10.1093/ajhp/56.22.2330
38. Chisholm MA, Wade WEJAJoPE. Using actual patients in the classroom to develop positive student attitudes towardpharmaceutical care. 1999;63:296-299.
39. Kennedy DT, Ruffin DM, Goode JVR, et al. The Role of Academia in Community‐Based Pharmaceutical Care. Pharmacotherapy.1997;17:1352-1356.
40. Schommer JC, Cable GLJAJoPE. Current status of pharmaceutical care practice: strategies for education. 1996;60:36-41.
41. Hammour KA, Farha RA, Basheti I. Hospital pharmacy medication reconciliation practice in Jordan: perceptions and barriers. JEval Clin Pract. 2016;22(6):932-937. https://doi.org/10.1111/jep.12565
42. Ramjaun A, Sudarshan M, Patakfalvi L, et al. Educating medical trainees on medication reconciliation: a systematic review.BMC Med. Educ. 2015;15:33. https://doi.org/10.1186/s12909-015-0306-5
43. Boockvar KS, Carlson LaCorte H, Giambanco V, et al. Medication reconciliation for reducing drug-discrepancy adverse events.Am J Geriatr Pharmacother. 2006;4(3):236-243. https://doi.org/10.1016/j.amjopharm.2006.09.003
44. Sluisveld NV, Zegers M, Natsch S, et al. Medication reconciliation at hospital admission and discharge: insufficient knowledge,unclear task reallocation and lack of collaboration as major barriers to medication safety. BMC Health Serv Res. 2012;12:170.https://doi.org/10.1186/1472-6963-12-170
45. Smidt A, Balandin S, Sigafoos J, et al. The Kirkpatrick model: A useful tool for evaluating training outcomes. Journal of Intellectual& Developmental Disability. 2009;34(3):266-274. https://doi.org/10.1080/13668250903093125
46. AbuRuz SM, Bulatova NR, Yousef AMJPW, et al. Validation of a comprehensive classification tool for treatment-related problems. Pharm world Sci. 2006;28(4):222-232. https://doi.org/10.1007/s11096-006-9048-0
47. Bond C, Raehl CL, Franke TJPTJoHP, et al. Clinical pharmacy services, hospital pharmacy staffing, and medication errors inUnited States hospitals. Pharmacotherapy. 2002;22(2):134-147.ttps://doi.org/10.1592/phco.22.3.134.33551
48. Boockvar KS, LaCorte HC, Giambanco V, et al. Medication reconciliation for reducing drug-discrepancy adverse events. Am J Geriatr Pharmacother. 2006;4(3):236-243. https://doi.org/10.1016/j.amjopharm.2006.09.003
49. Sluisveld NV, Zegers M, Natsch S, et al. Medication reconciliation at hospital admission and discharge: insufficient knowledge,unclear task reallocation and lack of collaboration as major barriers to medication safety. BMC Health Serv Res. 2012;12:1-12.ttps://doi.org/10.1186/1472-6963-12-170
50. Lubowski TJ, Cronin LM, Pavelka RW, et al. Effectiveness of a medication reconciliation project conducted by PharmD students.Am J Pharm Educ. 2007;71(5):94. https://doi.org/10.5688/aj710594
51. Lindquist LA, Gleason KM, McDaniel MR, et al. Teaching medication reconciliation through simulation: a patient safety initiativefor second year medical students. J Gen Intern Med. 2008;23(7):998-1001. https://doi.org/10.1007/s11606-008-0567-3
52. Abu Farha RK, Rashad M, Hasen E, et al. Evaluation of the effect of video tutorial training on improving pharmacystudents’ knowledge and skills about medication reconciliation. Pharm Pract. 2020;18(1):1711. https://doi.org/10.18549/ PharmPract.2020.1.171153. Walker PC, Tucker Jones JN, Mason NA. An advanced pharmacy practice experience in transitional care. Am J Pharm Educ.2010;74(2):20. https://doi.org/10.5688/aj740220
54. Lancaster JW, Grgurich PE. Impact of students pharmacists on the medication reconciliation process in high-risk hospitalized
general medicine patients. Am J Pharm Educ. 2014;78(2):34. https://doi.org/10.5688/ajpe78234
55. Fox LM, Pham KH, Dollar M. Using interactive digital images of products to teach pharmaceutics. Am J Pharm Educ.
2007;71(3):58. https://doi.org/10.5688/aj710358
56. Curley LE, Wu Z, Svirskis D. Using Technology in Pharmacy Education: Pharmacy Student Performance and Perspectives When
Visual Aids Are Integrated Into Learning. Front Pharmacol. 2018;9:1062. https://doi.org/10.3389/fphar.2018.01062
57. Woolfitt ZJLT, Learning, Sciences TIUoA. The effective use of video in higher education. 2015;1:1-49.
58. Brame CJJCLSE. Effective educational videos: Principles and guidelines for maximizing student learning from video content.
CBE Life Sci Educ. 2016;15(4):es6. https://doi.org/10.1187/cbe.16-03-0125
59. Wilson EA, Park DC, Curtis LM, et al. Media and memory: the efficacy of video and print materials for promoting patient
education about asthma. Patient Educ Couns. 2010;80(3):393-398. https://doi.org/10.1016/j.pec.2010.07.011
60. Von Schantz S, Katajavuori N, Juppo AMJP. The use of video instructions in patient education promoting correct technique
for dry powder inhalers: An Investigation on Inhaler-Naïve Individuals. Pharmacy. 2018;6(4):106. https://doi.org/10.3390/
pharmacy6040106
61. Kwan CY. A thorny path: the developmental course of problem-based learning for health sciences education in Asia. Adv Health
Sci Educ Theory Pract. 2019;24(5):893-901. https://doi.org/10.1007/s10459-019-09920-6
62. Hitch G, Williams J, Herbland A, et al. The use of videos in blended learning to enhance students’ learning in systems-based
patient assessment with development of associated clinical skills: An Analysis. 2014;14.
63. Lindner K, Blosser G, Cunigan KJMPS. Visual versus auditory learning and memory recall performance on short-term versus
long-term tests. 2009;15:6.
64. Fejzic J, Barker M. Implementing simulated learning modules to improve students’ pharmacy practice skills and professionalism.
Pharm. Pract. 2015;13(3):583. https://doi.org/10.18549/PharmPract.2015.03.583
65. DeMella C, Donohoe K, Morgan L, et al. Implementation of an online ethics course into a pharmacy curriculum. Currents in
Pharmacy Teaching and Learning. 2017;9(5):835-840. https://doi.org/10.1016/j.cptl.2017.05.001
66. Al-Aqeel SA. Pharmacy Students Feedback on the use of Role-play in Teaching Ethics. Pharmacy Education. 2013;13.
67. Sutton B, Bearman M, Jolly B, et al. Simulated Learning Environments Medical Curriculum Report. Health Workforce Australia.
2010.
68. Lundeberg MA, Yadav A. Assessment of case study teaching: Where do we go from here? Part II. Journal of College Science
Teaching. 2006;35:8.
69. Hasan S. Teaching ethics to pharmacy students using a team-based learning approach. Pharmacy Education. 2015;11.
70. Pinchevsky-Font T, Dunbar S. Best practices for online teaching and learning in health care related programs. Internet Journal
of Allied Health Sciences and Practice. 2015;13:8.
71. Basheti I. Effect of simulation in training pharmacy students on correct inhaler technique. Proceedings of International
Academic Conferences: International Institute of Social and Economic Sciences; 2014.
72. Odenina F, Segal R, Helper CJJoS, et al. Providing pharmaceutical care in community practice: differences between providers
and non-providers of pharmaceutical care. 1995;12:170-180.
73. Rapanta C, Botturi L, Goodyear P, et al. Online University Teaching During and After the Covid-19 Crisis: Refocusing Teacher
Presence and Learning Activity. Postdigital Science and Education. 2020;2:923-945.