Casey E. Gallimore

Simulated Medication Therapy Management Activities in a Pharmacotherapy Laboratory Course

Objective. To measure the impact of medication therapy management (MTM) learning activities on students’ confidence and intention to provide MTM using the Theory of Planned Behavior. Design. An MTM curriculum combining lecture instruction and active-learning strategies was incorporated into a required pharmacotherapy laboratory course. Assessment. A validated survey instrument was developed to evaluate student confidence and intent to engage in MTM services using the domains comprising the Theory of Planned Behavior. Confidence scores improved significantly from baseline for all items (p < 0.00), including identification of billable services, documentation, and electronic billing. Mean scores improved significantly for all Theory of Planned Behavior items within the constructs of perceived behavioral control and subjective norms (p < 0.05). At baseline, 42% of students agreed or strongly agreed that they had knowledge and skills to provide MTM. This percentage increased to 82% following completion of the laboratory activities. Conclusion. Implementation of simulated MTM activities in a pharmacotherapy laboratory significantly increased knowledge scores, confidence measures, and scores on Theory of Planned Behavior constructs related to perceived behavioral control and subjective norms. Despite these improvements, intention to engage in future MTM services remained unchanged.

Impact of a Paper vs Virtual Simulated Patient Case on Student-Perceived Confidence and Engagement

Objective. To evaluate online case simulation vs a paper case on student confidence and engagement. Design. Students enrolled in a pharmacotherapy laboratory course completed a patient case scenario as a component of an osteoarthritis laboratory module. Two laboratory sections used a paper case (n=53); three sections used an online virtual case simulation (n=81). Student module performance was assessed through a submitted subjective objective assessment plan (SOAP) note. Students completed pre/post surveys to measure self-perceived confidence in providing medication management. The simulation group completed postmodule questions related to realism and engagement of the online virtual case simulation. Group assessments were performed using chi-square and Mann Whitney tests. Assessment. A significant increase in all 13 confidence items was seen in both student groups following completion of the laboratory module. The simulation group had an increased change of confidence compared to the paper group in assessing medication efficacy and documenting a thorough assessment. Comparing the online virtual simulation to a paper case, students agreed the learning experience increased interest, enjoyment, relevance, and realism. The simulation group performed better on the subjective SOAP note domain though no differences in total SOAP note scores was found between the two groups. Conclusion. Virtual case simulations result in increased student engagement and may lead to improved documentation performance in the subjective domain of SOAP notes. However, virtual patient cases may offer limited benefit over paper cases in improving overall student self-confidence to provide medication management.

Evaluation of Pharmacotherapy Laboratory Revisions Implemented to Reduce Cost

Objectives. To revise a pharmacotherapy-laboratory curriculum to decrease course expenditures while maintaining a quality educational experience. Design. Course mapping identified laboratory activities that achieved the defined learning outcomes. Redundant activities were eliminated, and remaining activities not requiring active in-laboratory participation were converted into prelaboratory assignments and simulations. An online course-management system provided a platform for simulations and automated grading. Assessment. An evaluation of economic data showed a 64% and 43% decrease in total course expenditures for Pharmacotherapy Laboratory III and IV, respectively. Although a comparison of examination and course grades before and after redesign revealed a small decrease in grades for the Pharmacotherapy III and IV course, the reasons for this decrease were unclear and could not be directly attributed to the redesign. Comparison of students’ evaluation scores before and after the redesign showed continued high satisfaction with the course. Conclusions. Revisions made to the curriculum for a pharmacotherapy laboratory decreased course expenditures while maintaining the quality of education. The successful redesign was related to several key components including course mapping and enhanced use of technology. A similar revision process can be considered by other colleges and schools of pharmacy facing budgetary reductions.