Christine K. O'Neil

Comparison of Active-Learning Strategies for Motivational Interviewing Skills, Knowledge, and Confidence in First-Year Pharmacy Students

Objective. To compare 3 strategies for pharmacy student learning of motivational interviewing skills, knowledge of motivational interviewing principles, and confidence in and attitudes toward their application. Design. Following a motivational interviewing lecture, first-year students were randomized to perform practice activities (written dialogue, peer role-play, or mock-patient counseling activities). Motivational interviewing skills, knowledge, confidence, and attitudes were measured. Assessment. All students demonstrated improvement in skills, knowledge, and confidence. Students in the mock-patient counseling group demonstrated significantly better motivational interviewing skills during practice and trended toward higher scores on the summative evaluation. They also demonstrated a significant improvement in knowledge compared with that of the written dialogue group during practice. Feedback at the end was generally positive, with students expressing recognition for the value of motivational interviewing. Conclusions. Students demonstrated their best performance of motivational interviewing during assessments using interactions with mock or standardized patients.

Impact of the Fracture Risk Assessment on Patient and Physician Behavior in Osteoporosis Prevention

Objective: To evaluate the impact of a pharmacist-directed osteoporosis screening program utilizing the fracture risk assessment (FRAX) tool on patient and physician behavior. Methods: Postmenopausal women 45 to 65 years with Achilles T score <−1.0 not receiving bisphosphonate therapy were randomly assigned to a control or intervention group. All participants received a heel ultrasound and pharmacist education on risks of low bone mass. The intervention group received the FRAX and shared their results with their physician. Three months after screening, a telephonic questionnaire was administered to all participants. Results: A total of 749 patients were screened, with 87 meeting the enrollment criteria (43 control and 44 intervention). Physician behavior was not different between the groups with respect to ordering vitamin D levels, prescription medication, or dual-energy x-ray absorptiometry scan. A significant difference in vitamin D supplementation occurred between the 2 groups (P = .024). At follow-up, 72.2% of responding participants increased daily calcium intake and 76.4% started or increased physical activity. Conclusion: Physician behavior was not influenced by FRAX results in the intervention group; however, positive patient behavior changes occurred in both groups. Primary prevention efforts conducted through heel ultrasound screening and pharmacist consultation led women to follow-up; however, awareness still needs to be raised of the value of FRAX in osteoporosis prevention.

Reconsideration of Key Articles Regarding Medication Related Problems in Older Adults from 2011

This year, the oldest baby boomers turned 65 years of age. Baby boomers, which include individuals born between 1946 and 1964, represent 25% of the US population.1 In addition, given their life experiences, this group of individuals is likely to have higher expectations for the quality of health care services, including medication safety. Thus, it is timely to discuss what new knowledge on often preventable medication-related problems (i.e., medication errors and medication adverse events) in older adults was published in 2011. Hopefully, by doing so we can begin to develop approaches to reduce medication-related problems and meet this cohort’s expectations.

Beyond calcium and vitamin D

The role of calcium and vitamin D in the prevention and management of osteoporosis is widely accepted by clinicians. However, the importance of other vitamins and minerals for bone health has not been clearly defined. This article reviews available information for several vitamins (vitamins A, C, E, and K) and miscellaneous minerals (fluoride, iron, magnesium, phosphorus, and potassium), and their potential effects on bone health.

Implementing an interprofessional information literacy course: impact on student abilities and attitudes

Objectives The authors investigated the impact of an interprofessional, freshman-level, information literacy course on nursing, pharmacy, and allied health professions students by examining whether students successfully met learning objectives in the course related to interprofessional attitudes, identification of research study types, and ability to relate evidence-based practice questions to their disciplines. Methods Student posters (n=20) completed in a team project were evaluated to determine whether students were able to accurately identify the type of evidence, population, intervention, and primary outcome of studies (n=192). Additionally, posters (n=78) were evaluated to assess whether students could identify a relevant foreground question and link it to their disciplines. Students also completed the Readiness for Interprofessional Learning Scale (RIPLS) before (n=413) and after (n=352) the course to determine whether their attitudes toward interprofessional learning changed. Results Students performed well on learning outcomes in the course, with most teams identifying relevant evidence-based practice questions (83.8%) and effectively connecting questions with their disciplines (65.4%). Students correctly identified the type of evidence, population, intervention, and primary outcome for 70.0%, 81.8%, 76.0%, and 74.0% of cited studies, respectively. Student attitudes after the course did not significantly change. Conclusion Interprofessional information literacy education can generate positive learning experiences for freshman health care professions students to increase their beginning-level understanding of research in the health care professions and to prepare them for participation in future interprofessional courses and health care teams.