Learning to "think like a pharmacist": Problem-solving activities for first-year pharmacy students

American Journal of Pharmaceutical Education, Winter 1998 by Brandt, Barbara F, Clements, Markie, Piascik, Peggy

5. Generate Solution Alternatives/Apply Information. The group discusses how the researched information changes the view of the case. The most likely hypotheses are addressed in light of the new information, and the students determine whether more information is needed to understand and solve the problem. The hypotheses are narrowed to a short list of probable solutions. The group selects the most likely solution and discusses the rationale for this choice. If available, new case material is presented to the group to refresh the problem, and the process is repeated.

6. Case, Group, and Self Assessment. The students rate the case, their own performance, the group and the facilitator. The facilitator uses an individual assessment form to provide feedback to each student on his/her performance and group contribution. The feedback provides both the students and facilitators the opportunity for growth and development in their respective tasks.

After case assessment, each student receives a copy of the case objectives at the end of the final, second case meeting. These objectives are a contract of what students should know and be able to do as a result of participating in the case discussions. Receiving the objectives after the case is a departure from the format of classical PBL. The faculty members believe that because these cases draw primarily upon content learned in the curriculum, students do not need the type of structured guidance used in classical PBL.

As the faculty members often explain to students, patients do not come into the pharmacy with learning objectives "on their foreheads." In addition, having the learning objectives up front restricts the group discussion and robs the case of its impact, thus limiting the students' learning potential(5).

Students then meet in a large group setting for a case wrap-up. The course coordinator gathers input from the facilitators prior to the wrap-up in order to determine if unresolved issues need to be discussed and whether the students may have encountered difficulty with background information. Faculty members teaching other PYI classes that provide the underlying principles for the case can be invited for the purpose of reviewing essential information or answering questions. For example, following the thyroid case in the spring 1998 semester, the PYI physiology faculty member who also teaches thyroid therapeutics during the PY2 semester came to the wrap-up to discuss some aspects of the basis of hypothyroidism and hyperthyroidism and how to establish a dose for replacement therapy. The law faculty member came to the wrap-up to discuss generic substitution and therapeutic interchange regarding levothyroxine preparations.

During the group sessions, the students are expected to simulate professional behaviors, including dressing professionally. The facilitators, especially the community practitioners, serve as role models for students in developing professional behaviors and attitudes for practice. They are instrumental in validating the importance of the emerging contemporary philosophy of pharmacy practice. The facilitators encourage students to take the lead in a variety of ways including reading aloud, using the blackboard, asking questions and using reference materials. The facilitators also assign unanswered questions to individual students as learning issues to be researched and answered for subsequent meetings. Students engage in role-playing to learn how to take medication histories and to counsel patients. Other activities have included tasting a wide range of pediatric antibiotic suspensions to determine the range of palatability and measuring liquid suspensions using a variety of household and dosing devices to determine accuracy of typical measurement devices.