A continuous quality improvement model for developing innovative instructional strategies

American Journal of Pharmaceutical Education, Fall 1999 by Draugalis, JoLaine R, Slack, Marion K

A Continuous Quality Improvement Model for Developing Innovative Instructional Strategies1

We used the continuous quality improvement (CQI) process to implement changes in a course in pharmacy research methods. The goals were to: (i) increase integration between topics within the course and between it and other courses; (ii) enable students to become self-learners; and (iii) decrease class time devoted to lecture in anticipation of putting the class notes on the Internet. To increase integration between courses, the CQI process was applied to homework assignments by identifying the disease states covered in the pharmacology and medicinal chemistry case discussions. Relevant studies were identified and used as content for problems. For the research design section, topics were organized within a single conceptual framework. To enable students to become self-learners in pharmaceutical care practice, strong skills in reading a research report are needed. We developed a new session at the beginning of the semester on how to read a research report then provided multiple practice opportunities during classes, on assignments, and on exams. To decrease lecture time, short, in-class, small group activities were developed. Evaluation data were primarily student comments and scores on selected exam items. The CQl process provided an explicit approach to introducing innovative methods into the classroom and changed our focus from covering material to assuring that students have learned basic skills and concepts. Our experience indicates that the CQI process should be applicable to a wide range of course material.

INTRODUCTION

Faculty members in higher education must strive to continually improve both course content and instructional methods to enable student learning(1). Specific to pharmaceutical education is the call that how we teach (and students learn) is as important as what we teach(2). Therefore there is a need for pharmacy educators to change from a method based exclusively on lectures to incorporate student-centered and interactive methods. The purpose of this article is to describe how a continuous quality improvement (CQI) framework can be used to introduce innovative instructional methods in the classroom.

GOALS-AND OBJECTIVES

The goal of this innovation was to use the tools of CQI to address learning issues in a course on pharmacy research methods. CQI, as we have adapted it, uses insights about student learning, variation in student performance, and the psychology of learning to improve the learning process(3). The FOCUSPDCA cycle is shown in Figure 1.

The goal of changing the course was to respond to three objectives:

1. Modify the course content to increase integration and reduce the amount of material that appears isolated or with little relationship to other modules in the course and curriculum.

2. Modify the course to enable students to become self-learners. Continuous learning is a requirement for providing effective pharmaceutical care. After students leave the College environment, they will be responsible for their own learning and one of the primary methods of self-learning is reading reports of research. Hence, students must be able to assess the results of research as reported in the literature.

3. Increase class time spent on something other than the transmission of information in anticipation that class notes will become available on the Internet so students will not need to come to class to simply obtain information.

DESCRIPTION OF THE TEACHING INNOVATION

Content. The catalog course description of PhPr 461 Methodology in Pharmacy Research. 3 semester credits. Application of research design, statistical methods, evaluation techniques, and ethical dimensions to critically evaluate published literature, research reports, and proposals. The course is arranged in five parts: (i) introduction; (ii)statistical techniques/data analysis; (iii) aspects of research design; (iv) fundamentals of clinical studies; and (v) survey research and epidemiologic methods. An extensive set of course notes (360 pages) is disseminated the first day of class. The course purpose is to provide the student with the skills and principles of clinical research design and biostatistics needed for evaluation of the medical literature and assessment of research reports and proposals. The course has eight objectives. Each instructional topic has specific learning objectives. The specific course content and mechanics have been described previously(4,5).

Student Audience/Level of Student. Novice; course has no prerequisites.

Point in the Curriculum Where Used. required course in the first semester of the second professional year of four-years in an entry-level Phan-nD program.

The teaching innovation described is the application of a CQI process to on-going course evaluation and revisions in PhPr 461. The first learning process that we wanted to improve was that of integration. For quite some time, we have been integrating the statistical analysis and study design components. However, we wanted to increase students' ability to integrate the material from various units in the class and to increase their ability to integrate learning from this course with material learned in other courses. The changes in the course were based on the assumption that if the instructors can't or don't integrate material in the classroom, students will be very unlikely to integrate it outside the classroom.