Development and assessment of an Internet-based tutorial to supplement the teaching of medicinal chemistry within a multidisciplinary, disease-based course

American Journal of Pharmaceutical Education, Winter 2000 by Harrold, Marc W, Desselle, Shane P

Pharmacy academicians are well in accord for the need to supplement lecture material with participatory activities that engage students to reach higher levels of problem-solving capability. Additionally, changing pharmacy student demographics and advances in information technology dictate that student-consumers desire surrogate methods to traditional study and memorization of notes. Hence, a set of highly interactive tutorials was developed for the medicinal chemistry component of a multidisciplinary disease-based course. Tutorial design with features such as hidden questions, 3-D molecular modeling, and extended summaries allow for varying levels of student involvement. A study was conducted to assess students' perceptions of the utility of the tutorials and determine whether students who utilized them fared better on an examination. Analysis of data obtained from student surveys indicates that students regarded the tutorials very highly as a study aid and adjunct to lecture course material. Principal components analysis revealed that students conceptualize the utility of the tutorials across two domains; one for its use in learning course concepts and a second for its application in developing higher order cognitive skills. Users of the program scored better than nonusers on the medicinal chemistry portion of a subsequent examination, although the difference was not statistically significant. Moreover, further analysis of examination scores through one-way ANOVA procedures suggested certain students would have especially benefited from use of the tutorials. Survey respondents indicated overwhelmingly that the tutorials should continue to be made available, and, in fact, should be expanded to include more questions at a higher level of sophistication in addition to questions from other disciplines involved in the disease-based course.

INTRODUCTION

Consistent with changes throughout U.S. schools of pharmacy, Duquesne University introduced in 1994 a new six-year entry level PharmD curriculum to replace the existing five-year BS program. Among the many changes that were made was the implementation of a series of six integrated, disease-based modules (referred to as pharmaceutical and biomedical science or "PHBMS" courses) in lieu of traditional stand-alone courses in medicinal chemistry, pathophysiology, pharmacology, and therapeutics (Table I). In the BS program, medicinal chemistry was offered as two, four-credit courses in both the fall and spring semesters of the students' fourth year. In preparation for the integrated, disease-based modules, the spring semester course was initially combined with pharmacology courses during the 1996 and 1997 spring semesters. In the new PharmD program, the fall semester course was renumbered but remained a stand-alone course with essentially the same subject material as it had in the BS program. It serves as the introductory medicinal chemistry course and contains basic concepts such as the acid/base nature of drugs, functional groups, solubility, stereochemistry, receptor binding, and metabolism. Adrenergic, cholinergic and CNS agents are also discussed in this course. In contrast, the topics previously discussed in the spring semester course were distributed into five of the six aforementioned modules. The medicinal chemistry of drugs used to treat neurological and psychiatric disorders is discussed in the fall semester course and is therefore not included in the first PHBMS course. Over the past two years, the average enrollment for the PHBMS courses was 120 students.

Development and implementation of the integrated modules created numerous challenges for faculty from various disciplines involved in their teaching. Foremost within the discipline of medicinal chemistry was a desire to highlight the chemical aspects of drug action and emphasize the relevance of medicinal chemistry in the therapeutic decision-making process. Medicinal chemistry faculty at other universities have also encountered these same challenges and along with the authors have addressed them through a variety of instructional techniques. The incorporation of case study discussions into traditional and integrated courses is currently one of the most widely used methods to teach students how to apply discipline-specific information to actual patient scenarios. This is true, not only in the area of medicinal chemistry(I -4), but also in other basic science disciplines such as pharmaceutics(5), pharmacology(6), and biochemistry(7). A similar strategy, termed Structurally Based Therapeutic Evaluation, has been developed at Creighton University(8) and requires students to address specific therapeutic criteria when evaluating chemical and structural information. Additionally, computer-based tutorials which highlight structure identification and classification, the acid/base nature of drugs, and functional group chemistry have been previously reported by Duquesne faculty(9).

All of the above strategies are consistent with recent trends in pharmaceutical education. They emphasize thinking abilities and problem-based learning, skills which have been identified as essential for enabling entry-level practitioners to logically and analytically solve patient problems and recommend appropriate therapeutic action(10). They also require and promote active learning, a skill identified by the Focus Group on Liberalization of the Professional Curriculum as being an extremely important curricular component(11). Finally, the development and implementation of computer-based case studies(2,5) and tutorials(9) are consistent with the American Council on Pharmaceutical Education's statement that the enhancement of computer skills is an important issue in teaching and learning processes(12).