Public health screenings as a component of introductory practice experiences

American Journal of Pharmaceutical Education,  Winter 2000  by Doty, Randell E,  Latham, Kevin M,  Stewart, Ronald B

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The American Council of Pharmaceutical Education has mandated major changes in experiential coursework. Incorporation of introductory practical experiences early in the entry-level curriculum has been recommended, This paper describes our experiences with the design, implementation and results of a public health screening component that was incorporated into the first year of an entry-level curriculum. Students measured blood pressure and administered risk assessments for osteoporosis, cardiac disease and diabetes to participants visiting shopping malls. They also provided poison prevention information and conducted brown bag sessions for senior citizens.

INTRODUCTION

The American Council of Pharmaceutical Education (ACPE) has mandated major changes in experiential coursework. The Council recommends that introductory practice experiences be included early in the curriculum(l). Introductory practice experiences have been recommended to enhance the process of professionalization and to provide an environment for inculcating the philosophy of pharmaceutical care(2). Introductory practice experiences may be difficult to include in a pharmacy curriculum that is already crowded with didactic courses. To date, descriptions of introductory practice experiences in the pharmacy literature have been limited to shadowing programs in which students interact with a role model for brief periods or elective/volunteer programs(2,3,8,9).

ACPE recommends that health promotion and disease prevention be included in core curricular content(l). The Janus Commission of the AACP has urged incorporation of community outreach programs or service learning activities as a part of core pharmacy curriculum(4). Graber et al. recently reported on the current and ideal emphasis on 33 generalist curriculum topics in PharmD programs.(5) The 33 topics were selected following a survey of academic deans from five health profession schools and pharmacy curriculum directors. The purpose of the survey was to determine which topics the health profession deans and pharmacy curriculum directors thought needed greater emphasis in the curriculum. Health promotion/disease prevention ranked in the top third of all subjects by pharmacy curriculum directors and it ranked first by health profession deans. Results of this survey suggest that the current emphasis on health promotion and disease prevention in the pharmacy curriculum is receiving much less than ideal attention.

The purpose of this paper is to describe the design, implementation and results of a public health/disease prevention screening program component that was incorporated into the second semester of the first year of an entry-level curriculum. The screening component has been taught as the major focus of the Clinical Practicum 11 course for three years. This paper will concentrate on the methods and results for the second year the course was taught.

BACKGROUND

In 1996, the University of Florida College of Pharmacy faculty approved a revised entry-level Doctor of Pharmacy curriculum and it was implemented in the fall semester of 1997. One objective of the revised curriculum was to incorporate introductory practice experiences in the first year of the pharmacy program to better prepare students to provide pharmaceutical care(6,7).

In the new curriculum two semesters of introductory practice experience were integrated into the first year of didactic coursework (Clinical Practicum I and Clinical Practicum II). Each course is one credit hour. The course goals, ability based outcomes, and specific objectives for these courses are included in Appendixes A and B.

Clinical Practicum I is taught in the first semester of the first year. Even though it is not the focus of this paper, it is necessary to briefly describe the course to understand how it prepared the students for Clinical Practicum II. In Clinical Practicum I, students were introduced to basic communication techniques for gathering information on the medical history from patients or volunteers. Students also were introduced to basic physical assessment techniques including blood pressure, temperature, pulse and respiration, etc., which were performed on patients or volunteers. In Clinical Practicum I, first year pharmacy students were teamed with college of nursing junior students at a community site where they gathered information about patient's health status, health behaviors, and social issues. Student teams were assigned a single volunteer who they visited four times during the semester. Faculty members from the College of Nursing and College of Pharmacy supervised student teams. Experiences from Clinical Practicum I prepared the pharmacy students for their health screening/health promotion activities in Clinical Practicum II.

Clinical Practicum II was integrated into the second semester of the entry-level Doctor of Pharmacy program and it was expected to build on the knowledge and skills gained from the previous semester. Ability-based outcome goals of this course were for the student to use predetermined screening tools, physical assessment techniques, appropriate communication techniques, and professional demeanor to conduct a health screening or educational program for the community, including documentation of their activities. The concept of a health screening and disease prevention program was selected since it provided a source of real patients for the students to interact with and begin to develop their professional skills. The course was begun in the spring semester and has now been taught for three years. The number of students enrolled has ranged from 100-130.