A patient focused and outcomes-based experiential course for first year pharmacy students

American Journal of Pharmaceutical Education, Fall 2000 by Turner, Christopher J, Jarvis, Catherine, Altiere, Ralph

A Patient Focused and Outcomes-Based Experiential Course for First Year Pharmacy Students)

A first year experiential course for an entry-level Doctor of Pharmacy program is described. The course objectives were to introduce students to the competencies required to practice pharmacy and to provide patient care. Students completed six modules related to expiry dates; telephone reminder and call-back programs; refill histories; ACE inhibitor use in heart failure; and population health targeted at medication-- induced headache (MIH) sufferers; and were required to discuss and document their activities. Ninety one students examined 10,361 prescription products and found 255 out-dated; interviewed 524 and 424 patients, respectively, to remind them about uncollected medications and to identify drug-related problems; assessed the refill histories of 1,582 patients receiving HMG CoA reductase therapy for compliance and 721 heart failure patients for ACE inhibitor use; and designed public awareness programs for MIH. First year students were successfully introduced to the competencies required to practice pharmacy and contributed to patient care.

INTRODUCTION

The University of Colorado commenced its entry-level Doctor of Pharmacy (PharmD) program in 1999. The new curriculum was created with an outcomes-based philosophy and, in keeping with that philosophy, experiential courses were designed into each semester of the program. Experiential courses were assigned four hours per week for the first six semesters (three years) and seven 240 hour clerkships in the final year (semesters 7 and 8). This paper describes the design and evaluation of the first year, first semester experiential course (PHRD 3300) which was delivered for the first time in Fall 1999.

DEVELOPMENT OF PHRD 3300

The development of PHRD 3300 was undertaken by a faculty planning team which worked in collaboration with the school's Education Council, an advisory body comprised of local pharmacy practitioners. The process commenced with a literature review and discussion of the philosophies of experiential training and outcomes-based curricula. Students in experiential training can make substantial contributions to patient care(110). Even though this literature is focused on senior students it was the planning team's and the Education Council's opinion that students should contribute to patient care at a level commensurate with their training throughout their education. The groups also agreed that students that contribute to patient care can provide a net benefit to the clerkship site(5).

The purpose of the school's outcomes-based entry-level PharmD curriculum is to provide students with the professional and general competencies required to practice pharmacy (Table I). It was felt important to introduce first year students to these competencies. To achieve this objective PHRD 3300 was structured in a modular format with six modules designed to serve as "snap-shots" of the competencies. It was also felt important to supplement the students' experiential training by increasing their awareness of pharmacy practice issues. Therefore, three classroom-based programs were organized with panels of speakers representing chain and independent community pharmacists and managed care pharmacists.

The six modules and three classroom-based presentations were approved by the school of pharmacy faculty. The modules were then piloted with 13 entry-level PharmD students who participated in the school's 1999 Diversity Student Education and Scholarship Program. The course director identified 91 preceptors in the metropolitan Denver area willing to participate in PHRD 3300 and these individuals were mailed a copy of the course syllabus and timetable. In addition, the preceptors were invited to attend an orientation meeting with six options provided for meeting date and time. The course commenced on August 31, 1999 with a course orientation. The first module took place four weeks later to allow time to match each student with their preferred site.

DESCRIPTION OF THE MODULES

General Description

The modules incorporated a practical component and a number of exercises including topics for discussion with the preceptor. Each module was designed to be completed within four hours and addressed several professional and general competencies required to practice pharmacy such that each competency was dealt with at least once (Table I).

Students were required to document their work and experiences in a portfolio. The minimum content requirement for the portfolio entry for each module was title, objective, methods, results, discussion, references, identification of learning opportunities, identification of the general and specific competencies tested, impact of the module on the student, and student perceptions of the module. Students submitted the results of the practical exercises to the course director who collated and reported the cumulative workload (patient care) statistics to the class. The course was run in parallel with a seminar course (PHRD 3200) in which students' experiences in the experiential course were used as subject matter for 30 - 45 minute small group discussions. Each small group of first year students was assigned a senior PharmD student as a facilitator who also marked the students' portfolios using an assessment rubric (Appendix A).