Curricular evaluation using self-efficacy measurements

American Journal of Pharmaceutical Education, Spring 2002 by Plaza, Cecilia M, Draugalis, JoLaine R, Retterer, Jennifer, Herrier, Richard N

Self-efficacy measurements have been used in other health-related professions such as nursing and occupational therapy to assess proficiency in disciplinary areas but have not been used extensively in pharmacy education as a method of curricular evaluation. Self-efficacy is a measurement of an individual's confidence in his or her ability to perform a specific task to successful completion. The purpose of this study was to propose a methodology using self-efficacy measurements in curricular evaluation and assessment as well as to provide specific recommendations for potential uses in pharmacy education. The suggested methodology includes item generation, validation, administration, and correlation with behavior. A specific example is provided demonstrating the suggested methodology. Self-efficacy measurement could provide a potentially valuable methodologic framework for assessment and evaluation within pharmacy curricula. Self-efficacy measurements could be used in a wide range of applications.

INTRODUCTION

The Accreditation Standards and Guidelines for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree states that, "Evaluation measures focusing on the efficacy of the curricular structure, content, process, and outcomes should be systematically and sequentially applied throughout the curriculum in pharmacy."(1) Self-efficacy measurements have been used in other health-related professions such as nursing and occupational therapy to assess proficiency in disciplinary areas but have not been used extensively in pharmacy education as a method of curricular evaluation. Self-- efficacy is a measurement of an individual's confidence in his or her ability to perform a specific task or behavior to achieve a successful completion of a desired outcome(2-4). Perceived self-efficacy is based primarily on four sources of information. The first source of information is from performance attainment, having actual experiences with the said task. The second source is that of vicarious experiences of observing the performances of others. Verbal persuasion or trying to talk people into believing they possess the capabilities to accomplish a task and physiological states, also referred to as emotional arousal, form the basis for the other sources of information comprising self-efficacy. Bandura found that regardless of which sources of information a person uses, there is a close relationship between perceived self-efficacy and actual performance of individual tasks(4). He also found that knowledge and skills alone were insufficient to accomplish a desired outcome and that self-efficacy mediates the relationship between knowledge and action(4). Since formative and summative assessments can be used effectively in helping students meet the stated goals of the curriculum, self-efficacy measurement has the potential to provide an objective measure of curricular revision(5).

While self-efficacy has not been used extensively in pharmaceutical education, Farris and Schopflocher used self-efficacy to examine the relationship between intention to engage in a certain behavior (in this case provision of pharmaceutical care) and the behavior itself in a group of community pharmacists in Alberta, Canada(6). Over a period of two weeks they sought to quantify the constructs of intention, self-efficacy, and behavior with regard to providing pharmaceutical care in the community pharmacy setting. Between self-efficacy and intention, the authors found that self-efficacy was the only direct predictor of behavior. While behavior in this study was selfreported and potentially subject to social desirability bias, it does appear to support that there is a close relationship between self-efficacy and behavior.

The vast amount of research using self-efficacy in health-- related professions has been in nursing education. In a study examining the use of self-efficacy measurements in predicting practice outcomes in continuing education, Murdock and Neafsey proposed that since self-efficacy deals with perceptions related to actions, that it could be used as an outcome measure for educational interventions(7). They developed their self-efficacy instrument by translating each course objective into a corresponding self-efficacy item based on the methodology employed by Froman and Owen in the construction of a self-efficacy instrument for infant care(8). Both pre- and post-- knowledge and self-efficacy were assessed, with both measures increasing significantly after the educational intervention. The study found a low correlation between knowledge and self-efficacy, suggesting that each measures a different construct of learning.

Neafsey used this same methodology in another study to evaluate the use of computer-assisted instruction for home study for continuing education programs in nursing(9). Neafsey found similar results to the Murdock and Neafsey study, in that there were significant increases in both knowledge and self-efficacy but a low correlation between the two. This finding was further supported by another nursing study that examined the relationship between performance on computer-based clinical simulations and measured knowledge and self-efficacy. Henry and Holzemer found that clinical simulation performance was related to knowledge and self-efficacy measurements but that the constructs were not synonymous(10).