Current methods used to teach the medication history interview to doctor of pharmacy students

American Journal of Pharmaceutical Education, Summer 2002 by Ellington, Andrea Michelle, Barnett, Candace W, Johnson, Diane R, Nykamp, Diane

Articles

Current practices used to teach the medication history interview to Doctor of Pharmacy students were examined. An online survey was emailed to curriculum committee chairpersons at all 91 schools of pharmacy in the United States and Canada. Responses numbered 45 (48.9 percent). Respondents answered questions regarding how medication history interview skills are illustrated, practiced, and evaluated at their schools. Lack of consistency in interviewing skills taught at different schools was found. A mean of 8.62 2.94 skills of 13 recommended skills was being taught. As schools introduce practice experiences earlier in the curriculum, an early introduction of the medication history interview may be beneficial. At 48.4 percent of the schools, the medication history interview was taught before the end of the first year. An interest was expressed by the respondents (97.8 percent) for a CD-ROM of a simulated medication history interview for use as a teaching tool.

INTRODUCTION

The medication history interview is a vital tool the pharmacist can use to gather information and improve overall patient outcomes2-4(1-5). It affords the pharmacist insight into the patient's medication taking experiences (home medications, allergies, adverse drug reactions, etc.), patient understanding of their medications, patient motivation for compliance, and potential changes that could be made to the patient's medication regimen(l). When pharmacists share this valuable information with other health care professionals they make important contributions to the health care team(6).

It is important that the medication history interview is conducted effectively and efficiently to be of value. The pharmacist must be trained to properly use the communication techniques necessary to direct the interview and obtain accurate information from the patient(7). These techniques are typically learned as a student and perfected through practical experience.

The American Council on Pharmaceutical Education (ACPE) Accreditation Standards and Guidelines for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree(8) gives guidance on when this skill should be taught. Standard No. 10, titled Professional Competencies and Outcome Expectations, delineates professional competencies "that should be achieved through the College or School of Pharmacy's curriculum in Pharmacy..." Among others, these competencies include "communicate with health care professionals and patients regarding rational drug therapy, wellness, and health promotion;" "monitor and counsel patients regarding the purposes, uses, and effects of their medications and related therapy;" and "...counsel and monitor patient use of nonprescription drugs." Furthermore, in Standard 11, titled Areas and Content of Curricular Core, Guideline 11.5 states, "The Introductory Pharmacy Practice Experiences should be offered in various practice settings during the early sequencing of the curriculum for purposes of providing transitional experiential activities and active learning."(8) While these guidelines do not mandate introduction of the medication history interview early in the curriculum, the guidelines seem to encourage early introduction of this and similar practice skills. Despite these guidelines, there is little information in the literature regarding how the medication history interview should be taught to pharmacy students. A study published in 1977 discussed use of videotaping final year students performing a medication history interview in order to provide feedback to the students(9). Three studies published in the 1980s reported the use of simulated patients to provide pharmacy students an opportunity to practice medication history interviewing(7,1011). The first study concluded that using simulated patients provided a controlled environment with immediate patient feedback for the student(10). The second concluded that practicing with simulated patients allowed for better ease of personal interaction with actual patients(7). The final study showed that students improved their technique and the amount of pertinent information obtained through practice interviews with simulated patients(11). In 1993, an organized form for taking a medication history interview was published. This served as a template for students and pharmacists alike to prompt questions and record patient answers(12). A study conducted in 1999 documented that pharmacy students liked the use of computer-assisted modules in learning the medication history interview and the students would recommend its use in the classrooms. In the past two years no other suggestions for tools to teach the medication history interview to pharmacy students have been documented in the literature.

The purpose of this article is to report current practices used to teach the medication history interview to Doctor of Pharmacy students. Information was collected about: (i) where in the curriculum the medication history interview is being taught; (ii) methods used to initially illustrate, apply, and evaluate student performance of the medication history interview; (iii) coverage of specific communication techniques used in medication history interviews; and (iv) instructor interest in using a simulated interview on CD-ROM to illustrate the medication history interview. No hypotheses were tested.