Academic journal article American Journal of Pharmaceutical Education

A High-Stakes Assessment Approach to Applied Pharmacokinetics Instruction

Academic journal article American Journal of Pharmaceutical Education

A High-Stakes Assessment Approach to Applied Pharmacokinetics Instruction

Article excerpt

INTRODUCTION

The doctor of pharmacy (PharmD) degree offered at the Auburn University Harrison School of Pharmacy (AUHSOP) has evolved from a postgraduate program to a track-in program (2 years prepharmacy, 2 years BS pharmacy, 2 years PharmD), to a first professional degree doctoral program (2 years prepharmacy and 4 years pharmacy). AUHSOP has developed a comprehensive approach to instruction based upon recommendations of the American Association of Colleges of Pharmacy's Commission to Implement Change in Pharmaceutical Education, (1) in an effort to link educational outcomes to specific pharmacy practice responsibilities. To strengthen the link between factual content, pharmacy practice abilities, and patient care outcomes, a multidisciplinary, integrated curriculum was designed for the third year of our 4-year program. Because problem-based learning (PBL) is a student-centered, interactive educational process that promotes problem solving, reflective thinking, communication skills, and lifelong learning, it was thought to be the appropriate pedagogy for this portion of the curriculum. (2,3) Thus, the entire third year was comprised of a series of 10 multidisciplinary pharmacotherapeutic courses taught predominately utilizing a problem-based format. These pharmacotherapeutic courses were systems-based (eg, cardiology, pulmonary, etc.) and designed to integrate pharmacokinetics, pharmacology, medicinal chemistry, therapeutics, pharmaceutics, and psychosocial aspects of pharmacy practice utilizing small, facilitated student groups supplemented by periodic discussions involving the entire class.

When we combined PBL with an interdisciplinary curriculum we noted a pedagogical problem not previously well described in the literature: when skills that had previously been assured by specific, independent courses in narrowly defined areas of clinical competence became only a small portion of a student's overall grade within an integrated course, students could "choose" to become competent in that particular skill. When these individual courses or disciplines are collapsed into an integrated curriculum, a potential disadvantage might be fewer opportunities for assessment regarding abilities-based curricular outcomes. In addition, when course grades are a product of comprehensive examinations representative of the integrated coursework and are the only means of summative assessment, a student can progress through the curriculum without demonstrating competence in a given area of expertise. We found this to be particularly true for those skills most difficult to master.

Employers, residency directors, and students had historically praised AUHSOP graduates' working knowledge in all basic science areas and especially in the area of applied pharmacokinetics. Following the initiation of the first professional degree PharmD program and an integrated, problem-based learning curricular model, our feedback changed significantly. As a part of AUHSOP's formal Outcomes Assessment Program, focus group sessions were held with preceptors in order to identify programmatic strengths and weaknesses. In 2001, preceptors identified a steep decline in our students' ability to apply pharmacokinetic concepts in patient care environments. To address this deficiency, in 2002, our instructional methods, past and present, were assessed and modified utilizing collaborative action research. As a result, a new instructional methodology and a novel abilities-based assessment tool were developed. The focus of this article is to describe the problems encountered in this area, our analysis of the problem, the approach taken to address the problem, and an evaluation of the solution implemented.

DESIGN

Action research was utilized to evaluate and address the educational problem in our curriculum: a steep decline in the ability of students to apply pharmacokinetic principles in patient care environments. Action research endeavors to improve the quality of a program or an action by using a spiral process that alternates between action and critical reflection. …

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