Academic journal article American Journal of Pharmaceutical Education

An Objective Structured Clinical Examination to Assess Problem-Based Learning

Academic journal article American Journal of Pharmaceutical Education

An Objective Structured Clinical Examination to Assess Problem-Based Learning

Article excerpt

INTRODUCTION

The culture of pharmacy education is evolving to embrace the core competencies set forth by the Accreditation Council for Pharmacy Education (ACPE) (1) and the Center for the Advancement of Pharmacy Education. (2) Recommendations on the strategies to improve student proficiency in the areas of patient-centered care, population-based care, and systems management have been established to guide academics in developing curricula focused on the changing practice of pharmacy. (3) Additionally, the integration of active learning in curricula has been identified as a strategy essential to enhancing knowledge and self-directed learning skills and advancing problem-solving skills. Professionalism, leadership and advocacy, collaboration, and cultural competency need to be infused in the pharmacy curriculum.

Problem-based learning (PBL) is an andragogical strategy that implements an active student-directed approach to learning and has been adopted in some form by 71% of US pharmacy colleges and schools. (3,4) During PBL, students develop problem-solving skills, formulate evidence-based decisions, and enhance their communication skills; (3,5-7) all of which are abilities essential to achieving core competencies. (1-2) Additional competencies addressed include improving independent and team-directed learning, developing the ability to obtain and evaluate literature, and ultimately applying this information to patient cases. (3)

According to the ACPE, assessment and evaluation of these core competences are necessary and critical to provide accountability for the goals of pharmacy education. (1) One of the challenges pharmacy educators face is determining the most effective and reliable method to evaluate the PBL experience. (6) Assessment of student learning with PBL includes traditional testing tools, such as multiple-choice and short-answer examinations, surveys, and facilitator, group, peer and self-evaluations. (5,6,8-10) These tools determine students' knowledge and problem-solving abilities but do not evaluate students' clinical competence or their ability to effectively communicate their knowledge in a pharmacy practice setting. (11,12)

Objective structured clinical examination (OSCE) is a well-established tool for assessing clinical competence because it is a performance-based test that evaluates clinical knowledge, professional judgment, communication, interpersonal skills, problem-solving skills, and resolution development. (13-17) In a 2009 survey of US colleges and schools of pharmacy, Sturpe identified 32 programs using OSCEs, only 4 of which incorporated OSCE as an assessment tool in therapeutic courses. (18) Pharmacy OSCEs are also frequently used in laboratory courses, advanced pharmacy practice experience (APPE), yearly summative examinations, (11,19-20) continuing education, (21) and licensure. (13,18) Medical schools have used OSCEs as a component to evaluate PBL for decades. (22-24) No published reports were found of pharmacy schools using OSCEs to assess the PBL experience.

At Wayne State University (WSU), Eugene Applebaum College of Pharmacy and Health Sciences, PBL represents 20% to 40% of the second and third years of the PharmD curriculum. Standard multiple-choice and short-answer examinations, quizzes, and self-evaluations were the only tools used to assess PBL learning outcomes. Traditionally, OSCEs have been used at WSU in the first and second years of the curriculum to assess competencies for patient-care laboratories. An OSCE was introduced to assess PBL in the final pharmacotherapeutics module of the third year of the PharmD program. In an effort to demonstrate achievement of the competencies derived from social-learning theories (25) and the taxonomy of significant learning, (26) and, as required by ACPE, our team introduced an OSCE to assess these competencies during PBL. The purpose of this study was threefold: (1) to quantify student performance on the OSCEs in the areas of knowledge, clinical skills, and social skills; (2) to compare OSCE performance to the traditional multiple-choice written examination for the evaluation of student learning; and (3) to explore the perceptions of faculty members and students on the use of OSCEs to test knowledge, clinical skills, and communications, as well as their thoughts on OSCE examination logistics. …

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