Academic journal article American Journal of Pharmaceutical Education

Impact of Required versus Optional Remake of a Preparation on Pharmacy Students' Compounding Accuracy

Academic journal article American Journal of Pharmaceutical Education

Impact of Required versus Optional Remake of a Preparation on Pharmacy Students' Compounding Accuracy

Article excerpt

INTRODUCTION

The art and science of compounding is unique to the pharmacy profession, and for this reason, colleges and schools of pharmacy often include practical compounding laboratories in the curriculum to ensure student competency in this area. The American Association of Colleges of Pharmacy Council of Sections convened a task force to assess compounding education within the curriculum of its member institutions partly because there is not a national standardized compounding curriculum. (1) The report showed that the amount of training a student receives in compounding education depends on the individual institution's curriculum.

A fundamental requirement of any compounding education curriculum is the assessment of student abilities. Several assessment methods can be used, such as physically observing the student while performing a compounding operation, reviewing a laboratory report in which the student describes what was done and/or observed during a compounding operation, conducting an analytical procedure of the finished compounded preparation, measuring a physical attribute of the finished preparation, or a combination of these techniques. 2

Although some pharmacy educators feel that every college and school of pharmacy should use analytical testing in compounding courses to encourage accuracy, (3) only a few institutions appear to be doing this. In a study by Kadi and colleagues, students completed 2 different preparations, a potassium permanganate aqueous solution and a citrated caffeine syrup, that were each analyzed using a spectrophotometric assay. Approximately 46% and 22% of the preparations were not within 610% of the nominal concentration on the students' first attempt at compounding the solution and the syrup, respectively. (4)

The curriculum at the University of North Carolina Eshelman School of Pharmacy includes a compounding component integrated within the 5-semester Pharmaceutical Care Laboratory course sequence. The compounding component leads the students through a series of approximately 26 compounding exercises covering most of the dosage forms used in contemporary pharmacy compounding practice. The assessment tools used include laboratory report documentation, direct observation of the student's compounding techniques, measuring physical attributes of the finished preparation, and analyzing the compounded preparation for the content of the active principal ingredient. The pharmaceutical analysis of the compounded preparations is carried out using spectrophotometric assays or high performance liquid chromatography (HPLC) procedures.

For several years, the preparation analyses were used as the basis for assigning a grade for the compounding exercise. Typically, the preparation analysis accounted for 50% of the student's grade, with the other 50% consisting of the accuracy of the label and laboratory report, as well as the student's counseling abilities. Students received either the full score or a zero grade, dubbed the "analysis requirement," depending on whether their preparation was within an acceptable standard range (typically 6 10% of the label amount or concentration of the active principal ingredient). If the preparation was outside the range, the student was required to remake the preparation to receive the full score. After several years of requiring students to remake an inaccurate preparation, students were given the option to remake the preparation. The objective of this retrospective study was to determine the impact of changing the remake analysis requirement to an optional remake provision.

METHODS

There is no means to directly measure student effort in making a compounded preparation. However, we hypothesized that student effort could be inferred by examining the analytical data when a required remake was enforced versus when an optional remake was in place. Students may be less diligent when a less stringent assessment is used. …

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