Academic journal article American Journal of Pharmaceutical Education

An Active-Learning Course Model to Teach Pharmacotherapy in Geriatrics

Academic journal article American Journal of Pharmaceutical Education

An Active-Learning Course Model to Teach Pharmacotherapy in Geriatrics

Article excerpt

INTRODUCTION

The drug therapy needs of older adults present unique challenges. Although some older adults are healthy and live independently into their 90s and beyond, others have a significant burden of comorbid conditions and require treatment with complex drug regimens. All pharmacists, regardless of their practice site, must have a thorough knowledge of the diverse biological, medical, and psychosocial factors essential in providing quality care to older adults. As the proportion of US adults over 60 years of age continues to increase, pharmacists will have a critical and expanding role in the clinical care of these older adults. The Institute of Medicine (IOM) emphasized this in a report stating that the number of older adults will double between 2005 and 2030, and the United States is not prepared to meet the healthcare needs of this population. (1)

Traditionally, pharmacy students have learned about diseases and drug therapy used to treat older adults as part of a standard pharmacy curriculum. This approach often limits discussion to examples of patients with a single disease and limited drug therapy. Previously at this institution, an elective course had focused on the pharmacotherapy needs of both pediatric and geriatric patients. When the pediatrics component became a separate elective course, a separate Pharmacotherapy in Geriatrics elective also was formed in September 2007.

Publications on geriatric pharmacy education have stressed the importance of including geriatric therapy-competency nationally within college of pharmacy curricular content. (3) The Accreditation Council for Pharmacy Education (ACPE) competencies also stress the importance of developing appropriate communication skills, which are difficult to teach in the classroom. Thus, a mix of teaching and learning methods that reflected the ACPE standards on the importance of lifelong learning and emphasize patient safety, cultural competence, health literacy, health care disparities, and interdisciplinary teamwork was included in the course. (2) This innovative course combined both geriatrics and gerontology to provide students with a broad approach to the biological, medical, psychological, and sociological issues associated with aging.

DESIGN

Course Philosophy and Objectives

A primary goal of the course was to encourage active, self-directed learning by students, as well as to enhance their communication skills with older adults. Students were encouraged to use a patient-centered approach to care in healthy as well as frail older adults. Diverse teaching techniques and active-learning strategies were employed to strengthen students' understanding of age-related physiologic changes influencing pharmacokinetics and pharmacodynamics, as well as assessment techniques for evaluating functional status and complex drug regimens. The importance of interdisciplinary teams in the provision of care, issues in evaluating evidence from clinical trials, and recognition of the limitations of evidence-based practice in geriatrics were also discussed and applied through various course activities. In this course, students took their learning outside of the classroom and interacted directly with older adults to apply these principles. Students were provided with many opportunities to practice and refine their communication skills with older adults prior to their APPEs. Assignments such as interviewing patients, discussing medication regimens, and participating in activities at older adult care sites offered opportunities to enhance intergenerational communication.

The course incorporated problem-based learning approaches. Students were expected to dedicate time outside of class to prepare patient cases, develop care plans, and complete the assigned readings. Course faculty members guided students in their individual learning, but expected students to be self-motivated in their learning regarding diseases and drug therapy that may not have been covered in the PharmD curriculum prior to enrolling in the geriatrics elective. …

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