Academic journal article American Journal of Pharmaceutical Education

Using Electronic Medical Records to Teach Patient-Centered Care

Academic journal article American Journal of Pharmaceutical Education

Using Electronic Medical Records to Teach Patient-Centered Care

Article excerpt


The American Association of Colleges of Pharmacy Center for the Advancement of Pharmaceutical Education (CAPE) Advisory Panel on Educational Outcomes has defined criteria for providing pharmaceutical care. The CAPE outcomes state that doctor of pharmacy(PharmD) graduates should be able to provide exemplary patient-centered care including the ability to obtain, interpret, and evaluate patient information; determine the presence of a disease or medical condition; assess the need for treatment and/or referral; and identify patient-specific factors that affect health, pharmacotherapy, and/or disease management. Graduates should also be able to design, implement, monitor, and adjust patient-centered care plans and document care activities to facilitate communication and collaboration among the health care team. (1)

Standard 11, guideline 11.2, of the Accreditation Standards and Guidelines for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy outlines the use of innovative instructional technologies, case studies, and simulated electronic patients to foster the development of critical thinking and problem-solving in students. (2) Using an EMR to present disease state management cases is a unique learner-centric method of teaching patient-centered care skills to pharmacy students. Active-learning is used within a synchronous environment to guide students in the development of higher-order thinking through the application of didactic coursework topics to disease state management cases.

This article describes how third-year pharmacy students used EMRs to develop skills in patient-centered care.


Pharmaceutical Care Laboratory III is part of a 4-semester laboratory sequence. Eight 2-hour laboratory sections taught by 4 pharmacist faculty members were offered each week, with 12 third-year students enrolled in each section. Laboratory activities focused on nonsterile and sterile compounding, point of care testing, immunizations, and disease state management. Students also practiced basic physical assessment including blood pressure, pulse, and respiration rate. Disease state management activities using the EMR were introduced to provide a platform for students to practice advanced skills in patient-centered care. Activities were designed to correlate with course content taught in a weekly 1 -hour pharmaceutical care lecture series and didactic coursework. Previously, disease state management activities had not been emphasized in Pharmaceutical Care Laboratory III.

Disease state management activities were developed in response to the evolving role and responsibilities of pharmacists to provide pharmaceutical care including disease state management and medication therapy management. Faculty members and fourth-year pharmacy students developed and replicated 12 different patient cases for each disease state. Each student within a laboratory section was assigned a unique patient case. Disease state activities were designed to correlate with didactic course content taught throughout the third year. Disease states included tobacco abuse, anticoagulation, hypertension, community acquired pneumonia, and hyperlipidemia. Appendix 1 contains an example of 1 case variation developed for a patient with hypertension. The complexity of each student's patient case increased as additional comorbidities were introduced throughout the semester.

Each student experience was dependent on the assigned case variation. For example, 1 student may have followed a patient who was successful at smoking cessation, had controlled hypertension, uncontrolled hyperlipidemia, contracted community acquired pneumonia, and developed atrial fibrillation over the course of 1 semester. Another student may have followed a patient who refused to consider smoking cessation, had uncontrolled hypertension, uncontrolled hyperlipidemia, required treatment for hospital acquired pneumonia, and developed a deep vein thrombosis. …

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