Academic journal article American Journal of Pharmaceutical Education

Case-Based Assessment in an Online Nursing Pharmacotherapy Course

Academic journal article American Journal of Pharmaceutical Education

Case-Based Assessment in an Online Nursing Pharmacotherapy Course

Article excerpt


Pharmacotherapy is a complex topic that requires several years of study in both classroom and experiential contexts for pharmacy students to master. Other health professional training/degree programs often limit pharmacotherapy education to 1 semester or term. Because of their expertise in pharmacotherapy, pharmacy educators often are asked to teach the pharmacotherapy component of the curriculum within other health professional programs. Comprehensively covering the wide range of topics within the field and tailoring the content to a particular health professional audience presents significant challenges for the instructor. Increasingly, pharmacotherapy courses in nonpharmacy health professional programs are offered online, which adds a further challenge to creating a meaningful, yet manageable, educational experience.

Within health professional programs, a variety of related educational strategies are used to provide authentic learning opportunities, such as case-based, anchored, problem-based, project-based, and cognitive apprenticeship instruction. (1) Teaching cases, an active-learning strategy commonly used in health professional education, are used to expose students to important and common patient situations that have no definitive correct solution. The use of teaching cases is based on the premise that learning from a specific case discussed in the classroom can be transferred to an actual patient encounter in practice, and that exposure to teaching cases helps students to develop the complex skills and flexible thinking needed to adequately manage novel patient cases. (2) But effective use of case-based strategies requires a lot of instructor time and effort and careful development and planning. (1) For this reason, case studies often are not used in high enrollment courses, even though this strategy is recognized as an important tool for building clinical competency. (1)

Case-based reasoning agrees with a constructivism position that students must create their own understanding within a situated learning experience. (3) Through case-based design, the goal is to create learning opportunities that require active engagement of the learner; the learner is given opportunities to infer and apply judgment, and to detect similarities and differences between situations. (3) The ultimate goal is that students develop reasoning skills that can be transferred to patient situations later encountered in practice. The story aspect of case-based learning reinforces the idea of treating the whole patient, and recognizes that the patient's lifestyle as well as social and work history can impact treatment decisions and success. (3)

Transfer of knowledge, "the ability to extend what has been learned in one context to new contexts," (2(p51)) is a complex area of cognitive science, but in health professional education generally refers to the transfer of knowledge from a course to a real-life situation. Because every possible patient scenario cannot be taught, transfer is a primary skill for health professionals and the ability to transfer determines clinical competency. (2) Transfer requires that content knowledge not be overly situational and be learned in a meaningful way, allowing students to personally construct their knowledge and self-assess their learning. While disagreements in the literature concerning transfer is outside the scope of this manuscript, the importance for health professional educators to consider the goal of knowledge transfer in the design of educational activities and assessments is noteworthy.

As more health professional programs explore distance education formats, the challenges of providing engaging activities to a student audience separated from instructors and fellow classmates by distance and time is further complicated by high enrollment numbers. While synchronous distance activities are an option, they too, have their challenges, including: finding a specific time when all members of a course or group can participate; making adjustments for students who are not able to attend the synchronous event due to illness, technology issues, etc; dedicating the additional instructor time and effort that synchronous events require; and navigating through/maintaining continuity during the often disjointed discussion that occurs within a synchronous event (eg, different typing speeds, side conversations). …

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