Academic journal article American Journal of Pharmaceutical Education

An Innovative Elective Course in Anticoagulation Management

Academic journal article American Journal of Pharmaceutical Education

An Innovative Elective Course in Anticoagulation Management

Article excerpt

INTRODUCTION

In 2002 the American Association of Colleges of Pharmacy (AACP)/Accreditation Council for Pharmacy Education (ACPE) Task Force on Assessment and Accreditation created graduating student, faculty member, and alumni survey instruments to collect and evaluate data on doctor of pharmacy (PharmD) programs. (1) After the release of the ACPE Standards 2007, these survey instruments were revised and made available to assist colleges and schools of pharmacy in continuous quality improvement. The PharmD program of the Eugene Applebaum College of Pharmacy and Health Sciences at Wayne State University participated in these surveys in 2007. Results of the graduating student survey identified the lack of elective courses as a major concern (32% of students disagreed or strongly disagreed with being satisfied with elective course availability). The PharmD program at Wayne State University allows for 4-credit hours of electives to be completed prior to the beginning of the fourth year. The PharmD curriculum committee was charged with increasing the number of electives offered. Faculty members were asked to consider developing an elective course proposal in their area of interest and expertise. As a result, a new 2-credit-hour elective course entitled Contemporary Issues in Anticoagulation Management was developed for third-year PharmD students. This paper describes the rationale for this course, provides a summary of course development, and presents outcomes from the first offering of the course.

The traditional role of the pharmacist in anticoagulation therapy management in the inpatient and outpatient setting is well established. When compared to conventional physician care, pharmacist- managed anticoagulation has resulted in improved anticoagulation control, improved patient outcomes, and a reduction in health care costs. (2,3) As health systems increase their focus on medication safety, the pharmacist's role in anticoagulation management is expected to expand. (4) Numerous quality, regulatory, and reimbursement organizations have brought attention to the appropriate preventative and therapeutic use of antithrombotic therapy in the health care setting. The goal of reducing harm with anticoagulant medications was recently added to the list of Joint Commission National Patient Safety Goals. (5) The Institute for Safe Medication Practice, the Joint Commission, National Quality Forum, and the Agency for Health Care Research and Quality support the establishment of comprehensive anticoagulation management services. (5-9) Such services should encompass inpatient and outpatient care and the transition between these care environments. In the future, pharmacists will manage and monitor patients with a broad range of thrombotic disorders who are on a variety of antithrombotic medications. (4) Pharmacy education will play a central role in equipping pharmacy graduates with an appropriate foundation for future practice in this setting.

As an undergraduate anatomy and physiology course is a program prerequisite, students are expected to enter the PharmD program with baseline knowledge of the coagulation system. In the first year, students complete Pathophysiology I and II, which provide approximately 4 lecture hours on abnormalities in coagulation. In the second year, students complete the cardiology module, which provides 9 hours of lecture on the pathophysiology of thrombosis, pharmacology, and chemistry of antithrombotic agents, and the therapy of thrombosis. Students have the opportunity to evaluate patient cases and participate in class discussions of these cases. The goal in constructing the anticoagulation elective in the third year was to expand on the knowledge and patient management skills already developed, and to ensure that students developed an understanding of the patient's perspective on anticoagulation therapy.

DESIGN

Development of this course included 4 components: (1) Alignment of course objectives to/with Bloom's and Fink's taxonomies of learning; (2) identification of the desired pedagogy; (3) development of course assignments to meet each objective; and (4) determination of assignment and course assessment plans. …

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