Academic journal article American Journal of Pharmaceutical Education

Low Vision Simulator Goggles in Pharmacy Education

Academic journal article American Journal of Pharmaceutical Education

Low Vision Simulator Goggles in Pharmacy Education

Article excerpt


Nearly 135 million people around the world (1) and as many as 14 million Americans are currently affected by low vision, visual impairment that cannot be corrected by standard glasses, contact lenses, medicine, or surgery, and which hampers performance of daily activities. (1-5) The conditions primarily affect people over the age of 65 and are usually a result of age-related eye diseases such as cataracts, glaucoma, diabetic retinopathy, or macular degeneration, but may be caused by genetic diseases such as retinitis pigmentosa. (1,5) Low vision results in loss of visual acuity, loss of visual field, and poor detail discrimination. (6,7) In addition to affecting activities of daily living, low vision also interferes with performance of instrumental activities of daily living, including management of medications. (8) Therefore, low vision is a predictor for risk of at-home medication errors. (9-10)

The number of Americans with vision impairment is expected to increase dramatically with the aging of the US population. (3,5,11,12) In 2003 the Secretary of Health and Human Services tasked the Food and Drug Administration with a study to investigate the availability and use of prescription drug information in formats suitable for visually impaired individuals. A large percentage of this population did not have access to prescription drug labeling and usage information as a result of their visual impairments. (11) Consequently, the document Guidelines for Prescription Labeling and Consumer Medication Information for People with Vision Loss was published in 2008. The Guidelines explicitly state that "a concerted effort on the part of pharmacists and pharmacies is needed to address the problem" (12)[(p1).sup] of lack of access to prescription information due to vision loss. Therefore, pharmacy educators must ensure that future members of the profession best suited to address these issues are aware of the specific problems experienced by individuals with different low vision diseases.

Considering these issues, how do we prepare student pharmacists to help this growing patient population? Both the Accreditation Council for Pharmacy Education (ACPE) and the American Association of Colleges of Pharmacy (AACP) encourage design of doctor of pharmacy curricula to include strategies that develop active, self-directed, independent learners who connect material learned in the classroom with real-world practice, with simulation among the recommended methods. (13-15)

Historically, most published educational research studies on simulation have given little consideration to how well the simulators reproduce the given real-life conditions. (16) However, research in the field of low vision education suggests that both the purpose of the simulator and the specific characteristics required in the simulation are necessary considerations to achieve effective teaching using simulators. (17,18) Therefore, if we are to develop effective low vision simulation activities for use in pharmacy education, ensuring that the simulators are outcome based and produce the symptoms experienced by low vision patients while managing medications is important.

Researchers in health care professional education programs, including pharmacy, have studied multifactorial aging simulations that include visual impairments as a means of increasing empathy and generalized awareness of disability characteristics. (19-29) However, none have addressed the specific medication-related impairment differences among diseases causing low vision. Before activities using these simulations can be described and evaluated, ensuring that the simulators replicate specific characteristics of the diseases in the situations in which the difficulties will be experienced is essential.

Low vision simulator goggles were used first in the geriatric elective course at the University of Louisiana at Monroe (ULM) College of Pharmacy, Aging and Drug Use in the Elderly, in February 2005. …

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