Academic journal article American Journal of Pharmaceutical Education

Integration of an Online Simulated Prescription Analysis into Undergraduate Pharmacy Teaching Using Supplemental and Replacement Models

Academic journal article American Journal of Pharmaceutical Education

Integration of an Online Simulated Prescription Analysis into Undergraduate Pharmacy Teaching Using Supplemental and Replacement Models

Article excerpt


Using online resources to support learning has expanded in line with advances in technology and a growing body of evidence that well designed, online resources can be effective alternatives to traditional educational formats in general and specifically to health professions education. (1-4) The integration of e-learning into existing curricula is essential to the success of such resources. (5-9) Planning and coordination can ensure that e-learning is appropriately aligned to the intended learning outcomes. (10) The mandatory or voluntary nature of a resource, alignment to assessment, and availability are important considerations in the planning stage of integration. (6,8,11)

Mandating the use of a resource can increase student usage but can also lead to increased staffing time compared to using voluntary resources. Aligning the relevance of e-learning to assessments can increase student motivation to use the resource and can lead to students spending more time on the task. (6) Spacing and sequencing of resource availability in relation to other curriculum items may also impact student use. Khogali et al indentified that students who accessed e-learning after lectures and problem-based discussions saw less benefit and were less systematic in their use of e-learning compared to students who had used e-learning in preparation for either the lectures or problem-based discussion. (8) Maier et al investigated the effect of spacing the release of e-learning cases over an academic year, concluding that well-spaced resources can lead to more balanced usage when compared to releasing all the cases at the same time. (11)

While these studies demonstrate impact of an integration strategy, there are no clear guidelines for the integration of e-learning into established pharmacy curricula. As such, educators may look to other disciplines for ideas and advice to inform their integration strategies. Outside health professions education, Twigg defined 5 models for integrating e-learning into established curricula: supplemental, replacement, fully online, emporium, and buffet (Table 1) and suggested these models may help formulate a strategy when redesigning a curriculum. (5)

At the University of Strathclyde (UoS), the 4-year pharmacy degree (MPharm) is structured around learning outcomes specified by the regulatory body in Great Britain called the General Pharmaceutical Council (GPhC) (Table 2). The GPhC uses Miller's triangle, a model with four stages of development--knows, knows how, shows and does--to define the level of each learning outcome to be achieved at graduation. (12) To this end, competency-based outcomes are assessed through observation of performance in a competency-based class that runs simultaneously with an underpinning knowledge class. The competency-based class is taught in a laboratory setting that mimicks a real life pharmacy dispensary. Students assess prescriptions for clinical and legal appropriateness, then label, dispense, and check them. Staff members, who are all registered pharmacists, role-play as prescribers, patients, or patient representatives, and students issue prescriptions during role-play in class and at assessment.

Several factors supported the need for an e-learning integration strategy, including increased numbers of students entering the degree program, restrictions on laboratory space, and availability of suitably qualified teaching staff. As a response to this need, Strathclyde Computerized Randomized Interactive Prescription Tutor (SCRIPT), an e-learning simulated prescription analysis program, was designed as a revision tool for the competency-based class. This e-learning tool was meant to help students achieve the competencies required for safe and accurate dispensing, which are core in any pharmacy program. In the 2007-2008 session, SCRIPT was available to all students enrolled in the class as an outside-of-class tool used voluntarily. …

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