Academic journal article American Journal of Pharmaceutical Education

A Simulated Learning Environment for Teaching Medicine Dispensing Skills

Academic journal article American Journal of Pharmaceutical Education

A Simulated Learning Environment for Teaching Medicine Dispensing Skills

Article excerpt


Medicine dispensing is a core skill and a key competency for pharmacists. As such, it is a major focus of pharmacy education in Australia and many other countries. (1) As a key competency, the development of medicine dispensing skills requires access to specific equipment, specialized information, and resources. (2) All Australian pharmacies use computers to record prescriptions and maintain patient dispensing history as part of the dispensing process. The model pharmacy/dispensary, specified until 2013 as a requirement for course accreditation in Australia, (3) was commonly used to simulate dispensing contexts and activities in universities. However, the model dispensary at Monash University was difficult to use for teaching large classes and proved too costly to operate in terms of space, staffing, provision, and maintenance of current medicine packaging. Furthermore, the model dispensary did not use computers as part of the dispensing process.

As a professional competency, dispensing blends specialist knowledge, functional and behavioral competence, and judgment, and is underpinned by appropriate ethics and values. Medicine dispensing is the integrated application of knowledge and cognitive proficiency, professional values and attitudes, technical and cognitive skills, reflection, and personal skills within a specific context. (4, 5) The process of developing such competence occurs progressively by increasingly integrating separate dimensions during professional activities and decision making. (4) While pharmacy degrees can provide the knowledge and functional skills for the early stages of this competency development, as well as initiate development of the relevant ethical and professional values necessary for accurate dispensing, higher-level skills are usually acquired through continued professional practice following graduation. (6)

The challenge for many pharmacy education programs is to offer sufficiently rich and varied dispensing practice to undergraduates for successful transition to the clinical setting. (7) Most pharmacy degrees usually integrate experiential placements into the learning and teaching experience to offer learners the opportunity to develop their professional competencies and reflect upon their practice in situ, in professional contexts. (7-11) In the Monash bachelor of pharmacy (BPharm) program, these experiential placements are undertaken in the third and fourth years of the 4-year program. (12) To provide students with a variety of experiences, placement settings (experiential sites) include hospital, community, rural, and a limited number of international locations.

Although all pharmacy degrees teach some aspects of dispensing, for many students with no experience working in a pharmacy, experiential sites are the first exposure to an actual practice setting and to the mechanics and responsibilities of dispensing medicines to patients. For pharmacy students with little practice experience, experiential sites are also the first opportunity to become familiar with pharmaceutical products: identifying package color, shape and branding, and beginning to interpret the dense information displayed on the package. (8) However, such practical experiential opportunities remain limited for reasons related to increasing demand and finite student support resources. (10)

The use of simulated learning and teaching environments offer a viable alternative for students to develop dispensing skills. (13) When carefully developed, such learning and teaching environments can provide students with basic skills within the safety of the simulated environment, which support students' successful transition from university to the clinical setting. (14, 15) Moreover, simulated learning environments improve efficiency with large student numbers, enhance knowledge transfer to practical situations, and impact patient safety, all with a high degree of rigor. (14, 16)

The use of a simulated environment changes the teaching method from direct instruction, or lecture, to that of productive failure, or a hybrid approach, in which students are able to directly experience the task and, as a result of frequency and format of feedback, are able to learn from their mistakes in a safe environment. …

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