Academic journal article American Journal of Pharmaceutical Education

Introduction and Assessment of a Blended-Learning Model to Teach Patient Assessment in a Doctor of Pharmacy Program

Academic journal article American Journal of Pharmaceutical Education

Introduction and Assessment of a Blended-Learning Model to Teach Patient Assessment in a Doctor of Pharmacy Program

Article excerpt


Patient assessment, defined as the "evaluation of patient function and dysfunction through the systematic gathering of objective (physical assessment and laboratory data interpretation) and subjective (patient interview) data important to the provision of care," is viewed by accrediting agencies as an essential component of a contemporary, high-quality pharmacy education. (1-3) Patient assessment skills are an integral aspect of pharmacy practice, and will become even more vital as the profession transitions to focus more on medication therapy management. To effectively prepare students for high-level practice, this topic must be incorporated at an appropriate breadth and depth in the required doctor of pharmacy (PharmD) curricula. (1-3) As of 2007, 96% of pharmacy schools in the United States taught patient assessment skills. (4) Across these schools, patient assessment was either taught through standalone courses or integrated into parts of other courses. Eighty-six percent used a laboratory approach to teach this material, while 70% used lectures. Unfortunately, student attention and retention of information presented via lectures have been shown to decline steadily after the first 10 minutes. (5-7) This issue can be mitigated by integrating active-learning strategies such as problem-based learning (PBL), team-based learning (TBL), and case-based learning into the classroom. (8)

A flipped-classroom, in which students gain necessary knowledge before class (eg, through recorded lectures) and apply that knowledge under the guidance of an instructor during class (eg, through active learning), can be used to maximize student-teacher interaction in the classroom. (9) This contrasts with the traditional classroom model where instruction is provided during class time and student-teacher interaction is typically minimal. The use of a flipped classroom format that integrates TBL and case-based learning for teaching patient assessment skills to pharmacy students has not been previously described. The objective of this study was threefold: to introduce a blended-learning educational model that consisted of a flipped-classroom format that integrated TBL and case-based learning to teach patient assessment skills in a PharmD program; to assess the academic performance of students enrolled in this model as compared to that of students enrolled in the traditional classroom iteration of the course; and to assess student perceptions of using this model to teach patient assessment skills.


The first-professional year course sequence in patient assessment was composed of two one-credit-hour courses, Patient Assessment 1 and 2 (PA1 and PA2). This sequence was scheduled as a practical laboratory and allotted two weekly three-hour time slots. In the traditional classroom iteration of the course sequence, there were 30 to 60 students in each class. Students were taught using the following methods: lecture (40%), a skills laboratory (30%), case-based learning (25%), simulation (2.5%), and independent learning (2.5%). During the 2014-2015 academic year, the course was redesigned to incorporate a blended-learning model using a flipped-classroom approach. Teaching faculty members dedicated approximately eight hours per week to developing course content, recording online videos, creating TBL activities, etc.

Within this model, students were educated using: independent study through a series of 10-15 minute online videos (eg, prerecorded, online, voice-over PowerPoint presentations) prior to class (40%); case-based learning (30%); a skills laboratory (15%); TBL, consisting of an individual readiness assurance test (IRAT) and a group readiness assurance test (GRAT) (10%); and, discussion (5%) (Figure 1). A list of the topics discussed in the course sequence and the active-learning strategies used for each topic is provided in Table 1. Online videos were designed to be no longer than 10-15 minutes for two purposes: to divide the preclass work into manageable segments that could be completed at the learner's convenience; and, to create a video archive that was easily searchable for students throughout the semester (ie, prior to class, prior to the final examination, etc). …

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