Academic journal article American Journal of Pharmaceutical Education

Blended Simulation Progress Testing for Assessment of Practice Readiness

Academic journal article American Journal of Pharmaceutical Education

Blended Simulation Progress Testing for Assessment of Practice Readiness

Article excerpt

Objective. To design an assessment of practice readiness using blended-simulation progress testing.

Design. A five-station, blended simulation assessment was developed to evaluate patient care outcomes in first- and third-year pharmacy (P1 and P3) students, as well as first-year postgraduate (PGY1) pharmacy residents. This assessment of practice readiness included knowledge and performance evaluations administered as a progress test.

Assessment. Eighteen PGY1 residents, 108 P3 students, and 106 P1 students completed the assessment. P3 students scored significantly higher than P1 students across all evaluations. Third-year pharmacy students scored significantly lower than PGY1 residents in interprofessional communications and attitudes of ownership in a standardized colleague/mannequin model station, and in patient communication in a standardized patient station.

Conclusion. Learners demonstrated evolving skills as they progressed through the curriculum. A blended simulation integrated progress test provides data for improvement of individual student clinical skills, informs curricular advancement, and aligns curricular content, process, and outcomes with accreditation standards.

Keywords: simulation, assessment, progress test, readiness, quality assurance


Quality assurance in health science curricula is facilitated through assessment of student competence related to educational and professional outcomes. (1,2) Standards developed by the Liaison Committee on Medical Education (LCME) require medical schools to demonstrate curricular quality through assessments of students' fundamental abilities including problem solving, interprofessional collaboration, and communication, among others, that will prepare them for the contemporary practice of medicine. (2) The Accreditation Council for Pharmacy Education (ACPE) mandates pharmacy curricula be structured to facilitate student achievement of outcomes essential to the practice of the profession, including patient-centered care, problem-solving, patient advocacy, interprofessional collaboration, and communication. (3)

While traditional approaches to assessment, such as multiple-choice examinations, may reliably test students' fundamental knowledge, important aspects of curricular quality and practice integrity may go underemphasized, including interpersonal skills, lifelong learning, professionalism, and integration of core knowledge into decision making. (4) The most valid examinations for assessing competence of these outcomes emulate actual practice activities. (5,7) Authentic assessments are defined as performance assessments deployed under realistic conditions in which students are asked to perform real-world tasks that demonstrate meaningful application of essential knowledge and skills. (6,8,9) Authentic assessments emphasize the need to demonstrate the ability to apply the knowledge and skills in practical contexts and settings. (10) In health professions curricula, simulation is often used to mimic real-life practice due to the limitations of using real patients in actual settings, such as patient availability, safety, and the need to standardize student experiences. Simulation strategies include, but are not limited to, standardized patients and colleagues, virtual patients, and high-fidelity mannequin models. (11,12) However, reports on authentic assessments to evaluate learner readiness to handle patient care responsibilities and the use of those assessments to inform curricular quality are limited.

D'Angelo and colleagues developed a simulation-based exit examination to assess medical resident readiness for operative independence. (13) Authors reported a wide range of errors and procedure outcomes across study participants and highlighted the need for assessments to improve programmatic awareness of residents' learning needs. Ragan et al used standardized patients during an assessment examination to identify doctor of pharmacy (PharmD) students at risk of underperforming at advanced pharmacy practice experience (APPE) sites. …

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