Academic journal article American Journal of Pharmaceutical Education

Improving Pharmacy Student Communication Outcomes Using Standardized Patients

Academic journal article American Journal of Pharmaceutical Education

Improving Pharmacy Student Communication Outcomes Using Standardized Patients

Article excerpt


The flipped classroom is a method of instruction that is intended to be student- or learner-centered rather than instructor-centered. In the flipped classroom, the traditional course structure is inverted: the knowledge dissemination that once occurred during class time is instead transmitted to the student through recorded lectures, articles, and other materials outside of the classroom. (1-4) This in turn allows the instructor to dedicate class time to active learning activities focused upon student mastery and application of the material. Theory suggests that student learning can be enhanced through active learning in the flipped classroom because it encourages self-reflection, higher-order thinking, and can motivate students to develop the desired knowledge and skills.2 Furthermore, the flipped classroom can accommodate the uniqueness of each student's learning style because he or she can be allowed to work at his or her own pace, and the instructor can identify areas where each student is having difficulty and provide individualized assistance. (3,4)

A range of activities have been identified in the literature as being considered active learning, including problem-based learning, team-based learning, simulation, games, group discussions, and interactive case studies. (5) Among these, one of the earliest to appear in higher education is the use of standardized patient encounters, which has served as an instructional tool in pharmacy programs since at least the 1970s. (6) Standardized patients (SP) are individuals who are trained to portray a patient or family member of a patient, in a consistent manner. (7-8) SPs are useful because they allow health care students to practice different skills, such as physical examinations, patient counseling, and education. Employing SPs in the classroom is beneficial because students can safely make mistakes without causing harm to a real patient. Both medical and pharmacy students have been shown to view simulation with SPs favorably. (9,10) Medical students have rated SP encounters as being more applicable in future interactions with patients than peer role-play. (10) Presumably, students may view the simulated environment as more "lifelike" and are inclined to take it more seriously than peer role-play (RP).

Even though SP has been shown to be effective in teaching students in the health professions different skills, such as patient counseling, history taking, and physical assessment, this teaching method also requires significant time and monetary resources from institutions that wish to incorporate SP activities into their teaching. Frequently, some institutions employ staff whose sole responsibility is simulation to ensure that faculty have access to a robust pool of actors/actresses. Building cases and training SPs to portray a specific role requires significant time from faculty. Further, SPs are usually recruited from the community and are paid either a salary or an hourly stipend. Therefore, it is no surprise that there has been recent research examining whether other teaching methods that do not require additional salaried/hourly employees, such as RP, are as effective or more effective than SP activities. (10-14)

Findings to date about the effectiveness of SP vs RP have been mixed, with some studies showing that SP is superior to RP, some showing that RP is as effective as SP activities, and some showing that RP is more effective than SP activities. (10-16) One study also examined the cost-effectiveness of SP activities compared to RP and found that RP was cheaper and more effective than SP. (13) However, previous studies have generalizability issues, such as using a two-day workshop that compared SP vs RP, only examined one aspect of communication (end-of-life care), compared one class of students to another class of students, or had small sample sizes (N<40). (10-14)

To build on previous research, this study used a quasi-experimental design to investigate the performance of PharmD students across three administrations of a second-year drug information and communication course. …

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