Academic journal article American Journal of Pharmaceutical Education

Impact of Standardized Simulated Patients on First-Year Pharmacy Students' Knowledge Retention of Insulin Injection Technique and Counseling Skills

Academic journal article American Journal of Pharmaceutical Education

Impact of Standardized Simulated Patients on First-Year Pharmacy Students' Knowledge Retention of Insulin Injection Technique and Counseling Skills

Article excerpt

INTRODUCTION

The use of simulation or standardized patients are proven learning techniques which have been shown to increase student knowledge, confidence, clinical performance, and critical thinking skills within pharmacy education.1 Such techniques have been shown to improve learning in various clinical areas, including inhaler and injection techniques, acute decompensated heart failure management, medication error recognition, blood pressure assessment, and advanced cardiac life support. (2"8) Standardized patient techniques have further demonstrated improved knowledge retention outcomes when conducted in combination with traditional coursework from one-week to three-months post-intervention. (3,5) In addition to previous studies, the Accreditation Council for Pharmacy Education (ACPE) has recognized the value of simulated learning in their 2016 Standards, and recommend the use of simulation experiences within interprofessional experiential education. (9)

The benefit of simulated learning has been well documented when applied late in a pharmacy curriculum. In one study conducted in the fourth year of the pharmacy curriculum, students in the experimental group were exposed to a six-week high-fidelity patient simulation series in which they worked with a care team to manage patients with disease states such as asthma and heart failure exacerbations. (5) Following this intervention, it was shown that knowledge retention was significantly higher in the simulation group than the comparator at three months. (5) The students undergoing simulated learning experiences also saw significant increases from pre- to post-simulation quiz scores across all clinical topics tested and reported improvement in confidence making clinical recommendations to providers. (5) A second study conducted outside of the United States showed that final-year pharmacy students scored higher on inhaler-related counseling checklist exercises after undergoing standardized patient interactions. (3) In this study, students were randomly assigned to receive a simulated counseling scenario with a standardized patient in addition to supervised hands-on learning and peer-to-peer education. (3) The experimental group was compared to an active control group undergoing only supervised hands-on learning and peer-to-peer education. Student assessments on proper device technique were then tested one week later, showing improvements in counseling skills and confidence in favor of the simulated learning group. (3)

Unlike pharmacy literature, studies have demonstrated the positive impact of simulated learning and standardized patient interaction throughout early medical and dental school curricula. (10-13) It was demonstrated in the early 1990s that standardized patient interactions in medical school are effective throughout the curriculum. (10) Standardized patients were utilized in early curriculum learning to improve interviewing, counseling, and basic physical examination skills allowing the students early application of knowledge to build upon. (10) Another study in the first year of the medical curriculum noted that students' confidence levels and self-assessment skills improved when students reviewed their standardized patient interactions. (11) Standardized patient interactions have even been used to replace inpatient interactions due to a reduction in inpatient beds in first-year medical students at a teaching hospital. (12) While there was no significant improvement in clinical performance in the standardized patient (SP) group, the scores were equal to those of the control group and there was a trend noted toward greater student satisfaction in the SP group. (12)

Despite clear evidence of effectiveness, there exists a paucity of published data for utilizing simulation within the first year of pharmacy education. While the previous studies demonstrated improvement in student knowledge, knowledge retention, and counseling skills following simulated learning, all were conducted later in the pharmacy curriculum. …

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