Academic journal article American Journal of Pharmaceutical Education

A Team, Case-Based Examination and Its Impact on Student Performance in a Patient Safety and Informatics Course

Academic journal article American Journal of Pharmaceutical Education

A Team, Case-Based Examination and Its Impact on Student Performance in a Patient Safety and Informatics Course

Article excerpt


The Accreditation Council for Pharmaceutical Education (ACPE) Standards 2016 require student pharmacists to be proficient in topics related to health informatics, medication dispensing, distribution and administration, and patient safety. (1) The Center for the Advancement of Pharmacy Education (CAPE) 2013 Outcomes suggest that students should be prepared to optimize the safety and efficacy of medication use systems (2.2), design, implement, and evaluate viable solutions to problems (3.1), and effectively communicate when interacting with an individual, group, or organization (3.6). (2) Common student challenges associated with patient safety and related skills include lack of acceptance of culture of safety, poor ability to communicate about medication safety, and poorly developed skills to promote systems that reduce medication error potential. (3-5) There is an identified need for innovative approaches to teaching and assessing medication safety skills, with emphasis on team-based collaborative learning. (6) It has been recommended by multiple authors and the American Association of Colleges of Pharmacy (AACP) 2006-2007 Argus Commission that medication safety education in doctor of pharmacy programs be designed to be interactive, practice-oriented, and team-based. (3,4,7-9) Despite this, most patient safety instruction in pharmacy curricula is lecture-based, without incorporated active or team-based learning strategies. (10)

In an innovative pharmacy practice laboratory experience, students' patient safety knowledge and self-confidence improved when active learning was incorporated, although there was no team-based component to this activity. (10) Another study evaluated a team-based, root-cause analysis (RCA) project as part of a patient safety course that involved student teams performing an RCA on a given medication error case. (11) The maj ority of student teams achieved all associated RCA and team-based outcomes. Although there is robust literature on the benefits of team-based learning strategies, there is a paucity of literature on team-based final examinations in patient safety-related coursework and in general. Final examinations may be distinct from typical team-based learning activities because of the potential for a more high-stakes, high stress environment and the potential for more open-ended test items.

The doctor of pharmacy curriculum at Manchester University College of Pharmacy, Natural and Health Sciences, includes a required course dedicated to patient safety and informatics. Previously, student learning was assessed in a cumulative, traditional, multiple choice and short answer examination. Because of concerns regarding student performance, whether the examination was truly assessing course outcomes centered on student skills and attitudes relating to medication safety, and the importance of teamwork emphasized throughout the course, the final examination was redesigned as a case-based team examination consisting of nine activities. We hypothesized that this case-based, team examination could help improve student perceptions of self-confidence in performing medication safety-related skills and demonstrating positive medication safety-related attitudes. Our objectives were to describe the redesign of the patient safety and informatics course assessment plan and assess the team final examination in terms of student performance and perceptions.


Patient Safety and Informatics is a required, second professional year (P2) course offered in the fall semester. Course content is broadly grouped into three units: medication misadventures, tools for patient safety, and pharmacy informatics. Examples of medication misadventure content includes safety culture, prescription and medication order evaluation, and medication error causes, prevention, and assessment. Examples of tools for patient safety content includes root cause analysis (RCA), health care failure modes and effects analysis (HFMEA), transitions of care and risk communication, and medication use evaluation (MUE). …

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