Book Club Elective to Facilitate Student Learning of the Patient Experience with Chronic Disease

By Plake, Kimberly S. | American Journal of Pharmaceutical Education, April 2010 | Go to article overview

Book Club Elective to Facilitate Student Learning of the Patient Experience with Chronic Disease


Plake, Kimberly S., American Journal of Pharmaceutical Education


INTRODUCTION

Over the last century, the nature of health and health care has changed. Gone are the times when infectious diseases were among the top 10 causes of death. Instead, chronic diseases are the primary causes of death in the United States today. Chronic disease, by its very nature, is not curable and requires a long-term approach to improve health outcomes. With most chronic diseases, adherence to medications and lifestyle modifications are needed to improve patients' outcomes and quality of life. (1,2)

Over the last 2 decades, there has been an increasing emphasis on patient-centered care with the recognition that the traditional biomedical model is not the best method to treat chronic disease. Inherent in patient-centered care is the need to understand and address patient needs and concerns. The chronic illness experience is not limited simply to the dysfunction of body; instead, it impacts almost every aspect of an individual's life, including life course decisions, family, and work. Caring for patients with chronic illness requires a holistic approach to be successful in improving adherence and patient outcomes. Although a component of holistic care is patient education, it is not necessarily enough to improve patient adherence to treatment recommendations. Health behavior theory suggests that adherence goes beyond disease or medication knowledge. (3-5) A wide variety of factors influence adherence, including the patient-provider relationship, availability of social support networks, health/ illness beliefs, cultural beliefs, self-efficacy (confidence), expectations of treatment, and heath literacy. (2-7)

Through their recent publications and accreditation standards, the leading organizations in pharmacy education, including American Association of Colleges of Pharmacy (AACP), Accreditation Council for Pharmacy Education (ACPE), and Joint Commission of Pharmacy Practitioners (JCPP), recognize the need for a patient-centered approach to patient care. (8-10) Patient-centered care is the natural continuation of the pharmaceutical care movement of the 1990s. As a result of this emphasis, pharmacy educators should develop methods to illustrate the chronic illness experience to their students. This is further supported by the Center for the Advancement of Pharmaceutical Education (CAPE) Outcomes, which endorses educational outcomes specifically addressing the application of social/behavioral principles and theories in the design, delivery, and evaluation of pharmaceutical care and the ability to communicate with patients, as well as caregivers. (8)

Although textbooks and lectures can transmit information, they may not foster development of the empathy and compassion necessary to deliver patient-centered care. Multiple methodologies should be incorporated into the curriculum to maximize the students' understanding of chronic illness. One way to make the patient experience more real to students is by having them read about the "lived" experience of illness through the autobiographies/biographies of patients and families. Book clubs have been used for a variety of purposes in other disciplines, including education and nursing, to encourage empathy and compassion among students. (11-13) In these book clubs, group discussion, as well as writing assignments, were included as part of course activities. To the author's knowledge, there is limited literature in the use of autobiographies in pharmacy education.

Reading about the patient experience allows students to become familiar with patient issues and develop a holistic view of patient care. In addition, it allows students to reflect upon patients' experiences in a "safe" environment, preparing them for real-life patient encounters and experiential learning. (13) Students also can make connections between therapeutic content and its potential impact on the patient. The focus of the book club described here was to facilitate pharmacy students' learning about chronic illness by reading about the experience from the patient's point of view, utilizing a traditional book club format. …

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