An online module series to prepare pharmacists to facilitate student engagement in patient-centered care delivery: development and evaluation

Figures & data

Table 1 “A guide to Pharmaceutical Care”: overview of modules

Module topic	Module goals
Getting started as a clinicalinstructor	To have a common understanding of terminologyand practice-educator responsibilities to prepare for student arrival
Pharmaceutical care philosophy	To help practice educators understand thepharmaceutical care philosophy of practice
Benefits of pharmaceutical care	To help practice educators understand why pharmacy schools are emphasizing pharmaceutical care competencies within their curricula
Pharmaceutical care practice model	To present a proposed model of practice that triages patients to receive different levels of pharmaceutical care and to present tools, processes, and vocabulary to facilitate pharmaceutical care
Pharmaceutical care process	To provide an overview of the pharmaceutical care process
Therapeutic relationship	To provide an overview of the therapeutic relationship concept to better understand the skills and processes that lead to patient involvement in decisions about their drug therapy
Patient interview	To present a systematic approach for interviewing patients (for basic pharmaceutical care, disease management, and comprehensive pharmaceutical care)
DRPs	To understand what constitutes a drug-related problem
Thought processto identify DRPs	To provide an overview of the “thought process” to facilitate students’ learning, decision making, and self-refection
Professional writing	To help practice educators understand principles of documentation
Pharmacy care plan	To help practice educators understand what constitutes a pharmacy care plan and its benefits

Adapted from “A guide to Pharmaceutical Care.” This guide can be accessed through the URL: http://www.preceptoreducation.ca

Abbreviation: DRPs, drug-related problems.

Figure 1 “Pharmaceutical Care Practice Model” opening screen shot. Reproduced from “A guide to Pharmaceutical Care.”

Figure 2 “Pharmaceutical Care Practice Model” closing screen shot. Reproduced from “A Guide to Pharmaceutical Care.”

Figure 3 “Patient interview – setting the wheels in motion.” Reproduced from “A Guide to Pharmaceutical Care.”

Figure 4 “Professional writing – let’s practice drafting brief narrative notes.” Reproduced from “A guide to Pharmaceutical Care.”

Table 2 Preceptors’ pre–post self-assessment of confidence gains to facilitate student engagement with pharmaceutical care processes (n = 32)

Assessment questions (worded as statements)	Pre-confidence	Post-confidence	Pre–post	P-value	Normalized gain	Gain
	Mean (SD)	Mean (SD)	MPre – MPost		M/sd(pre)	%
1. Facilitate learning opportunities that enable pharmacy students to practice pharmaceutical care competencies	2.69 (0.64)	3.66 (0.48)	0.97	<0.001	1.52	36.1
2. Incorporate different levels of pharmaceutical care at your site	2.72 (0.63)	3.44 (0.56)	0.72	<0.001	1.14	26.4
3. Provide constructive feedback to the student on how to enhance therapeutic relationships	2.66 (0.75)	3.53 (0.51)	0.875	<0.001	1.16	33.0
4. Identify appropriate patients to interview for disease management and comprehensive pharmaceutical care	3.16 (0.63)	3.72 (0.46)	0.56	<0.001	0.88	17.7
5. Provide constructive feedback to the student on patient interviewing skills for different levels of pharmaceutical care provided	2.88 (0.55)	3.69 (0.47)	0.813	<0.001	1.14	28.2
6. Provide constructive feedback to the student on how to formulate a drug related problem statement	2.84 (0.63)	3.69 (0.47)	0.844	<0.001	1.34	29.7
7. Assist the student in assessing and developing a logical and systematic approach to decision making for individualizing drug therapy	2.66 (0.79)	3.44 (0.62)	0.78	<0.001	0.99	29.3
8. Facilitate the student’s understanding and use of different documentation tools available for assessment and follow-up in the provision of PC	2.66 (0.79)	3.47 (0.51)	0.81	<0.001	1.03	30.4
9. Evaluate the student’s decision making and clinical reasoning in initial/follow-up pharmacy care plan(s)	2.59 (0.71)	3.41 (0.50)	0.81	<0.001	1.14	31.3
Total for all nine assessment issues	2.76 (0.50)	3.56 (0.33)	0.80	<0.001	1.19	29.1

Abbreviation: PC, patient care.

Table 3 Reasons for participating in the pilot study

Theme 1: to enhance preceptor skills (n = 23)

• To improve preceptorship skills

• To play a positive role in students’ education

• To provide a supportive learning environment where students canpractice and apply concepts and skills learned in the classroom topractical scenarios

• To gain confidence as a preceptor

• To align students’ learning with the university’s experiential guidelines

• To better understand documentations completed by students forvarious experiential activities

• To improve feedback skills regarding PC processes such as patient interviewing, care plans, and thinking through alternative treatments

Theme 2: development of professional and personal skills (n = 5)

• To improve personal PC skills

• To learn about strategies and tools that can support effective deliveryof care (identifying and formulating DRPs and writing care plans and professional notes)

Theme 3: required or preconditions (n = 3)

• Recommended by the university or employer prior to taking students

Abbreviations: n, number of pharmacist respondents; PC, patient care; DRPs, drug-related problems.

Table 4 Key learning from the online module series

Theme 1: professional development

1. Better understanding of the PC practice model:

• Differentiate between three levels of PC in practice including comprehensive, disease management, and basic (goals and process)

• How the triage process can be used to move patients between the three levels of care

2. Better understanding of the PC process and how to apply it in practice:

• PC and informed shared decision making

• Importance of providing monitoring and follow-up

3. Better understanding of and access to various PC tools:

• How various PC tools can be applied in practice to support PC

• Awareness of different types of documentation tools and professional writing approaches and their place in practice

• Importance of clear documentation

4. Better understanding of DRPs:

• Clarification on the different categories of DRPs

• Benefits of using a systematic approach for identifying DRPs

• Why a clearly formulated DRP statement can facilitate appropriate recommendation(s)

5. Skills development:

• To improve communication with patients

• improved skills to identify DRPs

• How to interview patients for comprehensive PC

• How to formulate DRP statements

• How to use a systematic approach to identify DRPs

• How to document assessment and follow-up

• How to formulate a care plan

Theme 2: enhance preceptorship competencies

1. Improved knowledge regarding:

• Experiential requirements and expectations

• How students are taught PC in the classroom

• How students are prepared for experiential learning

• How to recruit appropriate patients for PC

• What to look for when grading PC processes completed by students

• Value of giving immediate feedback

• Elements of providing effective constructive feedback

2. Improved ability and skills to support students:

• Develop an extensive experiential activity schedule

• Provide proper orientation to experiential site

• Promote self-directed learning

• Support learning without over-supporting students

• Motivate students to engage in PC

• Integrate learning with practice

• Work with struggling students

• Cultivate critical thinking and a logical/systematic approach to decision making

• Provide constructive feedback on various PC processes such as communication skills, therapeutic relationships, interviewing skills, identifying and stating DRPs, documenting care plan and writing professional notes

• Evaluate critical thinking process for identifying DRPs and developing care plans

• Provide final evaluation

3. Improved attitude

• Allow students adequate time to provide and complete care with each patient

• Incorporate different levels of PC to enrich students’ learning

• Recognize the importance of feedback, the evaluation process, and providing reinforcement of success

Abbreviations: PC, patient care; DRPs, drug-related problems.

Table 5 Changes participants intend to make as a result of the online modules

Theme 1: improve teaching methods

• Provide a better learning environment for students

• Develop a calendar of activities ahead of time

• Provide many different PC opportunities

• Evaluate work in line with experiential guidelines

• Provide more effective feedback and evaluation by spending more time

• Take a more active role in students’ experiences, not just during evaluations (directly observe students, provide them with challenging learning tasks, use “what if” situations, use tips to motivate students, allow autonomy but remain available, avoid giving them the rightanswer right away

• Stress the importance of clear, concise, and accurate documentationand communication

• Help students understand the benefits of PC and better utilizepharmacy care plans

• Engage struggling students early on

• Encourage students to use PC tools to help bridge the gap between paper cases and real patients when assessing their patients

Theme 2: professional practice

• Incorporate some of the skills, particularly written documentation inclinical practice

• Use PC tools more often when evaluating patients

Theme 3: no change

• Will continue with the status quo

• The module reinforced my current skills and knowledge on precepting pharmacy students

• No specific changes, but I will reflect on what I have learned from theonline module

Abbreviation: PC, patient care.