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|Institution:||University of Washington|
|Institution:||University of British Columbia|
|Organization:||Faculty of Pharmaceutical Sciences|
|Position:||Coordinator and Drug Information Pharmacist|
|Organization:||B.C. SMILE program, Faculty of Pharmaceutical Sciences|
|Position:||Drug Information Pharmacist|
|Organization:||B.C. SMILE program, Faculty of Pharmaceutical Sciences|
|Name:||Helen McCrae Award|
I coordinate, and teach in, the four courses that encompass the appropriate use of nonprescription medications and the self-medicating patient. These courses run throughout 2nd and 3rd year pharmacy.
I have given approximately 60 one-hour presentations to members of community-based organizations through my work with B.C. SMILE
This professional practice laboratory is the third and final such lab for our undergraduate students and is taught to 3rd year pharmacy students in our Bachelor of Science (Pharmacy) program. I developed a number of different ways to engage the students during these 3- hour labs. In my first year of coordinating this lab, two teaching assistants (graduate students) and I taught each lab section. The pharmacy students would rotate through 3 stations, such as computer entry/dispensing issues, patient care, and legislation issues. In subsequent years, I made significant changes to the traditional lab structure to incorporate more of the time pressure of pharmacy practice. The goal with these changes was to help prepare the students not only for their upcoming clerkships, but also for their licensing exams. One such example was my development and implementation of multiple short, timed mini-stations through which each student would rotate during the three-hour lab session. This change in structure provided a new challenge to the students and, from student feedback, also helped them with their future licensing exams.
Another idea I developed and incorporated into this senior year lab was a Bone Density Screening Clinic. Not only was this the first time such a clinic had been held in our faculty, I understand it was also the first such clinic held in an undergraduate pharmacy laboratory across Canada. This clinic involved recruitment of 65 ambulatory volunteer participant patients from the community, each of whom was assigned to a pair of third year students. The students underwent an in-lab training session for this specific clinic. Then, the students were required to contact their specific patient to perform a detailed telephone interview of the patient. Next, the patients came to UBC to meet with their student pair, who then conducted a 20-30 minute bone density screening clinic in the professional practice centre. The students provided interpretations of the bone mineral density results to their patient with respect to the patient's risk of fracture over the next 10 years. As well, the students provided lifestyle and non-drug measures counselling specific to their patient. Feedback from both patients and students alike regarding this project was extremely positive. I coordinated and taught this project for two years, after which it became less feasible to operate such a clinic.
In conjunction with the UBC Pharmacy Continuing Education Department (now Continuing Pharmacy Professional Development), I implemented the requirement that each pharmacy student enrolled in the Pharmacy 300 Lab complete 1.0 credits of extracurricular pharmacy continuing education in that school term. Because achieving a certain number of continuing education credits was not a requirement for pharmacists in B.C., the intention of this initiative was to expose the students to these programs and hopefully encourage their continuing participation in such programs post-graduation.
Just prior to my joining the Faculty, a Faculty of Pharmaceutical Sciences Teaching Support Group had been formed by a few of the lecturers/instructors in our Faculty. I joined this group in an effort to learn more about how to improve my teaching. During meetings, the members would share ideas they were considering implementing in their courses and receive constructive feedback from the other members. One idea that appealed to me was the suggestion to use senior level pharmacy students as peer teachers to the junior students. Two of us subsequently implemented such a project in our courses. My project was entitled, “Using Senior Students as Peer Tutors in the Professional Practice Lab.” This project actually became an elective 3-credit course that I coordinated and taught to 4th year pharmacy students.
I designed this project to be both a teaching course for fourth year pharmacy students as well as a teaching support system for my professional practice laboratory. I was of the strong belief that our 3rd year pharmacy students needed to be challenged more, particularly in the area of patient counselling. At the time, we were providing scenarios and having the students counsel each other, with a varying quality of both counselling and feedback. With the directed studies project, the 4th-year students were to each design both a major and minor patient case (differentiated by number of scenarios attached to each case). At least one scenario had to involve non-prescription medications (to coordinate with the lecture schedule in the non-prescription products lecture course stream). The students worked diligently on these cases over the summertime with regular check-ins with me. During the academic year, the group met to discuss the upcoming lab and the scenarios that would be portrayed. The goal was to bring back some of the patients throughout the year so that the students would be able to do follow-up with them, as well as incorporate some of the information obtained from previous appearances. The peer tutors (i.e. the 4th year directed studies students) came into the labs to play the patients (in costume) for the 3rd-year students to interact with, problem-solve, and counsel. The project started with 12 directed studies students in the September 1999 academic year, but due to overwhelming student interest, it was expanded in the September 2000 session to 17 students. In subsequent years, the directed studies students’ role was expanded to include assessment and assigning of marks for the third year students. These marks contributed significantly to the final lab grade for each student. Feedback from the third year students who were taught by the directed studies standardized patients in the pharmacy 300 lab was extremely positive. In each year that I coordinated this directed studies project, the number of applicants for the directed studies positions was significantly greater than could be accepted into the program.
Because we no longer had an adequate supply of peer tutors for the senior year of the professional practice lab, I developed a proposal to request funding to allow the hiring of professional standardized patients (through a program operated through the UBC Faculty of Medicine), to play the roles of patients throughout the year to our 3rd year students. This proposal was approved, and so the task of re-writing the scenarios and providing them to the trainer of the standardized patients ensued. Training the actors was much more time intensive (as what would be clear to a senior pharmacy student was not clear to a lay-person) compared to training the peer tutors. Benefits of using these actors included the interpersonal skills and empathy feedback they provided to individual students, as well as the provision of a greater sense of authenticity (older age, etc) compared to the 4th year students. The students also reported being better prepared for their licensing exams. Although costly, this standardized patient project that I initiated and developed continues to be used in the professional practice laboratory today.
In order to have the students apply the use of non-prescription products and non-drug measures to specific sample patients, I implemented the use of group projects for a large lecture-based class. To that end, I designed a group project that would enable small groups of students to work together throughout the year. The project design included developing roughly 40 case studies (one per group) each with multiple scenarios that the students would need to answer from both the lecture material and from their own research. Some topics involved self-teaching to cover content not taught in the lectures (due to time constraints). For the first year of this project, I recruited faculty colleagues to role-play a specific patient for the group members to interview. This was a time-consuming venture in that I had to create 40 patient profiles that would fit the many different scenarios so that there would be drug-related problems with each one. Then, the faculty members had to be encouraged to memorize as much of the material as possible to allow for a more realistic interaction. The material gathered by the students from that interview would then form the basis for their scenario recommendations (i.e. medical history, allergy status, current medications, etc). I created a specific patient scenario for each group to reduce the chances of collaboration between groups. For subsequent years of this project, I omitted the use of the faculty colleague “actors” as it was too onerous for many of them to be available to the students. Thus, these student groups received written patient scenarios and had to work through the cases with that information. The class feedback was very positive for this project. This project continued until the introduction of the new curriculum in our program, which changed the non-prescription course stream into four one-credit courses. Plans are currently underway to explore running this course stream as on-line courses with coordinating small-group tutorials.
To support the teaching of the new non-prescription courses, I developed a directed studies project for a small group of senior pharmacy students. The goal was to produce pre-reading chapters for the students enrolled in the non-prescription courses. My reason for wanting these chapters was because the Canadian textbook we had been using was becoming out-of-date. I also wanted pre-readings that would emphasize possible benefits and harms of both drug and non-drug measures, and also provide pictures of products as well as their costs. Running this project was a real learning experience for me as well as being very time-intensive. I had limited prior experience as an editor of someone else’s work and found the process very slow. The students participating in the project found that creating the chapters of material reinforced their understanding of the material. The students for whom the chapters were created found them easy to read and informative, and they found the product pictures very useful.