Evaluation of an individualized vs non-specific standardized patient activity in improving communication skills amongst pharmacy students.

BACKGROUND AND PURPOSE: To evaluate the impact of two standardized patient (SP) approaches on student communication skills and self-perceived confidence. EDUCATIONAL ACTIVITY AND SETTING: Second professional year pharmacy students were assessed on overall and area of improvement (AOI) communication skills and self-perceived confidence. Students were invited to participate in a SP intervention activity, following a fall and before a spring class assessment, where they were randomized to an individualized or non-specific SP group. Communication skills were assessed using a four component 64-point rubric; confidence was assessed using an 11-question Likert-type survey. FINDINGS: Nineteen students participated in the SP intervention activity; 11 students comprised the individualized group and eight students comprised the non-specific group. Students in the individualized group demonstrated a significantly higher median change in AOI communication scores compared to the non-specific group [five points vs. three points, respectively (p = 0.033)]. There was a significantly higher median change in overall communication skills in the individualized compared to the non-specific group of 12 points and 6.5 points, respectively (p = 0.017). Student self-perceived confidence in the individualized and non-specific group showed similar improvements overall from pre- to post assessment [seven points vs. eight points, respectively (p = 0.62)]. SUMMARY: The use of SPs in pharmacy curricula can improve student communication skills. However, tailoring the activity to students' needs significantly improves their communication AOI and overall communication skill scores more than a non-specific activity. Student self-perceived confidence improved similarly in both groups, although no statistically significant differences were found between groups.

Impact of a simulated electronic health record on pharmacy students' perceptions of preparedness for clinical practice.

BACKGROUND AND PURPOSE: The growing use of electronic health records (EHRs) in clinical practice highlights the need to incorporate simulated EHRs into the curriculum of healthcare professions. The purpose of this study was to evaluate the impact of a simulated EHR on student performance and to describe students' perceptions of preparedness to use an EHR in clinical practice. EDUCATIONAL ACTIVITY AND SETTING: A simulated EHR was introduced to third-year pharmacy students in a practice lab and case studies course series. The impact of the simulated EHR was measured by comparing student grades from acute patient care and ambulatory care advanced pharmacy practice experiences (APPEs) before and after EHR implementation. Data on students' perceptions of preparedness to use an EHR was collected by means of a questionnaire. FINDINGS: There was no significant difference between groups on student performance from the acute patient care APPE (p = 0.522) or from the ambulatory care APPE (p = 0.936). Questionnaire responses showed statistically significant improvements in students' perceptions of preparedness to use an EHR in clinical practice. DISCUSSION: Positive findings related to students' perceptions of preparedness to use an EHR in clinical practice were used to guide expansion of the simulated EHR throughout the didactic curriculum at the Philadelphia College of Pharmacy. SUMMARY: Implementation of a simulated EHR at the end of the PharmD didactic curriculum did not show a difference in student performance on select APPEs, but did show improvements in students' perceptions of preparedness to use an EHR in clinical practice.

Golimumab: a tumor necrosis factor alpha inhibitor for the treatment of rheumatoid arthritis.

OBJECTIVE: To review the pharmacologic, pharmacokinetic, efficacy, and safety data of golimumab, an anti-tumor necrosis factor alpha (TNF-alpha) monoclonal antibody. DATA SOURCES: A search of MEDLINE (1950-September 2009) was performed to identify any published clinical trials or review articles pertaining to golimumab. Key search terms included golimumab, rheumatoid arthritis, CNTO 148, and anti-TNF-alpha inhibitors. Bibliographies of selected articles were reviewed to identify other relevant citations. Abstracts from national and international meetings and information from the manufacturer were also reviewed. STUDY SELECTION AND DATA EXTRACTION: All available published articles and abstracts describing golimumab's pharmacologic or pharmacokinetic profile, efficacy, and safety were included. DATA SYNTHESIS: Golimumab is a fully humanized TNF-alpha monoclonal antibody that is specific for human TNF-alpha. Trials have investigated the use of golimumab in patients who have rheumatoid arthritis (RA) and are on methotrexate, are methotrexate-naïve, and have previously tried TNF-alpha inhibition therapy. When used in combination with methotrexate or another disease-modifying antirheumatic drug, golimumab therapy results in improvements of clinical outcomes including the American College of Rheumatology parameters in all of the aforementioned populations. Although multiple doses and dosing regimens have been studied, the Food and Drug Administration-approved dose is 50 mg subcutaneously every 4 weeks. The most common adverse effects include injection site erythema, headaches, and nausea. There were a limited number of incidences of serious infection or malignancy. CONCLUSIONS: With 4 TNF-alpha monoclonal antibodies currently on the market, it is unclear what golimumab's place in therapy for RA will be. Some benefits include monthly injections, proven efficacy after previous TNF-alpha inhibitor therapy, and limited antibody development during therapy. However, with a lack of longer-term trials assessing efficacy and safety compared with other TNF-alpha inhibitors, golimumab should be reserved for use after other therapies fail.