Medication Optimization and Patient Education in Heart Failure: A Standardized Patient Case for Clerkship Students.

INTRODUCTION: Heart failure is not only a common cause of hospitalization, it is also a condition associated with a high rate of readmission following discharge to home due to several factors including complex medication regimens. Medical management of patients with heart failure involves a number of monitoring parameters of which both physicians and patients must be aware, but are often not. METHODS: In this exercise, clerkship students are presented with a patient scenario in which they are tasked with optimizing medication therapy as well as providing patient education regarding medications to engage and empower the patient to adhere to the prescribed regimen. RESULTS: We found that students were most successful communicating the reason why medications were prescribed. Students exhibited similar performance regarding the likelihood of providing education regarding adverse drug events that could be anticipated. On the other hand, students were much less inclined to communicate appropriate monitoring and intensification information to patients. DISCUSSION: Utilizing this case with third-year medical students highlights the need for additional opportunities for students to practice medication-related communication skills. In addition to its applicability to medical students, this case may also have utility in interprofessional education activities that involve learners from pharmacy or nursing programs who will be involved with reconciling, dispensing, educating, or administering medications to patients.

Rash in Breast-Feeding Mother: Standardized Patient Case for Clerkship Students.

INTRODUCTION: Adverse drug reactions are a leading cause of morbidity and mortality. The full impact of these reactions is often not recognized by health care providers, which can lead to a cascade of additional medications prescribed to treat adverse effects caused by the inciting medication. METHODS: In this exercise, clerkship students are presented with a standardized patient portraying a medical problem. The students must identify the underlying cause of the problem, drawing on their knowledge of pharmacology, clinical therapeutics, special populations, and pharmacogenetics, to uncover and correct the deeper medical concerns, and compose a SOAP note. Thirty-five minutes were allotted for each student for this case. RESULTS: To date, this scenario has been used with all 23 third-year medical students at our regional campus. We found that most students tended to prematurely close the case after identifying the one obvious primary problem, leaving other issues unresolved. DISCUSSION: Utilizing this case with third-year medical students highlighted the need for continued reinforcement and application of pharmacologic principles throughout the clinical years of training. Furthermore, given that recent medical graduates often feel unprepared to prescribe safely and effectively, this case may also have utility as a teaching and discussion tool among medical residents. Additionally, it can be used in interprofessional educational activities with learners from pharmacy or nursing programs who will be involved in dispensing or administering medications to patients.