A Student-Led Elective Provides Quality Improvement Feedback for a Required Compounding Course.

Objective. To implement an advanced elective compounding course where pharmacy students conduct investigations to improve compounding-related issues that were subsequently evaluated in a required compounding course. Methods. The elective compounding course required students to engage in self-directed learning, critical thinking, creation and evaluation of laboratory data, and self- and group reflection. Students researched and developed "solutions" to compounded preparation problems, and their solutions were tested in the next iteration of a required compounding course. For example, students in the elective course identified sources of potency variability in a ketoprofen Pluronic organogel (PLO) emulsion preparation. The students identified six variables and executed an investigative action plan. They considered all data collected and proposed a method to reduce potency variation. The recommended solution was implemented in the next offering of a required compounding course and the potency variability results were compared to the previous required course's results. Results. The mean ketoprofen PLO emulsion potency achieved in the required course prior to implementing the elective course recommendation was 129% (SD 21%), n=158. After the recommended change from elective course was implemented, the mean potency was 118% (SD 21%), n=131. Conclusion. The teaching methods and activities conducted in the elective course provided students with a deeper level of learning and understanding of compounding science, while providing practical experience in scientific research methodology. The course also provided a cyclic quality improvement feedback mechanism for the required course.

The Positive Impact of an Extended Intervention on Dosing Accuracy of Student Compounded Suspensions.

Objective. To demonstrate the impact of an extended intervention on the dose accuracy and consistency of a compounded zonisamide suspension. Methods. A laboratory exercise was initially conducted by pharmacy students to determine the beyond-use date (BUD) of a compounded zonisamide suspension. The student results were inconsistent with data in a published reference study. The exercise was repeated several times testing various hypotheses to explain the inconsistency. The final hypothesis was the student techniques of shaking and sampling their suspensions resulted in inaccurate samples. Therefore, a final hypothesis study was designed to include an extended intervention (weeks 5-7) that would demonstrate the impact of explicit verbal and visual instructions on the proper shaking and sampling of suspensions on dose accuracy and consistency. Results. The initial study found that students' weekly average zonisamide potencies ranged from 71%-122% of label, with a relative standard deviation (RSD) of 17%-53%; weekly potencies in the reference study had ranged from 92%-105%. In the final hypothesis study before the extended intervention, dosing accuracy ranged from 64%-111% (RSD 17%-76%). During the 3 week long intervention, dosing accuracy became 91%-118% with a RSD of 5%-29% which were consistent with the reference study. Conclusion. Providing more explicit auditory and visual instructions to pharmacy students regarding the proper shaking and sampling techniques of their compounded suspensions resulted in more consistent and accurate dosing of a zonisamide suspension. By implication, pharmacists providing specific and personalized instructions to patients should reduce their self-dosing inconsistencies at home.