Instructional educational games in pharmacy experiential education: a quasi-experimental assessment of learning outcomes, students' engagement and motivation.

BACKGROUND: This study aimed to determine the impact of implementing instructional educational games on attaining the intended learning outcomes mapped with the competencies of a pharmacy practice experience course, and to assess students' attitudes towards motivation and engagement in this active learning activity. METHODS: This was a quasi-experimental study that utilized a pretest-posttest for the research groups. Students were divided into teams and challenged to answer different questions related to the case scenarios. Different gaming platforms as Gamilab, Wisc-Online, and Quizizz were accordingly used to create different questions that help students memorize medications' brand names, and acquire the advanced community knowledge and skills. The attainment of the intended learning outcomes was assessed and compared between the experimental and control groups through the course total average of grades, and the subsequent averages of domains relating to the course competencies. Attitudes towards motivation and engagement in educational games activities were also assessed among the experimental group. RESULTS: A total of 233 students were enrolled in the study. The experimental group had significantly higher total posttest average compared to the control group (Beta = 7.695, 95% CI = 4.964-10.425, P < 0.001). The experimental group had also significantly higher averages of competency domains related to foundational knowledge (Beta = 1.471, 95% CI = 0.723-2.219, P < 0.001), pharmaceutical care (Beta = 1.650, 95% CI = 0.673-2.627, P < 0.001), essentials to practice and care (Beta = 1.838, 95% CI = 0.626-3.050, P < 0.003), and approach to practice and care (Beta = 2.736, 95% CI = 1.384-4.088, P < 0.001) averages. The experimental group reflected positive attitudes toward gamification engagement and motivation, with greater than 60% of the students recommend engage educational games to be part of the course. CONCLUSION: Incorporation of educational games into pharmacy practice experiences resulted in better learning outcomes. This kind of active learning appears to be acceptable and motivational for students, and is recommended for further research in didactic courses in the pharmacy curriculum.

Comprehension of prescription orders with and without pictograms: tool validation and comparative assessment among a sample of participants from a developing country.

BACKGROUND: Medication errors can often occur due to the patient's inability to comprehend written or verbal medication orders. This study aimed to develop pictograms of selected medication orders and to validate the comprehension of prescription orders index and compare the comprehension scores with and without pictograms. In addition to determine the predictors that could be associated with a better or worse comprehension of prescription orders with pictograms versus that of their written counterparts. METHODS: A cross-sectional study was conducted using a snowball sampling technique. Six pictograms were developed to depict specific medication orders. The comprehension of prescription orders index was constructed and validated. The study then compared the comprehension scores of prescription orders with and without pictograms, and identified the predicting factors score difference. RESULTS: A total of 1848 participants were included in the study. The structure of the comprehension of prescription orders index was validated over a solution of four factors, with an adequate Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy of 0.711 and a significant Bartlett's test of sphericity (P < 0.001). The construct validity of the index was further confirmed by highly significant correlations between each item and the full index (P < 0.001). The study also found a significant association between the difference in comprehension scores for prescription orders with and without pictograms and several factors, including age, level of education, area of residence, number of children, and smoking status with the difference of comprehension scores (P < 0.001). CONCLUSION: Pictogram-based instructions of medication orders were better understood by the Lebanese population than written instructions, making the incorporation of pictograms in pharmacy practice paramount to optimize medication use by the patient and thus yielding better health outcomes.

Fever among preschool-aged children: a cross-sectional study assessing Lebanese parents' knowledge, attitudes and practices regarding paediatric fever assessment and management.

OBJECTIVES: This study investigated parental knowledge, attitudes and practices towards fever in preschool children to help address gaps in public health and provide information with the aim of supporting clinical reports for parental education. DESIGN: A cross-sectional study design was used to explore parental experiences with fever. SETTING: Participants were recruited randomly from schools all over Lebanon targeting the preschool divisions. PARTICIPANTS: Parents of children aged 5 years or less. INTERVENTIONS: An electronic self-administered questionnaire was sent to the parents through the schools' emails and e-learning mobile applications. PRIMARY AND SECONDARY OUTCOMES: The primary outcome measure was to assess parental knowledge about the precise definition of fever, correct use of medications and to evaluate the impact of sociodemographic factors on this knowledge. The secondary outcome measures were to assess parental attitudes and practices of fever management, sources of information and reasons to seek primary medical attention. RESULTS: A total of 733 parents were included in the study. Only 44% identified fever correctly according to the recognised definition by international guidelines. A significant association between parents' knowledge of antibiotics and years of parenting experience was found (adjusted OR, ORa=4.23, 95% CI 1.41 to 12.68, p=0.01). Other sociodemographic factors that were significantly associated with parents' knowledge of antibiotics were age (ORa=3.42, 95% CI 1.09 to 10.73, p=0.036) and education level (ORa=7.99, 95% CI 3.71 to 17.23, p<0.001). Greater than 75% usually give their children antipyretics without consulting a doctor. Approximately one-quarter of parents (26.3%) consulted different doctors at the same time, of which more than half (58.4%) had received different medical information. CONCLUSIONS: This research determines deficiencies in parents' knowledge of fever with some malpractices in its management particularly regarding antipyretic use. It provides insight for healthcare providers to empower parental experiences by offering the necessary information to enhance general outcomes of febrile sickness.

Assessment of knowledge, attitude and practice of Lebanese pharmacists in providing patient counseling on urinary tract infection and its treatment.

Background: Urinary tract infection (UTI) is the second most common type of infections, accounting for about 7 million annual visits to health-care providers. Pharmacists have an important role in counseling patients about this disease. Objectives: The study explored the Lebanese pharmacists' knowledge, attitudes and counseling practices (KAP) around UTI. The aim was to provide a better understanding on the pharmacist role in this context, and improve the patient care process and the health of the public. Methods: A cross-sectional knowledge attitudes practice study was conducted and enrolled pharmacists who were practicing in the community setting. The questionnaire collected data about the sociodemographic characteristics, pharmacist's knowledge about UTIs, their attitudes and practice in providing patient counseling. Results: A sample of 450 pharmacists was reached, the majority (>90%) of which had good knowledge about UTIs. Moreover, greater than 90% of pharmacists believe that UTIs are serious, and that being unhygienic is one of its causes (93.6%). The majority reported educating patients about the most common causes (90.4%), risk factors (88.4%) and preventive measures (95.1%) of UTIs. A mean score of 8.44 was reported for the knowledge score and multivariable linear regression has shown that female pharmacists have higher knowledge score than males. A significant association between having a PhD degree and believing that men are more prone to UTI. Furthermore, the province of the pharmacists' practice, being in Beirut, was positively and significantly correlated with better practice. Conclusions: Lebanese pharmacists are well knowledgeable about UTIs and showed good attitude and practice in this field. This study provides insight for discussion with policy makers to upgrade legislation to enable pharmacists to legally prescribe antibiotics for uncomplicated UTIs, similar to other countries, to improve the patient care process and minimize the burden of the disease.

Chronic kidney disease awareness among the general population: tool validation and knowledge assessment in a developing country.

INTRODUCTION: Good knowledge and early identification of chronic kidney disease (CKD) can help in preventing disease progression in its early stages and reducing undesired outcomes. The aim of the current study was to assess the level of public knowledge about CKD, determine predictors of better knowledge, and to construct and validate a CKD knowledge scale for public health assessment and research use. METHODS: A community-based cross-sectional study was conducted using an electronic self-administered questionnaire. All people living in Lebanon and being 18 years of age and above were considered eligible for recruitment. CKD knowledge was assessed by a 37-item scale that was constructed by principal component analysis and then validated. The score of the CKD knowledge scale was computed from the extracted factors. A multivariable binomial logistic regression model evaluated the sociodemographic and clinical predictors of the knowledge score. RESULTS: A total of 1308 participants were included. The scale items converged over 9 factors with Eigenvalue greater than 1 and explaining 53.26% of the total variance, and the total scale had a high Cronbach's alpha of 0.804. All items of the scale significantly correlated with the full scale with correlation coefficients ranging from 0.082 to 0.558. The ROC curve analysis determined an optimal cutoff point of better knowledge at 47.5 with 70.6% sensitivity and 44.2% specificity. The CKD knowledge score had a median of 51.00 (IQR 47.00-55.00). Higher knowledge score was significantly associated with old age (ORa = 1.018, 95% CI 1.006-1.030, P = 0.003),, occupation (ORa = 3.919, 95% CI 2.107-7.288, P <  0.001), and recent renal function assessment (ORa = 2.314, 95% CI 1.532-3.495, P <  0.001). However, a lower knowledge score was significantly associated with lower level of education (ORa = 0.462, 95% CI 0.327-0.653, P <  0.001). CONCLUSION: A reliable tool to assess public knowledge and awareness about CKD was developed and validated. The overall knowledge was good, however, important gaps in CKD awareness were detected in some areas and subpopulations. Therefore, public health stakeholders need to implement targeted CKD educational activities to minimize the disease burden.