Evaluating video-based lectures on YouTube for dental education.

PURPOSE/OBJECTIVES: Multimedia presentations and online platforms are used in dental education. Though studies indicate the benefits of video-based lectures (VBLs), data regarding user reception and optimal video features in dental education are limited, particularly on Web 2.0 platforms like YouTube. Given increasing technology integration and remote learning, dental educators need evidence to guide implementation of YouTube videos as a freely available resource. The purpose of this study is to determine video metrics, viewership and format efficacy for dental education videos. METHODS: First, a cross-sectional survey was conducted of viewers (N = 683) of the Mental Dental educational videos on YouTube. Analytics were evaluated for 677 200 viewers to assess audience demographics, retention and optimal video length. Second, a randomized crossover study was conducted of dental students (N = 101) who watched VBLs in either slideshow or pencast formats and were tested on content learning to compare format efficacy. RESULTS: Most viewers of Mental Dental videos were dental students (44.2%) and professionals (37.8%) who would likely recommend the platform to a friend or colleague (Net Promoter Score = 82.1). Audience retention declined steadily at 1.34% per minute, independent of video length. Quiz performance did not differ between slideshow and pencast videos, with students having a slight preference for slideshows (P = 0.049). CONCLUSIONS: Dental students and professionals use VBLs and are likely to recommend them to friends and colleagues. There is no optimal video length to maximize audience retention and lecture format (slideshow vs. pencast) does not significantly impact content learning. Results can guide implementation of VBLs in dental curricula.

Development and implementation of a formative instructional coaching program using the Teaching Practices Inventory within a health professions program.

BACKGROUND: A growing body of literature describes teaching practices that are positively associated with student achievement. Observing, characterizing, and providing feedback on these teaching practices is a necessary, yet significant challenge to improving teaching quality. This study describes the design, implementation, and evaluation of an instructional coaching program created to provide formative feedback to instructors based on their use of evidence-based teaching practices. METHODS: The program was designed for formative purposes utilizing an instrument adapted from the Teaching Practices Inventory. All faculty were invited to participate in the program on a voluntary basis when the program launched in Fall 2019. Program coaches included any School personnel who completed required training. Two rounds of instrument development were conducted with multiple observers and assessed using Krippendorff's Alpha. The program was evaluated using an anonymous post-session survey. RESULTS: Interrater reliability of the form improved over two rounds of piloting and no differences were found in scoring between trainees and education professionals. Seventeen observations were completed by nine coaches. Instructors indicated that feedback was practical, timely, specific, and collegial, suggesting that including student perspectives (e.g., focus groups, student course evaluations) in the coaching program might be helpful. CONCLUSIONS: Creating programs that emphasize and foster the use of evidence-based teaching are critical for health professions education. Additional research is needed to further develop coaching programs that ensure teaching practices in the health professions are optimizing student learning.

Activating prior knowledge using multiple-choice question distractors.

CONTEXT: A student's academic success in graduate and professional school may depend on prior knowledge. However, these students may not see important and necessary material for extended periods of time between their pre-requisites and their new course work. As such, they are more prone to being unable to access available information from memory when needed. This study investigated the use of multiple-choice (MC) question examinations in stabilising or reactivating these students' memories for material that is available in their memories, but currently inaccessible due to disuse. METHODS: A total of 156 incoming first-year student-pharmacists were recruited. These student-pharmacists completed a baseline examination on physiology prior to coursework. This assessment contained fill-in-the-blank (FIB) questions followed by MC versions of the FIB questions. In the experimental sets, 10 questions had MC distractor answers that were answers to a future FIB question; in the other condition, the MC distractors were not answers to future FIB questions. The primary outcome was performance on future or target FIB questions in the context of whether the prior or priming MC questions contained the answer within the distractors. RESULTS: Performance on target FIB questions improved when the distractors in the MC questions contained the relevant answer (29%) compared to when the distractors did not contain the correct answer (18%) (P < .001, d = 0.78). When students could not generate a correct response to the FIB question, the experimental condition outperforming the control condition (17% vs 30%, d = 0.76). CONCLUSIONS: Multiple-choice questions that contained a correct response as a distractor to a future question, improved student performance. As such, the use of MC may be an inexpensive way to reactivate prior knowledge, especially knowledge that has become inaccessible due to disuse.

Effects of Citrulline Malate and Beetroot Juice Supplementation on Blood Flow, Energy Metabolism, and Performance During Maximum Effort Leg Extension Exercise.

Trexler, ET, Keith, DS, Schwartz, TA, Ryan, ED, Stoner, L, Persky, AM, and Smith-Ryan, AE. Effects of citrulline malate and beetroot juice supplementation on blood flow, energy metabolism, and performance during maximum effort leg extension exercise. J Strength Cond Res 33(9): 2321-2329, 2019-Citrulline malate (CitMal) and beetroot juice (BEET) are increasingly popular ergogenic aids, but few studies have rigorously investigated their effects on resistance exercise performance and underlying mechanisms. The current randomized, double-blind, crossover study evaluated the effects of CitMal and BEET supplementation on blood flow, metabolic efficiency, and performance during maximal isokinetic leg extension exercise. After familiarization, 27 recreationally active men (age: 22 ± 4 years) completed 3 visits in which subjects ingested a treatment beverage (CitMal [8 g], BEET [400-mg nitrate], or placebo [PLA]), followed by a 2-hour rest period, warm-up, and 5 sets of 30 concentric leg extensions. Before and after exercise, ultrasound was used to measure diameter (aDIAM) and blood flow (aBF) of the superficial femoral artery, along with cross-sectional area and echo intensity of the vastus lateralis. Plasma analytes (lactate, nitrate/nitrite [NOx], and urea nitrogen [BUN]) were also assessed at these times, and indirect calorimetry was used to measure energy expenditure and respiratory exchange ratio before and during exercise. Resting NOx values were higher in BEET (233.2 ± 1.1 µmol·L) compared with CitMal (15.3 ± 1.1, p < 0.0001) and PLA (13.4 ± 1.1, p < 0.0001). Postexercise NOx values, adjusted for resting differences, were higher in BEET (86.3 ± 1.2 µmol·L) than CitMal (21.3 ± 1.1, p < 0.0001) and PLA (18.1 ± 1.1, p < 0.0001). No other variables were affected by treatment (all p > 0.05). While BEET increased NOx, neither treatment was found to enhance performance, blood flow, metabolic efficiency, nor the hormonal response to leg extension exercise.

Effects of Coffee and Caffeine Anhydrous Intake During Creatine Loading.

The purpose of this study was to determine the effect of 5 days of creatine (CRE) loading alone or in combination with caffeine anhydrous (CAF) or coffee (COF) on upper-body and lower-body strength and sprint performance. Physically active males (n = 54; mean ± SD; age = 20.1 ± 2.1 years; weight = 78.8 ± 8.8 kg) completed baseline testing, consisting of 1 repetition maximum (1RM) and repetitions to fatigue with 80% 1RM for bench press and leg press, followed by a repeated sprint test of five, 10-second sprints separated by 60-second rest on a cycle ergometer to determine peak power (PP) and total power (TP). At least 72 hours later, subjects were randomly assigned to supplement with CRE (5 g of CRE monohydrate, 4 times per day; n = 14), CRE + CAF (CRE +300 mg·d of CAF; n = 13), CRE + COF (CRE +8.9 g of COF, yielding 303 mg of CAF; n = 13), or placebo (PLA; n = 14) for 5 days. Serum creatinine (CRN) was measured before and after supplementation, and on day 6, participants repeated pretesting procedures. Strength measures were improved in all groups (p ≤ 0.05), with no significant time × treatment interactions. No significant interaction or main effects were observed for PP. For TP, a time × sprint interaction was observed (p ≤ 0.05), with no significant interactions among treatment groups. A time × treatment interaction was observed for serum CRN values (p ≤ 0.05) that showed increases in all groups except PLA. Four subjects reported mild gastrointestinal discomfort with CRE + CAF, with no side effects reported in other groups. These findings suggest that neither CRE alone nor in combination with CAF or COF significantly affected performance compared with PLA.

An Integrative Review of Approaches Used to Assess Course Interventions.

Objective. The objectives of this review are to describe the utility of approaches used for the assessment of course interventions in pharmacy education and to provide recommendations that may guide faculty members in their scholarship of teaching and learning (SoTL) efforts that encompass assessment of course interventions.Findings. Thirty-four articles that included educational interventions published between 2016 and 2020 in the American Journal of Pharmaceutical Education and Currents in Pharmacy Teaching and Learning were selected for analysis. Those articles used various approaches for the assessment of course interventions. In the order of decreasing frequency of use, those methods were surveys, student academic performance, student evaluations, mixed quantitative and qualitative methods, pre- and posttest, and learning analytics.Summary. The use of more than one assessment approach, ie, triangulation, and multiple student cohorts are advantageous. When multiple cohorts are used, it is beneficial to present the students' demographic information. Student academic performance should be part of an assessment of course interventions whenever relevant. Surveys about student perceptions and confidence may contribute to the assessment of course interventions. However, since the information collected is subjective and is usually unrelated to student learning, such an approach should be coupled with other assessment approaches that reflect student learning, such as academic performance and/or a pre- and a posttest. Depending on the research question, qualitative methods and learning analytics may also be a part of the assessment of course interventions.

Faculty Process for Reviewing and Utilizing a School's Course Evaluation Comments.

OBJECTIVE: This study aimed to explore faculty engagement with qualitative comments from course evaluations. METHODS: Course faculty from the University of North Carolina Eshelman School of Pharmacy were recruited via email to participate in a 30-minute interview session. Previous course evaluation comments were adapted to create a de-identified mock evaluation. Six interviews were conducted via Zoom, consisting of a think-aloud protocol based on the mock course evaluation followed by a cognitive interview focused on goals and current utilization of comments, and common patterns and issues sought by faculty. Interview transcripts were manually cleaned and de-identified. Transcripts were inductively coded by 1 researcher using MAXQDA. RESULTS: Three overarching themes were identified: general faculty process for reviewing comments (ie, how faculty perceive and analyze comments), comments utilization for course change (ie, how faculty utilize comments in making course changes), and faculty analysis strategy (ie, faculty approach to locating common patterns in evaluation comments). The most common subthemes included usefulness of comments, methods for tracking comment patterns, and challenges with the large number of comments each semester. CONCLUSION: Faculty provided useful insight and feedback regarding the current state of the course evaluation process that can be used to improve the structure, organization, and utilization of course evaluations by faculty. These findings could inform the creation of the course evaluation comment automated analysis program in the next stage of an ongoing project.

Lessons From Using Design Thinking to Develop the 2021 AACP Teachers' Seminar.

Objective. To describe and evaluate how a design thinking approach aided the creation of the 2021 American Association of Colleges of Pharmacy (AACP) Teachers' Seminar.Methods. The design thinking framework (ie, inspiration, ideation, and implementation) was used to structure the seminar development process from July 2020 to July 2021. Nine committee members engaged in a persona activity (ie, inspiration), a brainstorming activity (ie, ideation), and a prototyping activity (ie, implementation) to create a user-centered learning experience. Twenty-five small group facilitators were then recruited to create and deliver breakout session content. After the seminar, the team was invited to debrief their experience in a focus group and an electronic survey to evaluate the perceived impact of using design thinking in the planning process.Results. Twenty-one (62%) of the 34 committee members and small group facilitators attended the focus group, and 28 (82%) completed the electronic survey. Most agreed that design thinking was a useful approach to support the Teachers' Seminar, and they were generally positive about the experience. There was a significant increase in self-reported creative self-efficacy for coming up with novel ideas, ability to solve problems, and helping expand others' ideas. Team members identified positive attributes about the seminar and planning process as well as areas for improvement. Team members also acknowledged challenges and potential solutions for professional organizations and program developers to consider when creating user-centered experiences.Conclusion. Design thinking can be a useful framework for seminar planning and implementation to create engaging, meaningful, and valuable educator development experiences.

Assessing the Use of Microlearning for Preceptor Development.

The objective of this study was to evaluate microlearning as a preceptor development method compared to a traditional method of learning. Twenty-five preceptor participants volunteered to engage in a learning intervention about two preceptor development topics. Participants were randomized 1:1 to either a thirty-minute traditional learning experience or a fifteen-minute microlearning experience; participants then crossed over to the other intervention for comparison. Primary outcomes were satisfaction, changes in knowledge, self-efficacy, and perception of behavior, confidence scale, and self-reported frequency of behavior, respectively. One-way repeated measures ANOVA and Wilcoxon paired t-tests were used to analyze knowledge and self-efficacy, and Wilcoxon paired t-tests were utilized to assess satisfaction and perception of behavior. Most participants preferred microlearning over the traditional method (72% vs. 20%, p = 0.007). Free text satisfaction responses were analyzed using inductive coding and thematic analysis. Participants reported that microlearning was more engaging and efficient. There were no significant differences in knowledge, self-efficacy, or perception of behavior between microlearning and the traditional method. Knowledge and self-efficacy scores for each modality increased compared to the baseline. Microlearning shows promise for educating pharmacy preceptors. Further study is needed to confirm the findings and determine optimal delivery approaches.

Pharmacy Leaders' Reflections on Leadership and Legacy.

OBJECTIVE: To explore the experiences, contributions, and perceived legacy of individuals recognized as leaders in the pharmacy profession and compare these by gender and generational category. METHODS: A total of 54 leaders were interviewed about their journey to leadership and the legacy they leave to the profession. Interviews were transcribed, de-identified, and qualitatively analyzed using an inductive, modified constant comparison approach for open and axial coding. Qualitative responses were quantified to allow for the comparison of themes by gender and generational category. RESULTS: Common leadership themes included: humility, not expecting to be in a leadership role, taking initiative, being passionate about their work, having mentors to guide them, having a network of people around them, being a part of change, serving during a challenging time, seizing opportunities when they presented themselves, and being involved in professional organizations. The individual's clinical work (38.9%), helping to develop pharmacy as a clinical profession (33.3%), publications (29.6%), impact on students (29.6%), building programs (22.2%), involvement in organizations (20.4%), and impactful research (16.7%) were common themes noted in the legacy responses. CONCLUSION: Although there are many advancements still to be made, upcoming leaders would benefit from the journey and perceived legacy of these leaders as they carry the torch to advance the practice of pharmacy.

Pharmacy Leaders' Advice to Students Pursuing Leadership: A Qualitative Study.

INTRODUCTION: Leadership development is important both from a curricular standpoint and for continued advancement of the profession. Advice from current leaders in the profession may serve as a powerful motivator to students desiring to be leaders. The purpose of this qualitative study was to provide advice from experienced pharmacy leaders. METHODS: Fifty-four pharmacy leaders were identified based on pre-determined, specific criteria and by using a snowball sampling method. Interviews with leaders were conducted via Zoom to learn about their leadership journey, their legacy, and advice they would give students. The interviews were transcribed, de-identified and analyzed using the inductive, modified constant comparison approach for open and axial coding. Advice themes were compared by gender and generational category. RESULTS: The majority of the interviewees were male (69%), belonged to the Baby Boomer Generation (1946-1964, 59.3%), and held leadership positions in education (78%) and health systems (48%). Thirty-seven leadership advice themes were present. The topmost advice to students was to keep an open mind (35%) and to get involved in organizations (32%). Pieces of advice shared by both men and women leaders included: being open minded, getting involved in organizations, taking initiative, trying new or difficult things, and finding your passion. Keeping an open mind, and taking initiative were common across the three generations. CONCLUSION: Pharmacy leaders have insightful information for students aspiring to be future leaders. Leadership advice was similar by gender and generational category. Students would benefit in developing their leadership based on advice from the lived experience of pharmacy leaders. Future studies could examine students' perspectives on leadership advice.

A Practical Review of Mastery Learning.

Objective. To review mastery learning and provide recommendations for implementation in a competency-based curriculum.Findings. Mastery learning, introduced in the 1960s, was developed to ensure all students reach a desired level of mastery or competency. In this model, students acquire knowledge, skills, or attitudes and then complete formative assessments on that learning. If they achieve the desired level, they can proceed to enrichment activities. Students who do not meet the desired level of mastery proceed through corrective activities and retesting. Evidence suggests students within a mastery learning model perform better academically than those in nonmastery learning models with moderate effect sizes. Mastery learning may result in better performance due to several theoretical reasons, including aspects of motivation, testing, and feedback.Conclusion. We make several recommendations on how to modernize mastery learning for apply it to the pharmacy education, including the recommendation to use more cumulative testing and assessment of baseline knowledge and skills. In addition, models of successive relearning may be applied to this model.

A Practical Review for Implementing Peer Assessments Within Teams.

Objective. The objective of this review is to maximize the benefit of peer assessments in teamwork settings in professional pharmacy curricula.Findings. Best practices do not exist for using peer assessments in academic settings. The studies on peer assessments that we reviewed applied various conditions: Some studies used peer assessments of teams for formative assessments, while others used them for summative assessments; some assessed teamwork at a limited number of time points, while some assessed multiple time points; some attached student names to the assessments, while some were anonymous; and some explained why the tool was being used, while others offered no explanation.Conclusion. To use peer assessments most beneficially, instructors must define the purpose for their use, explain the purpose of teamwork, orient students to the tool being used, assess teamwork over time, provide feedback, minimize grades associated with the assessment, and use partial anonymity when collecting feedback.

Determining Whether Pharmacy Students Can Accurately Recall Items on an Examination Using Their Collective Memory.

Objective. To determine the extent to which students can recreate a recently completed examination from memory.Methods. After two mid-term examinations, students were asked, as a class, to recreate recently completed examinations. Students were given 48 hours to recreate the examination, including details about the questions and answer choices. The results were compared to the original examination to determine the accuracy of students' recall and reproduction of content.Results. The students were able to collectively recreate 90% of the questions on the two examinations. For the majority of questions (51%), students also recreated the question as well as the correct response and at least one incorrect response. The majority of questions that the students recreated were of medium to high accuracy as they contained detailed phrasing that aligned with the original question on the examination.Conclusion. The collective memory of a group of students may allow them to accurately recreate the majority of a completed examination from memory. Based on the findings of this study and tenets of social psychology, faculty should consider the potential implications for examination security, whether to provide feedback to students on examinations, and whether completed examinations should be released to students following the examination.

Overcoming Past Perceptions and a Profession-Wide Identity Crisis to Reflect Pharmacy's Future.

The profession of pharmacy has come to encompass myriad identities, including apothecary, dispenser, merchandiser, expert advisor, and health care provider. While these identities have changed over time, the responsibilities and scope of practice have not evolved to keep up with the goals of the profession and the level of education of practicing pharmacists in the United States. By assuming that the roles of the aforementioned identities involve both product-centric and patient-centric responsibilities, our true professional identity is unclear, which can be linked to the prevalence of the impostor phenomenon within the profession. For pharmacy to truly move forward, a unified definition for the profession is needed by either letting go of past identities or separating these identities from each other by altering standards within professional degree programs and practice models. Without substantial changes to the way we approach this challenge as a profession, the problems described will only persist and deepen.

True Entrustment Decisions Regarding Entrustable Professional Activities Happen in the Workplace, not in the Classroom Setting.

Entrustable Professional Activities (EPAs) are workplace responsibilities that directly impact patient care. The use of EPAs allows pharmacy faculty and preceptors to provide learners with feedback and assessment in the clinical setting. Because they focus assessment on a learner's execution of professional activities which requires integration of the respective competencies, EPAs help provide a more holistic picture of a learner's performance. Using EPAs to backwards design classroom learning for those competencies is highly encouraged, but instructors cannot or should not assess performance and make entrustment decisions using EPAs in the classroom setting for several reasons: a learner's classroom performance usually does not predict clinical performance very well, assessment of EPAs require direct observation of the learner performing the EPAs, EPA assessment requires multiple observations of the learner with different patients with varying level of acuity, and most importantly, EPA assessment must result in a decision to trust the learner to perform the clinical activity with limited supervision. By ensuring all entrustment decisions are made in a clinical or experiential setting, students will receive an accurate assessment and benchmark of their performance that will lead them one step closer to becoming independent practitioners.

Methods for Optimizing Student Pharmacist Learning of Clinical Note Writing.

Objective. To investigate the effectiveness of using problem-solving and worked examples in teaching clinical note writing to Doctor of Pharmacy students.Methods. First year student pharmacists who were recruited to participate in the study first studied a worked example on generating a clinical note from a written patient case. Participants were then randomized either to study another worked example or to practice writing a clinical note from a written patient case. Embedded in each condition was problem variability (ie, participants encountered either a similar disease state as that in the initial worked example or a different disease state). The primary outcome was the combined performance on writing two clinical notes. Secondary outcomes included quiz performance on knowledge of the components of a clinical note and ability to transfer writing skills to a novel disease state.Results. Seventy-nine students completed the study. Participants who studied a worked example followed by problem-solving (WE-PS) practice performed better than participants who studied two worked examples (WE-WE) on clinical note writing. However, there was no difference in their respective knowledge as determined by quiz performance.Conclusion. Both worked examples and problem-solving facilitated students' learning of the basic knowledge of clinical note writing. However, only problem-solving improved student pharmacists' ability to apply that knowledge. While there were significant improvements in student pharmacists' knowledge of the basics of clinical note writing, it is unclear how worked examples or problem-solving influence the clinical decision-making skills needed to write a clinical note.

Exploring career development through a student-directed practicum to provide individualized learning experiences.

INTRODUCTION: The primary objective was to assess the impact of an optional student-directed career development program on career and professional development between the second and third year of a doctor of pharmacy curriculum. METHODS: Students who completed the student-directed practicum (SDP) completed a nine item pre-/post-survey assessing its impact on their career development within the learning constructs of discovery, application, and reflection. Additional open-ended questions assessed why students participated in the SDP and their perceived benefits of doing so. An additional questionnaire regarding the impact of the practicum was conducted at graduation. Quantitative data were analyzed with Wilcoxon signed-rank test for the pre-/post-survey and descriptive statistics for the graduation survey while qualitative data used a two-cycle open coding process. RESULTS: Statistically significant increases were noted with those responding with "agree" or "strongly agree" to each of the nine statements in the pre-/post-survey. Students participated to further explore career options, and believed doing so resulted in enhanced career direction and future employability. The graduation survey showed those participating in the SDP had a higher rate of: postgraduate placement (86% vs. 77%), receiving ≥ five residency interview offers (81% vs. 69%), and first or second choice residency match (92% vs. 85%) compared to those who completed an internship outside of the SDP. Students commented that the SDP was a valuable part of their education and helped them take the next steps for their career. CONCLUSIONS: A student-directed career development experience can positively impact student's career direction and professional development.

A Concept Mapping Activity to Enhance Pharmacy Students' Metacognition and Comprehension of Fundamental Disease State Knowledge.

Objective. To examine the impact of pre-class concept mapping activities on pharmacy students' ability to self-assess their degree of foundational disease state knowledge and predict their pre-class quiz performance.Methods. Second year pharmacy students in a problem-based learning course were responsible for self-directed learning of foundational knowledge for 14 disease states. After completing their independent pre-class reading, students worked in groups to create concept maps for which feedback was provided for four laboratory sessions, worked in groups to create concept maps but received no formal feedback for three laboratory sessions, and did not engage in any formal group activity for seven laboratory sessions. The day following each session, prior to the formal in-class discussion, students were asked to predict the number of questions they could answer correctly on a quiz covering foundational knowledge and then completed the quiz. Quiz performance was compared based on the three conditions, and bias and absolute bias were calculated to evaluate students' metacognitive skills.Results. There was no difference in pharmacy students' metacognition based on the conditions, as reflected by inaccuracy between predicted and actual quiz scores. However, when students had engaged in concept mapping the previous day, their quiz performance was significantly higher than when they had not.Conclusion. Concept mapping did not improve pharmacy students' metacognitive skills but did have a small effect on their quiz performance. More research is needed to tease apart the roles of concept mapping, group activity, and feedback in altering pharmacy students' quiz performance and metacognitive skills.

The Psychology of Following Instructions and Its Implications.

The ability to follow instructions is an important aspect of everyday life. Depending on the setting and context, following instructions results in outcomes that have various degrees of impact. In a clinical setting, following instructions may affect life or death. Within the context of the academic setting, following instructions or failure to do so can impede general learning and development of desired proficiencies. Intuitively, one might think that following instructions requires simply reading instructional text or paying close attention to verbal directions and performing the intended action afterward. This commentary provides a brief overview of the cognitive architecture required for following instructions and will explore social behaviors and mode of instruction as factors further impacting this ability.