ABSTRACT
Background: This paper describes a series of integrative courses intentionally designed to prepare students for Advanced Pharmacy Practice Experiences (APPEs) in a block system curriculum. Innovation: Three integration blocks are interspersed throughout the didactic curriculum to serve as checkpoints to ensure competency as students progress in the curriculum, rather than waiting until the end to determine competency. Complex patient case discussions and a series of high-stakes assessments are used to reinforce and evaluate cumulative retention of knowledge, skills, and attitudes. Findings: Class of 2022 exam results showed that in the cohort of students who failed the high-stakes comprehensive knowledge assessment (CKA) and pharmacy calculations exams during the first integration block (IB), failure rates decreased in subsequent IBs, indicating early detection of knowledge deficiencies and either exam performance improvement in each IB or failure to progress to the next IB. A survey of the same cohort indicated that the final integration block prior to advanced pharmacy practice experiences (APPEs) helped improve confidence in applying key knowledge and skills into practice. Conclusion: The series of integration blocks designed and implemented at WesternU provides opportunities to reinforce knowledge and skills while requiring students to demonstrate maintenance of core competency as they progress through the curriculum.
ABSTRACT
BACKGROUND: Long-acting injectable antipsychotics (LAIAs) are integral for managing schizophrenia, schizoaffective disorder, and bipolar I disorder among veterans. Studies comparing LAIAs, such as risperidone microspheres and paliperidone palmitate, are limited. The primary objective of our study was to compare the number of psychiatric hospitalizations among veterans initiated on risperidone microspheres and those taking paliperidone palmitate pre- and post-LAIA initiation. METHODS: We included veterans who had received ≥ 2 injections of risperidone microspheres or paliperidone palmitate between January 1, 2016 and December 31, 2018. Nonadherence was defined as missing an injection by > 3 days for risperidone microspheres and > 7 days for paliperidone palmitate. Pre-LAIA and post-LAIA hospitalizations and rehospitalizations were assessed using a pre-post design with equivalent periods. Descriptive statistics were used for demographics and diagnoses. Nonparametric tests were used to analyze primary and secondary outcomes. RESULTS: The study included 97 veterans; 44 took risperidone microspheres and 53 received paliperidone palmitate. Participants' average mean (SD) age was 46 (13.8) years, 92% were male, and 94% were diagnosed with schizophrenia or schizoaffective disorder. Veterans administered risperidone microspheres had fewer mean (SD) post-LAIA hospitalizations (0.4 [1.0] vs 0.9 [1.5]; P = .02), were less likely to be rehospitalized (22.7% vs 47.2%; P = .013) and had a shorter mean (SD) treatment duration (41.6 [40.2] vs 58.2 [45.7] weeks; P = .04) compared with paliperidone palmitate. CONCLUSION: Veterans receiving risperidone microspheres had fewer posttreatment psychiatric hospitalizations and were less likely to be rehospitalized.
ABSTRACT
Objective. To assess the impact of using a flipped classroom instructional approach on Doctor of Pharmacy (PharmD) students' learning outcomes and instructional preferences in a pharmacotherapy course within a block curriculum. Methods. Select topics in a gastrointestinal and liver pharmacotherapy course were taught using a flipped classroom method that required students to view lecture modules and respond to self-assessment questions prior to class. Classroom time included quizzes, application exercises, and discussion. The following year, teaching of these topics was switched back to a lecture/case format, and different topics were taught in the flipped classroom format, Student performance under each teaching method was examined, and student preferences and study habits were collected via a survey administered before and after experiencing the flipped classroom. Results. Combined mean formal assessment scores were higher for all four topics taught using the flipped classroom format compared to the lecture/case format. This pattern persisted when topics were examined individually, except for scores on one review topic. Survey responses reflected acknowledgement by about half of the students that the flipped format was more beneficial than traditional methods, but they still clearly preferred live lectures over prerecorded lectures. The majority of students reported that the amount of preparation time required for the flipped classroom was appropriate and that they had a positive or neutral experience with the flipped classroom overall. Conclusion. This study supports use of the flipped classroom method for teaching standard pharmacotherapy topics within a block curriculum, but underscores some of the resistance expressed by students despite understanding the potential benefits of the flipped format.
