Developing an international concept-based curriculum for pharmacology education: The promise of core concepts and concept inventories.

Over recent years, studies have shown that science and health profession graduates demonstrate gaps in their fundamental pharmacology knowledge and ability to apply pharmacology concepts in practice. This article reviews the current challenges faced by pharmacology educators, including the exponential growth in discipline knowledge and competition for curricular time. We then argue that pharmacology education should focus on essential concepts that enable students to develop beyond 'know' towards 'know how to'. A concept-based approach will help educators prioritize and benchmark their pharmacology curriculum, facilitate integration of pharmacology with other disciplines in the curriculum, create alignment between universities and improve application of pharmacology knowledge to professional contexts such as safe prescribing practices. To achieve this, core concepts first need to be identified and unpacked, and methods for teaching and assessment using concept inventories developed. The International Society for Basic and Clinical Pharmacology Education Section (IUPHAR-Ed) Core Concepts of Pharmacology (CCP) initiative involves over 300 educators from the global pharmacology community. CCP has identified and defined the core concepts of pharmacology, together with key underpinning sub-concepts. To realize these benefits, pharmacology educators must develop methods to teach and assess core concepts. Work to develop concept inventories is ongoing, including identifying student misconceptions of the core concepts and creating a bank of multiple-choice questions to assess student understanding. Future work aims to develop and validate materials and methods to help educators embed core concepts within curricula. Potential strategies that educators can use to overcome factors that inhibit adoption of core concepts are presented.

Defining core conceptual knowledge: Why pharmacy education needs a new, evidence-based approach.

INTRODUCTION: No pharmacy program, however well-resourced, has sufficient time or resources to teach students all current, practice-relevant knowledge. And while the volume of potential pharmacy education curriculum content increases exponentially each year, available time for direct instruction continues to decline. Given these constraints, pharmacy curricula must focus on promoting deep learning of the most critical, fundamental, broadly applicable, and lasting knowledge. Yet, in terms of didactic knowledge, pharmacy education currently has no agreed upon, evidence-based criteria for determining which foundational concepts are most important to teach nor any research-based assessment tools to demonstrate how well students have learned those core concepts. PERSPECTIVE: This lack of consensus regarding core conceptual knowledge makes disparities in learning outcomes both more likely to occur and less likely to be detected or addressed. Over the past 30 years, several scientific disciplines undergirding pharmacy have developed research-based lists of core concepts and related concept inventories, demonstrating their transformative educational potential. Core concepts are big, fundamental ideas that experts agree are critical for all students in their discipline to learn, remember, understand, and apply. Concept inventories are research-based, psychometrically validated, multiple-choice tests designed to uncover learners' prior knowledge and potential misconceptions and determine their depth of understanding of disciplinary core concepts. IMPLICATIONS: This commentary proposes adapting and applying this evidence-based core concepts approach to enhance pharmacy education's overall effectiveness and efficiency and outlines an ongoing, multinational research initiative to identify and define essential pharmacy concepts to be taught, learned, and assessed.

Defining and unpacking the core concepts of pharmacology education.

Pharmacology education currently lacks a research-based consensus on which core concepts all graduates should know and understand, as well as a valid and reliable means to assess core conceptual learning. The Core Concepts in Pharmacology Expert Group (CC-PEG) from Australia and New Zealand recently identified a set of core concepts of pharmacology education as a first step toward developing a concept inventory-a valid and reliable tool to assess learner attainment of concepts. In the current study, CC-PEG used established methodologies to define each concept and then unpack its key components. Expert working groups of three to seven educators were formed to unpack concepts within specific conceptual groupings: what the body does to the drug (pharmacokinetics); what the drug does to the body (pharmacodynamics); and system integration and modification of drug-response. First, a one-sentence definition was developed for each core concept. Next, sub-concepts were established for each core concept. These twenty core concepts, along with their respective definitions and sub-concepts, can provide pharmacology educators with a resource to guide the development of new curricula and the evaluation of existing curricula. The unpacking and articulation of these core concepts will also inform the development of a pharmacology concept inventory. We anticipate that these resources will advance further collaboration across the international pharmacology education community to improve curricula, teaching, assessment, and learning.

Content, costs, and characteristics of United States prepharmacy curricula.

INTRODUCTION: The objective of this study was to examine pharmacy prerequisites and estimate the costs prospective students may incur to complete those requirements. METHODS: Prepharmacy requirements for doctor of pharmacy (PharmD) degree programs in the United States (US) (n = 137) were sourced from school websites in 2018. Credit hour costs for community colleges, public four-year institutions, and private four-year institutions were collected. Chi-square and independent t-tests compared group differences. RESULTS: Schools required 66.12 ± 8.15 prerequisite credit hours (range 41 to 91  hours). All schools required one course in general chemistry and organic chemistry. A higher proportion of schools in 2018 required anatomy/physiology and statistics when compared to 2009. Estimated costs to complete prerequisites ranged from US $16,359 at a community college to US $187,800 for a bachelor's degree at a private institution. CONCLUSIONS: Trends in healthcare and education make it timely for schools to reconsider prerequisites. Renewed consideration should be given to identifying what is core to the profession and the minimum competencies students must demonstrate for entry into PharmD programs.

Comparing Empathy Levels in Doctor of Pharmacy Students and Exemplary Pharmacist Preceptors.

Objective. To determine how student pharmacists' empathy compares to that of exemplary pharmacist preceptors. Methods. First- through third-year Doctor of Pharmacy students and nominated preceptors demonstrating a model level of empathy in patient care were invited to take the Jefferson Scale of Empathy (JSE) and answer demographic questions. A comparison of total JSE scores was made between students and preceptors. Comparisons of total JSE scores were performed between male and female students, students with and without direct patient care experience, students with and without chronic care experience, and among students based on class year. A factor analysis was completed. Results. The response rate for students and preceptors was 70.3% (n=318) and 73.7% (n=14), respectively. No significant differences in median JSE scores were identified for any of the comparisons. Factor analysis revealed two factors as underlying constructs: "compassionate care" and "perspective taking." Seven of 20 items on the JSE had mean scores >6.0 (possible range 1-7). Conclusion. The majority of students had moderately high cognitive empathy not related to class year that was similar to that of exemplary pharmacist preceptors. A possible ceiling effect was found in several items on the JSE, potentially limiting its use for measuring changes in empathy longitudinally in students with baseline high empathy.

Assessing student academic time use: assumptions, predictions and realities.

CONTEXT: In an era of medical education reform and increasing accountability at all levels of higher education, there is a need to understand how the time in which students engage in academic activities can inform evidence-based quality improvement of the curriculum. Time logging provides an opportunity to quantify student use of academic time and guide data-informed decision making in curriculum design. OBJECTIVES: This study aimed to evaluate faculty staff and student predictions of students' academic time use and to assess students' reported academic time use. METHODS: Graduate-level professional students engaged in a time use exercise during the first semester of Year 1 (autumn 2015) and second semester of Year 2 (spring 2017) of a redesigned curriculum launched in autumn 2015. This exercise involved three key activities: (i) prediction of time use; (ii) time logging, and (iii) reflection on time use. Key faculty staff predicted students' weekday time use in both semesters. RESULTS: Students' predictions of academic time use strongly correlated with their reported academic time use during both the first semester of Year 1 and second semester of Year 2 (r = 0.55 and r = 0.53, respectively). Faculty members' predictions of academic time use did not correlate with student academic time use during either semester. Although 63.8% of Year-1 students reported the time use exercise motivated them to change their time use, students reported spending similar amounts of time on academic activities during the first semester of Year 1 (7.8 ± 1.5 hours per weekday) and the second semester of Year 2 (7.9 ± 2.0 hours per weekday). Most students reported that the exercise had been useful and indicated that their logged time accurately reflected their actual time use. CONCLUSIONS: Although curriculum reform efforts may always require that some assumptions be made, time logging can quantify students' academic use of time. Although students predict their use of time more accurately than do faculty staff, negligible changes in students' academic time use despite reported desires to make changes indicate that students' academic time use may remain inelastic. Educators must consider these findings as they design curricula, identify academic rigour, and establish student expectations of academic time use.