Retrospective study assessing student utilization of optional practice questions on pharmacy calculations final examination performance.

OBJECTIVE: Pharmacists are often the last line of defense from medical errors caused by inaccurate calculations. Effective teaching and assessment of pharmaceutical calculations is essential in preparing students for successful pharmacy careers. This study aimed to elucidate the potential benefit of self-testing practice questions on final examination performance in a first-year pharmaceutical calculations course. METHODS: One-hundred and sixteen students across the class of 2026 and 2027 were given access to 110 online practice calculation questions eight days prior to the final examination. Retrospective analysis using Pearson's Correlation Coefficient and an Unpaired t-test was used to assess the effect of self-study practice questions on exam performance. RESULTS: A correlation between higher quiz scores and enhanced final examination scores was observed for both the class of 2026 and 2027. A greater number of attempts on practice quiz questions correlated with a higher score on the final examination for the class of 2026, but not the class of 2027. Also, an earlier first access date was associated with higher final examination scores specifically for the class of 2026. CONCLUSION: This retrospective study was conducted to evaluate the use of practice calculation questions on final examination performance, and results reveal that the utilization of practice calculation questions positively correlates with improved final examination performance, notably observed in the class of 2026 but not in 2027. These findings suggest the potential efficacy of this preparatory method across various pharmaceutical courses and other calculation-based disciplines internationally.

Counting on Change: Conquering Challenges in Teaching Pharmaceutical Calculations.

All pharmacists are expected to accurately perform pharmaceutical calculations to ensure patient safety. In recent years, there have been trends in declining performance on the North American Pharmacist Licensure Examination related to calculations. Understanding the cause of this decline and determining methods to correct underlying issues could benefit pharmacy administration, faculty, students, and patients. The aims of this commentary are to present the factors impacting the students' pharmaceutical calculations abilities, discuss the consequences of declining math skills, and provide a call to action for scholarship of teaching and learning pertaining to calculations, as well as increased administrative support to rectify this challenge.

Evaluating the Effectiveness of Videos for Teaching Pharmaceutical Calculations to Pharmacy Students.

Performing pharmaceutical calculations accurately is a fundamental aspect of the pharmacy profession, ensuring treatment efficacy and patient safety. Incorporating videos in teaching can enhance visualisation and reinforce learning. The current study utilised videos to teach calculations and assessed how these affected students' performance. Initially, pharmacy students were surveyed at one UK University to identify calculation topics they found most challenging, and then two prototype videos were created based on these topics. Feedback was gathered through a follow-up survey on these prototypes, leading to the development of five additional videos. To evaluate the impact of these videos, students were given quizzes before and after watching them. The data were analysed in Microsoft Excel and included paired t-tests to compare mean scores, with significance set at p < 0.05. The survey was completed by 98/130 (75% response rate), with 58% expressing average or low confidence in calculations. A majority (78%) believed that videos would aid their comprehension of calculation concepts. In the subsequent phase, most respondents (92%, 80/87) agreed that the prototype videos improved their understanding of the two topics, but this increase was not statistically significant. However, quiz performance evaluation revealed a significant increase in average scores. This study affirms that videos can boost students' performance in calculations by allowing them to visualise the relevant practical scenarios.

Adopting video assignments as a tool to improve first-year pharmacy students class engagement.

OBJECTIVES: The objective of this study was to evaluate the use of video assignments as a tool to improve students' engagement and maximize their benefit from the assigned homework in a pharmaceutical calculations course. METHODS: This was an intervention study, including the use of a new electronic educational tool. The study was conducted during the academic year 2021-2022. Six video assignments were created for two of the four modules of the pharmaceutical calculations course for the first-year pharmacy students. The video assignments were employed in a flipped classroom mode, with each video including 3-4 questions on successive steps in one problem. Students' perceptions of the video assignments were assessed through a survey conducted at the end of the course. The survey items represented the five domains of the Technology Acceptance Model (TAM). RESULTS: All the first-year students (n=356) were assigned to this new educational tool. A total of 296 students responded to the survey, with a response rate of 83%. The majority of students agreed with the perceived usefulness, ease of use, and behavioral intention to use the video assignment. Multiple linear regression analysis indicated a significant positive association between two items (perceived usefulness and attitude to use) and the outcome variable (behavioral intention to use). CONCLUSIONS: The video assignment tool was successfully used to provide immediate feedback to a large class in a pharmaceutical calculations course. The students were in favor of the video assignment compared to traditional paper assignments. This finding could encourage other instructors to assess the benefit of implementing such tools in other pharmacy courses.

Correlative and Comparative Study Assessing Use of a Mock Examination in a Pharmaceutical Calculations Course.

Objective. Faculty at Massachusetts College of Pharmacy and Health Sciences University's School of Pharmacy-Worcester/Manchester are engaged in continuous quality improvement of their teaching and assessment methods to prepare students for successful careers in pharmacy. This study evaluated the impact of a formative mock examination on student performance on a main summative examination (main examination) administered during the spring 2020 semester of a pharmaceutical calculations course.Methods. A retrospective analysis of student test scores in a summative assessment (main examination) was performed across two cohort years (2019 and 2020) during which students were not administered and administered a formative mock exam, respectively. Central tendency and comparative analysis measures were performed to assess differences in student performance.Results. Out of 237 students enrolled, 221 students participated in the optional mock exam, and all 237 students participated in the main examination, with average scores for the mock examination and the main examination being 67% and 94%, respectively. Ninety-two students who received a grade C or better on their mock examination had a main examination average score (98%) that was significantly higher than those who received a D or F (n=129, main average score of 92%). Further, the average score in the 2020 examination was significantly higher when compared to the 2019 examination when no mock examination was offered (94% vs 77%, respectively).Conclusion. This was a descriptive, cross-sectional study to understand the differences in student performance in a summative assessment across two cohort years with and without a formative mock assessment. The results demonstrate that the formative mock examination was correlated with better performance among students but did not establish a causal relationship.

The use of ratio and proportion, dimensional analysis, and equations to solve pharmacy calculations problems.

INTRODUCTION: To evaluate the effects of using different problem-solving approaches on the success rates of student pharmacists in solving problems throughout a pharmacy calculations course. METHODS: A survey was administered to first-year students (N = 96, response rate 100%) near the completion of a pharmacy calculations course. The survey assessed whether students used the approaches of ratio and proportion (RP) or equations vs. dimensional analysis (DA) to solve calculation problems involving conversions, weight-based doses, flow rates, electrolyte solutions, and expressions of concentration. Questions used on course exams were tagged according to topics. Mean success rates in solving tagged questions were correlated with the problem-solving approaches that students used. RESULTS: Approximately 60% of students used RP/equations, 30% used DA, and 10% used both approaches equally. The success rate of students solving conversions was 74% ± 24% for RP, 84% ± 14% for DA (P < .05 vs. RP), and 91% ± 12% for the use of both approaches equally (P < .05 vs. RP). Success rates in solving calculation problems of weight-based doses, flow rates, electrolyte solutions, and expressions of concentration were similar across all approaches. CONCLUSIONS: The use of DA, or the combination of RP and DA equally, may be advantageous for solving conversions but not for the other types of calculation problems studied. Therefore, for most topics, pharmacy calculations instructors can demonstrate the method of their choice. Since a considerable number of students use each of the approaches, the demonstration of both approaches in class may be advantageous.

Course design, delivery, and assessment strategies for pharmaceutical calculations course in a doctor of pharmacy program: A review.

BACKGROUND: Pharmaceutical calculations is a fundamental course taken by doctor of pharmacy students in United States schools and colleges of pharmacy. To minimize medical errors and increase the accuracy with which future pharmacists perform calculations, a comprehensive training during the program is deemed. This review attempts to summarize research outcomes of interventions described thus far in the literature concerning the improvement of course design, delivery, and assessment strategies. METHODS: A detailed literature review of various educational resources was conducted using pharmaceutical calculations and related terms. RESULTS: The literature review outcomes were divided into three major categories: educational interventions in design, delivery, and assessment of pharmaceutical calculations courses. The research findings of course design describe a standalone course vs. an integrated course, a computer-aided course, use of compact disc read-only memory, and implementation of Gagne's Nine Events of Instructions. Findings in course delivery include the use of self-paced vs. integrated courses, flipped classroom vs. traditional lecture, Keller's Personalized System of Instruction, condensed videos, and podcasts. Finally, different types of assessments are presented such as those based on selected- vs. constructed-response questions, collaborative quizzes, the approach of repeated testing, and the use of technology. IMPLICATIONS: While the review intends to present educational interventions available to construct and/or modify an existing pharmaceutical calculations course, the choice of design, delivery, and assessment approaches depends upon various factors such as the purpose of course modification, resources available, and the number of students in class.

Identifying Low Pharmaceutical Calculation Performers Using an Algebra-Based Pretest.

Objective. To determine whether a pretest assessing algebra-based problem-solving skills could aid in identifying those who may underperform in calculations course assessments and whether this provides additional value beyond preadmission and demographic characteristics.Methods. Student pharmacists were screened for algebraic problem-solving skills using an 18-item pretest taken the semester prior to a course containing pharmaceutical calculations content. These scores were compared to students' later performance on pharmaceutical calculations assessments. Linear regression models were computed to determine the relationship between pretest scores and pharmaceutical calculations performance after controlling for preadmission factors and demographic characteristics.Results. The median pretest score was 15 out of 18 possible points, with scores ranging from 5 to 18 points. After controlling for age, gender, American College Testing (ACT) scores, and high school grade point average (GPA), scores on the algebra-based, word-problem pretest were associated with performance on pharmaceutical calculation assessments.Conclusion. This research demonstrates the ability of a pretest aimed at identifying deficiencies in algebraic problem-solving skills to identify those at risk of failing to obtain mastery of pharmaceutical calculations, even after controlling for demographics, prior grades, and prior standardized test scores. Identifying these students is a first step towards implementing tailored interventions to improve students' algebra-based word problem skills to prevent deficiencies in pharmaceutical calculations mastery before class even begins.

A Mixed-Methods Exploration of the Effect of Disabling Backward Navigation on Calculations-Focused Computerized Examinations.

Objective. The aim of this mixed-methods study was to examine the effect of disabled backward navigation on computerized calculation examinations in multiple courses.Methods. Student performance on comprehensive pharmacy calculation examinations before and after implementation of disabled backward navigation were compared. Deidentified data from ExamSoft were used to determine median examination scores, passing rates, and time to completion for all three attempts given on comprehensive calculation exams held in a pharmacy calculations course (PharDSci 504) and in three applied patient care laboratory courses (Pharm 531, 541, and 551). An anonymous, voluntary student survey gathered student perceptions of disabled backward navigation. Qualitative data were evaluated for thematic findings.Results. The impact of disabled backward navigation on test scores and passing rates varied by course and test attempt. Students in Pharm 541 and 551 performed significantly worse on the initial test attempt after backward navigation was disabled compared to the previous year, with no significant differences in student performance seen on the retakes. Performance in PharDSci 504 and Pharm 531 followed the opposite pattern, with no significant difference in performance for the initial tests but significantly increased performance on the retakes. The amount of time spent on examinations either significantly decreased or remained the same. Student perceptions were generally consistent across all cohorts, with at least 74% agreeing that disabling backward navigation increased examination difficulty.Conclusion. Disabling backward navigation had a mixed effect on student examination performance. This may highlight how student behaviors change as backward navigation is disabled.

Design and evaluation of an application-based pharmaceutical calculations review module.

BACKGROUND AND PURPOSE: To describe the design of an application-based calculations review module, determine retention of skills learned in a calculations course, determine student ability to identify information necessary to solve calculations, and evaluate student perceptions. EDUCATIONAL ACTIVITY AND SETTING: Three student cohorts completed the calculations application-based review module. All students passed a required pharmaceutical calculations course previously (17 months prior for Cohort 1 and nine months prior for Cohorts 2 and 3). The activity included seven themed stations each with three questions. Each question was categorized by calculation type. Students utilized stock bottles and patient chart information to solve problems. For select stations, necessary information was missing, and students had to request it. Each student completed an activity evaluation form. FINDINGS: Two hundred ninety students completed the module (90, 102, and 98 in Cohorts 1, 2, and 3, respectively). Two hundred eighty students (97%) completed the activity assessment form. The overall average score was 85.1%, which did not differ significantly among the cohorts. Cohort 1 performed significantly lower on dosage, unit conversion, ratio, and milliosmole calculations. Almost all (96.4%) students agreed the activity reinforced lecture material, and 90% agreed the activity improved their ability to perform in future pharmacy practice. Participating students scored significantly higher on a pre-graduation math skills assessment. SUMMARY: Some calculation types, such as dosage, unit conversion, ratio, and milliosmoles may warrant more closely spaced reinforcement activities in the curriculum. Inclusion of the review module was associated with increased knowledge retention.

Evaluating the numeracy skills of pharmacy students in multiple choice questions and free-text answer assessments and their perception of numeracy in clinical practice.

INTRODUCTION: Numerical errors can cause unintentional harm to patients and are a burden to healthcare systems worldwide. There is a paucity of research regarding numerical competence in pharmacists and pharmacy students and how this should be assessed within undergraduate and licensure assessments. METHODS: Two numeracy assessments were given to year three and four pharmacy students at the University of Sunderland, United Kingdom. One paper included ten multiple-choice questions (MCQs) and the second ten free-text answer questions. Participants were then given an evaluation questionnaire to explore their perceptions about the assessments and numeracy in clinical practice. RESULTS: A response rate of 75% (n = 247) was achieved, with 60.9% of students passing the MCQ and 27.9% passing the free-text answer assessments. There were statistically significant differences in pass rates depending on year of study, ethnicity, and previous mathematics qualifications. Participants were asked if numeracy was an important skill for pharmacists in practice; 57.9% thought it were essential and 36.4% quite important. However, only 1.4% felt sufficiently supported in the development of the required numeracy skills, and this has prompted a redesign of teaching and assessment at the university. CONCLUSIONS: Educators need to ensure taught and assessed numeracy is reflective of and transferable to pharmacy practice, whilst ensuring students are supported effectively and engaged. This is likely to be achieved with integrated and clinically focused teaching approaches and appropriately constructed assessments throughout the pharmacy programme.

'Both useful in their own way': Video podcasts and typed solutions as feedback on undergraduate pharmaceutical calculations skills assessment.

INTRODUCTION: Accurately completing pharmaceutical calculations is a core professional skill for pharmacists. To date, few studies have focused on to providing feedback on calculations, or the role of technology in feedback provision. This study aimed to develop a theory-informed video podcast-based method of providing formative feedback and evaluate student perceptions. METHODS: First-year pharmacy students (n = 53) completed a formative pharmaceutical calculations assessment. Two forms of feedback were designed and evaluated; typed solutions (traditional format commonly used/seen in textbooks) and video podcasts informed by instructional design theory (novel format). RESULTS: A survey was completed by 70% (37/53) of students. Specific features of video podcasts reported useful included hearing reasoning, and the ability to pause and rewind. Most (76%) reported positive attitudes towards video podcasts, considered them useful (75%) and helpful for learning (79%). A comparable number (76% and 71% respectively) felt positively about typed solutions. The majority (51%) preferred to receive both types rather than podcasts alone (24%), or typed solutions alone (8%). Free-text responses indicated both were used in different ways; typed solutions for quick verification and video podcasts for clarification. CONCLUSIONS: Video podcasts appear to be a potentially helpful additional method of delivering feedback that afford specific advantages. They can be readily developed by faculty with minimal expense/difficulty. However, as respondents indicated that they used both kinds of feedback in different ways to support their learning, and indicated a preference to receive both types, they should be considered an addition rather than replacement for typed solutions.

Effectiveness of Providing Video Podcasts to Pharmacy Students in a Self-Study Pharmaceutical Calculations Module.

Objective. To evaluate the effect of providing educational video podcasts to first-year pharmacy students enrolled in a self-taught pharmaceutical calculations module.Methods. Six video podcasts were designed and posted online for pharmacy students to review prior to taking pharmaceutical calculations quizzes over the course of one year. The video podcasts demonstrated how to solve the most difficult problems on each of the six quizzes. Quiz performance was compared for the 2017-2018 year (no videos available) and the 2018-2019 year (videos available). Students provided feedback about the videos in a year-end survey.Results. Overall quiz scores and passing rates improved during the 2018-2019 academic year. Enhanced student performance on three of the six quizzes was demonstrated. A majority of students strongly agreed that the videos were helpful.Conclusion. Watching video podcasts was effective in improving pharmacy students' performance on calculations quizzes. The students indicated that the podcasts were helpful in improving their math skills and facilitated their learning of the material.

Predicting success in pharmaceutical calculations.

INTRODUCTION: Understanding preadmission predictors of success in pharmacy calculations, an important aspect of pharmacy practice, could impact admissions selection and advising practices. The objective of this study was to determine which student specific preadmission variables best predict success in a pharmaceutical calculations course. METHODS: Preadmission data from 388 students who completed a one semester pharmaceutical calculations course between 2013 and 2016 were evaluated. This retrospective analysis was performed to determine which of the independent preadmission variables were positively correlated to the pharmaceutical calculations course grade. Fifteen preadmission variables, including demographics, grade point average (GPA), Pharmacy College Admission Test (PCAT) score, prior degrees, and number of pre-professional credit hours completed, were evaluated. Descriptive statistics were used for baseline characteristics and relative importance analysis was used to examine association between the dependent and independent variables. RESULTS: The relative importance analysis revealed eight of the fifteen preadmission variables were significantly correlated with final grades in pharmaceutical calculations. Overall, 26.1% of the variance was explained by these variables. GPA (cumulative and science specific) and PCAT (quantitative and verbal) were the strongest indicators. CONCLUSIONS: Preadmission GPA and PCAT scores were the best predictors of success in a pharmaceutical calculations course. About one quarter of the variance was explained by the identified predictive variables, therefore other factors, not evaluated in this study, likely influence the success in pharmaceutical calculations and should be investigated to determine a more dependable set of predictors.

Use of condensed videos in a flipped classroom for pharmaceutical calculations: Student perceptions and academic performance.

BACKGROUND AND PURPOSE: The flipped teaching method was implemented through a series of multiple condensed videos for pharmaceutical calculations with student perceptions and academic performance assessed post-intervention. EDUCATIONAL ACTIVITY AND SETTING: Student perceptions from the intervention group were assessed via an online survey. Pharmaceutical exam scores of the intervention group were compared to the control group. The intervention group spent a greater amount of class time on active learning. FINDINGS: The majority of students (68.2%) thought that the flipped teaching method was more effective to learn pharmaceutical calculations than the traditional method. The mean exam scores of the intervention group were not significantly different than the control group (80.5 ± 15.8% vs 77.8 ± 16.8%; p = 0.253). DISCUSSION: Previous studies on the flipped teaching method have shown mixed results in regards to student perceptions and exam scores, where either student satisfaction increased or exam scores improved, but rarely both. SUMMARY: The flipped teaching method was rated favorably by a majority of students. The flipped teaching method resulted in similar outcomes in pharmaceutical calculations exam scores, and it appears to be an acceptable and effective option to deliver pharmaceutical calculations in a Doctor of Pharmacy program.

An evaluation of student performance and perceptions within an integrated pharmaceutics course sequence.

BACKGROUND AND PURPOSE: To describe the design of an integrated pharmaceutics course sequence and to assess the sequence by evaluating both student performance and perceptions. EDUCATIONAL ACTIVITY AND SETTING: The non-sterile products portion of a pharmaceutics course sequence was designed to integrate the disciplines of physical pharmacy, dosage forms, pharmacy compounding, and pharmaceutical calculations and to include the respective topics deemed most relevant to doctor of pharmacy curriculum. The appropriate course content was organized in a modular format that began with the general concepts of drug product administration, preparation, stability, and performance and then specifically applied these concepts to a variety of non-sterile dosage forms. FINDINGS: Student performance was assessed through several cumulative exams and lab practicals. Mean performance on these assessments was at a level generally considered to be adequate within the study institution. However, students performed better on the assessments having a lesser emphasis on physical pharmacy (p < 0.05) and a greater focus on basic skill development (p < 0.05). Student perceptions were evaluated using a survey instrument that had a useable response rate of 93%. Each course design element was utilized by a majority of respondents and was generally perceived as being beneficial to student learning. SUMMARY: The collected data indicate that the integrated course design facilitated the learning of applicable pharmaceutics-related topics and support the use of a number of different design elements. In addition, this study provides valuable insights for others providing professional-level pharmaceutics-related education and has helped guide our own course improvement efforts.

Design and Evaluation of Video Podcasts for Providing Online Feedback on Formative Pharmaceutical Calculations Assessments.

Objective. To evaluate worked example video podcasts as a method of providing feedback to pharmacy interns for an online and formative pharmaceutical calculations assessment. Methods. A theory-informed approach based on multimedia learning theory was used to design video podcasts as feedback on a calculations examination. A mixed-methods evaluation completed by pharmacy interns enrolled in Ireland's National Pharmacy Internship Programme was used to establish cognitive and affective attitudes toward video podcasts compared with conventional written solutions. Results. The majority of students found video podcasts were clear, helpful for learning, easy to understand, and useful as a method of feedback. Majority reported that they felt positively about standard written solutions. The evaluation suggested distinct benefits for each kind of feedback, something that has not been previously reported. Thematic analysis of qualitative data indicated useful features of video podcasts, including clear explanation, step-by-step approach, and synchronization of audio and visual information. Conclusion. Respondents reported positive cognitive and affective attitudes toward video podcasts as online feedback. Video podcasts are a helpful and novel way of providing feedback on pharmaceutical calculations. A similar opinion of traditional written solutions suggests that students may benefit from both forms of feedback. Further study is required to identify the particular benefits associated with both kinds.

Impact of a required pharmaceutical calculations course on mathematics ability and knowledge retention.

OBJECTIVE: To assess doctor of pharmacy (PharmD) students' mathematics ability by content area before and after completing a required pharmaceutical calculations course and to analyze changes in scores. METHODS: A mathematics skills assessment was administered to 2 cohorts of pharmacy students (class of 2013 and 2014) before and after completing a pharmaceutical calculations course. The posttest was administered to the second cohort 6 months after completing the course to assess knowledge retention. RESULTS: Both cohorts performed significantly better on the posttest (cohort 1, 13% higher scores; cohort 2, 15.9% higher scores). Significant improvement on posttest scores was observed in 6 of the 10 content areas for cohorts 1 and 2. Both cohorts scored lower in percentage calculations on the posttest than on the pretest. CONCLUSIONS: A required, 1-credit-hour pharmaceutical calculations course improved PharmD students' overall ability to perform fundamental and application-based calculations.

Pharmacy student performance on constructed-response versus selected-response calculations questions.

Objective. To introduce PharmD students to changes in calculations question types (constructed-response versus selected-response questions); measure and compare student performance on constructed-response and selected-response questions in a pharmaceutics course; and collect student feedback on the use of differing question types.Methods A pharmaceutics/pharmaceutical calculations examination was administered that included 15 pairs of questions; each pair consisted of a constructed-response question and a similar selected-response question. An online questionnaire was conducted to collect student feedback.Results. Of the 15 topics, the class scored higher on the constructed-response question for 4 topics and higher on the selected-response question for 10 topics. Eighty percent of the class preferred selected-response questions, although 47.8% felt constructed-response questions better prepared them for a career in healthcare.Conclusions. Students correctly answered more selected-response questions than constructed-response questions and felt more confident in doing so. Additional constructed-response teaching and testing methods should be incorporated into pharmacy education.

Pharmaceutical calculations instruction and assessment in US colleges and schools of pharmacy.

OBJECTIVE: To characterize the current strategies used in the instruction and assessment of pharmaceutical calculations content through the administration of a nationwide survey. METHODS: Instructors of pharmaceutical calculations were invited to complete a 34-item questionnaire designed to gather information on course logistics, content delivery, covered topics, homework, examinations, and retention measures. RESULTS: Seventy-two colleges and schools responded to the survey. Exactly half of the respondents indicated that they had a standalone pharmaceutical calculations course, while the other half indicated this material was integrated into other coursework. An average of 24.8 hours was devoted to calculations topics. A minimum passing examination score of 70% was reported by 53% of programs. Knowledge retention was formally measured in 16% of programs, while 27% responded that they did not measure retention. CONCLUSION: This survey provided the first assessment of the strategies used to teach and assess pharmaceutical calculations content. Further work is needed to determine the optimal teaching and assessment strategies for pharmaceutical calculations, as well as optimal methods of evaluating and promoting retention of this material.