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Curr Pharm Teach Learn ; 13(7): 862-867, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34074519


BACKGROUND AND PURPOSE: The novel severe acute respiratory syndrome coronavirus 2 restricted student involvement in direct patient care. Virtual learning is an effective education strategy in pharmacy curriculums. This study aimed to evaluate student perceptions of virtual learning advanced pharmacy practice experiences (APPE) utilizing an electronic 12-question survey. EDUCATIONAL ACTIVITY AND SETTING: Virtual learning was developed and implemented, and students were surveyed at the end of the APPE. The survey was comprised of one open-ended and 11 Likert scale questions. It assessed implementation and use of virtual learning in place of a standard on-site APPE. FINDINGS: Responses were attained from 19 students. Questions regarding resources provided and virtual learning enabling autonomous, independent learning had the highest percent of strong agreement. No responses indicated strong disagreement. Three questions solicited >10% response rate of somewhat disagree, 16% associated with virtual learning helping the student become a better member of the healthcare team after graduation. Open-ended responses acknowledged appreciation of the virtual APPE and presented material. One in six students commented on the ability to apply the learned information to direct patient care. Feedback was delivered on consideration for increased utility of patient care-orientated applications to facilitate simulation of real-life patient cases. SUMMARY: Students who completed the virtual APPE were satisfied overall. Virtual teaching modalities may be incorporated into APPEs, particularly when direct patient care access is limited, but should not be used to completely replace the experience gained during direct patient care.

Currículo , Educação à Distância/métodos , Educação em Farmácia/métodos , Aprendizagem Baseada em Problemas/métodos , Competência Profissional , Estudantes de Farmácia , Humanos
Curr Pharm Teach Learn ; 12(11): 1320-1328, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32867930


INTRODUCTION: Simulation-based teaching is an effective instructional strategy gaining momentum in pharmacy education but remains variable across programs. This is the first known report depicting the development of a multifaceted, integrated simulation program during concurrent initiation of a new skills-based pharmacy curriculum. METHODS: A significant infrastructure expansion created simulation areas whose availability corresponded with the initiation of a new skills-based curriculum. Integration of simulation occurred with existing personnel resources using area pilots. Pilots developed operational and educational design standards spanning the pre-simulation, simulation, and debriefing phases. The value of high-fidelity simulation pilots detailed here was assessed through both student survey and successful transference of tools to other courses. RESULTS: The pilots developed core operational and educational design standards, super-user faculty groups, and created an operational director position, essential for simulation promulgation throughout the curriculum. In the high-fidelity patient simulation pilot, operational elements included mannequin and equipment procedures, best practices for faculty and confederate engagement, and formulary development. Educational design standards addressed objective development, session flow, team roles, and debriefing. A grading rubric template aligned goals and assessed outcomes. All elements were structured into a planning worksheet. Student survey reflected the perceived value of this pilot. CONCLUSIONS: Operational support, integration coordination, and perceived value are all essential elements for successful curricular integration of simulation in a pharmacy curriculum. The pilots created the operational and educational structure establishing standards and defining required resources to sustain success. These pilots allowed for rapid curricular proliferation of simulation across the first and third professional years.

Curr Pharmacol Rep ; : 1-10, 2020 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-32837852


Purpose of Review: This article provides an overview of simulation as an effective and evolving tool for teaching clinical pharmacology within the health professions. Further, opportunities for positioning this methodology to meet current educational challenges are presented. Recent Findings: Clinical pharmacology is an essential core competency for all health professionals, correlating with ability to appropriately and safely prescribe, administer, or optimize medication regimens. Computer-assisted learning became the earliest form of simulation applied to pharmacology teaching, arising from increasing pressure to deviate from animal and tissue experiments in undergraduate education in the 1990s. In the last decade, high fidelity patient simulation, using manikin technology, has demonstrated benefit in building connectivity between knowledge and clinical application within patient care. Serious games, or computer-based educational games, provide an alternative method for creating context, with potential realized for newer technologies like augmented reality. These tools, while beneficial, are not applied in a uniform manner across programs. We advocate for routine incorporation of these tools as they offer significant opportunities to address the challenges faced in today's healthcare education, particularly with the need for continued social distancing and limitations on in-person educational engagement during coronavirus. Partnership with faculty utilizing simulation in other areas of the curriculum will assist in overcoming potential barriers to implementation. Summary: Simulation provides various methods that have significant potential to address the challenges in today's provision of clinical pharmacology education, especially with new directives for social distancing and limitations for in-person educational engagement.

Creat Nurs ; 25(1): 17-24, 2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30808781


In response to the merger of our 248-bed community hospital with a new health system, a multidisciplinary team began a journey of holistic transformation via the evolution of a new rounding process called Leadership, Ownership, Transformation, Unity, and Sustainability (LOTUS) in the 20-bed ICU. Morphing from a hierarchical practice structure with limited engagement of multidisciplinary members, the LOTUS initiative (named for the blossom whose petals surround its core, the patient) afforded each discipline (petal) an equal voice and allowed a once-fragmented team to work cohesively, collaboratively, and at the highest level of the scope of practice for each discipline, thus affording expert guidance during care planning while providing a method to collect quality metrics. LOTUS allows us to view our patients in a new way as we refocused goal determination on patients and their families. The restructuring and evolution into a high-functioning team was targeted with the goal of enhancing quality critical care for patients, which, in the literature, has correlated with improved patient safety and decreased mortality and ICU length of stay.

Unidades de Terapia Intensiva/organização & administração , Assistência Centrada no Paciente/organização & administração , Instituições Associadas de Saúde , Hospitais Comunitários , Humanos , New Jersey , Qualidade da Assistência à Saúde
Pharmacotherapy ; 35(6): 631-48, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26032691


Chronic obstructive pulmonary disease (COPD) is the third leading cause of death and is a substantial source of disability in the United States. Moderate-to-severe acute exacerbations of COPD (AECOPD) can progress to respiratory failure, necessitating ventilator assistance in patients in the intensive care unit (ICU). Patients in the ICU with AECOPD requiring ventilator support have higher morbidity and mortality rates as well as costs compared with hospitalized patients not in the ICU. The mainstay of management for patients with AECOPD in the ICU includes ventilator support (noninvasive or invasive), rapid-acting inhaled bronchodilators, systemic corticosteroids, and antibiotics. However, evidence supporting these interventions for the treatment of AECOPD in critically ill patients admitted to the ICU is scant. Corticosteroids have gained widespread acceptance in the management of patients with AECOPD necessitating ventilator assistance, despite their lack of evaluation in clinical trials as well as controversies surrounding optimal dosage regimens and duration of treatment. Recent studies evaluating the safety and efficacy of corticosteroids have found that higher doses are associated with increased adverse effects, which therefore support lower dosing strategies, particularly for patients admitted to the ICU for COPD exacerbations. This review highlights recent findings from the current body of evidence on nonpharmacologic and pharmacologic treatment and prevention of AECOPD in critically ill patients. In addition, the administration of bronchodilators using novel delivery devices in the ventilated patient and the conflicting evidence surrounding antibiotic use in AECOPD in the critically ill is explored. Further clinical trials, however, are warranted to clarify the optimal pharmacotherapy management for AECOPD, particularly in critically ill patients admitted to the ICU.

Estado Terminal , Doença Pulmonar Obstrutiva Crônica , Corticosteroides/uso terapêutico , Antibacterianos/uso terapêutico , Broncodilatadores/uso terapêutico , Ensaios Clínicos como Assunto , Cuidados Críticos , Progressão da Doença , Humanos , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/prevenção & controle , Respiração Artificial , Fatores de Risco