Student pharmacists' performance and perceptions on an evidence-based medicine objective structured clinical examination.

BACKGROUND AND PURPOSE: Studies have examined evidence-based medicine (EBM) focused objective structured clinical examinations (OSCEs) in medical training, but data are lacking in pharmacy trainees. This study sought to assess student pharmacists' performance on and perceptions of a novel EBM OSCE. EDUCATIONAL ACTIVITY AND SETTING: This EBM OSCE included answering a drug-information inquiry, researching background questions, calling a simulated provider to acquire specific patient information, developing a foreground clinical question, reviewing pre-appraised trial synopses, and applying evidence to write a recommendation. Pharmacy faculty served as simulated providers and assessed students on knowledge/analytical (AC) and global communication (GC) skills. Students completed a worksheet (WS) that included developing a patient, intervention, comparison, outcome (PICO) statement, trial selection, and clinical recommendation. After OSCE completion, students were surveyed regarding perceptions of their performance and OSCE applicability. Outcomes assessed were performance scores (AC, GC, WS) and student perceptions. FINDINGS: One-hundred twenty-nine students completed the survey and were included in analysis. AC, WS, and GC performance [median (IQR)] were 75.0 (37.8), 86.4 (36.9), and 88.9 (22.2), respectively, on a 100-point scale. On the WS, 89% of students developed a suitable searchable clinical question and 61% selected the correct trial synopsis to apply to the case. Students felt literature application and WS development were most challenging. A majority of students felt this OSCE increased comfort in engaging with providers (74%) and that these skills correlate with real clinical scenarios (77%). SUMMARY: OSCEs can be a valuable tool for simulating clinical scenarios and assessing student pharmacists' EBM skills.

Designing professional program instruction to align with students' cognitive processing.

BACKGROUND AND PURPOSE: In health professional programs, training for educators in instructional design is sparse and may be absent altogether. Implementing evidence-based, systematic instructional design can improve pharmacy curricula. This paper describes Gagné's instructional design model which is particularly effective because the instructional steps align with learners' cognitive processes. The model is applied to the teaching of liver pharmacotherapeutics in a pharmacy curriculum. EDUCATIONAL ACTIVITY AND SETTING: Second-year pharmacy students completed 25 hours of liver pharmacotherapeutics instruction that was developed using Gagné's nine instructional events: gain attention, inform about objectives, stimulate recall of prior information, present information, provide guidance, elicit performance, provide feedback, assess performance, and enhance retention. FINDINGS: Students completed individual and team-based assessments including SOAP notes, recorded case presentations, web-based quizzes, a pre- and post-knowledge assessment, and midterm and final exam multiple-choice test. Students demonstrated significant improvement in liver pharmacotherapeutics knowledge from the pre- to post-knowledge assessment. Student course instructor evaluations also reflected effectiveness of the format. SUMMARY: Evidence-based instructional design strategies, such as Gagné's model, can enhance learning of challenging pharmacotherapeutics concepts using a systematic framework that aligns with cognitive processing.