Implementing and evaluating virtual patient cases within a team‐based learning pedagogy in a therapeutics course sequence

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149331/1/jac51053.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149331/2/jac51053_am.pd

Measuring the educational benefits of using a virtual patient to practice pharmacist-patient consultations

Objective: Virtual patients (VPs) are a method of simulating clinical practice however little is known about their use by healthcare professionals. This study explores if, and how, one VP is educationally beneficial for pharmacists and pre-registration trainees to teach non-vitamin K oral anticoagulant (NOAC) patient counselling. Method: The evaluation used a before and after questionnaire measuring self-perceived counselling ability; further questions considered the outcomes of VP use. Data were analysed using descriptive and inferential statistics; ethical approval was granted by Keele University. Results: There was an average improvement in the user’s (n=94) self-perceived ability to conduct NOAC counselling (+10.2%). Although, there was variation in educational outcomes with changes in both knowledge and confidence reported. Some reported a decreased ability, but they were still positive towards the VP as it may have had a regulatory effect. Conclusion: Most users perceived multiple benefits of use; more generic outcomes related to counselling skills were also reported.</jats:p

Experiencing a virtual patient to practice patient counselling skills

Introduction Virtual patients (VPs) are a safe and standardised method of simulating clinical environments but few studies have explored health care professional's experiences of learning via a VP. This study explored how users experienced and used a VP that aimed to teach the user to deliver non-vitamin K oral anticoagulant patient education. Methods The study used semi-structured interviews with pharmacists and pre-registration trainees from a wider research study. Interview topics were based on key areas concerning VP use. Interviews were audio-recorded and transcribed verbatim before being analysed using the framework approach to thematic analysis. Ethical approval was granted by Keele University. Results There was variation in the type and nature of use of the VP and in the reported learning, which included reinforcement of knowledge, an opportunity to promote reflection, and acquisition and application of knowledge to clinical, patient-facing interactions. The VP was seen as an adjunct to other education and training. The majority of users indicated that they used the VP more than once. Some users seemed to have gamified their learning with a drive to achieve perfect feedback rather than true engagement with the learning, whereas for others the learning appeared to be deep with a reflective focus. Conclusions The VP offered an educational use as experiential learning, although the users experienced the VP differently; commonly the VP facilitated learning via reinforcement of pre-existing knowledge. The users reported that the VP had value as an adjunct to other education and training resources

A simulação no ensino de competências para a realização de serviços farmacêuticos de âmbito clínico

O cuidado farmacêutico, operacionalizado em serviços farmacêuticos de âmbito clínico, é capaz de aumentar os desfechos desejáveis a partir do uso dos medicamentos. A realização destes depende de competências clínicas adequadas, cujo desenvolvimento ocorre por meio de métodos que permitam ao estudante a associação entre conhecimentos, habilidades e atitudes. A simulação é um método que proporciona um cenário adequado para esse fim e, por isso, buscou-se analisar e reunir evidências sobre seu uso no desenvolvimento de competências para a realização desses serviços por meio de uma revisão integrativa. A intersecção entre os descritores “cuidados farmacêuticos” e “competências clínicas” nos bancos de dados PubMed/MedLine e Lilacs, entre os anos de 2013 e 2018, retornou 703 estudos, dos quais 18 foram incluídos por dois pesquisadores independentes. 61,1% dos estudos utilizaram a simulação para desenvolvimento e avaliação da comunicação com paciente e equipe de saúde, 50,0% dos estudos avaliou o componente “habilidade” e a simulação realística ou virtual foi utilizada em 55,5% dos estudos. A simulação demonstra ser um método pertinente ao desenvolvimento de competências clínicas, porém seu uso no Brasil se mostra incipiente e os recursos de infraestrutura e econômicos são os principais obstáculos para seu o uso

An empirical study of neural network-based audience response technology in a human anatomy course for pharmacy students.

This paper presents an empirical study of a formative neural network-based assessment approach, by using mobile technology to provide pharmacy students with intelligent diagnostic feedback. An unsupervised learning algorithm was integrated with an audience response system called SIDRA, in order to generate states that collect some commonality in responses to questions and add diagnostic feedback for guided learning. A total of 89 pharmacy students enrolled on a Human Anatomy course were taught using two different teaching methods. Forty-four students employed intelligent SIDRA (i-SIDRA), whereas 45 students received the same training but without using i-SIDRA. A statistically significant difference was found between the experimental group (i-SIDRA) and the control group (traditional learning methodology), with T (87)=6.598, p < 0.001. In four MCQs tests, the difference between the number of correct answers in the first attempt and in the last attempt was also studied. A global effect size of 0.644 was achieved in the meta-analysis carried out. The students expressed satisfaction with the content provided by i-SIDRA and the methodology used during the process of learning anatomy (M=4.59). The new empirical contribution presented in this paper allows instructors to perform post hoc analyses of each particular student's progress to ensure appropriate training

The use of a virtual patient to simulate a pharmacist-patient anticoagulation consultation: a mixed methods evaluation

Introduction Patients commencing new medications, particularly those that are high risk such as non-vitamin K oral anticoagulants (NOACs), require counselling to ensure safe, effective and empowering use of the medicine. Pharmacists are well placed to provide this counselling, but they require an underpinning ability to do so. Training on NOACs is unstandardised and variable. A virtual patient (VP) educational tool on the topic of NOACs has been developed to help develop counselling skills relating to NOAC use in atrial fibrillation. VPs have been used to provide training for undergraduate students, but they are largely uninvestigated for use by qualified healthcare professionals. This study aims to evaluate the VP application and explore perspectives of pharmacists and pre-registration trainees on its use and potential. Methods The study followed a sequential exploratory mixed methods design using a sample of pharmacists and pre-registration trainees from sites across England. The participants completed a questionnaire pre and post-VP use. Following an interim analysis, a sample of the respondents were selected to undertake a follow-up semi-structured interview. Questionnaire results were analysed using a mixture of descriptive and inferential statistics; qualitative results were analysed using the Framework approach to thematic analysis. Results were then integrated via triangulation and corroborated to give an overall interpretation of the findings. Results and discussion NOAC training appears to be an under provided for area with many participants lacking in confidence in conducting NOAC patient counselling. There was a significant average increase in self-reported counselling ability across the respondents pre- to post-VP which suggests a benefit to VP use. The exact nature of the benefits were wide ranging and included changes in knowledge, confidence, contextualisation of content and an opportunity to practice. Some participants also cited effects of VP use on their practice, including using the learning as part of continuing professional development. Well recognised benefits to VP use were also further demonstrated including mobility and safety. The VP was largely well liked, usable and acceptable as a learning resource, but some improvements could be made prior to wider implementation. This includes changes to the delivery of feedback and increased flexibility in responses within the VP. The study considered how VP use maps to the theory of experiential learning to provide a learning opportunity routed in andragogical theory. There was a discussion around different VP users with no single ideal group identified but rather multiple groups that could all benefit from VP use; pre-registration trainees and newly qualified pharmacists were the most favoured. Implementation of the VP needs to be more well thought-out with a clear strategy and considerations for the required supporting infrastructure. This supporting infrastructure needs to be developed to support sustained and useful use of the VP application. Conclusion This research has demonstrated value of the VP, both from an individual user and wider educational perspective. A number of improvements, developments and further considerations have been identified including things to be addressed prior to any further implementation. The VP application is a useful additional resource which should be considered when pharmacy professionals are undertaking education and training around NOACs

Clinical simulations using virtual patient avatars for pre-registration pharmacist training: a mixed methods evaluation

Virtual patients (VPs) are routinely used in the training of medicine and nursing professionals but uptake into pharmacy has been slower. The pharmacy pre-registration training year takes place in the workplace and a disparity in the perceptions of support provided and the pre-registration examination pass rates has been established between the training sectors. This programme of work aimed to evaluate the effectiveness of virtual patients (VPs) at supporting pre-registration training when compared to a non-interactive (NI) learning tool. Following institutional ethical approval, a mixed methods approach was adopted to evaluate the VP technology. A purposive sample of 165 pre-registration trainees (2014-2015) who were completing their training in a UK-based community or hospital pharmacy were recruited. Participants were randomly stratified to receive three VP or NI case studies. Knowledge surrounding the case studies was assessed using a quasi-experimental evaluation and thoughts on the two learning tools were obtained and compared via questionnaires and semi-structured telephone interviews. Quantitative data was analysed using descriptive and inferential statistics and qualitative data was analysed using content analysis (questionnaire) and framework analysis (interviews).No significant differences in knowledge improvement between pre-registration trainees in the VP and NI groups were obtained. Significant improvements in knowledge were found between the sectors of training for the three case studies. Pre-registration trainees reported that the VP enabled them to apply their learning and engage in experiential learning. The VP case studies were associated with greater satisfaction and were reported to provide a more realistic, interactive and enjoyable learning experience. Pre-registration trainee’s perspectives of the VP technology as a learning tool were more favourable regarding the development of real-life complex skills and aspects of learning, which provides a remit for further evaluation of the technology in undergraduate and postgraduate pharmacy training