Team-Based Decision-Making in an Objective Structured Clinical Examination (OSCE): Are Pre-Licensure Healthcare Students “Collaborative Practice-Ready”?

  Evaluation of pre-licensure students’ competency in team-based decision-making is lacking. The purposes of this study were to evaluate pre-licensure pharmacy students’ competency in team-based decision-making in the context of an objective structured clinical examination (OSCE), and to determine whether performance correlated with reflective assignment scores. Students’ self-assessment and conceptualization of team-based decision-making in practice was also evaluated. Twenty-three pre-licensure pharmacy students’ competency in team-based decision-making was evaluated in an OSCE station and with a reflective journal assignment; rubric scores for both evaluations were compared using Spearman’s rank order analysis. Students completed an 18-item questionnaire regarding attitudes, confidence, and perceptions related to team-based decision-making. Descriptive statistics and construct analysis with open coding were used to analyse questionnaire results. Mean OSCE station and reflective journal scores were 45% and 66.3%, respectively, and were not correlated. Students’ attitudes toward team-based decision-making were positive, and they reported performing associated behaviours during experiential education rotations. Students appropriately defined ‘team-based decision-making’ and were highly confident in performing related activities. However, students’ conceptualization of team-based decision-making did not align with the pharmacy program’s competency framework.  Three key themes were identified through the study analyses: 1) student performance is dependent on assessment context when evaluating collaborator-related competencies; 2) there is a mismatch between students’ perceived competency and objectively measured competence when collaborator outcomes were assessed within an OSCE; and 3) students’ perceptions of team-based decision-making do not align with the program’s competency framework. Future research is necessary to assess competency and perceptions of team-based decision-making in students from other healthcare professions, and to further evaluate whether pre-licensure students are “collaborative practice ready”.   Article Type: Case Stud

A Standardized Narrative Profile Approach to Self-Reflection and Assessment of Cross-Cultural Communication

Objectives: 1) to explore clinical assessor’s values regarding behaviours related to cultural aspects of care, 2) to generate standardized narrative profiles regarding cultural behavioural outcomes within clinical teaching settings, and 3) to rank order standardized narrative profiles according to performance expectations. Methods: Ten interviews were completed with clinicians to determine values and performance expectations for culturally competent behaviours. Transcripts were produced and coded. Six narrative profiles were developed based on data obtained. Twenty clinicians categorized profiles according to performance expectations and rank ordered. Intraclass correlation coefficients (ICCs) determined inter-rater reliability. Clinicians rated usability of profiles in clinical training settings. Results: Eighteen categories were coded with communication, awareness and ability most frequently reported with each ranging from 9.6-11.5% of the utterances. Consensus for categorization of all profiles was achieved at a level of 70% (ICC = 0.837, 95% CI 0.654-0.969). High inter-rater reliability was achieved for rank ordering (ICC = 0.815, 95% CI 0.561 to 0.984). Seventeen (85%) clinicians agreed that the profiles would be usable in clinical training settings. Conclusions: Standardized narrative profiles may aid assessment and self-reflection for student performance within culturally diverse interactions. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.   Type: Original Researc

Patient Counseling and Education: Models and Methods in Pharmacy Practice

Patient counseling and education in pharmacy practice is essential to develop the role of pharmacist within the healthcare system. As such, pharmacists largely depend on communication with patients to fulfill their mission of optimizing health outcomes through prevention and treatment of diseases. This chapter aims to provide an overview of theoretical models relevant to patient education, a comparison of international communication norms, and a discussion of patient education in three special populations (pregnancy and lactation, pediatrics, and mental health)