Do We Need a More “Elementary” Approach to Pharmacy Education?

By Chris Johnson, PharmD, MEd

Knowledge is growing at an unprecedented rate.1  Educators in the elementary through high school levels have been grappling with this problem for years: what is the most beneficial approach to prepare students for jobs that may not exist, and information that may be quickly outdated?  Historically, pharmacy education has predominantly focused on the science of medications (e.g. pharmacology, medicinal chemistry, compounding).  More recently, pharmacy curricula have been designed to prepare students for direct patient care by shifting this primary focus toward pharmacotherapy knowledge.  The most recent Accreditation Council for Pharmacy Education (ACPE) Standards have placed more of an emphasis on skill development within pharmacy curricula (especially Standards 2-4).2 In spite of this shift, there is still a potential gap growing between what our students are taught and what society expects them to do with the information and skills they acquire. This gap may only widen as healthcare change accelerates over the span of their professional careers.  In the setting of rapid change within healthcare, are we doing enough to prepare our students to adapt their practice as the pharmacist’s role evolves?  

Figure 1: P21 Framework for 21st Century Learning

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The P21 Framework for 21st Century Learning (Figure 1) may be a useful approach to integrating skill development into curricula in alignment with accreditation standards and the future role of pharmacy in healthcare.3  It’s an important consideration that three of four domains (colorful areas in Figure 1) are skill related.  For example, the ACPE Standards recognize that pharmacy practice and healthcare are moving in a direction in which the importance of leveraging technology to improve access and quality of care can’t be understated.  The technology-related skills are included within the P21 framework in the Information, Media, and Technology (IMT) Skills domain (Purple box in Figure 1).  Table 1 describes the linkages between the IMT domain and ACPE Standards 2016.

Although this framework is aimed at improving the education of K-12 students, there are several aspects of the framework that are applicable to pharmacy education.  A stronger focus on skills is important because the professional roles that students take on may be vastly different from the roles that have existed in the educator’s time; roles including web design and IT didn’t exist until relatively recently.  The development of skills that can translate across many fields is critical for K-12 students to have adaptability in this changing economy.

Table 1: Information, Media, and Technology (IMT) Skills for Pharmacy Students

P21 IMT SkillsPharmacy-related ExamplesRelated ACPE Standards2
Information LiteracyMedical literature evaluation, drug information, population health managementACPE 1.1: Foundational knowledge
ACPE 2.1: Patient-centered care
ACPE 3.6: Communication
Media LiteracyEvaluating bias within medical literature and DTC advertising, development of patient education materialsACPE 3.2: Education
ACPE 3.3: Patient advocacy
ACPE 3.6: Communication
ICT (Information, Communications and Technology) LiteracyUse (and development) of EHRs, mobile apps, telepharmacy/telemedicine, informaticsACPE 2.2: Medication use systems management
ACPE 2.3: Health and wellness
ACPE 2.4: Population-based care
ACPE 3.1: Problem-solving
ACPE 4.3: Innovation & entrepreneurship

DTC=Direct to Consumer; EHRs=Electronic Health Records

Recently, schools and colleges have expanded Introductory Pharmacy Practice Experiences (IPPE) curricula, implemented Objective Structured Clinical Examinations (OSCEs) and simulation, and some have even integrated team-based learning into pharmacy curricula.  Although curricula are evolving to include more emphasis on skill development, more should be done to thoroughly integrate and assess these skills. This is especially true of IMT skills.

Several studies have recently examined approaches at incorporating pharmacy informatics into pharmacy curricula, including team-based and online approaches that were found to be effective methods of delivery the content.4-5

As an example of integrating change without a total curricular overhaul, our institution will be integrating a simulated EHR into our therapeutics course series so that students will be able to develop stronger skills in utilizing EHRs for patient care while still learning therapeutics content.  Although there are examples of initiatives aimed at increasing the development of IMT skills and delivery of IMT content in pharmacy curricula,  I would argue that graduates need to have IMT skills that are much more developed upon graduation so they are able to adapt and lead innovations that leverage technology.

In order to truly prepare graduates for the future of pharmacy practice, schools and colleges of pharmacy should examine their curricula to determine what approach would be best for them to ensure these skills are developed.  Some may wish to include skill development more strongly with the addition of a new course, but this isn’t always feasible.  Others may wish to incorporate skill development into existing courses and activities.  No matter the approach, pharmacy educators must take the initiative to consider how they are teaching these skills because we can do more.  Do you agree that a more “elementary” approach is needed in pharmacy education?

Acknowledgements:

James Lokken, PharmD, MS, MEd for his assistance in refining this article.

References :

  1. Arbesman S. The Half-Life of Facts, Why Everything We Know Has an Expiration Date. Penguin; 2013.
  2. Accreditation Council for Pharmacy Education. Accreditation Standards and Key Elements for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree (“Standards 2016”). Published February 2015. Available at: https://www.acpe-accredit.org/pdf/Standards2016FINAL.pdf . Accessed August 15th, 2017.
  3. Framework for 21st Century Learning. Partnership for 21st Century Learning (P21). Washington, DC;2007.
  4. Hincapie AL, Cutler TW, Fingado AR. Incorporating Health Information Technology and Pharmacy Informatics in a Pharmacy Professional Didactic Curriculum-with a Team-based Learning Approach. Am J Pharm Educ. 2016;80(6): Article 107.
  5. Fuji KT, Galt KA. An online health informatics elective course for doctor of pharmacy students. Am J Pharm Educ. 2015;79(3): Article 41.

JohnsonChris

Chris Johnson, PharmD, MEd is an Assistant Professor of Pharmacy Practice at the University of Arkansas for Medical Sciences College of Pharmacy.  Educational scholarship interests include underserved pharmacy practice, ambulatory care practice development, and impacts of innovative pedagogical approaches on student learning.  In his free time, Chris enjoys hiking and spending time with his wife, Kati, and son, Lincoln.


Pulses is a scholarly blog supported by a team of pharmacy education scholars.

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