Contributing to Curriculum Change with Focus Groups: A Student Perspective

By: Madalyn Wickham, Student Pharmacist; Riley Bowers, PharmD, BCCP, BCPS

In August 2017, 109 first-year student pharmacists entered Campbell University College of Pharmacy & Health Sciences. It was a new year and the Class of 2021 was to be the flagship-class for Campbell’s new “Integrated Curriculum,” a common buzzword without clear definition in pharmacy education.^1-3 At this moment, most of the class had no idea what that entailed, but we were anxious to find out. Instead of the previous legacy curriculum, with courses progressing in difficulty, the new curriculum was systems-based and focused on bringing us more clinical pharmacotherapy as early as P1 year.

The integrated curriculum faced its own set of challenges, including revised course structure, a few change-resistant faculty, and student pharmacists who were terrified of what was to come. Throughout the progression of the year, additional challenges were faced: a course schedule that changed every seven weeks (compared to the previous 14-week structure), and new professors who were used to instructing third-year students instead of first. 

The second-year started with the Cardiovascular and Renal Integrated Pharmacotherapy (CV/Renal) modules, part of the systems-based Integrated Pharmacotherapy series that spans the entire didactic curriculum. The CV/Renal modules were challenging for the class with the addition of integrated patient cases, difficulty understanding the continuity between topics, and increased application-based assessments. When student course evaluations were released, the class of 2021 had plenty of ideas for adjustments to improve the modules but were unsure of what would be implemented.  

Focus Group Activity

Following the completion of winter break, students received an email asking for participants in CV/Renal focus groups to further investigate the student evaluations. Based on input from the course coordinators, the Director of Assessment developed a script and questions for each session. The focus groups were facilitated by two independent faculty members, including the Director of Assessment, in accordance with the developed scripts. Eight students took advantage of the opportunity to turn critiques into a plan to revise the CV/Renal module. During the focus groups, we weighed previously assigned lecture hours versus the difficulty of subject/material. In the initial focus group, we were provided with a blank class schedule and rearranged the course material as we saw fit. This activity provided great insight into the challenges of mapping a course. In the second session, perspectives on time spent studying for exams and quizzes versus pre-class assignments, integrated cases, and simulated patients were shared. Following this discussion, we could redistribute the assessment weight to reflect where the most time was spent. As the groups reconvened, it was realized that while the groups had some differences in perspectives on time spent in activities, most had very similar ideas for the progression of material. Further development of the initial activity was also completed following the second focus group session with the same student contributors. This information was all reviewed with the entire group and any final recommendations, edits, or additions were discussed. 

Outcomes

Considerable insight was gathered during the student focus groups, held in two sessions, that led to multiple changes in the CV/Renal curriculum (Figure 1). Themes were identified and will be described in a later publication.  In general, similar to previous studies, we found that students need to better understand how the material was being integrated.⁴ They also desired more application of the material, with strategies like team-based learning, and increased grade allocation towards application-based assessments. Our focus group results demonstrated additional evidence to previous studies that showed curricular improvements due to focus group discussions.⁵ 

Figure 1: Course Changes from Focus Groups

Conclusion

Upon the completion of our focus group, a feeling of accomplishment was shared between educators and students. While universities often use anonymous student evaluations of teaching to garner feedback, students are less often involved directly in the revision process. With the use of directed focus group activities, course directors and faculty can gain more insight than a few sentences from students. Allowing students to map the course structure and sequence was an incredible opportunity for students to have a hand in the curricular development process. Additionally,  educators gained new insights into student perspectives on integration. Course directors were able to better assess the amount of time and effort students placed on graded assessments through the activities. The insights provided not only impacted the CV/Renal modules, but identified themes also changed the perspective of the entire curriculum. Although considerable time and effort is required to organize these focus groups, utilizing directed activities to implement change is something I would recommend to all educators. 

Acknowledgments

I would like to thank Dr. Riley Bowers for his willingness to work with me, as well as his guidance, patience, and contributions throughout this project.  

References

1. Ratka A. Integration as a paramount educational strategy in academic pharmacy. Am J Pharm Educ. 2012;76(2):19.
2. Islam MA, Talukder RM, Taheri R, Blanchard N. Integration of Basic and Clinical Science Courses in US PharmD Programs. Am J Pharm Educ. 2016;80(10):166.
3. Pearson ML, Hubball HT. Curricular integration in pharmacy education. Am J Pharm Educ. 2012;76(10):204.
4. Husband AK, Todd A, Fulton J. Integrating science and practice in pharmacy curricula. Am J Pharm Educ. 2014;78(3):63.
5. Lee JK, Cooley JH, Tanner NE, Hanauer CN, Schiefer DM, Herrier RN. Development of a pharmacy capstone course from focus groups to advanced patient care. Am J Pharm Educ. 2014;78(8):156.

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