Presenting Author: Abigail Shockley, PharmD, BCOP, Division of Pharmacy, University of Texas MD Anderson Cancer Center, Houston, TX
Co-Authors: JP Sanchez, PharmD, BCOP, and Todd W. Canada, PharmD, BCNSP, BCCCP, FASHP, FTSHP, FASPEN, Division of Pharmacy, University of Texas MD Anderson Cancer Center, Houston, TX
BACKGROUND: An interactive Ambulatory Shared Pharmacy Student Instruction (ASPSI) program was developed to supplement ambulatory care clinic rotations at a large oncology academic medical center. However, traditional ambulatory care disease management is mostly absent due to the specialized nature of these oncology clinics. Pharmacy students completing advanced pharmacy practice experiences (APPE) primarily engage in specialized oncology-related patient care during their rotations, which limits their ability to fully apply didactic knowledge and gain practical application of common ambulatory care diseases such as diabetes mellitus or hypertension during their 6-week rotation.
OBJECTIVE: To evaluate the perceptions of 4th year APPE students on their ambulatory care disease expertise after participation in ASPSI.
METHODS: ASPSI is a series of case-based interactive topic discussions to enhance learning on designated topics for APPE students during their ambulatory care rotation(s) at MD Anderson Cancer Center. Four discussions are held during each 6-week rotation. The discussions are diabetes mellitus, hypertension, constipation/diarrhea, and anticoagulation. Discussions are intended to be interactive learning experiences while led and facilitated by ambulatory care oncology clinical pharmacy specialists. Over the past academic year, each student involved in these topic discussions was asked to voluntarily complete an anonymous survey at the end of the 6 weeks. Students were asked to rate their confidence level on a 5-point Likert-type scale for the ability to care for a patient on a scale of 1 to 5, with 1 being very low confidence and 5 being very high confidence. Survey results were compiled and described.
RESULTS: All students (N=11) completed the survey, with 100% reporting these discussions improved their confidence in managing patients with diabetes mellitus, hypertension, constipation/diarrhea, and anticoagulation. The mean confidence score for diabetes management increased from 2.36 to 3.55, for hypertension from 2.82 to 4.18, for anticoagulation from 2.82 to 4.09, and for constipation/diarrhea from 2.45 to 4.18. Median confidence scores across all conditions also showed a shift from 2 to 3 before the discussions to 4 after the discussions. These results indicate a marked increase in student confidence in managing these conditions after participating in the interactive discussions.
CONCLUSIONS: Student evaluations of the interactive ASPSI topic discussions were overwhelmingly positive in a nontraditional ambulatory care APPE setting. The results support the continued use of this instructional approach to reinforce core ambulatory care topics during specialized oncology APPE ambulatory care rotations. Ongoing use of student feedback through surveys will allow preceptors to improve the program and potentially expand the range of topics covered in future iterations.
- Sullivan GM, Artino AR Jr. Analyzing and interpreting data from Likert-type scales. J Grad Med Educ. 2013;5:541-542.