International Journal of Healthcare Simulation

Background:

In response to a sector-wide lack of placement opportunities for undergraduate pharmacy students during the COVID-19 pandemic [1], a range of simulated placement experiences were developed by a university teaching team. These experiences were developed at a time of significant change for pharmacy education, with all pharmacists being annotated as independent prescribers at the point of registration from 2026 onwards [2]. This innovation was intended to support final year undergraduate pharmacy students in developing, refining and demonstrating clinical history taking and decision-making skills, which are skills essential to the existing single competency framework for prescribing practitioners [3].

Methods:

Four ‘experiential learning days’ (ELDs) were developed, focussing on a ‘day in the life’ of a pharmacist engaged in multiple spheres of practice: a community pharmacy, a hospital environment, a primary care setting and a care home environment. Experienced pharmacist practitioners co-developed sessions to ensure that the activities were reflective of the real-life setting. In designing these screen-based activities, the teaching team prioritised the development of an immersive event, which felt like a live activity despite being undertaken at a time and place chosen by the learner. Scheduled space in the timetable was allocated for students to undertake these ELDs, although they could be accessed at any time following this. A pre-recorded orientation lecture was provided one week ahead of the first scheduled date. The ELDs were developed through the Canvas VLE platform, making use of pre-requisites and conditional requirements to allow feedback and debriefing to be released after completion of activities. Patient Communication Simulator (PCS) Spark was utilised to integrate multiple patient interactions into each of the days.

Findings:

These interactions focussed on clinical history taking, clinical decision-making, and patient communication. Immersion was increased through the use of pre-recorded handover videos, realistic documentation and simulated patient interactions. Consolidation and testing of learning took place in multiple forms, including short multiple-choice quizzes, which tested collation of key patient information, understanding of physical assessment findings and plans for ongoing patient management. Additional mechanisms were selected to be reflective of day-to-day communication and included the recording of voicemail messages and responding to emails. Email responses that were received by students were screened for key information, and automatically generated replies were sent to learners to allow them to mark activities as completed. Feedback was released as a pre-recorded presentation to students who had completed all milestones, identifying key discussion points and encouraging reflection of learning and performance.

Conclusion:

A range of simulated screen-based virtual ‘day in the life experiences’ were developed and implemented in the undergraduate Master of Pharmacy (MPharm) curriculum, intended to support students in developing key skills including clinical decision-making and clinical history taking. A variety of mechanisms were used to maximise immersion, despite sessions being run asynchronously. A high level of student engagement was observed with the activities, and formal work to investigate student attitudes and perceptions to these events is ongoing.

References

1. Liu L, Caliph S, Simpson C, Khoo RZ, Neviles G, Muthumuni S, Lyons KM. Pharmacy Student Challenges and Strategies towards Initial COVID-19 Curriculum Changes. InHealthcare. 2021;9(10):1322.

2. General Pharmaceutical Council. Standards for the initial education and training of pharmacists. January 2021. https://ddec1-0-en-ctp.trendmicro.com:443/wis/clicktime/v1/query?url=https%3a%2f%2fwww.pharmacyregulation.org%2fsites%2fdefault%2ffiles%2fdocument%2fstandards%2dfor%2dthe%2dinitial%2deducation%2dand%2dtraining%2dof%2dpharmacists%2djanuary%2d2021%5f1.pdf&umid=557331e6-a625-4471-be2d-52126f877c7e&auth=6b639a990a359ff1d6cc8761081d57748ce3c81e-89f467ee17139335739043f4013d904870c9f291 [Accessed on 27/09/2022]

3. The Royal Pharmaceutical Society. A competency framework for all prescribers. September 2021. https://www.rpharms.com/Portals/0/RPS%20document%20library/Open%20access/Prescribing%20Competency%20Framework/RPS%20English%20Competency%20Framework%203.pdf [Accessed on 27/09/2022]