A Mixed-Methods Exploration of the Effect of Disabling Backward Navigation on Calculations-Focused Computerized Examinations.

Objective. The aim of this mixed-methods study was to examine the effect of disabled backward navigation on computerized calculation examinations in multiple courses.Methods. Student performance on comprehensive pharmacy calculation examinations before and after implementation of disabled backward navigation were compared. Deidentified data from ExamSoft were used to determine median examination scores, passing rates, and time to completion for all three attempts given on comprehensive calculation exams held in a pharmacy calculations course (PharDSci 504) and in three applied patient care laboratory courses (Pharm 531, 541, and 551). An anonymous, voluntary student survey gathered student perceptions of disabled backward navigation. Qualitative data were evaluated for thematic findings.Results. The impact of disabled backward navigation on test scores and passing rates varied by course and test attempt. Students in Pharm 541 and 551 performed significantly worse on the initial test attempt after backward navigation was disabled compared to the previous year, with no significant differences in student performance seen on the retakes. Performance in PharDSci 504 and Pharm 531 followed the opposite pattern, with no significant difference in performance for the initial tests but significantly increased performance on the retakes. The amount of time spent on examinations either significantly decreased or remained the same. Student perceptions were generally consistent across all cohorts, with at least 74% agreeing that disabling backward navigation increased examination difficulty.Conclusion. Disabling backward navigation had a mixed effect on student examination performance. This may highlight how student behaviors change as backward navigation is disabled.

Comparing trained student peers versus paid actors as standardized patients for simulated patient prescription counseling.

Background: Simulation can be a useful tool for teaching and assessing clinical skills, but can also be costly and faculty-time intensive. It is defined as a technique to create an activity to portray a real experience for purpose of practicing or evaluating. Simulations can use standardized patients (SPs), which can be paid actors (PASPs), staff and faculty, manikins, volunteers, or students from higher level cohorts, also known as advanced class standardized patients (ACSPs). Objective: The objective of this study was to conduct a multifaceted analysis comparing ACSPs and PASPs, based on student performance in the assessment, student preference of SP type, and SP performance as an actor. Methods: ACSPs and PASPs were used in a summative prescription counseling role play. For the evaluation, students counseled a SP about a new prescription medication and answered questions about taking an over-the-counter product with the new medication. The interaction was recorded and evaluated by faculty using a previously developed rubric. SP performance was evaluated by faculty using a separate rubric to determine how well the patient role was performed. A pre- and post-evaluation survey was completed by student pharmacists to gather student preferences about SPs and confidence in their counseling skills. Data were evaluated using a paired t-test. Results: One hundred sixty-seven student pharmacists completed the summative prescription counseling evaluation. Student pharmacists performed well overall with minimal differences between SP types. Students preferred PASPs to role play the patient but felt that the actor type did not affect their performance. Conclusions: ACSPs performed the role of the SP well for a summative prescription counseling session without impacting student performance compared to PASPs and with reduced cost. However, students preferred PASPs, and PASPs were better at role playing the patient.

Training Student Pharmacists in Suicide Awareness and Prevention.

Objective. To determine whether students gained knowledge, confidence, and skills in identifying and preventing suicide in patients, peers, friends, and family after receiving training in suicide prevention. Methods. Student pharmacists participated in a 3.5-hour suicide prevention training program. A pre- and post- intervention assessment and pre- and post-intervention survey were administered before and after completion of the training program. Questions were designed to assess knowledge of, comfort with, and confidence in assessing and intervening with individuals at risk of suicide. A standardized patient prescription counseling session was conducted two weeks after the training session. Videos of the counseling sessions were reviewed to determine whether student pharmacists assessed the patient for suicide risk. Additionally, a post-counseling reflection was completed asking students to reflect on incorporation of the suicide prevention training into their prescription counseling session. Results. One-hundred seventy-one student pharmacists participated in the training. Knowledge increased across all areas as evidenced by improved scores on the post-intervention knowledge assessment. Students' comfort level with asking about suicidal ideation and their confidence with intervening significantly increased from the pre- to post-intervention survey. After the training, 40% stated they knew someone who may need help and 21% said they had decided to seek help for themselves. Conclusion. The training program increased student pharmacists' knowledge of and confidence in assessing and counseling individuals considering suicide. Encouraging student pharmacists to participate in prevention training may aid future providers in preventing death by suicide.