Using nominal group technique to determine skills that applied improvisation can teach health profession education learners.

Objective: Applied improvisation (AI) is an approach used in health professions (HP) education to teach skills essential for clinical practice such as communication, teamwork, and empathy. Little is known about which skills can be developed using AI, or those which an AI should prioritize. Our research aims to identify skills essential to include in an AI curriculum for HP learners. Methods: A modified nominal group technique (NGT) was conducted to identify and prioritize specific skills which can be taught using AI. This involved silent generation of ideas, round robin, discussions, 2-rounds of preliminary voting, and a final ranking survey to determine a prioritized list of skills to include in an AI curriculum for HP learners. Results: Six content experts participated in the NGT meeting. Initially, 83 skills were identified, and through NGT, a final list of 11 skills essential to an AI curriculum were determined including: adaptability, affirmation of others, acceptance, active listening, being present, cooperation, collaboration with other, advancement, compassionate communication, sharpened non-verbal communication, resilience. Conclusion: Essential skills for an AI curriculum relate to adaptability, attunement, collaboration, affirmation, and advancement. Innovation: This study is a novel application of NGT as a strategy to organize an approach to curriculum innovations.

How to Use Improv to Help Interprofessional Students Respond to Status and Hierarchy in Clinical Practice.

Hierarchy and status and power differentials in current health care practice persist, despite recognition of their ethical issues and movement toward collaborative practice. As interprofessional education continues to emphasize shifting from individual siloed practice to team-based approaches to improving patient safety and outcomes, addressing status and power is key to mutual respect and trust cultivation. What has become known as medical improv applies techniques of theater improvisation to health professions education and practice. This article shares how an improv exercise called Status Cards prompts participants to recognize their responses to status and how this awareness can be applied to improve their interactions in real encounters with patients, colleagues, and others in health care contexts.

An innovative patient interview activity in a women's health elective.

BACKGROUND AND PURPOSE: To develop, integrate, and evaluate an innovative women's health and sexual health history interview activity in an elective course for pharmacy students. EDUCATIONAL ACTIVITY AND SETTING: Students reflected on personal experiences where a healthcare provider addressed sensitive health-related topics. Students used this reflection and other resources to prepare for and conduct an interview with an adult woman. Students wrote a reflection paper describing their interview experience. Female participants provided feedback on student performance via an anonymous, electronic survey. Analysis of student reflection papers explored the impact of students' personal health care experiences on their approach with the participant and achievement of activity learning objectives. FINDINGS: In 2015 and 2016, 38 of 51 (74.5%) participants interviewed completed the survey. In response to open-ended questions about student performance, 47% of participants stated the student helped them feel comfortable, 44% said the student was professional, and 13% stated the student seemed nervous or uncomfortable. All participants agreed or strongly agreed students used appropriate communication to obtain health information and asked sensitive questions professionally. Among 51 student reflections, all students were able to describe how their experience influenced them, and most described its application to future practice. Further reflection paper analysis revealed students tried to emulate behaviors, attitudes, and skills seen in personal encounters with clinicians. Examples of behaviors included empathy and patient-centered communication. DISCUSSION AND SUMMARY: Students achieved the activity learning objectives. Authors felt this unique activity may help students prepare for challenging patient interviews encountered in future practice.

A Financial Evaluation of the Centralized Repackaging of Intracameral Moxifloxacin for Cataract Surgery and Its Impact on Cost Reduction.

Background: Extensive evidence-based literature supports the use of intracameral (IC) moxifloxacin for the prevention of postoperative endophthalmitis after cataract surgery. The Aurora Pharmacy Packaging Center (APPC) has developed a process for centrally preparing IC moxifloxacin. Purpose: The aim of this study was to evaluate the centralized preparation of IC moxifloxacin production for quality assurance and to quantify a potential reduction in costs. Methods: The APPC's compounding procedure of IC moxifloxacin was evaluated using United States Pharmacopeia (USP) Convention 797 standard and compared with practices described in evidence-based literature. Patients who received IC moxifloxacin intraoperatively from one of 3 ophthalmologists during cataract surgery performed between February 15, 2016, and August 15, 2016, were identified using electronic health records. Cost savings were calculated by reviewing costs associated with drug supplies used by the APPC. Results: The APPC process for the centralized preparation of IC moxifloxacin was deemed compliant with USP 797's sterile compounding standards. USP 797 validation criteria included proper sterile technique, equipment, room sterility and pressure, beyond use dating, and storage. Implementation of the centralized production of moxifloxacin reduced the direct product cost per surgery from $140 to $20 (a cost savings of $120 per surgery). There were 459 cataract surgeries analyzed during the study period, resulting in a savings of $55 080 over 6 months. Conclusion: The APPC's centralized compounding procedure was found to be compliant with pharmacy compounding standards and to yield significant cost savings.

Incorporation of practice testing to improve knowledge acquisition in a pharmacotherapy course.

BACKGROUND AND PURPOSE: To incorporate and assess the impact of a coordinated practice testing activity on pharmacy student knowledge acquisition, retention, and perception as an effective study technique in a pharmacotherapy course. EDUCATIONAL ACTIVITY AND SETTING: Students were instructed to individually create, exchange, complete, and discuss solutions to weekly, cumulative practice tests of targeted material during the first unit of the course. Students completed surveys on their perceptions of practice testing. Unit and final examination scores were compared to the previous year. FINDINGS: Comparison of average unit examinations scores showed only minimal improvement in knowledge acquisition, and no impact was detected in knowledge retention. Most students in the course did not perceive practice testing to be beneficial in learning or retaining unit material. DISCUSSION AND SUMMARY: Incorporating a coordinated practice testing activity may have minimally improved knowledge acquisition in our pharmacotherapy course. However, limitations exist which make it difficult to attribute improvement solely to our learning activity.