Perceptions and performance using computer-based testing: One institution's experience.

BACKGROUND AND PURPOSE: The purpose of this study was to evaluate student and faculty perceptions of the transition to a required computer-based testing format and to identify any impact of this transition on student exam performance. EDUCATIONAL ACTIVITY AND SETTING: Separate questionnaires sent to students and faculty asked about perceptions of and problems with computer-based testing. Exam results from program-required courses for two years prior to and two years following the adoption of computer-based testing were compared to determine if this testing format impacted student performance. FINDINGS: Responses to Likert-type questions about perceived ease of use showed no difference between students with one and three semesters experience with computer-based testing. Of 223 student-reported problems, 23% related to faculty training with the testing software. Students most commonly reported improved feedback (46% of responses) and ease of exam-taking (17% of responses) as benefits to computer-based testing. Faculty-reported difficulties were most commonly related to problems with student computers during an exam (38% of responses) while the most commonly identified benefit was collecting assessment data (32% of responses). Neither faculty nor students perceived an impact on exam performance due to computer-based testing. An analysis of exam grades confirmed there was no consistent performance difference between the paper and computer-based formats. DISCUSSION AND SUMMARY: Both faculty and students rapidly adapted to using computer-based testing. There was no evidence that switching to computer-based testing had any impact on student exam performance.

Impact of Pre-Pharmacy Work Experience on Development of Professional Identity in Student Pharmacists.

Objective. To determine the benefit of pharmacy work experience on the development of student pharmacists' professional identity. Methods. Students in all four professional years were surveyed using a validated Professional Self-identity Questionnaire (PSIQ). They were also asked about pharmacy experience prior to matriculation and their performance on Drug Information tests given midway through the P1 year and at the beginning of the P3 year. PSIQ responses and test results were compared based on pharmacy experience. Results. The PSIQ was completed by 293 student pharmacists, for a 67% response rate, with 76% of respondents reporting pharmacy experience prior to matriculation. Statistically higher scores on responses to 6 of the 9 PSIQ Likert-type items were observed from students in the first professional year for those with pharmacy experience; however, only one item in the second year showed differences with none in the third and fourth years. No impact of experience was observed on Top 100 or Top 300 grades. Conclusion. Pre-matriculation pharmacy experience may increase development of professional identity early in the student experience but may have little impact on academic readiness. Schools and colleges of pharmacy hoping to recruit students with an early sense of professional identity should consider adding such experience to their admissions requirements.

Measuring adherence in a community-based elderly population.

OBJECTIVE: To examine the reliability and validity of the Medication Adherence Individual Review-Screening Tool (MedAdhIR-ST) for assessing medication adherence in a community-dwelling elderly population. DESIGN: A prospective, observational pilot study comparing the reliability and validity of the MedAdhIR-ST and the Medication Adherence Questionnaire (MAQ). SETTING: Independent senior-housing apartments and senior centers in Wake County, North Carolina. PARTICIPANTS: Eligible subjects included individuals 60 years of age or older who were living in the community and managing their own medication regimens. INTERVENTIONS: Each subject was asked to participate in two assessment visits, two weeks (+/- 3 days) apart, in which the questions of the MedAdhIR-ST and MAQ were administered. MAIN OUTCOME MEASURE: Medication adherence. RESULTS: Both tools showed moderate-to-high test/retest reliability in the study population (correlation coefficient of 0.632 for MAQ, and 0.699 for MedAdhIR-ST), and moderate internal consistency (Cronbach's a of 0.551 and 0.584, respectively). Moderate concordance in the ability to assess adherence was observed between MedAdhIR-ST and MAQ (positive correlation coefficient of 0.450). When compared with refill records, MedAdhIR-ST was slightly more sensitive (67% vs. 43%) and specific (60% vs. 50%) for detecting adherence and nonadherence, respectively, compared with MAQ. Exploratory factor analysis indicated that MedAdhIR-ST is multidimensional. CONCLUSION: MedAdhIR-ST appears to be a reliable and valid tool for screening nonadherence in a community-dwelling elderly population.

Medication errors and penalties in assisted living facilities.

OBJECTIVE: To determine the percentage of medication-related proposed penalties for licensed assisted living facilities in North Carolina. DESIGN: This retrospective, cross-sectional study examined all proposed penalties and related case-file narratives stemming from annual surveys of licensed assisted living facilities conducted by the state between July 2007 and December 2008. The percentage of medication-related deficiencies and proposed penalties were calculated. Associations between the medication-related proposed penalties and facility size, location, and penalty type were explored using chi-square tests. SETTING: Assisted living facilities in North Carolina. MAIN OUTCOME MEASURES: Percentage of medication- and non-medication-related penalties. RESULTS: A total of 1,256 licensed assisted living facilities (51% adult care homes, 59% metropolitan) were surveyed during the study period. There were 88 proposed penalties (51% medication-related) among 60 facilities. No association between medication-related proposed penalties and facility size or location was detected. However, an association (P = 0.002) was found between type of penalty (A or B) and whether the proposed penalty was medication- or non-medication-related (37.3% and 70.3% of Type A and B penalties, respectively, were medication related). Medications commonly cited were insulin, cardiovascular agents, supplements, anticonvulsants, and antipsychotics. Common categories of medication errors were drug not administered and wrong dose administered. CONCLUSIONS: Medication errors, regardless of facility size or location, were contributing factors in approximately one-half of violations sufficient enough to warrant a penalty proposal among the licensed assisted living facilities in North Carolina. These findings demonstrate a need for continued regulation and increased pharmacist involvement to improve medication safety.