Design of a foundational sciences curriculum: Applying the ICAP framework to pharmacology education in integrated medical curricula.

Expectations for physicians are rapidly changing, as is the environment in which they will practice. In response, preclerkship medical education curricula are adapting to meet these demands, often by reducing the time for foundational sciences. This descriptive study compares preclerkship pharmacology education curricular practices from seven allopathic medical schools across the United States. We compare factors and practices that affect how pharmacology is integrated into the undergraduate medical education curriculum, including teaching techniques, resources, time allocated to pharmacology teaching, and assessment strategies. We use data from seven medical schools in the United States, along with results from a literature survey, to inform the strengths and weaknesses of various approaches and to raise important questions that can guide future research regarding integration of foundational sciences in medical school and health professions' curricula. In this comparative study, we found that there is significant heterogeneity in the number of hours dedicated to pharmacology in the preclerkship curriculum, whereas there was concordance in the use of active learning pedagogies for content delivery. Applying the ICAP (Interactive, Constructive, Active, Passive) Framework for cognitive engagement, our data showed that pharmacology was presented using more highly engaging pedagogies during sessions that are integrated with other foundational sciences. These findings can serve as a model that can be applied beyond pharmacology to other foundational sciences such as genetics, pathology, microbiology, biochemistry, etc.

The importance of collaboratively designing pharmacology education programs.

A grounded knowledge of pharmacology is essential for healthcare providers to improve the quality of patients' lives, avoid medical errors, and circumvent potentially dangerous drug-drug interactions. One of the greatest tools to achieve this foundational knowledge of pharmacology is the dedicated pharmacology educators who teach in health sciences programs. Too often, the pharmacology educators responsible for teaching this material are left siloed at their own institutions with little room for dialog and collaboration. As scientists, we know that it is through dialog and collaboration that ideas grow, are refined, and improve. More collaborative work is needed to identify and describe best practices for pharmacology education in health sciences programs. While evidence-based, outcomes-focused studies are the optimum standard for this work, there is also a place for descriptive studies and innovative reports.

The Flipped Classroom and Simulation: a Primer for Simulation Educators.

The flipped classroom has become part of the lexicon in discussion of pedagogies in healthcare education. When reviewing the simulation literature, however, the term is only recently being mentioned. We determined there was a need for this article based on workshops held at the annual International Meeting for Simulation in Healthcare (IMSH), which were facilitated by the authors. In the workshops, most of the participants had heard the term and had first-hand experience with the flipped model in simulation; however, there were varied interpretations of the flipped model and several concerns related to implementation of the model. In this article, we define the flipped classroom model, review the existing work on using the flipped model in healthcare education, and provide five recommendations regarding use of the flipped model in simulation. The framework for summarizing the work and presenting the recommendations is based on a brief review of the literature and from the participant discussions at the IMSH workshops.

A Quantitative and Narrative Evaluation of Goodman and Gilman's Pharmacological Basis of Therapeutics.

Goodman and Gilman's The Pharmacological Basis of Therapeutics (GGPBT) has been a cornerstone in the education of pharmacists, physicians, and pharmacologists for decades. The objectives of this study were to describe and evaluate the 13th edition of GGPBT on bases including: (1) author characteristics; (2) recency of citations; (3) conflict of interest (CoI) disclosure; (4) expert evaluation of chapters. Contributors' (N = 115) sex, professional degrees, and presence of undisclosed potential CoI-as reported by the Center for Medicare and Medicaid's Open Payments (2013-2017)-were examined. The year of publication of citations was extracted relative to Katzung's Basic and Clinical Pharmacology (KatBCP), and DiPiro's Pharmacotherapy: A Pathophysiologic Approach (DiPPAPA). Content experts provided thorough chapter reviews. The percent of GGPBT contributors that were female (20.9%) was equivalent to those in KatBCP (17.0%). Citations in GGPBT (11.5 ± 0.2 years) were significantly older than those in KatBCP (10.4 ± 0.2) and DiPPAPA (9.1 ± 0.1, p < 0.0001). Contributors to GGPBT received USD 3 million in undisclosed remuneration (Maximum author = USD 743,718). In contrast, DiPPAPA made CoI information available. Reviewers noted several strengths but also some areas for improvement. GGPBT will continue to be an important component of the biomedical curriculum. Areas of improvement include a more diverse authorship, improved conflict of interest transparency, and a greater inclusion of more recent citations.

The IUPHAR Pharmacology Education Project.

Online learning, an essential component of most traditional contact-based educational programs, must be of high quality to contribute effectively to learning. The availability of first-class web-based materials is particularly valued by both learners and educators in resource-poor nations. In this Practice article, we introduce the International Union of Basic and Clinical Pharmacology (IUPHAR) Pharmacology Education Project (PEP) (https://www.pharmacologyeducation.org/), a freely accessible online learning resource intended to support education and training in pharmacological sciences worldwide.

Development and evaluation of a regional, large-scale interprofessional collaborative care summit.

The Northeastern/Central Pennsylvania Interprofessional Education Coalition (NECPA IPEC) is a coalition of faculty from multiple smaller academic institutions with a mission to promote interprofessional education. An interprofessional learning program was organized, which involved 676 learners from 10 different institutions representing 16 unique professions, and took place at seven different institutions simultaneously. The program was a 3-hour long summit which focused on the management of a patient with ischemic stroke. A questionnaire consisting of the Interprofessional Education Perception Scale (IEPS) questionnaire (pre-post summit), Likert-type questions, and open comment questions explored the learners' perceptions of the session and their attitudes toward interprofessional learning. Responses were analyzed using descriptive statistics and statistical tests for difference and qualitative thematic coding. The attitude of learners toward interprofessional education (as measured by the IEPS) was quite high even prior to the summit, so there were no significant changes after the summit. However, a high percentage of learners and facilitators agreed that the summit met its objective and was effective. In addition, the thematic analysis of the open-ended questions confirmed that students learned from the experience with a sense of the core competencies of interprofessional education and practice. A collaborative approach to delivering interprofessional learning is time and work intensive but beneficial to learners.

Release of non-mast cell histamine from rat aorta.

We previously reported that A23187 induces release of histamine from bovine intrapulmonary vein and provided pharmacological evidence against an involvement of mast cells as the source of histamine. This study was conducted to test more definitively the hypothesis that histamine is released from non-mast cell sources in blood vessels. The effects of A23187 on release of histamine were determined using rat aorta which does not contain mast cells. Aortic rings were mounted for recording of isometric tension, and following exposure to A23187 or vehicle, histamine in the bathing media was measured using enzyme immunoassay. A23187 (100 nmol/l - 10 micromol/l) induced concentration-related release of histamine from rings with endothelium. The accumulation of histamine in the bathing media induced by 10 microM A23187 reached plateau at 60 min (6.2 +/- 1.1 pmol/mg) and was markedly and significantly higher than vehicle control (0.4 +/- 0.1 pmol/mg, p < 0.05). Destruction of endothelium significantly inhibited A23187-induced histamine release (5.5 +/- 1.5 pmol/mg with endothelium, 1.1 +/- 0.3 pmol/mg without endothelium, p < 0.05). The results demonstrate that A23187 induces release of histamine from rat aorta which does not contain mast cells and that the release of histamine is largely dependent on the presence of endothelium.