Improving preparation for pharmacy entry-to-practice OSCE using a participatory action research.

INTRODUCTION: In Switzerland, becoming a licensed pharmacist requires succeeding a federal entry-to-practice exam that includes an Objective Structured Clinical Examination (OSCE). Candidates from the University of Geneva (UNIGE) exhibited a higher failure rate in this part of the examination in comparison to candidates from other Swiss institutions. The institution made a specific set of pedagogical changes to a 3-week pharmacy services course that is run during their Master's second year to prepare them for their entry-to-practice OSCE. One key change was a switch from a summative in-classroom OSCE to an on-line formative OSCE. METHODS: New teaching activities were introduced between 2019 2020 and 2021-2022 academic years to help students strengthen their patient-facing skills and prepare for the federal OSCE. These online activities consisted in formative OSCEs supplemented with group and individual debriefings and in 18 h clinical case simulations reproducing OSCE requirements and assessed with standardized evaluation grids. Failure rates before and after the introduction of these activities were compared, and their perceived usefulness by UNIGE candidates was collected through a questionnaire survey. RESULTS: The UNIGE failure rate decreased from 6.8% in 2018/2019 to 3.3% in 2022 following the implementation of the new teaching activities. The difference in failure rates between UNIGE and the other institutions became less pronounced in 2022 compared to 2018/2019. The redesigned Master's course was highlighted as useful for preparation, with all new activities perceived as beneficial. Questionnaire responses brought attention to challenges faced by UNIGE candidates, including stress management, insufficient information or practical training, and experiences related to quarantine. These insights informed further development of teaching methods. DISCUSSION: Although the results do not establish a direct link between participation in new teaching activities and increased performance, they suggest resolving the initial issue. Our findings relate to pedagogical concepts such as constructive alignment, formative assessment and examination anxiety, and generally support the benefits of online format. CONCLUSION: This study used a participatory action research based on mixed methods to address a challenge in pharmacy education. Online teaching activities including formative OSCEs, case simulations and debriefings were implemented. Improved performance in entry-to-practice OSCE was subsequently observed. The results highlight the potential of formative, active, and constructively aligned online activities, such as role-playing and case simulation, to enhance patient-facing skills and improve outcomes in summative assessments of these skills.

One Health education in Kakuma refugee camp (Kenya): From a MOOC to projects on real world challenges.

Today, the world counts millions of refugees but only a fraction of them have access to higher education. Despite the multiple public health problems in refugee camps and the need to build local capacities to prevent and combat them, University level courses in public health are largely unavailable for refugees. This paper describes the development, implementation and evaluation of an innovative two-module blended-learning programme on One Health in Kakuma refugee camp (Kenya). This programme combines: (I) Interdisciplinary and multi-expert MOOC on "Global Health at the Human-Animal-Ecosystem interface"; (II) peer-to-peer learning involving students from University of Geneva Master of science in Global Health and research collaborations around specific and locally-relevant problems; (III) online mentoring and lecturing by experts from the Institute of Global Health of the University of Geneva in Kakuma. A total of 67 refugees applied to Module 1; 15 started the Module 1 in October 2017, of these 14 completed it and 6 passed the exams, finally five students started the Module 2 in October 2018 which they all passed in February 2019. Five student-led collaborative projects were developed focusing on the conception of a community-based monitoring system for prevalent diseases in the camp. With such a pedagogic approach, the programme provides an overview on Global Health challenges at the human-animal-ecosystem interface and the importance of the One Health approach, and introduces students to scientific research through interdisciplinary and international collaborations and innovation. The high number of applicants and positive feedback from students in Kakuma show the interest in One Health education in the camp. This learning experience ultimately aims at building local knowledge and capacity fostering "One Health" champions to reinforce local and national health system. This framework for One Health education could be potentially scaled up to other camps in Africa and the world.

First 'Global Flipped Classroom in One Health': From MOOCs to research on real world challenges.

In 2016 and 2017 the first three MOOCs (Massive Online Open Course) addressing One Health were released, two of them by University of Geneva and University of Basel (Switzerland). With the support of Swiss School of Public Health and using these two highly interdisciplinary MOOCs, the first 'Global Flipped Classroom in One Health' was organized in Geneva and Basel in July 2017. This innovative event gathered 12 Swiss and international MOOC learners to work on specific public/global health challenges at the human-animal-ecosystem interface in interdisciplinary teams supported by experts from academia and international organisations (e.g. World Health Organization) based in Geneva, Basel and internationally. According to the final survey, the level of satisfaction by learners was high and they benefited from the experience in different ways: reinforcement of their knowledge and capacity to perform innovative research in One Health (e.g. using digital epidemiology), visits and meetings with experts in Global Health (e.g. World Health Organization and Institute of Global Health in Geneva, Swiss Tropical and Public Health Institute in Basel) and emerging research collaborations etc. A novel project-based learning and research model arising from MOOCs was successfully created, which offers opportunities for global education and research addressing real world challenges utilising a One Health approach.