RESUMO
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.
