Implementing cognitive apprenticeship theory into the design of a doctor of pharmacy course.

BACKGROUND AND PURPOSE: Cognitive apprenticeship theory is a model instructors can use to develop expert thinking in a classroom setting. Cognitive apprenticeship theory has been discussed in the literature; however, descriptions of its application in the classroom setting are lacking. We describe how cognitive apprenticeship guided the development and implementation of a new critical care course with a goal of making expert thinking "visible" to students. EDUCATIONAL ACTIVITY AND SETTING: A four-credit-hour course implemented in the 2018-2019 academic year was developed around the dimensions of cognitive apprenticeship. Clinical pharmacists with the affiliated healthcare system contributed to the design and implementation. Elements of the course in which cognitive apprenticeship theory guided the design included pre-class work, in-class group work, and an attending-facilitated discussion session. FINDINGS: All four dimensions of cognitive apprenticeship were incorporated throughout the course. The course coordinator perceived that student questions and the quality of the discussion were higher level than in previous years. SUMMARY: Cognitive apprenticeship theory can be used to design and implement a professional doctor of pharmacy course that prepares students for the types of thinking required in practice. We believe this model could be successfully implemented at other schools of pharmacy.

Pediatric Scurvy: How an Old Disease Is Becoming a New Problem.

Ascorbic acid (vitamin C) functions as a cofactor and antioxidant within the human body that enables tissue growth and repair, but vitamin C is not intrinsically produced. Scurvy, or ascorbic acid deficiency, has traditionally been viewed as a historical disease. With the incidence of autism spectrum disorder and food restriction on the rise, children's hospitals may see increasing cases of scurvy. This is a single-center, retrospective case series including patients aged 7 to 14 years who were admitted to the Kentucky Children's Hospital with scurvy in the 2018-2019 period. Although selective or restricted eating is not an uncommon behavior among children, especially toddlers, parents of autistic children frequently report their children to be exceedingly selective eaters. However, there currently are conflicting findings on whether this leads to nutritional inadequacy. Although no guidelines exist for the treatment of scurvy, the mainstay of therapy is reintroduction of vitamin C. Oral therapy is generally preferred, but vitamin C can be given parenterally when necessary. In conclusion, oral aversion is a symptom commonly seen in patients with autism spectrum disorder and other developmental delays, potentially leading to increased cases of scurvy. Treatment of scurvy includes reintroduction of vitamin C into the diet. However, oral supplementation may pose unique challenges in this patient population.