Monash Pharmacy Practice Symposium
New approaches to teaching and learning
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“Experiential teaching and learning in pharmacy”
was the theme of the inaugural Monash Pharmacy Practice Symposium
held in Prato, Italy, on 9 and 10 September. The symposium was hosted
by Monash University, Victoria, Australia. Paul Rutter, senior
lecturer, pharmacy practice division, Portsmouth University, reports
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The need for more pharmacists in many countries has resulted in new schools
of pharmacy being opened and new ways of teaching and learning being considered.
Professor Mariette Lowes, dean of the faculty of health sciences, Technikon
Pretoria, South Africa, described how innovative teaching methods were
embedded into the curriculum of a new school of pharmacy which opened
in 1999 at the university. Initially, learning outcomes and competency
standards were identified which were needed to produce competent practitioners.
The curriculum was developed using horizontal integration and taught primarily
on a body systems approach. The teaching approach followed an outcomes
based approach to education and was solely taught by problem-based learning
(PBL).
Professor Lowes went on to explain how PBL works and what steps are involved
in this new approach. Students work in small groups, usually of six or
eight people, and meet twice a week. At the first meeting students are
presented with a scenario, from which they have to identify the problem
and decide what information has to be sought and who should do what. Later
in the same week the students come together again to assimilate the information
and feedback their findings to others. No formal didactic lectures are
part of the learning process, although students can request lectures when
they feel more information on a topic is required. At the meetings, a
facilitator is on hand to help but not intervene in the process. Self-motivation
and self-directed learning are key attributes that students must have
or gain during PBL.
Professor Lowes was asked about how students acquired such skills. She
replied that all students undertake a life skills programme, which covers
such topics.
Using case-based learning and clinical teaching
Associate Professor John Rovers, Drake University, Des Moines, Iowa, United
States, spoke about the value of case-based learning to clinical teaching.
Case-based learning, like PBL, addresses higher levels of cognitive skills,
ie, students are able to apply knowledge. He highlighted three types of
cases: trigger, focused and integrative. Trigger cases were described
as a simple descriptive account of an event, intended to invoke the student
to follow some course of action, yet allowing for a variety of problems
to be considered. The example of a patient presenting at a community pharmacist
asking for something for constipation was highlighted as a trigger case.
This type of case teaches data collection and assessment but does not
require identification or resolution of the problem.
The focused case does not require exploration of multiple issues or problems
but is directed toward a specific pharmacist act. For example, in the
constipation scenario, the case would change from a trigger case to a
focused case if the pharmacist had decided the problem was constipation
and had to recommended a particular type of laxative. Focused cases are,
therefore, intended to try to get the student to develop patient care
plans.
The integrative case is the most complex type. It presents the student
with multiple problems and requires the student to prioritise information.
At Drake University, Professor Rovers said this type of teaching is used
to teach therapeutics while the student is at the university and on practice-based
placements.
Experiential teaching — theory to practice
Dawn Best, postgraduate medical education co-ordinator, Western Health,
Australia, challenged participants to think of reasons why experiential
learning should be included in curricula. She outlined the different educational
theories underpinning experiential teaching and how these theories can
be applied to pharmacy education. Fundamentally, anything that is active,
other than note taking, could be classed as experiential learning, eg,
practical classes, role play, PBL, case-based learning and work placements.
A key to successful experiential learning is how active the learning is
and how involved the students are. Is it relevant to the student perception
of real world practice and how much autonomy do they have on setting the
learning objectives?
In addressing student perception of real life practice, Dr Jennifer Marriott,
lecturer in clinical pharmacy, Monash University, Australia, described
a case-based authentic assessment of clinical pharmacy students. Students
were provided with case studies of real patients to which a series of
clinical scenarios were added. Students were then required to assess the
new clinical situation taking into consideration individual patient factors
and to determine appropriate treatment. Each student, therefore, had an
individualised patient scenario unique to them, thus negating plagiarism.
Professor Jo-anne Brien, department of clinical pharmacy, University of
Sydney, Australia, outlined how theory had been put into practice. The
pharmacy course had been extended from three to four years in Australia
in 1997 and this had provided the opportunity to introduce experiential
programmes to the undergraduate curriculum. Two such examples, at Monash
and Sydney universities, were briefly explained. Both programmes have
fundamentally the same aims but are administered in different ways to
accommodate the different curricula structures.
Meeting all parties’ expectations and logistics of placements were
highlighted as two key personal learning objectives about implementing
such schemes.
Rohan Elliott, preceptor co-ordinator, Austin and Repatrition Medical
Centre, Australia, described in more detail how the Monash experiential
programme operated. Students attend a designated hospital in both their
third and fourth years. A minimum of nine weeks’ practical experience
is obtained. The work involved in the third year is introductory and the
fourth year advanced. The advanced practical experience was presented
and detailed what training elements were covered.
Students are assigned a ward-based tutor and given initial training in
the clinical tasks they are expected to perform. In time, students are
expected to perform these tasks on their own, including any background
reading or research required to undertake the role. Periodically, tutorials
are run for all students at the hospital to cover the generic skills needed,
eg, how to take a patient’s history.
Positive outcomes from the programme have shown that recruitment into
the hospital sector has dramatically improved and anecdotal evidence suggests
that graduates have much better clinical task performance skills than
previous cohorts.
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