Medication therapy problems assessment within medication history objective structured clinical examinations using standardized patients versus peer actors

Abstract

AbstractIntroductionStandardized patients (SPs) are actors who role‐play patients in objective structured clinical examinations (OSCEs). Potential benefits of using SPs may include standardized learning experiences and realistic emulations. Use of SPs on academic performance remains unreported.ObjectiveTo compare students' identification of medication therapy problems (MTPs) in medication history OSCEs utilizing SPs versus those utilizing student peer actors.MethodsThis single‐center historical cohort study included two cohorts of third‐year student pharmacists in a capstone course in spring 2019 and 2021. One cohort had peers acting as patients and another interacted with SPs. Students completed two OSCEs and were assessed by faculty using a performance‐based rubric. Outcomes included students' identification of MTPs defined per Pharmacy Quality Alliance Frameworks, OSCE performance, levels of MTP management, and questionnaire item responses.ResultsOne‐hundred forty‐three subjects were enrolled: 86 in the peer and 57 in the SP cohorts. Baseline characteristics between cohorts were similar across age, overall grade point average, and composite Pharmacy College Admission Test score. Fewer students in the SP cohort identified MTPs versus the peer actor cohort on both OSCEs (52.6% vs. 89.7%, p < 0.001, and 64.9% vs. 88.2%, p = 0.001), and OSCE grades were significantly lower in the SP cohort (76.0% vs. 81.5%, p = 0.01, and 76.5% vs. 89.0%, p < 0.001). Medication therapy problem management was significantly different between the cohorts across both OSCEs (p < 0.05). Students responded to questionnaire items by agreeing SPs were effective and improved the OSCEs.ConclusionUse of SPs in medication history OSCEs was associated with significant decreases in students' identification of MTPs and lower OSCE grades. Continued research is warranted to assess factors associated with differences in performance and to provide recommendations optimizing SP and peer actor roles.