Drug Literature Evaluation Research Articles

Use of a novel videotaped presentation to improve pharmacy student confidence in presenting evidence-based medicine

IntroductionWe assessed the use of a novel videotaped presentation on pharmacy student confidence in presenting an evidence-based recommendation to theoretical healthcare professionals from various disciplines. MethodsStudents in a required drug literature evaluation course prepared a three-min videotaped presentation critiquing an assigned journal article with the goal of providing a patient care recommendation to a fictional physician. To determine change in confidence, students completed a pre−/post-survey on a 5-point scale. Survey questions explored confidence in presenting and discussing article evidence with both peers and licensed healthcare providers as well as making verbal recommendations for medication use. The survey also included open-ended questions to assess perceptions of the assignment and suggestions for assignment improvement. ResultsOver two years, 208 students completed both surveys (75.9%). Student confidence significantly increased for all items from the pre- to the post-survey. Items with the largest increase in confidence were presenting medical literature to peers, pharmacists, and other healthcare professionals (range 0.72 to 0.89 mean increase for these items). Students reported increased preparedness in presenting, improved conciseness in presenting, and increased self-awareness as a result of the assignment. The majority of students had no suggestions for assignment improvements. ConclusionsUse of a videotaped assignment is a novel, low-resource option for assessing student skills. This video presentation activity allowed students to gain additional communication practice without additional administrative resources. The activity resulted in increased pharmacy student confidence in discussing medical literature and making evidence-based recommendations for medication use.

Longitudinal evaluation of pharmacy students' metacognition in interpretation of evidence-based medicine

Background and purposeMetacognition is one's ability to “think about thinking” and to understand what knowledge and skills one has. Pharmacy professionals are required to have high metacognitive skills to ensure they are aware of what information they know and when to utilize resources. This longitudinal evaluation of pharmacy students' metacognitive ability was conducted via analysis of students' knowledge and confidence in evidence-based medicine (EBM) skills. Educational activity and settingA survey was administered to the graduating classes of 2017 and 2018 four times, from the beginning of the second-year drug literature evaluation course (baseline) through graduation. The surveys included seven self-confidence questions for which a corresponding knowledge question was asked. Students' metacognition was evaluated on the basis of whether the level of confidence was a “match” or a “mismatch” to their corresponding level of knowledge of each question. The proportion of matches over time was determined. FindingsFifty-eight students (22%) completed all four surveys. The mean proportion of matches at baseline was 40% and increased over time until graduation when the proportion of matches was 74%. The proportion of matches at baseline for all seven questions were ranged from 33% to 57%. An improvement in meta-cognition was seen in 5 out 7 questions. SummaryThis evaluation provides evidence that as students learned material and revisited concepts, their confidence, knowledge, and potentially metacognition regarding EBM concepts increased. However, as 26% of items measured were not a match at graduation, interventions need to be designed and tested to improve student metacognition.

Student Outcomes and Perceptions Related to Chroma Key (Green Screen) Technology Utilized in a Drug Literature Evaluation Course

Evaluate student perceptions of a blended course design for pharmacy education utilizing chroma key (i.e., green screen) technology plus a face-to-face active learning session. Green-screen videos were created using the TouchCast Studio® iPad® application to replace face-to-face didactic instruction in a 2016 course module. Third-year pharmacy student opinions of using asynchronous green-screen video content in a required drug literature evaluation course and performance on five identical examination items using a historical control (2012–2015) were assessed. In total, 62 (48%) of students responded to the post-exposure perception survey. While only 37.1% of responding students preferred online learning compared to traditional learning in general, 67.7% of responding students considered a green-screen video an acceptable substitute to an in-person demonstration, and 85.5% of responding students found the green-screen video modules to be helpful for their learning. Furthermore, 58.1% of respondents agreed that they would like to see more courses incorporate green-screen technology in the future. Intervention group student performance on identical exam items did not significantly differ from students in the control group on a collective basis (2012–2015). This pilot study supports the utility of green-screen technology in pharmacy education as a newer tool to facilitate delivery of didactic content in a blended learning approach. Replacing face-to-face instruction with green-screen videos was well received by students and did not negatively impact examination scores. Analysis of student outcomes and perceptions over more extended periods of time and in other curricular content areas is warranted.

Teaching Student Pharmacists to Apply Drug Literature to Patient Cases

Objective. To implement a series of activities designed to build drug literature evaluation skills and assess their impact on student pharmacists' ability to apply study results to patient cases. Design. Coursework was integrated across two didactic and pharmacy practice laboratory (PPL) courses. Team and individual journal clubs were used in traditional and case-based approaches during PPL courses to reinforce skills introduced in didactic courses. Student performance and perceptions were assessed during orientation for the third professional (P3) year and after the objective structured clinical examination (OSCE) at the end of the P3 year in identical drug literature evaluation assessments and pre- and post-intervention surveys of students. Assessment. Mean scores on team and individual journal club sessions were 91.8%±7.3% and 88.0%±8.2%. Of 64 students who completed both P3 assessments, 29 (45.3%) earned a passing score on the drug literature evaluation assessment at orientation compared to 57 (89.1%) after the OSCE. Conclusion. Student performance and confidence improved on objective assessments following a series of both team and individual, and traditional and case-based journal clubs.

Evaluation of a Flipped Drug Literature Evaluation Course

Objective. To evaluate a flipped drug literature evaluation course for first-year pharmacy students. Design. A drug literature evaluation course was flipped during the 2014 winter semester. Homework from 2013 was transformed into activities and lectures were transformed into multiple short YouTube videos. Assessment. Average examination scores increased from 75.6% to 86.1%. Eighty-two of 94 students completed the postcourse survey in 2014. Compared to traditional lecture, 59.8% of students indicated they preferred the flipped course. Additionally, students felt the course was important, the in-class activities were helpful, and some of the YouTube videos could be improved. We found length of the video to be significantly correlated with the percentage of videos viewed. Conclusion. The flipped model should be considered in drug literature evaluation courses that seek to increase the amount of active learning in the classroom.

From Drug Literature Evaluation to Evidence-Based Medicine: Transforming the Focus of a First Year Pharmacy Curriculum

This case study describes a longitudinal curricular sequence implemented to teach evidence-based medicine (EBM) skills. The longitudinal sequence is innovative in its approach, design, and assessment of EBM. This approach moves away from the conventional strategy of teaching drug information and drug literature evaluation as stand-alone courses and instead embraces the EBM Framework and its use in the context of authentic problem solving. The EBM Framework—Ask, Acquire, Appraise, and Apply—was used as the basis for defining seven EBM skills. These skills were targeted in the evidence-based, integrated design of 17 learning episodes delivered with eight faculty members through six courses in the first year. Student perceptions of relevance of EBM and performance on assessments and learning activities throughout the sequence suggest that integrating EBM across the first year of the curriculum is an effective strategy for teaching EBM skills. Three themes emerged from analysis of the data and experience, including the need for: a strong teaching team, a whole task approach with a focus on solving authentic problems, and care in interpreting the progression of assessments and patterns of student performance. Through instructor observations and peer review, the longitudinal sequence has been refined and has had an impact on the rest of the curriculum.
 
 Type: Case Study

Effects of an evidence-based medicine workshop on Japanese pharmacy students' awareness regarding the importance of reading current clinical literature.

BackgroundDrug literature evaluation has been taught at pharmacy schools in the United States, allowing pharmacy students to learn how to read clinical literature critically. In advanced pharmacy practice experiences, preceptors often assign pharmacy students to journal clubs in which they repeatedly train how to read such literature. This enables them to understand the importance of reading clinical literature prior to graduation. The objective of this study was to create evidence-based medicine (EBM) workshop that would enhance Japanese pharmacy students’ awareness regarding the importance of reading up-to-date clinical literature.MethodsThe EBM workshop were designed as a one-day workshop consisting of student presentations regarding their opinions about reading clinical literature, a lecture on methods for reading required literature critically, and small group discussions using the KJ (Kawakita Jiro) Method. To evaluate the effectiveness of the EBM workshop, students were administered questionnaire surveys both before and after the workshop. The students also took a 15-question test on EBM. Regarding the questionnaires, students were asked to respond to dichotomous items (yes/no) and to indicate on a 7-point Likert scale the extent to which they agreed with statements about clinical literature. Student responses to both the pre- and post-workshop questionnaires were then compared to evaluate the effectiveness of the EBM workshop.ResultsA total of 37 students participated in the EBM workshop. Significant improvement was seen between the pre- and post-workshop questionnaires in responses regarding whether they thought that pharmacists should read clinical literature regularly (pre-workshop: 5.70 ± 0.17 versus 6.51 ± 0.13 post-workshop; p < 0.0001), whether they were confident in their ability to read clinical literature (1.81 ± 0.15 versus 3.92 ± 0.18; p < 0.0001), and whether they could discuss treatment with nurses and physicians based on the results of clinical literature if they were a hospital pharmacist (2.49 ± 0.22 versus 3.86 ± 0.21; p < 0.0001). Significant improvement was also seen in scores on the EBM tests (11.4 ± 0.29 versus 12.6 ± 0.22; p < 0.0001).ConclusionOur EBM workshop significantly enhanced student awareness regarding the importance of reading up-to-date clinical literature. It is therefore expected that students who participated in our EBM workshop will contribute to improvements in the quality of the pharmacy profession in the future.

Drug Information and Literature Evaluation

According to “About the Authors” section of this book, Marie A. Abate and Matthew L. Blommel, bring a combined tenure of 28 years to West Virginia University's Center for Drug and Health Information. Abate is nationally known in the arena of drug information and serves as director of the center, while Blommel serves as assistant director at the center. Blommel instructs in pharmacy-related information resources as well as precepts more than 150 pharmacy students in the advanced practice pharmacy experience drug information rotation program. Both authors are indexed in PubMed, reflecting their articles and studies conducted from the 1990s to present time. Collaborating as primary investigator and coinvestigator, Abate and Blommel authored two articles that were published in the February and August 2007 issues of the American Journal of Pharmaceutical Education. The first article deals with a drug information self-assessment tool used by pharmacy students; the second article deals with a rubric that pharmacy students use to assess critical literature evaluative skills. Both articles reveal the importance behind data collection based upon self-assessment and feedback that goes toward fine-tuning a curriculum program and assessment tool. This attests to their knowledge and professionalism in the area of pharmaceutics. Drug Information and Literature Evaluation is one of several titles in the Remington Education Series. It should be noted that these beginning titles are aimed especially at those students who are pursuing an undergraduate pharmacy degree. Other series titles include Introduction to Pharmacotherapy, Physical Pharmacy, Law & Ethics in Pharmacy Practice, and Pharmaceutics. This book is similar in content and scope as Basic Skills in Interpreting Laboratory Data by Mary Lee, Fundamental Skills for Patient Care in Pharmacy Practice by Colleen Doherty Lauster and Sneha Baxi Srivastava, and Clinical Pharmacokinetics by John E. Murphy. Amazon.com states that these titles are often purchased or bundled together. Drug Information and Literature Evaluation is described as being written by pharmacists for pharmacists to assist in making their transition from the classroom realm of undergraduate pharmacy students to the pharmaceutical world as bona-fide pharmacists. Early on in the book's “Introduction,” the reader is provided with a listing of the twelve chapters and a brief synopsis for each chapter. Topics range from a suitable approach to an information request; to tertiary, secondary, and Internet information resources; and finally, to six specific steps one takes when evaluating clinical studies. The text of each chapter includes: learning objectives, tips and tricks, key points, illustrations, assessment questions, and further reading. This type of arrangement style reinforces the chapter's content and offers a quick glance at each chapter's contents. The answers are provided within the working examples, and answers to the self-assessments are located at the end of the book, along with a bibliography and subject index. In addition to being a guide for pharmacy students in evaluating medical literature such as clinical studies, this book would benefit novice librarians who are looking to augment their collections. In particular, the chapters on tertiary, secondary, and Internet resources offer a foundational starting point for available resources. These will be applicable in addressing a plethora of medication-related and health-related questions. The tertiary resources are divided into general drug information resources and information-specific resources. The secondary resources include abstracting or indexing services found at databases such as CINAHL, Cochrane Library, EMBASE, or International Pharmaceutical Abstracts (IPA). The chapter on Internet services reminds savvy public health consumers, when seeking their own information from the Internet, to take time to apply provided criteria and questions referenced in Table 4.1 (pp. 43–44). These questions should cover issues concerning the site's reliability, its accuracy, and its completeness. Drug Information and Literature Evaluation would be an asset to your library's collection and would offer both advantages and limitations to provided resources in print, online, or in mobile versions (p. iii).

A Research Elective Course on Dietary Supplements to Engage Doctor of Pharmacy Students in Primary Literature Evaluation and Scholarly Activity

Purpose: To develop and implement a research elective course to enhance skills of pharmacy students on primary literature evaluation and evidence-based practice on dietary supplements and generate scholarly publications. Methods: A 2 credit hour independent research elective course was designed and implemented in the third-year doctor of pharmacy curriculum. The course involved student-led research activities that included formulating research project, reviewing of primary literature, collection and evaluation of data, and writing of review articles for publication in peer-reviewed journals. An online survey was administered to evaluate students’ perceptions of the course. Results: Students successfully completed the course. The course resulted in peer-reviewed publications through student–faculty collaboration. Pharmacy students enrolled in the elective course perceived that the course helped them enhance their analytical reasoning, critical thinking and drug-literature evaluation skills, gain evidence-based knowledge, and apply the knowledge into practice during their advanced pharmacy practice experiences community pharmacy rotations. Conclusions: The course provided opportunity to the pharmacy students to not only critically search and evaluate the literature but also publish in peer-reviewed journals. Other pharmacy schools/colleges can adopt this course model to create opportunities for student–faculty collaborations toward scholarly accomplishments.

Combined Use of Online Tutorials and Hands-On Group Exercises in Bibliographic Instruction for Pharmacy Students

This study describes the new blended learning methodology implemented in a Drug Literature Evaluation course for pharmacy students that involves combined use of online tutorials and in-class group exercises. Assignment grades earned by 909 students enrolled in the course before and after the new methods were implemented (2008–2010) were studied to measure student performance. Course evaluations were analyzed in order to ascertain students’ perceptions. The hybrid approach used to deliver the course content allowed students to perform at the same level as traditional didactic teaching. Students’ evaluations reported a positive educational experience and favorable perceptions of the new course design.

Pharmacy Students’ Perceptions of and Attitudes Towards Peer Assessment Within a Drug Literature Evaluation Course

To assess pharmacy students' perceptions of and attitudes towards the use of peer assessment within a drug literature evaluation course. A 15-item, electronic survey instrument was sent to 158 second-year pharmacy students enrolled in a 2-credit required literature evaluation course at the Purdue University College of Pharmacy. One hundred fifty-two (96.2%) responses were received. Approximately 95% of students agreed that they had the necessary skills to assess their peers and 91.8% agreed that their peers possessed these skills as well. More students agreed they were comfortable receiving feedback from peers (95.7%) than agreed they were comfortable providing feedback to peers (80%). The majority of students (91.9%) agreed that peer assessment was a skill they will use in their career as a pharmacist. Students were more comfortable receiving feedback from peers than providing peer assessment. This skill is used by pharmacists throughout their career; therefore, students should become familiar and comfortable with the peer assessment process.

Principles of Drug Literature Evaluation for Observational Study Designs

Clinical pharmacists must often interpret and use data derived from observational studies when making clinical decisions and recommendations, answering drug information questions, and educating patients about drug therapy. This is the third article in a three-part series intended to enhance clinical pharmacists' understanding of methods frequently used in such research and their application to patient care. Principles for critical evaluation of published observational studies are presented. Issues of bias and confounding that must be taken into account when assessing the data derived from observational studies are explained. Finally, examples of applications in pharmacy practice are presented.

Biostatistical Applications in Epidemiology

Understanding the application of statistical methods is an essential component in the process of evaluating the medical literature. Statistical methods can differ when evaluating randomized controlled clinical trials (experimental design) compared with observational study designs such as cohort or case-control. A review of common statistical concepts includes variables, measures of central tendency, and measures of dispersion. Other methods include sensitivity, specificity, and predictive value. Observational study designs often include relative risk, odds ratios, relative risk reduction, attributable risk, number needed to treat, and forest plots. A critical component of drug literature evaluation is the understanding of the proper use of parametric and nonparametric statistical tests. Common parametric tests and their nonparametric equivalents are discussed.

Impact of a Student Response System on Short- and Long-Term Learning in a Drug Literature Evaluation Course

To evaluate the effectiveness of a student response system on short- and long-term learning in a required second-year pharmacy course. Student volunteers enrolled in the course Drug Literature Evaluation were blinded and randomized to 1 of 2 groups. Group 1 attended a lecture in which the instructor used a student response system. Group 2 attended the same lecture by the same instructor an hour later, but no student response system was used. A 16-point unannounced quiz on the lecture material was administered to both groups at the end of class. Approximately 1 month later, both groups were given another unannounced quiz on the same material to test long-term student learning. One hundred seventy-nine (92.3%) students participated in both quizzes. Students who attended the class in which the student response system was used scored an average 1 point higher on quiz 1 than students who were assigned to the control group (10.7 vs. 9.7; p = 0.02). No significant difference was seen between the quiz 2 scores of the 2 groups (9.5 vs. 9.5; p = 0.99). The use of a student response system can positively impact students' short-term learning; however, that positive effect did not appear to last over time. Faculty members may want to consider the use of student response systems to enhance student learning in large lecture classes.

Evaluating student perceptions of a learner-centered drug literature evaluation course.

To evaluate pharmacy students' perceptions of a drug literature evaluation course implementing learner-centered teaching principles. A drug literature evaluation course was redesigned to create a more learner-centered course through the inclusion of optional assignments, self-reflection opportunities, and a point-based grading system. A questionnaire was developed to assess student perceptions of the course and preferences for the learner-centered approach. One hundred two questionnaires were returned (94.4% response rate). The most highly rated items were those related to student control in determining their overall grade (4.7 +/- 0.6; mean +/- SD), less pressure to perform well on every examination or assignment (4.5 +/- 0.9), and a less stressful learning environment (4.4 +/- 1.0). Eighty-eight percent of students found that completing the optional assignments helped reinforce material presented in class. Learner-centered methods were viewed favorably by students. The effects of learner-centered teaching on pharmacy education deserve further study.

LETTERS

Preceptors play an important role in the education of pharmacy students. According to the Accreditation Council for Pharmacy Education (ACPE) accreditation standards effective in 2007, approximately one third of the curriculum should be devoted to experiential education (5% to introductory experiences and 25% to advanced experiences).1 To meet this demand, colleges of pharmacy must depend on a large number of volunteer preceptors who have had a wide variation in knowledge and practice experience. Since preceptors serve as the primary link between students' didactic education and their entrance into the practice of pharmacy, it is vital that preceptors are aware of the many outcomes that are expected of students, including components of their curriculum. Skills necessary to the practice of evidence-based pharmacy such as research design and literature evaluation are required components of the doctor of pharmacy curriculum. According to both the ACPE accreditation standards and the Center for Advancement of Pharmacy Education (CAPE) outcomes statements, students are expected to be exposed to practical applications of primary literature in both the classroom and in practice.1,2 Furthermore, experiential education must “integrate, apply, reinforce, and advance the knowledge, skills, attitudes, and values developed through the other components of the curriculum.”1 Since literature evaluation skills are necessary components of the curriculum, preceptors should be able to provide supervision of the student's development in these areas while on any rotation. In 2003, a cross-sectional survey instrument was mailed to randomly selected pharmacists in Illinois.3 Pharmacists were asked to report their level of training in drug literature evaluation and their use of computerized bibliographic databases (eg, MEDLINE/PubMed). Of the 322 respondents, 131 (41%) indicated that they served as preceptors for pharmacy students. Of these preceptors, only 59% (n = 77) reported receiving any formal training in literature search strategy, and only 66% (n = 86) reported any formal training in drug literature evaluation. Less than two thirds (61%, n = 80) of preceptors indicated that they had performed a primary literature search with a database such as PubMed within the last year. Preceptors who had received formal training in literature search strategy were much more likely to have performed a primary literature search than those without formal training (81% v. 34%, p < 0.001). While 75% (n = 98) of preceptors indicated having access to the Internet at work, only two thirds (66%, n = 86) reported having access to PubMed at work, despite availability of PubMed to the public on the Internet. Access to the Internet varied based on practice site. Community preceptors were much less likely to have access to the Internet at work than preceptors in other practice settings (52% v. 90%, p < 0.001). Since more than a third of preceptors have received no formal training in literature search strategy and drug literature evaluation, it is imperative that colleges take steps necessary to prepare all of their preceptors to effectively supervise student development in this area. ACPE accreditation guidelines call for colleges to provide for the ongoing training and development of their preceptors (Guideline 14.1).1 In the design of such training programs, colleges should consider literature search strategy and drug literature evaluation skills as a priority. While training programs may help to close this gap, the integration of these skills into evidence-based pharmacy across practice settings is a multifaceted problem. There are barriers to the implementation of evidence-based practice in pharmacy, including resource constraints that keep schools from delivering and preceptors from attending training programs. Pharmacy practice settings vary in their support for access to resources necessary to apply evidence-based skills to patient care. ACPE standards and guidelines call for colleges to establish minimum quality criteria for pharmacy practice experiences.3 In the development of these quality criteria, colleges should consider access to the Internet and PubMed in selection of experiential education sites. To address our shared vision for the future of pharmacy, colleges and the practice community must work together in an effort to expand evidence-based practice. Jill S. Burkiewicz, PharmD David P. Zgarrick, PhD Avery L. Spunt, MEd Midwestern University Chicago College of Pharmacy

Evaluating the Accuracy of Health News Publications in a Drug Literature Evaluation Course

To design an assignment for second-professional year pharmacy students to assess the accuracy and quality of health information published in the news. Students in a literature evaluation course were assigned a health-related news publication to review and find the original published research article. They then critically evaluated the quality and accuracy of the news publication based on the original research. All students wrote a critique focusing on the quality and accuracy of the news article and potential responses the lay public might have. Eighty-four percent of students agreed the writing assignment reinforced critical literature evaluation skills, while 90% agreed the assignment contributed to completion of course objectives. A writing assignment requiring comparison of a news publication to the original research reinforces critical literature evaluation and communication skills, as well as stimulates thought about the accuracy, quality, and public responses to health information published in the news.

An Assessment of Critical Thinking: Can Pharmacy Students Evaluate Clinical Studies Like Experts?

Objective. The objective of this study was to examine whether students in a drug literature evaluation class evaluated research studies similarly to the way in which experienced researchers (expert...

Therapeutic Issues in the Evaluation and Treatment of the Hypertensive Patient: White Coat Hypertension and Once Daily Dosing of Antihypertensive Agents

Pharmacists are an invaluable resource of drug and other treatment information for the primary provider because of their skills in drug literature evaluation and retrieval. The implementation of a home blood pressure monitoring program at the HMO of Delaware has allowed the establishment of excellent relations between medical, nursing, and pharmacy personnel and has allowed the pharmacist to become involved in the decision-making process for many hypertensive patients.

Evaluation of a Self-Paced Learning Module in Drug Literature Evaluation

Evaluation of a Self-Paced Learning Module in Drug Literature Evaluation