Fourth-year Pharmacy Students Research Articles

Pharmacy students' interprofessional experience and performance in advanced pharmacy practice experience rotations amid COVID-19 pandemic.

Interprofessional education (IPE) is essential in pharmacy training, providing students with vital collaborative skills for real-world healthcare. Advanced Pharmacy Practice Experience (APPE) is integral to IPE, allowing students to apply their knowledge in diverse healthcare settings. The COVID-19 pandemic has disrupted healthcare education and raised concerns about its impact on IPE during APPE rotations. Our study investigates the pandemic's influence on pharmacy students' interprofessional interactions and APPE performance. To assess the interprofessional experiences of fourth-year pharmacy students before and during the COVID-19 pandemic in the context of APPE. This retrospective observational study examined the experiences of P4 pharmacy students in the United States during APPEs before and during the pandemic. We employed electronic surveys with 21 questions to gauge interactions and interprofessional team effectiveness, employing Likert scale response options. We compared responses between the 2019-2020 and 2020-2021 APPE rotations using statistical tests. Our study encompassed 83 and 86 students for the 2019-2020 and 2020-2021 APPE rotations, respectively, achieving a 100% response rate. Amid the pandemic, written communications between pharmacy students and healthcare providers in general medicine rotations increased, while in-person engagement decreased. Pre-COVID, students reported higher colleague referrals and greater interprofessional utilization during ambulatory care rotations. COVID-19 shifted interactions from in-person to written communication between pharmacy students and healthcare providers. Students reported decreased satisfaction with their interprofessional experiences. This research offers insights into the changing landscape of pharmacy education, helping students prepare for evolving challenges in healthcare delivery and education.

Implementation and evaluation of an interprofessional prescription writing workshop with a simulated electronic prescribing activity for preclerkship medical students

BackgroundPrescription writing skills are essential for physician practice. This study describes the development and implementation of a curricular intervention focused on improving the knowledge and confidence of preclerkship medical students’ prescription writing practices utilizing an interprofessional education model, with a focus on electronic prescribing.MethodsMedicine and Pharmacy Faculty from a large, urban university collaborated to develop the content of the workshop and a simulation platform was used for the e-prescribing activity. Second-year medical students attended a mandatory in-person workshop facilitated by fourth-year pharmacy students. A pre and post knowledge test and confidence survey were used to assess students’ knowledge, confidence, and satisfaction. Outcomes from the knowledge test were evaluated with paired-samples proportions tests, and confidence survey data was evaluated with paired t-tests and Wilcoxon signed-rank tests in a pre-post study design.ResultsStudents demonstrated a significant increase in prescription writing knowledge and confidence after completing the workshop. On the pre-test, 7% of students (21/284) completed the electronic prescribing assessment correctly and 51% of students (149/295) completed it correctly on the post-test. All items on the confidence survey showed a significant increase in pre- versus post-survey comparisons (p < 0.001).ConclusionsThis interprofessional prescription writing workshop facilitated by pharmacy students shows promise for improving the knowledge and confidence of prescription writing and electronic prescribing practices in preclerkship medical students.

Implementation of pharmacy-led preoperative medication reconciliation in surgical oncology patients

BackgroundPharmacy-led medication history collection and reconciliation have demonstrated decreased medication errors, increased patient safety, and improved cost-savings. However, literature lacks documented efforts to implement such services in the preoperative space, where having accurate medication lists following complex procedures with high postoperative admission rates is critical. ObjectivesThe purpose of this study was to describe the implementation of a telephonic pharmacy student and pharmacist-led preoperative medication reconciliation program. Practice descriptionThe service was piloted using third- and fourth-year pharmacy students to conduct telephonic medication histories for urologic surgical oncology patients. Weekly reports identified eligible patients with scheduled procedures within 2 weeks’ time. Using standardized methods for patient communication and documentation, students authored telephone encounter notes that were reviewed and signed by pharmacist preceptors. Pharmacist preceptors also reconciled home medication lists based on students’ findings. Practice innovationA standardized preoperative medication reconciliation process was developed and implemented utilizing third- and fourth-year pharmacy students. Resulting notes were available for surgical staff on the day of patients’ procedures and upon potential postoperative admission. Evaluation methodsA retrospective chart review was conducted to evaluate successfully documented medication histories collected by pharmacy students within the pharmacy-led preoperative medication reconciliation program. ResultsForty-six medication reconciliation notes were identified between August 2021 and February 2022, and 39 met inclusion criteria. Amongst the 177 medication additions, deletions, and edits, deletions were the most common, and 95% of patients had at least 1 medication discrepancy identified. A total of 33 medication classes were represented by the identified discrepancies, and each encounter took an average of 33 minutes to complete. ConclusionPreoperative medication reconciliation services can be successfully accomplished through a telephonic pharmacy student and pharmacist-led workflow. Accurate medication histories aid in minimizing medication errors and increasing patient safety.

A quantitative exploration of the knowledge of pharmacy and medical students about Pharmacogenetics: Findings from a public university in Malaysia

Background: Having a strong foundation in the science of pharmacogenetics is a significant prerequisite for both pharmacy and medical students to apply this knowledge in patient care once they enter into the healthcare setting. This study examines the level of foundational knowledge of pharmacogenetics and interest in learning about pharmacogenetics among third and fourth-year pharmacy and final-year medical students of the University Sultan Zainal Abidin (UniSZA) in Malaysia. Method: A total of 95 students participated in the study. A descriptive, cross-sectional study was conducted using a validated questionnaire from a previously published research paper. It was an electronic-based survey shared among the targeted population. Results: The average knowledge score for pharmacy students was 15.58 (SD ± 0.49) while final-year medical students had an average score of 14.56 (SD ± 0.32). A major percentage of the fourth-year pharmacy students were able to obtain scores higher than their junior counterparts and final-year medical students. Although the overall average knowledge score of the medical students was lower than that of the pharmacy students, nevertheless, they had a greater interest in learning about pharmacogenetics. Conclusion: There is a need to introduce up-to-date curricula for both pharmacy and medical students to enhance student comfort levels in pharmacogenetics practice.

Survey of pharmacy students to assess attitudes toward a career in older adult care

IntroductionIn the United States, the older adult population is growing faster than the geriatrics-trained healthcare workforce. The primary objective of this study was to determine the top factors that increase or decrease pharmacy student interest in seeking a career in geriatrics. MethodsA 23-item survey was disseminated to 611 first- through fourth-year pharmacy students. Participants were recruited from two public schools of pharmacy in the United States from February through September 2022. Surveys were administered during class or distributed via email and websites for required courses. Participation was voluntary, and responses were anonymous. Descriptive statistics, independent-samples t-tests, Fisher's exact test, and analysis of variance were used for analysis. ResultsA total of 210 responses were received. Respondents were evenly split between somewhat or extremely interested and somewhat or extremely disinterested in geriatrics. Among those interested, the top factors driving interest were past positive experiences with older adults, interest in deprescribing, and perceived need for geriatrics-trained providers. Among those not interested, the top three factors discouraging interest were emotional impact of death and end-of-life care, disinterest in geriatric syndromes, and perception of inadequate exposure to geriatrics within the curriculum. ConclusionsIn order to ensure an adequately trained geriatrics workforce for the aging population, it is crucial to intensify efforts to encourage health profession students to pursue careers in geriatric care. Creating opportunities to increase interest and addressing factors that discourage interest may augment the pipeline of pharmacy students wishing to seek a career specializing in older adult care.

Knowledge and attitudes of pharmacy students towards artificial intelligence and the ChatGPT

Background: This study examined pharmacy students' knowledge and attitudes to artificial intelligence (AI) and ChatGPT. Methods: A survey was conducted with 258 fourth-year pharmacy students at Kitasato University, Japan, assessing their AI knowledge, ChatGPT impressions, and literacy regarding its appropriate use. Data were analysed descriptively, and participants were divided into two groups based on ChatGPT awareness for further analysis. Results: A total of 113 students (43.7%) participated, with 19.5% having prior ChatGPT experience, 4.4% were unaware, and 42.5% could describe it. General AI terms like "machine learning" were more familiar (83.2%) than specific ones like "natural language processing" (2.6%). Positive impressions of ChatGPT included 65.5% finding it efficient and 50.4% mentioning enhanced comprehension. However, only 3.5% correctly identified all inappropriate purposes, and 24.8% selected all precautions for its use. The 48 participants (42.5%) who described ChatGPT and had higher AI knowledge showed more correct answers than the other group (65 participants, 57.5%). Conclusion: Students with AI knowledge and the ability to describe ChatGPT demonstrated a better understanding of its appropriate usage. Educating students on AI fundamentals helps them utilise AI tools like ChatGPT effectively. This study offers valuable insights on ChatGPT among pharmacy students, with implications for responsible AI usage and education.

Pharmacy School and Pharm.D. Program in the United States of America

Pharmacy schools in Japan started to offer the 6-year undergraduate program in 2006. Currently, students are eligible for the national licensing examination to become a pharmacist only after completing the six-year program and receiving a bachelor's degree. Meanwhile, pharmacy schools offer the four-year graduate program in the United States of America (U.S.A.). In addition to the length of the program, there are several significant differences between pharmacy schools in Japan and the U.S.A. In the U.S., students receive a professional doctoral degree in pharmacy, doctor of pharmacy (Pharm.D.), after completion of the program. Fourth-year pharmacy students in the U.S. spend 1600 h in their clinical rotations, which is considerably longer than those in Japanese programs. It is also unique that pharmacists and pharmacy students are authorized to administer vaccines in the U.S. upon completion of immunization training. This symposium review aims to introduce the pharmaceutical education and the Pharm.D. program offered in the U.S.

Descriptive survey of pharmacy students’ self-evaluation of Advanced Pharmacy Practice Experiences (APPE) and practice readiness using entrustable professional activities

Objective: To evaluate pharmacy students’ self-identified levels of entrustability before and after their advanced pharmacy practice experiences (APPE). Methods: Third and fourth-year pharmacy students completed a Qualtrics survey where they were asked to self-identify their entrustability level (scale of I–V) on each of the fifteen core entrustable professional activities (EPAs) for pharmacy graduates. Results: A total of 249 third-year students completed the APPE-readiness survey in the Fall of 2017–2019, and 106 fourth-year students completed the practice-readiness survey in the Spring of 2018. The highest entrustability level in both surveys was “create a written plan for continuous professional development”. The lowest reported entrustability levels in both surveys were: “Oversee the pharmacy operations…”, “Maximise the appropriate use of medications…,” and “Establish patient-centred goals and create a plan…”. The largest area of change from pre-APPE to post-APPE was overseeing pharmacy operations, with an increase of 26%. The average pre-APPE entrustment level was 3.72, increasing to 4.2 in the practice readiness portion. The percentage of students self-reporting below an entrustment level of 3 in the practice-readiness survey ranged from 0–0.99%. Conclusion: Pharmacy students increased their self-reported level of entrustability over all 15 EPA domains from pre-APPE to post-APPE year.

Clinical decision-making by fourth-year pharmacy students: Towards an understanding of their uncertainty

IntroductionClinical decision-making is a critical process underpinning much of a pharmacist's daily activities. While it is known that pharmacists hesitate to make decisions, it remains unclear whether pharmacy students experience similar hesitancy. The objective of this study was to better understand the phenomenon of decision-making in pharmacy students. MethodsThis study was designed from a social constructivist paradigm using qualitative case study methodology. The purpose was to investigate issues related to hesitancy in clinical decision-making by fourth-year pharmacy students. Data were collected through observation of students engaging in simulations, post-simulation interviews, and written reflections. Data analysis included multiple stages of coding, followed by pattern identification and discovery of interrelationships. ResultsThe primary themes relating to issues in pharmacy student clinical decision-making were relational factors, teaching and learning, degree of certainty, and personal characteristics. Relational factors include elements of relationships with patients and physicians as well as a sense of autonomy. The theme of teaching and learning included the sub-themes of formal education and learning in the real world. Degree of certainty included patient complexity, weighing risks and benefits, comfort in ambiguity, and a lack of information. Finally, personal characteristics associated with decision-making include personal experiences, leadership skills, and confidence. ConclusionsPharmacy education needs to focus on ensuring preceptors can help model comfort in ambiguity, that assessments include the reality of practice, and ensuring ample practice of decision-making in a simulated environment.

The Development of a Post-Graduate Training Committee for Fourth-Year Pharmacy Students

The Development of a Post-Graduate Training Committee for Fourth-Year Pharmacy Students

Online teaching smoking cessation to the fourth-year pharmacy students during the COVID-19 pandemic

Online teaching smoking cessation to the fourth-year pharmacy students during the COVID-19 pandemic

Factors Influencing Professional Identity Construction in Fourth-Year Pharmacy Students

Objectives. To explore the key factors that influence professional identity construction in fourth-year pharmacy students enrolled in a Doctor of Pharmacy program.Methods. A single-site instrumental case study of current fourth-year pharmacy students from the Leslie Dan Faculty of Pharmacy, University of Toronto, was used. Thirteen students participated in semistructured interviews. Poststructural social identity theories were used to analyze the data and identify themes that influence identity construction in pharmacy students.Results. Data analysis identified five overarching themes that influence pharmacy student professional identity construction: path to pharmacy, curriculum, environment, preceptors, and patient interactions. The Leslie Dan Faculty of Pharmacy curriculum prioritized the health care provider identity, which influenced the students desire to "become" clinicians. Based on their internalized health care provider identity, they rejected preceptors and practice environments that negatively impacted their ability to embody this identity.Conclusion. The findings of this study suggest that pharmacy students align themselves strongly with health care provider identities at the cost of other potentially relevant identities. Pharmacy education programs may benefit from curricular reforms that incorporate and legitimize multiple pharmacist identities to ensure a strong pharmacy workforce for the future.

Pharmacy student self-assessment of interprofessional behaviors in inpatient general medicine advanced pharmacy practice experiences

IntroductionThe World Health Organization defines interprofessional education (IPE) “as an experience where students from two or more professions learn about, from, and with each other to…improve health outcomes.”1 Recent studies have demonstrated that IPE experiences can produce positive outcomes, and the Accreditation Council for Pharmacy Education Accreditation Standards require IPE experiences to be incorporated in both didactic and experiential components of pharmacy curricula. The purpose of this study was to measure the impact of required rotation interprofessional activities on fourth-year pharmacy students' self-assessment of interprofessional collaboration behaviors. MethodsThis was an ambidirectional cohort study conducted among students enrolled in their inpatient general medicine advanced pharmacy practice experience (APPE) at the University of Texas at El Paso School of Pharmacy during academic year 2020–2021. Students completed the Interprofessional Education Collaborative (IPEC) competency self-assessment instrument at the beginning and end of their six-week APPE. The survey instrument assessed IPEC competencies in the four IPE domains. ResultsDuring the 2020–2021 academic year, 29 APPE pharmacy students completed the pre- and post-assessment during their inpatient general medicine APPE. There was a significant increase (P < .001) in IPEC scores from baseline to post-assessment in each domain. ConclusionsStudents had a positive change in interprofessional collaboration behaviors after completing the required IPE on their inpatient general medicine APPE, which is consistent with prior studies.While students' perceived IPE behaviors improved, further research is needed to elucidate the value of IPE learning activities and impact on learning outcomes.

Evaluation of interactive teaching strategies and learning outcomes on the topic of kidney pharmacotherapy

Background and purposeStudents' knowledge retention decreases overtime when experiencing large-group teaching. Engaging class activities improve student learning. We report the rapid changes in teaching methods and measurable learning outcomes on the topic of kidney pharmacotherapy (KP) in a doctor of pharmacy program. Educational activities and settingThe KP modules were delivered using two different methods, traditional lecture (TL) (in-person class) and interactive strategies of online learning (ISOL), to fourth-year pharmacy students during the academic years 2019 and 2020, respectively. This study aimed to compare the learning outcomes from TL and ISOL examinations. Students' perceptions regarding their new learning experiences were also explored. FindingsA total of 226 students were included in the study (TL, n = 118; ISOL, n = 108). The median percentage of the overall score from the ISOL examinations was higher than that achieved by the TL class (73% vs. 67%, P = .003). Further analyses revealed similar improvements in most learning outcomes and cognitive domains. A higher proportion of students taught through ISOL achieved scores >80% than those in the TL group (39% vs. 16%, P < .001). The student respondents provided positive feedback regarding activities in the ISOL cohort. SummaryThe delivery of online KP when integrated with interactive strategies can maintain the outcome-based learning in Faculty of Pharmacy, Mahidol University. Approaches that aid student engagement during teaching and learning become opportunities for the improvement of education adaptability.

A Programmatic Approach to Peer-Led Tutoring to Assist Students in Academic Difficulty

Objective. To evaluate a peer-led tutoring program to assist students in academic difficulty in the didactic curriculum across multiple courses using one-on-one and large group peer-led sessions, and to evaluate the academic performance and perceptions of students in this program.Methods. This study involved first-year (P1) through fourth-year (P4) pharmacy students who served as tutors and their P1 through P3 tutees. Tutoring was offered in multiple didactic courses using one-on-one and large group peer-led sessions. Didactic curriculum completion rates and perceptions of the program were assessed.Results. A total of 463 (47%) P1 through P3 student pharmacists used the one-on-one or large group peer-led tutoring services in 28 courses across four academic years. Tutored students had a lower grade distribution compared to nontutored students, suggesting a more at-risk group for academic failures and dismissals. Despite this, the didactic curriculum completion rate was comparable between the tutored and nontutored students during the study period, suggesting that the program helped reduce academic dismissals of the at-risk tutored students. On the perceptions survey, 95% of respondents felt they improved their study habits, and 92% felt more confident in their ability to succeed.Conclusion. This peer-led tutoring program appeared to be successful in providing comparable didactic curriculum completion rates of tutored students, who represented an at-risk group for academic failures and dismissals compared with nontutored students. The tutoring program structure and design may be a useful tool for other colleges of pharmacy as they seek ways to assist students.

Evaluation of pharmacy student empathy scores before and after a geriatrics advanced pharmacy practice experience (APPE)

IntroductionEmpathy from healthcare providers is associated with improved patient care and satisfaction, resulting in increased emphasis on empathy in pharmacy school curricula. Previous studies showed improvement in pharmacy student empathy after older adult-specific simulation activities in the didactic setting, but no such data exist for the practice environment. This study's purpose was to evaluate the impact of a geriatrics advanced pharmacy practice experience (APPE) on pharmacy student empathy toward older adults. MethodsAll fourth-year pharmacy students in a geriatrics APPE at one of four participating sites were offered to participate in the study at the beginning of the rotation. Empathy was measured at baseline and end of the rotation using the Kiersma-Chen Empathy Scale (KCES). Wilcoxon matched-pairs signed-ranks test was used to test differences from pre- to post-rotation. ResultsFifty-four of the 110 eligible students opted to participate in the study, and 46 completed both the pre- and post-surveys. Most students were female (55.6%), and the average age was 27.3 years. Mean empathy scores for all students increased significantly by 4.89 points (z = 4.17, P < .001, d = 0.97). Specific KCES items related to handling other's feelings and viewing another person's perspective also significantly improved. ConclusionsEmpathy is a key component to professional development in healthcare students, and a geriatrics APPE provides an opportunity for students to grow this soft skill. Although further study is warranted, older adult focused rotations may be considered by schools of pharmacy to aid in preparing “graduate-ready” pharmacists.

Assessing the Perception of Pharmacy Students on Launching a Doctor of Pharmacy/Master of Public Health Dual Degree Program in Saudi Arabia: A Multi-Institutional Cross-Sectional Study

There is a lack of Doctor of Pharmacy (PharmD) and Master of Public Health (MPH) dual degree programs in Saudi Arabia. This study aims to examine current pharmacy students’ perceptions regarding establishing such a program and the perceived limitations and advantages of pursuing such a degree. We conducted a cross-sectional web-based short survey to assess the feasibility of establishing a PharmD/MPH dual degree program in several randomly selected pharmacy schools in Saudi Arabia. Our cohort consisted of 657 students. Almost 56% were males, and nearly 58% were fourth-year pharmacy students. Close to 85% had a “very well” or “well” understanding regarding the pharmacist’s role in the public health area, and almost 70% stated that they see themselves playing a role in public health as a future pharmacist. Nearly 93% reported that they are either “very likely” or “likely” to enroll in such a program if given the opportunity. Almost 80% felt it would increase their job opportunities. On the other hand, close to 70% felt it would increase workload and stress. This study highlights pharmacy students’ positive perceptions regarding establishing a PharmD/MPH dual degree program in Saudi Arabia. The study results could be utilized as the starting point to propose and establish this program to health education policymakers in Saudi Arabia.

Development of an Online Role-play-based Medical Interview Training Method for Fourth-year Pharmacy Students

With the coronavirus disease 2019 pandemic, businesses are rapidly expanding their online practices, and the online medical care system has been established and is growing. The field of pharmacy education is also looking for ways to conduct practical online training. Hence, we developed an online role-play-based medical interview training method for fourth-year pharmacy students. The purpose of this study was to describe in detail this method and to clarify the effect of online on medical interviewing practice. The training sessions were conducted using video teleconferencing software. Two settings were used for the role-play scenarios: the pharmacy and hospital. To evaluate the effectiveness of the sessions, a questionnaire was sent to the students, and the results were analyzed using text mining. The most important requirement for successfully conducting the interviews was a stable voice connection, and we reduced audio interruptions and delays by connecting the host personal computer to a wired local area network. We also solved the problem of howling when multiple terminals were installed in the same room by muting all devices in the room. Results of the analysis of the questionnaires suggested that students were more tense online. We also found that students perceived a difference between online and face-to-face interviews in terms of eye contact and the presentation of documents. In this way, we succeeded in conducting smooth online role-playing sessions while taking countermeasures against infection. In the future, it will be necessary to devise nonverbal communication methods and digital methods of presenting the training material.

A comparison between student performances on objective structured clinical examination and virtual simulation

Objective: To compare the pharmacy students’ performance on an interactive web-based virtual pharmacy tool versus in-person objective structured clinical examination (OSCE). Methods: The academic performance of fourth-year pharmacy students in patient interview, counseling and medication dispensing were assessed using MyDispense, a virtual pharmacy practice online case scenario, versus physical OSCE. The grades of the same students in both exams were compared, and the students were administered a questionnaire to explore their perception of virtual experience after completion of the exercise. The internal consistency and reliability of the case scenarios and questionnaire were examined by calculating Cronbach’s alpha coefficient. Results: There was a significant increase (p = 0.01) in the average test scores of the virtual exam than the in-person OSCE. Similarly, female students had higher performance on virtual simulation than OSCE (p = 0.03). However, a comparison of the online MyDispense and OSCE assessment grades did not find a direct correlation (Spearman’s rho = 0.060). The results from the self-administered questionnaire demonstrated high students’ satisfaction and effective application of their knowledge through MyDispense for targeted patient interview, counseling and communication skills. Conclusion: The MyDispense virtual experience was well-perceived by the students as a useful online learning tool for pharmacy practice. However, there was no direct correlation between online and in-person OSCE assessment grades.

The Effectiveness of Flipped Classroom during the COVID-19 Pandemic in Higher Pharmaceutical Education

BACKGROUND: Despite the apparent advantages of the flipped classroom model especially during a pandemic or natural or technogenic disasters, its overall effectiveness in higher medical and pharmaceutical education continues to be debated. AIM: The goal of the study was to test the effectiveness and acceptability of using the flipped classroom model during the COVID-19 pandemic in higher pharmaceutical education based on the example of the “Pharmaceutical Marketing” discipline at Sechenov First Moscow State Medical University, Russia. METHODS: The study involved 156 fourth-year pharmacy students. They were divided into three clusters: FC – studying in accordance with the flipped classroom model, FC+TBL – using the flipped classroom technology combined with the team-based method, and CC – studying by the traditional scheme (control). The study used the Unified educational portal of the Sechenov University. Additional elements were developed for the electronic educational and methodical complex for the studied section “Analysis of the marketing environment of a pharmaceutical organization.” The effectiveness of the flipped classroom model was evaluated through test control (entrance, formative, thematic, and final) and control of the development of skills and abilities in solving situational problems (thematic and final). The study participants’ attitude toward the use of the flipped classroom model was assessed through a survey. RESULTS: The study demonstrated that students from the FC and FC+TBL clusters were significantly better prepared for practical lessons and worked more effectively and productively during these classes compared to the CC cluster students. The results of the final control also substantiate the advantages of the flipped classroom technology both in assessing practical skills and abilities and in testing. The opportunities for rational implementation of the complex technology (FC+TBL cluster) are identified. CONCLUSIONS: The analysis of students’ general opinion on the flipped classroom model shows that 90.4% of the FC cluster members and 84.6% of the FC+TBL cluster members are satisfied with the results of using this model and consider it suitable for studying both the “Analysis of the marketing environment of a pharmaceutical organization” section and the entire pharmaceutical marketing course. Students’ positive feedback on the use of the flipped classroom model provides grounds for further implementation of this technology in the “Pharmaceutical Marketing” discipline in its entirety and demonstrates that further research on the use of other blended learning models is quite promising.