Pharmacology Teaching Research Articles

Threshold concepts and core concepts in pharmacology education: A commentary.

Threshold concepts and core concepts in pharmacology education: A commentary.

An augmented reality mobile application designed for pharmacology teaching.

An augmented reality mobile application designed for pharmacology teaching.

Automatic telephonic follow up in heart failure by a natural language processing artificial intelligence: pilot program

Abstract Introduction Heart failure (HF) burden on public health is substantial and efficient patient management strategies are needed. Traditional methods of HF monitoring face limitations in scalability and effectiveness. Artificial Intelligence (AI) might offer novel solutions for enhanced resource management and alleviation of healthcare burdens. Purpose To study the feasibility of implementing automatic remote monitoring via phone calls operated by AI in a HF unit. Methods We conducted a non-randomized, open, pilot trial employing an AI technology based on natural language processing for autonomous telephone outreach for the follow up of HF patients. 86 patients from a tertiary hospital HF unit undergoing pharmacological titration and education were enrolled. The AI conducted weekly calls to gather symptomatology, vital signs, and health status changes, which were then displayed on a virtual platform featuring alerts preconfigured by the research team. These alerts guided patient communication and intervention as deemed necessary by a specialized nurse. Results Characteristics of patients are shown in Table 1. The AI followed these patients for a median of 251.5 days. 2773 telephonic calls were performed. We estimate an equivalent to 1445h of work (17.2 days/month). Adherence was high during the study, with 98% of the calls completed. 1427 alerts were generated, being the most frequent weight change (251; 17.6%), orthopnea (220; 15.4%) and fatigue (187; 13.1%). It led to 487 remote interventions, most of them consisting in calling the patient for assessment (409; 84.0%), but also in adjusting medication remotely (34; 7.0%). See Figure 2. A HF telemedicine specialized nurse required 205min per week for alert review, 2.38min/patient-week. 2 patients died, one from cardiovascular causes, and 7 patients had a HF hospitalization, 42.9% with previous alarms. 20 events of worsening HF were recorded, comprising hospitalization, emergency visit or IV diuretic administration. Oral diuretic dose was increased in 22 occasions, 15 of them remotely in response to an alert raised by the AI operator. At 6 months functional class globally improved (p = 0.028), but NTproBNP increased (p=0.0472). Quality of life was evaluated at baseline and at 6 months, with no change in EQ5D5L (median 0.717, change -0.005, p 0.71) or PHQ4 (median 2.88, change -0.29, p 0.7792), but KCCQ12 total score worsened (median 74.49, change -2.32, p 0.048). Experience was rated with 8.97/10 in a satisfaction questionnaire. All patients recommended the program, remarking a closer follow up, better communication and a safety feeling. Conclusions AI enables closer monitoring of patients with HF, maintaining contact with stable patients while also allowing for resource allocation and tracking of higher-risk patients or those experiencing changes in symptoms. A randomized clinical trial comparing to standard follow-up is needed to evaluate this promising technology.Table 1Figure 2

Improvement of Statistical Models by Considering Correlations among Parameters: Local Anesthetic Agent Simulator for Pharmacological Education

Improvement of Statistical Models by Considering Correlations among Parameters: Local Anesthetic Agent Simulator for Pharmacological Education

Evaluation of problem-based learning for pharmacology based on a comprehensive analysis in undergraduate students.

Problem-based learning (PBL) has been widely employed in pharmacology teaching. However, the benefits of PBL for undergraduate students have not been clearly demonstrated. We performed a meta-analysis to compare the effects of PBL and lecture-based learning (LBL) in undergraduate pharmacology education. We systematically searched literature databases for comparative studies related to PBL pedagogy in the undergraduate pharmacology curriculum from the inception of the databases to December 2023. The obtained literature was screened according to the selection criteria, and Review Manager 5.4 was used for the meta-analysis of the included studies. A total of 33 comparative studies involving 4425 undergraduate students were enrolled. The standardized mean differences (95% confidence intervals) of the examination scores and students' self-rated scores on learning interest, comprehension of knowledge and thinking ability between PBL and LBL were calculated to be 2.03 (1.53-2.53), 0.50 (0.26-0.74), 0.69 (0.46-0.92), and 1.65 (1.21-2.09), respectively. The risk ratios of the proportion of satisfaction on improving students' learning interest, comprehension of knowledge, thinking ability, self-study ability, and communication skills were calculated to be 2.08 (1.17-3.71), 1.84 (1.26-2.67), 1.42 (1.19-1.69), 1.44 (1.16-1.79), and 1.66 (1.22-2.27), respectively. The current evidence indicates that PBL is more effective than LBL in improving examination scores and student satisfaction in undergraduate pharmacology education.

Unveiling the Schematic Organization of Pharmacological Information for Nurses: A New Approach to Pharmacology Education for Nurses.

Unveiling the Schematic Organization of Pharmacological Information for Nurses: A New Approach to Pharmacology Education for Nurses.

Evaluating the quality of multiple-choice question pilot database: A global educator-created tool for concept-based pharmacology learning.

The Core Concepts of Pharmacology (CCP) initiative is developing educational resources to transform pharmacology education into a concept-based approach. This study evaluated the quality of global educator-created MCQs in generating items for the pharmacology concept inventory (PCI) instrument and developed as a resource for learning pharmacology fundamental concepts. A panel of 22 global pharmacology experts recruited from the CCP initiative research team participated in the MCQ pilot database design and evaluation. The quality analysis framework of the MCQs in the pilot database included four assessment tools: item writing guidelines (IWGs), Bloom's taxonomy, the CCP, and the MCQ design format. A two-phase evaluation process was involved, including inter-rater agreement on item quality, followed by resolving conflicts that occurred in quality assessment. The chi-square (χ2) test of independence and Cramer's V correlation tests were utilized to measure the relationship among quality assessment attributes. About 200 MCQs were gathered and 98% underwent expert evaluation. Nearly 80% addressed one or more CCP, with 52% designed using a context-dependent format. However, only 40% addressed higher levels of Bloom's cognitive domain and 10% adhered to all IWGs. A strong positive correlation was observed between the context-based item format and its effectiveness in assessing the higher cognitive domain, the main CCP and improved IWGs adherence. Context-based item construction can assess the higher cognitive skills and fundamental pharmacology concepts, showing potential for rigorous PCI development. The pilot database will store items to create the PCI, aiding the development of a concept-based pharmacology curriculum.

Analysis of self-reported confidence in independent prescribing among osteopathic medical graduating seniors.

Prescribing medications is one of the physicians' most important professional activities throughout their careers. Lack of confidence and competency to prescribe may lead to preventable medical errors. The prevalence of prescription errors among new graduate physicians has been widely studied. Studies have linked this to inadequate foundational pharmacology education and work environment, among other factors. Suggestions were made for different educational interventions to increase the physicians' confidence and competency in prescribing to reduce the risk of medical errors. However, many of these studies were about students or graduates of medical schools other than osteopathic medical schools. This study analyzed the self-reported confidence of graduating seniors in the United States osteopathic medical schools in their current ability to prescribe safely and independently and the possible associated factors. This study analyzed secondary data on the graduating seniors' surveys published by the American Association of Colleges of Osteopathic Medicine (AACOM) from the 2012/2013 to 2020/2021 academic years. Data were analyzed utilizing SPSS version 26.0 and MedCalc version 22.009, and statistical inferences were considered significant whenever p≤0.05. The aggregated data show that 38,712 Doctor of Osteopathic Medicine (DO) seniors responded to the AACOM survey, representing 72.1 % of expected graduates during the study period. Most of the DO graduating seniors (70.8 %) reported feeling confident in their current abilities to independently write safe and indicated orders and to prescribe therapies or interventions in various settings. Thepercentage of respondents who perceived the time devoted to clinical pharmacology instruction as appropriate increased systematically over these reported years. A positive correlation was found between the percentage ofstudents who reported the time dedicated to clinical pharmacology as excessive and the percentage of students who reported being confident in prescribing. A statistically significant positive correlation was found between the percentage of students who agreed that the first two years of medical school were well organized and the percentage ofstudents who reported being confident in prescribing. A statistically significant correlation was found between the percentage of students who agreed with statements about frequent interactions with the attendee, testing at the end ofeach rotation, and being prepared for Comprehensive Osteopathic Medical Licensing Examination Level 2-Cognitive Evaluation (COMLEX Level 2-CE) during the required clerkships and the percentage of students who reported being confident in independent prescribing. During this study period, most osteopathic medical graduating seniors (70.8 %) felt confident about their current prescribing abilities; the rest did not, whichcanincrease the risk of preventable medical errors. The prescription confidence may be boosted by more organization for the first 2 years, increasing the time devoted toclinical pharmacology education, and developing more interactive courses during the required clerkships in clinical education.

Serious gaming as potential training tool for recognition of adverse drug reactions: side-effect exposure—medical education (SeeMe)

PurposeThe recognition of adverse drug reactions (ADRs) is an important part of daily clinical work. However, medical education in this field is mostly drug-based and does not address adequately the complexity of this field regarding individual risk factors and polypharmacy. This study investigates the potential of the web-based serious game SeeMe (side-effect exposure—medical education) in pharmacological education of medical students to improve the recognition of relevant ADRs.MethodsOne hundred fifty-seven medical students were recruited to evaluate the serious game SeeMe. SeeMe was developed to improve knowledge and recognition of ADRs in clinical practice. Players take on the role of a physician trying to understand fictional patients with ADRs. Before and after an 8-week playing period, an evaluation was carried out through a pre- and post-questionnaire and a pre- and post- knowledge test.ResultsThe students achieved significantly better results in the knowledge test, as almost twice as many exam-relevant questions were answered correctly (p < 0.001). The serious game had a positive effect on the students’ perception of the importance of ADRs.ConclusionThis study demonstrates the potential of web- and case-based fictional serious games in medical education. The improved recognition of side effects represents a crucial step for education and training in clinical pharmacology. Future versions of the serious game may take this further and focus on training in the treatment of ADRs and their relevance in various healthcare professions.

The evaluation of digital educational game use in pharmacology teaching process.

The aim of the study was to determine the usefulness of educational video games as a variety applied to the traditional teaching of pharmacology in topics of antifungal and hypolipidemic drugs. Sixty-six volunteers were divided into control group (n = 33) and experimental group (n = 33). The first group received traditional seminar only, and the second played video game designed with the use of Kahoot! platform after the seminar. The assessment of knowledge was conducted with the use of three tests: pre-test was presented before seminar, post-test after seminar (for control group) or after playing the video game (for experimental group), and test no. 3 took place 4 weeks later. Analysis of tests' scores with respect to both topics resulted in the observation that the control and experimental groups show statistically significant improvement in knowledge, whether it was measured after the seminar or 4 weeks later. However, the results of experimental group were statistically better in comparison to the control group. It proves that electronic GBL (game-based learning) applied to standard educational processes increases short- and long-term knowledge retention compared to traditional seminars.

--------Comparison of Hybrid-Simulation-Based Teaching with Traditional Teaching of Pharmacology.

To compare the outcome of traditional teaching with hybrid simulation-based teaching for undergraduate medical students. Place and Duration of the Study: Department of Pharmacology, Jinnah Medical and Dental College, Karachi, Pakistan, from June to August 2023. Quasi-experimental study. One hundred students from MBBS 3rd year were included in the study after taking the informed consent. Participants were divided into two cross-over groups and sampling was done randomly. Group A: (even roll numbers, n = 50) was the control group, taught by traditional lecture on positive inotropic medicines. Group B: (with odd roll numbers, n = 50) was the intervention group, taught the same topic by simulation-based teaching through 5 case scenarios. The teaching of this group was reinforced by role plays. Scores of post-test and retention test were compared by applying the Student's t-test. Students taught by traditional lectures i.e., Group A, their post-test mean scores were 30.7 ± 5.6, whereas Group B scored 45.7 ± 3.3, taught by hybrid stimulation (p <0.001). Retention test (MCQs based) was conducted after one month in which Group A obtained a mean score of 18.8 ± 9 with a passing percentage of approximately 30, whereas Group B obtained a score of 41.3 ± 5.6 (p <0.001). Hybrid-simulation-based teaching improved the immediate test scores as well as retention. Traditional teaching, Hybrid-simulation, MCQs, Retention test, Intervention group.

Perceptions of undergraduate nursing students regarding their competency in administering medications: A qualitative study

AimThis study aims to explore and describe self-reported perceptions of nursing students’ competence in the administration of medication. BackgroundMedication errors are a significant concern in hospitals, as they can result in serious harm and even death for patients. Nursing students play a crucial role in administering medication and preventing errors, but they are also prone to making mistakes. While numerous studies have extensively examined the factors that contribute to medication errors, few have focused on the assessment of competency among nursing students. DesignThis study employed a qualitative exploratory and descriptive design. MethodsA total of 10 undergraduate nursing students at a higher education institution consented to participate in face-to-face, semi-structured individual interviews. Data were collected between August and September 2022 using an interview guide. The interviews were audio recorded and analysed using Braun and Clarke's six steps of thematic analysis. ResultsThe study revealed two major themes: (1) ‘Perceived barriers to competency’, which include participants' concerns regarding making errors, knowledge in pharmacology, self-efficacy in mathematics and level of supervision; and (2) ‘Mechanisms for improvement’, which centre on enhancing simulation proficiency, improving supervision and integrating pharmacology education in year two of nursing training. ConclusionThe study findings suggest that student nurses face various barriers to competence, such as a fear of making mistakes, a lack of pharmacology knowledge and low self-confidence in calculating drug dosages. To address these issues, prioritising supervision is crucial to facilitate student learning and ensure safety. Future research should consider investigating the perspectives of nurse educators on pharmacology curricula.

The affinity-efficacy problem: an essential part of pharmacology education.

A fundamental mistake in receptor theory has led to an enduring misunderstanding of how to estimate the affinity and efficacy of an agonist. These properties are inextricably linked and cannot be easily separated in any case where the binding of a ligand induces a conformation change in its receptor. Consequently, binding curves and concentration-response relationships for receptor agonists have no straightforward interpretation. This problem-the affinity-efficacy problem-remains overlooked and misunderstood despite it being recognized in 1987. To avoid the further propagation of this misunderstanding, we propose in this review that the affinity-efficacy problem should be included in the core curricula for pharmacology undergraduates proposed by the British Pharmacological Society and the International Union of Basic and Clinical Pharmacology (IUPHAR).

Technology-enhanced learning in Pharmacology through non-linear storytelling

There is a growing body of literature highlighting the potential of game-based learning (GBL) in creating immersive, highly engaging, active learning experiences. Furthermore, advances in digital technology along with the demand for online learning during the COVID-19 pandemic has brought digital GBL to the forefront of innovative teaching practice. Here, I share some of the digital GBL strategies we have developed to support our pharmacology teaching. In collab¬oration with our students, we have co-created a series of “choose your own adventure” style games using Twine; an open-source storytelling game engine. Importantly, we have shown that adoption of these GBL approaches is highly effective in promoting student engagement, subject understanding, and learning community. Furthermore, I also dis¬cuss how AI tools can allow educators with little knowledge or experience of game development to create unique and engaging learning experiences for their students.

Computer simulation versus chalk and talk for experimental pharmacology teaching

Abstract: INTRODUCTION: Computer simulation is an alternative method for teaching experimental pharmacology to medical undergraduates, which can reduce the usage of animals for this purpose. This study compares computer simulation with chalk-and-talk method for teaching experimental pharmacology to medical undergraduate students with respect to understanding and retention of the topic. MATERIALS AND METHODS: Two groups of students (n = 25 each) were taught a topic with and without the help of computer simulation for 30 min. A questionnaire was provided at the end of the class, and the responses of the two groups were compared. The opinions of the students were also evaluated on the Likert scale. RESULTS: The mean of the marks obtained by the students in the computer simulation group was 18.08 ± 1.66 while in the chalk-and-talk group was 15.44 ± 2.83 (P &lt; 0.001). More students were of the opinion that computer simulation helps in better understanding and long-term retention of the topic and did not feel any further necessity to read books for understanding. More students were comfortable with computer simulation as a method of teaching and were confident in handling animals. More students also suggested that computer simulation is a better method for teaching at the undergraduate level. CONCLUSIONS: Computer simulation may be considered a suitable method for teaching experimental pharmacology to medical undergraduates with an intention to reduce the requirement of animals for teaching purposes and hence reduce trauma and discomfort to animals.

From Dose to Exposure: Shifting the Paradigm of Pediatric Clinical Pharmacology Research and Education.

From Dose to Exposure: Shifting the Paradigm of Pediatric Clinical Pharmacology Research and Education.

PharmaCORE: Optimizing medical pharmacology education with an innovative instructional dashboard

What was the educational challenge? Diminishing emphasis on pharmacology education in medical schools has resulted in a concerning lack of prescribing knowledge among physician graduates. These concerns mirror our graduates’ expressed dissatisfaction with the structure and quality of pharmacology educational experiences over the past 5 years. What was the solution? PharmaCORE, a web-based instructional dashboard, was developed as an interactive faculty development tool to enhance integration and instruction of pharmacology content in pre-clinical curriculum at a US medical school. How was the solution implemented? PharmaCORE was introduced in Spring 2022 for instructors teaching pharmacology in the pre-clinical curriculum. Instructors used the dashboard to assess coverage of specific drug topics throughout the curriculum and to apply tailored, learner-centered teaching strategies to optimize learner engagement and comprehension. What lessons were learned that are relevant to a wider global audience? The initial assessment indicated that the dashboard was user-friendly and positively influenced instructor awareness of pharmacology content and learner-centered teaching. This faculty development approach underscores the importance of skill-based mapping and maintaining learner-centered teaching standards to address other integrated subjects and broader curricular challenges. What are the next steps? This study lays the foundation for the broader applicability of instructional dashboards in tracking and addressing curricular challenges across pharmacology and other science subjects. Future steps include more personalized feedback for instructors, creating a student-accessible version, and ongoing monitoring of maintenance measures like milestone exams.

Knowledge of Speech and Language Therapists about Drugs Related to Speech, Language, Voice and Swallowing Disorders

This descriptive study aims to assess the knowledge of speech and language therapists, who assess and treat clients with speech, language, voice, and swallowing disorders, their pharmacology education, and regarding the drugs related to these disorders. This study involved 96 speech and language therapists from different regions of Türkiye. A survey based on the literature was created to assess the level of knowledge of participants about the indications, contraindications and side effects of drugs related to speech, language, voice and swallowing disorders, as well as their pharmacology training. Our study determined that more than half of the participants had a low level or no knowledge about the indications, contraindications and side effects of drugs related to speech, language, voice and swallowing disorders. In addition, 86.5% of participants reported that they had not received adequate training on drugs at the bachelor and graduate level, and 93.8% of participants would like to receive more training on this subject. Since there is no study in literature that assesses the pharmacology knowledge of speech and language therapists, it is envisaged that our research will make a significant contribution to the field and raise the level of knowledge and awareness among professionals.

Learning of clinical pharmacology by future prescribers in Bologna: Teachers' and students' reflections on the way forward.

In this reflection paper, the authors, based on their experience as teachers and students of the courses of Pharmacology at the University of Bologna, reflect on their specific roles towards innovation in the teaching of Clinical Pharmacology. Strengths, weaknesses and challenges are presented as identified during the teaching and learning experience in the currently evolving medical degree programmes of the University in light of current trends in medical education. Keeping in mind the identified challenges together with the features proposed for the model prescriber (knowledgeable, contemporary, communicative and safe), we indicate some ways to improve the students' experience and make sure they develop up-to-date skills in Clinical Pharmacology taking advantage of recent ongoing collaborations at European level. International collaboration is indeed necessary to adequately address the current challenges of teaching clinical pharmacology. Our shared conclusion is that empowering students with a scientifically sound method to retrieve relevant information and developing their skills to communicate in an interprofessional and, wherever possible, international environment is the key to prepare future prescribers and, ultimately, to improve patient safety.

Evaluating Knowledge, Self-Reported Confidence Levels, and Prescription Patterns among Dental Practitioners Regarding Analgesics in Dentistry: A Cross-Sectional Study.

Background and Objectives: Dental pain is a common problem that often leads to unscheduled dental visits and requires a comprehensive understanding of analgesics, including their indications and contraindications. The aim of this study was to investigate dentists' knowledge, self-reported confidence levels, and prescribing patterns of analgesics in dentistry. Materials and Methods: A nationwide cross-sectional online survey was conducted, resulting in 379 responses. Of these, 68.6% were general dentists, and 31.4% were specialists. The collected data included sociodemographic information, levels of knowledge, and prescription patterns. The survey questionnaire explored self-perceived practices, patient information during prescription, and guiding factors. Descriptive statistics and a generalized linear model for regression were used for data analysis. Results: Higher levels of knowledge were observed in specific contexts such as secondary/tertiary healthcare (p = 0.022), specialization in endodontics (p = 0.003), and a higher number of working hours with patients (p = 0.038). Conversely, increased self-confidence was observed among endodontists (p = 0.008), oral surgeons (p = 0.011), and dentists with more than 6 h of patient interaction (p ≤ 0.001). Orthodontists and prosthodontists demonstrated lower knowledge levels, while specialists in family dentistry exhibited lower self-confidence. Self-confidence and knowledge displayed a significant positive correlation (r = 0.039, p < 0.001). The most frequently prescribed medication was ibuprofen (97.9%), primarily for surgical (83.9%) and endodontic procedures (60.9%), with the main indications being pulpal (85.8%), periradicular (57.3%), and postoperative pain (40.1%). Conclusions: This study reveals significant knowledge and confidence gaps among dentists, including limited awareness of the efficacy of nonsteroidal anti-inflammatory drugs for odontogenic pain, a lack of time for effective counseling, and perceived deficits in pharmacology education. To address these issues, targeted educational interventions are recommended to improve analgesic prescribing practice, close knowledge gaps, and increase dentists' confidence in more effective pain management.