RESEARCH ARTICLE: Structured incremental measurement of directed and objective simulation experiences-pilot (SIM DOSE-P)
Keywords:High-fidelity, Patient simulation, Pharmacy education
Objective: To describe performance, anxiety, confidence, and time effects across multiple individual simulation experiences in an acute care environment among volunteer Pharm.D. students.
Methods: This pilot study used five different cases spanning five weeks. Participants were not aware of case content until each simulation began but topics had been taught in the curriculum. Performance on a SOAP note, self-reported anxiety and confidence, and time to complete each activity were measured. A focus group provided qualitative feedback.
Results: Fifteen participants completed the study. Mean performance scores across all cases were variable without a predictable pattern. Global measures of anxiety and confidence numerically improved. The average time to complete simulation activities was similar across the first three cases but decreased for the remaining two cases. Participant comments supported the overall design as meaningful and encouraged self-directed learning.
Conclusion: The design of repeated individual simulation experiences improves anxiety and confidence scores and promotes self-directed learning.
Accreditation Council for Pharmacy Education. Accreditation standards and key elements for the professional program in pharmacy leading to the doctor of pharmacy degree “Standards 2016”. https://www.acpe-accredit.org//, accessed April 19, 2021
Al-Ghareeb, A., McKenna, L., & Cooper, S. (2019). The influence of anxiety on student nurse performance in a simulated clinical setting: A mixed methods design. International journal of nursing studies, 98, 57–66. https://doi.org/10.1016/j.ijnurstu.2019.06.006
Davis, L. E., Storjohann, T. D., Spiegel, J. J., Beiber, K. M., & Barletta, J. F. (2013). High-fidelity simulation for advanced cardiac life support training. American journal of pharmaceutical education, 77(3), 59. https://doi.org/10.5688/ajpe77359
Dreifuerst, K. T. (2015). Getting started with debriefing for meaningful learning. Clinical simulation in nursing, 11(5), 268-275. https://doi.org/10.1016/j.ecns.2015.01.005
Ericsson K. A. (2004). Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Academic medicine: journal of the Association of American Medical Colleges, 79(10 Suppl), S70–S81. https://doi.org/10.1097/00001888-200410001-00022
Fernandez, R., Parker, D., Kalus, J. S., Miller, D., & Compton, S. (2007). Using a human patient simulation mannequin to teach interdisciplinary team skills to pharmacy students. American journal of pharmaceutical education, 71(3), 51. https://doi.org/10.5688/aj710351
Haines, S. T., Pittenger, A. L., Stolte, S. K., Plaza, C. M., Gleason, B. L., Kantorovich, A., McCollum, M., Trujillo, J. M., Copeland, D. A., Lacroix, M. M., Masuda, Q. N., Mbi, P., Medina, M. S., & Miller, S. M. (2017). Core Entrustable Professional Activities for New Pharmacy Graduates. American journal of pharmaceutical education, 81(1), S2. https://doi.org/10.5688/ajpe811S2
Issenberg, S. B., McGaghie, W. C., Petrusa, E. R., Lee Gordon, D., & Scalese, R. J. (2005). Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Medical teacher, 27(1), 10–28. https://doi.org/10.1080/01421590500046924
McGaghie, W. C., Issenberg, S. B., Petrusa, E. R., & Scalese, R. J. (2006). Effect of practice on standardised learning outcomes in simulation-based medical education. Medical education, 40(8), 792–797. https://doi.org/10.1111/j.1365-2929.2006.02528.x
McHugh M. L. (2012). Interrater reliability: the kappa statistic. Biochemia medica, 22(3), 276–282
Mieure, K. D., Vincent, W. R., 3rd, Cox, M. R., & Jones, M. D. (2010). A high-fidelity simulation mannequin to introduce pharmacy students to advanced cardiovascular life support. American journal of pharmaceutical education, 74(2), 22. https://doi.org/10.5688/aj740222
Persky, A. M., & Robinson, J. D. (2017). Moving from Novice to Expertise and Its Implications for Instruction. American journal of pharmaceutical education, 81(9), 6065. https://doi.org/10.5688/ajpe6065
Robinson, J. D., Bray, B. S., Willson, M. N., & Weeks, D. L. (2011). Using human patient simulation to prepare student pharmacists to manage medical emergencies in an ambulatory setting. American journal of pharmaceutical education, 75(1), 3. https://doi.org/10.5688/ajpe7513
Seybert, A. L., & Barton, C. M. (2007). Simulation-based learning to teach blood pressure assessment to doctor of pharmacy students. American journal of pharmaceutical education, 71(3), 48. https://doi.org/10.5688/aj710348
Seybert, A. L., & Kane-Gill, S. L. (2011). Elective course in acute care using online learning and patient simulation. American journal of pharmaceutical education, 75(3), 54. https://doi.org/10.5688/ajpe75354
Seybert, A. L., Kobulinsky, L. R., & McKaveney, T. P. (2008). Human patient simulation in a pharmacotherapy course. American journal of pharmaceutical education, 72(2), 37. https://doi.org/10.5688/aj720237
Seybert, A. L., Laughlin, K. K., Benedict, N. J., Barton, C. M., & Rea, R. S. (2006). Pharmacy student response to patient-simulation mannequins to teach performance-based pharmacotherapeutics. American journal of pharmaceutical education, 70(3), 48. https://doi.org/10.5688/aj700348
Sørensen, J. L., Navne, L. E., Martin, H. M., Ottesen, B., Albrecthsen, C. K., Pedersen, B. W., Kjærgaard, H., & van der Vleuten, C. (2015). Clarifying the learning experiences of healthcare professionals with in situ and off-site simulation-based medical education: a qualitative study. BMJ open, 5(10), e008345. https://doi.org/10.1136/bmjopen-2015-008345
Thomas, M. C., & Hughes, P. J. (2018). Simulation as a Central Feature of an Elective Course: Does Simulated Bedside Care Impact Learning? Pharmacy (Basel, Switzerland), 6(2), 40. https://doi.org/10.3390/pharmacy6020040
Vyas, D., Bhutada, N.S., & Feng, X. (2012). Patient simulation to demonstrate students’ competency in core domain abilities prior to beginning advanced pharmacy practice experiences. American journal of pharmaceutical education, 76, Article 176
Vyas, D., Bray, B.S., & Wilson, M.N. (2013). Use of simulation-based teaching methodologies in US colleges and schools of pharmacy. American journal of pharmaceutical education, 77, Article 53
Vyas, D., Ottis, E.J., & Caligiuri, F.J. (2011). Teaching clinical reasoning and problem-solving skills using human patient simulation. American journal of pharmaceutical education, 75, Article 189
Vyas, D., Wombwell, E., Russell E., & Caligiuri, F. (2010). High-fidelity patient simulation series to supplement introductory pharmacy practice experiences. American journal of pharmaceutical education, 74, Article 169
Wongwiwatthananukit, S., Newton, G.D., & Popovich, N.G. (2002). Development and Validation of an Instrument to Assess the Self Confidence of Students Enrolled in the Advanced Pharmacy Practice Experience. American Journal of Pharmaceutical Education, 66(1), 5-19