RESEARCH ARTICLE: Teaching asthma first aid to pharmacy students: A comparative study between an online course and simulation by role-play

Authors

  • Dalia Bajis University of Sydney, Australia https://orcid.org/
  • Betty Chaar University of Sydney, Australia
  • Iman Basheti Applied Science Private University, Jordan
  • Rebekah Moles University of Sydney, Australia

DOI:

https://doi.org/10.46542/pe.2021.211.92104

Keywords:

Active learning, asthma first aid, competency-based assessment, pharmacy education, Blended Learning

Abstract

Objective: To assess the impact of a bimodal workshop on pharmacy students’ ability to perform asthma first aid (AFA) and their preferred method of learning.

Method: Pharmacy students from the Applied Science University (ASU) in Amman, Jordan were invited to participate in an AFA training workshop, comprised of an online training course and simulation by role-play. Students were randomly allocated to one of two groups to start with either a simulation-based session or an interactive online course. After completion of the first session, groups were switched. Student ability to perform AFA was assessed by role-play using an AFA checklist. Students’ preferences on methods of learning were investigated by evaluation forms and focus group discussion using a semi-structured survey.

Results: Fifty students enrolled in the study, 35 (70%) completed the evaluation forms on self-perceived confidence and overall satisfaction with the workshop. Performance in the role-played scenarios was not significantly correlated to whether students received the online training prior to assessment. Students (n=35, 97%) agreed the AFA workshop increased their knowledge and confidence in managing a patient experiencing asthma exacerbation. When asked about their preferred method of learning, 77% stated a combination of online coursework and role-play.

Conclusion: Students valued the novelty of combining learning methods, and hands-on training was perceived as necessary to consolidate knowledge into practice. Thus, blended learning was preferred by pharmacy students attending ASU in Jordan for learning how to perform AFA, and their performance was not affected by the mode of learning in this study.

Author Biographies

Dalia Bajis, University of Sydney, Australia

School of Pharmacy, Faculty of Medicine and Health

Betty Chaar, University of Sydney, Australia

School of Pharmacy, Faculty of Medicine and Health

Iman Basheti, Applied Science Private University, Jordan

Faculty of Pharmacy

Rebekah Moles, University of Sydney, Australia

School of Pharmacy, Faculty of Medicine and Health

References

Al-Elq, A.H. (2010). Simulation-based medical teaching and learning. Journal of Family and Community Medicine, 17(1), 35-40. https://doi.org/10.4103/1319-1683.68787

Al Hroob, A.M., Nawafleh, H., & Altaif, K.I. (2016). Population Prevalence of Asthma in Ma'an Governorate, Jordan. Health Science Journal, 10(2:1)

Almaghaslah, D., Ghazwani, M., Alsayari, A., & Khaled, A. (2018). Pharmacy students' perceptions towards online learning in a Saudi pharmacy school. Saudi Pharmaceutical Journal, 26(5), 617-621. https://doi.org/10.1016/j.jsps.2018.03.001

Almomani, B.A., Al-Sawalha, N.A., Samrah, S.M., Gamble, J.M., & Al Momani, M.A. (2016). Asthma insights from Jordan: cross-sectional observational study. Journal of Asthma, 53(4), 349-355. https://doi.org/10.3109/02770903.2015.1121493

Anderson, C. (2010). Presenting and Evaluating Qualitative Research. American Journal of Pharmaceutical Education, 74(8). https://doi.org/10.5688/aj7408141

Asthma and Respiratory Foundation NZ. (2020). Asthma First Aid (online). Available at: https://www.asthmafoundation.org.nz/your-health/living-with-asthma/asthma-first-aid

Asthma Australia. (2019). Asthma First Aid For Schools-2020 (online). Available at: https://asthmaonline.org.au/product/asthma-first-aid-for-schools/

Asthma UK (2020). Asthma Attacks (online). Available at: https://www.asthma.org.uk/advice/asthma-attacks/

Australian Resuscitation Council. (2016). First aid for Asthma - ANZCOR guideline 9.2.5 (online). Available at: https://resus.org.au/guidelines/

Bajis, D., Chaar, B., Penm, J., & Moles, R. (2016). Competency-based pharmacy education in the Eastern Mediterranean Region - A scoping review. Currents in Pharmacy Teaching and Learning, 8(3), 401-428. https://doi.org/10.1016/j.cptl.2016.02.003

Bajis, D., Chaar, B., Basheti, I.A., & Moles, R. (2019). Pharmacy students' medication history taking competency: Simulation and feedback learning intervention. Currents in Pharmacy Teaching and Learning, 11(10), 1002-1015. https://doi.org/10.1016/j.cptl.2019.06.007

Bajis, D., Moles, R., & Chaar, B. (2018). Stakeholders' perspectives on quality assurance of pharmacy education in the Eastern Mediterranean Region. American Journal of Pharmaceutical Education, 82(10), 1209-1223. https://doi.org/10.5688/ajpe6482

Bauer, M., Geront, M., & Huynh, M. (2001). Teaching blood pressure measurement: CD-ROM versus conventional classroom instruction. Journal of Nursing Education, 40(3), 138-141

Biggs, J. (1999). Teaching for Quality Learning at University. Society for Research in Higher Education and Open University Press, Buckingham

Biggs, J. (2003). Aligning teaching for constructing learning. Higher Education Academy, York

Boukouvalas, E.A., El-Den, S., Chen, T.F., Moles, R., Saini, B., Bell, A., & O’Reilly, C.L. (2018). Confidence and attitudes of pharmacy students towards suicidal crises: patient simulation using people with a lived experience. Social Psychiatry and Psychiatric Epidemiology, 53(11), 1185-1195. https://doi.org/10.1007/s00127-018-1582-2

Carter, N., Bryant-Lukosius, D., DiCenso, A., Blythe, J., & Neville, A.J. (2014). The use of triangulation in qualitative research. Oncology Nursing Forum, 41(5), 545-547. https://doi.org/10.1188/14.ONF.545-547

Chang, M.Y., & Hsu, L.L. (2006). Qualitative research: an introduction to focus group methodology and its application. Hu Li Za Zhi. Journal of Nursing, 53(2), 67-72

Cheema, E. (2018). The need to introduce simulation-based teaching in pharmacy education in Saudi Arabia. Pharmacy, 6(3). https://doi.org/10.3390/pharmacy6030060

Collier, I.A., & Baker, D.M. (2017). Creation of an active learning healthcare communications course using simulations relevant to pharmacy practice. Currents in Pharmacy Teaching and Learning, 9(4), 626-632. https://doi.org/10.1016/j.cptl.2017.03.012

Eagleton, S. (2017). Designing blended learning interventions for the 21st century student. Advances in Physiology Education, 41(2), 203-211. https://doi.org/10.1152/advan.00149.2016

Elo, S., & Kyngäs, H. (2008). The qualitative content analysis process. Journal of Advanced Nursing, 62(1), 107-115. https://doi.org/10.1111/j.1365-2648.2007.04569.x

Erlingsson, C., & Brysiewicz, P. (2017). A hands-on guide to doing content analysis. African Journal of Emergency Medicine, 7(3), 93-99. https://doi.org/10.1016/j.afjem.2017.08.001

Garrison, D.R., & Kanuka, H. (2004). Blended learning: uncovering its transformative potential in higher education. The Internet and Higher Education, 7(2), 95-105. https://doi.org/10.1016/j.iheduc.2004.02.001

GBD 2015 Chronic Respiratory Disease Collaborators. (2017). Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990-2015: a systematic analysis for the global burden of disease study 2015. Lancet Respiratory Medicine, 5(9), 691-706. https://doi.org/10.1016/S2213-2600(17)30293-X

Giannousi, M., Vernadakis, N., Derri, V., Michalopoulou, M., & Kioumourtzoglou, E. (2009). Students’ satisfaction from blended learning instruction. Proceedings of the TCC Worldwide Online Conference, 1, 61-68

Gleason, B.L., Peeters, M.J., Resman-Targoff, B.H., Karr, S., McBane, S., Kelley, K., Thomas, T., & Denetclaw, T.H. (2011). An active-learning strategies primer for achieving ability-based educational outcomes. American Journal of Pharmaceutical Education, 75(9). https://doi.org/10.5688/ajpe759186

Global Initiative for Asthma (GINA). (2020). Global strategy for asthma management and prevention (online). Available at: https://ginasthma.org

Goeman, D.P., Abramson, M.J., McCarthy, E.A., Zubrinich, C.M., & Douglass, J.A. (2013). Asthma mortality in Australia in the 21st century: a case series analysis. BMJ Open, 3(5). https://doi.org/10.1136/bmjopen-2012-002539

Ho, J., Bidwal, M.K., Lopes, I.C., Shah, B.M., & Ip, E.J. (2014). Implementation of an accelerated physical examination course in a doctor of pharmacy program. American Journal of Pharma-ceutical Education, 78(10). https://doi.org/10.5688/ajpe7810182

International Pharmaceutical Federation. (2020). Strategic Plan 2019-2024. The Hague, NETH (online). Available at: https://www.fip.org/file/4369

Jacklin, S., Maskrey, N., & Chapman, S. (2018). Improving shared decision making between patients and clinicians: design and development of a virtual patient simulation tool. JMIR Medical Education, 4(2). https://doi.org/10.2196/10088

Kaveevivitchai, C., Chuengkriankrai, B., Luecha, Y., Thanooruk, R., Panijpan, B., & Ruenwongsa, P. (2009). Enhancing nursing students' skills in vital signs assessment by using multimedia computer-assisted learning with integrated content of anatomy and physiology. Nurse Education Today, 29(1), 65-72. https://doi.org/10.1016/j.nedt.2008.06.010

Kowalski, A.F. (2000). Reducing asthma morbidity and mortality. Cost containment strategies. American Association of Occupational Health Nurses, 48(9), 418-422. https://doi.org/10.1177/216507990004800902

Levy, M.L. (2015). The national review of asthma deaths: what did we learn and what needs to change? Breathe, 11(1), 14-24. https://doi.org/10.1183/20734735.008914

Lewis, L.H., & Williams, C.J. (1994). Experiential learning: Past and present. New Directions for Adult and Continuing Education, 1994(62), 5-16. https://doi.org/10.1002/ace.36719946203

Luckie, K., Pang, T.C., Kritikos, V., Saini, B., & Moles, R.J. (2018). Systematic review and content analysis of asthma knowledge questionnaires: A focus on the knowledge surrounding acute exacerbation management. Journal of Asthma, 55(6), 615-628. https://doi.org/10.1080/02770903.2017.1355380

Luckie, K., Saini, B., Galstaun, V., Kritikos, V., Collins, J.C., & Moles, R.J. (2018). The effectiveness of an online training programme to prepare teachers to provide asthma first aid. Journal of Paediatrics and Child Health, 54(12), 1348-1352. https://doi.org/10.1111/jpc.14080

Luckie, K., Saini, B., Soo, Y.Y.B., Kritikos, V., Collins, J.C., & Moles, R.J. (2018). Impact of scenario based training on asthma first aid knowledge and skills in school staff: an open label, three-arm, parallel-group repeated measures study. Journal of Asthma, 56(9), 973-984. https://doi.org/10.1080/02770903.2018.1508471

Margolis, A.R., Porter, A.L., & Pitterle, M.E. (2017). Best practices for use of blended learning. American Journal of Pharmaceutical Education, 81(3), 1-8. https://doi.org/10.5688/ajpe81349

McCutcheon, K., Lohan, M., Traynor, M., & Martin, D. (2015). A systematic review evaluating the impact of online or blended learning vs. face-to-face learning of clinical skills in undergraduate nurse education. Journal of Advanced Nursing, 71(2), 255-270. https://doi.org/10.1111/jan.12509

Mehuys, E., Van Bortel, L., De Bolle, L., Van Tongelen, I., Annemans, L., Remon, J.P., & Brusselle, G. (2008). Effectiveness of pharmacist intervention for asthma control improvement. European Respiratory Journal, 31(4), 790-799. https://doi.org/10.1183/09031936.00112007

Miller, G.E. (1990). The assessment of clinical skills/competence/performance. Academic Medicine, 65(9), 63-67. https://doi.org/10.1097/00001888-199009000-00045

Morse, J.M., Barrett, M., Mayan, M., Olson, K., & Spiers, J. (2002). Verification strategies for establishing reliability and validity in qualitative research. International Journal of Qualitative Methods, 1(2), 13-22. https://doi.org/10.1177/160940690200100202

National Asthma Council Australia. (2017). Asthma first aid (online). Available at: https://www.nationalasthma.org.au/asthma-first-aid

National Asthma Council Australia. (2020). Australian Asthma Handbook. Available at: http://www.asthmahandbook.org.au/

National Heart Lung and Blood Institute. (2011). Management of asthma exacerbations: school treatment suggested emergency nursing protocol for students with asthma symptoms who don’t have a personal asthma action plan (online). Available at: https://www.nhlbi.nih.gov/files/docs/resources/lung/sch-emer-actplan.pdf

Nunes, C., Pereira, A.M., & Morais-Almeida, M. (2017). Asthma costs and social impact. Asthma Research and Practice, 3(1), 1-11. https://doi.org/10.1186/s40733-016-0029-3

O'Reilly, C.L., Bell, J.S., Kelly, P.J., & Chen, T.F. (2011). Impact of mental health first aid training on pharmacy students' knowledge, attitudes and self-reported behaviour: a controlled trial. Australian and New Zealand Journal of Psychiatry, 45(7), 549-557. https://doi.org/10.3109/00048674.2011.585454

Patton, M.Q. (1999). Enhancing the quality and credibility of qualitative analysis. Health Services Research, 34(5:2), 1189-1208

Pierce, R., & Fox, J. (2012). Vodcasts and active-learning exercises in a “flipped classroom” model of a renal pharmacotherapy module. American Journal of Pharmaceutical Education, 76(10), 196. https://doi.org/10.5688/ajpe7610196

Rowe, M., Frantz, J., & Bozalek, V. (2012). The role of blended learning in the clinical education of healthcare students: a systematic review. Medical Teacher, 34(4), 216-221. https://doi.org/10.3109/0142159X.2012.642831

Schneider, C., & Moles, R. (2016). Walking in consumers’ shoes: reshaping the pharmacy student placement curriculum via mystery shopping with feedback (online). Available at: https://ltr.edu.au/resources/SD14_4207_Schneider_Report_2016.pdf

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

Shute, V.J. (2008). Focus on formative feedback. Review of educational research, 78(1), 153-189. https://doi.org/10.5688/aj710348

Skoy, E.T., Eukel, H.N., & Frenzel, J.E. (2013). Comparison of low- and higher-fidelity simulation to train and assess pharmacy students' injection technique. American Journal of Pharmaceutical Education, 77(2). https://doi.org/10.5688/ajpe77233

Soo, Y.Y., Luckie, K.H., Saini, B., Kritikos, V., Brannan, J.D., & Moles, R.J. (2017). Improving childcare staff management of acute asthma exacerbation - An Australian pilot study. Journal of Asthma, 54(7), 732-740. https://doi.org/10.1080/02770903.2016.1258076

Stewart, D.W., Brown, S.D., Clavier, C.W., & Wyatt, J. (2011). Active-learning processes used in US pharmacy education. American Journal of Pharmaceutical Education, 75(4). https://doi.org/10.5688/ajpe75468

Torjesen, I. (2014). Two thirds of deaths from asthma are preventable, confidential inquiry finds. BMJ, 348. https://doi.org/10.1136/bmj.g3108

Toumas-Shehata, M., Henricks, M., Ovchinikova, L., Smith, L., & Bosnic-Anticevich, S. (2018). Teaching pharmacy undergraduate students inhaler device technique and exploring factors affecting maintenance of technique. Canadian Respiratory Journal. https://doi.org/10.1155/2018/1597217

Wongwiwatthananukit, S., Zeszotarski, P., Thai, A., Fuller, R., Owusu, Y., Tan, C., Gomez, L., & Holuby, S. (2013). A training program for pharmacy students on providing diabetes care. American Journal of Pharmaceutical Education, 77(7). https://doi.org/10.5688/ajpe777153

WHO [World Health Organisation]. (2020). Asthma (online). Available at: http://www.who.int/news-room/fact-sheets/detail/asthma

Published

12/06/2021

Issue

Section

Research Article