RESEARCH ARTICLE: SOAP with self-reflection to improve student confidence regarding clinical reasoning competencies in community pharmacy practice

Authors

  • Kitiyot Yotsombut Chulalongkorn University, Thailand http://orcid.org/0000-0001-5475-6944
  • Suntaree Watcharadamrongkun Chulalongkorn University, Thailand
  • Anuchai Theeraroungchaisri Chulalongkorn University, Thailand

DOI:

https://doi.org/10.46542/pe.2021.211.18

Keywords:

Clinical reasoning, Community pharmacy, Confidence, Reflection, SOAP note

Abstract

Objectives: Self-reflection has been shown to foster clinical reasoning competencies (CRC). Thus, the SOAP+, which incorporated self-reflection into the SOAP note, has been implemented in community pharmacy clerkship. The aims of this study was to explore the opinion of pharmacy students regarding 1) the confidence in CRC in community pharmacy practice following the SOAP+ writing and 2) the benefits of reflection in SOAP+ writing.

Methods: This was a mixed method study, including a questionnaire survey and focus group discussions of 6th year pharmacy students. The self-rating confidence score before SOAP writing, after SOAP writing, and after reflection writing to complete the SOAP+ were compared using repeated measure ANOVA. The data from the focus group discussions was analyzed using thematic analysis. 

Results: Thirty-seven students completed the questionnaire (68.52% response rate). The scores after reflection writing are the highest score with statistically significant difference for every CRC. The perceived benefits of reflection include promoting of self-directed learning, CRC improvement, and improvement of assessment validity.  

Conclusions: The student confidence regarding CRC in community pharmacy practice were improved through SOAP+ writing, which promotes self-reflection and learning from student experiences.

Author Biographies

Kitiyot Yotsombut, Chulalongkorn University, Thailand

Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences

Suntaree Watcharadamrongkun, Chulalongkorn University, Thailand

Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences

Anuchai Theeraroungchaisri, Chulalongkorn University, Thailand

Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences

References

Al-Quteimat, O.M., & Amer, A.M. (2016). Evidence-based pharmaceutical care: the next chapter in pharmacy practice. Saudi Pharmaceutical Journal, 24(4), 447-451. https://doi.org/10.1016/j.jsps.2014.07.010

Chaffey, L., de Leeuw, E.J., & Finnigan, G. (2012). Facilitating students' reflective practice in a medical course: literature review. Education for Health, 25(3), 198-203. https://doi.org/10.4103/1357-6283.109787

Croft, H., Gilligan, C., Rasiah, R., Levett-Jones, T., & Schneider, J. (2018). Thinking in pharmacy practice: a study of community pharmacists’ clinical reasoning in medication supply using the think-aloud Method. Pharmacy, 6(1), 1. https://doi.org/10.3390/pharmacy6010001

Fernandez, S.C., Chelliah, K.K., & Halim, L. (2015). A peek into oneself: reflective writing amongst undergraduate medical imaging students. Reflective Practice, 16(1), 109-122. https://doi.org/10.1080/14623943.2014.982524

Fry, M., & MacGregor, C. (2014). Confidence and impact on clinical decision-making and behaviour in the emergency department. Australasian Emergency Nursing Journal, 17(3), 91-97. https://doi.org/10.1016/j.aenj.2014.03.003

Maudsley, G., & Strivens, J. (2000). Promoting professional knowledge, experiential learning and critical thinking for medical students. Medical Education, 34(7), 535-544. https://doi.org/10.1046/j.1365-2923.2000.00632.x

Hecimovich, M.D., & Volet, S.E. (2009). Importance of building confidence in patient communication and clinical skills among chiropractic students. Journal of Chiropractic Education, 23(2), 151-164. https://doi.org/10.7899/1042-5055-23.2.151

Judge, T.A., Jackson, C.L., Shaw, J.C., Scott, B.A., & Rich, B.L. (2007). Self-efficacy and work-related performance: the integral role of individual differences. Journal of applied psychology, 92(1), 107. https://doi.org/10.1037/0021-9010.92.1.107

King, M.C.A., & Bithell, M.C. (1998). Expertise in diagnostic reasoning: a comparative study. British Journal of Therapy and Rehabilitation, 5(2), 78-87. https://doi.org/10.12968/bjtr.1998.5.2.14219

Linn, A., Khaw, C., Kildea, H., & Tonkin, A. (2012). Clinical reasoning - a guide to improving teaching and practice. Australian Family Physician, 41(1-2), 18-20.

Lutz, G., Scheffer, C., Edelhaeuser, F., Tauschel, D., & Neumann, M. (2013). A reflective practice intervention for professional development, reduced stress and improved patient care--a qualitative developmental evaluation. Patient Education and Counseling, 92(3), 337-345. https://doi.org/10.1016/j.pec.2013.03.020

Mann, K., Gordon, J., & MacLeod, A. (2007). Reflection and reflective practice in health professions education: a systematic review. Advances in Health Sciences Education, 14(4), 595. https://doi.org/10.1007/s10459-007-9090-2.

Martins, J.C.A., Baptista, R.C.N., Coutinho, V.R.D., Mazzo, A., Rodrigues, M.A., & Mendes, I.A.C. (2014). Self-confidence for emergency intervention: adaptation and cultural validation of the self-confidence scale in nursing students. Revista Latino-Americana de Enfermagem, 22(4), 554-561. https://doi.org/10.1590/0104-1169.3128.2451

Mazzo, A., Martins, J.C.A., Jorge, B.M., Batista, R.C.N., Almeida, R.G.d.S., Henriques, F.M.D., Coutinho, V.R.D., & Mendes, I.A.C. (2015). Validation of the self-confidence scale of nursing care in urinary retention. Revista Latino-Americana de Enfermagem, 23, 814-820. https://doi.org/10.1590/0104-1169.0256.2619

McBrien, B. (2007). Learning from practice--reflections on a critical incident. Accident and Emergency Nursing, 15(3), 128-133. https://doi.org/10.1016/j.aaen.2007.03.004

Pearce, P.F., Ferguson, L.A., George, G.S., & Langford, C.A. (2016). The essential SOAP note in an EHR age. Nurse Practitioner, 41(2), 29-36. https://doi.org/10.1097/01.NPR.0000476377.35114.d7

Rencic, J. (2011). Twelve tips for teaching expertise in clinical reasoning. Medical Teacher, 33(11), 887-892. https://doi.org/10.3109/0142159X.2011.558142

Stajkovic, A.D., & Luthans, F. (1998). Self-efficacy and work-related performance: a meta-analysis. Psychological bulletin, 124(2), 240. https://doi.org/10.1037/0033-2909.124.2.240

Tsingos, C., Bosnic-Anticevich, S., & Smith, L. (2014). Reflective practice and its implications for pharmacy education. American Journal of Pharmaceutical Education, 78(1), 18. https://doi.org/10.5688/ajpe78118

Published

06/04/2021 — Updated on 09/05/2021

Versions

Issue

Section

Research Article