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Let’s ThinkAbout It
INSIDE THIS ISSUE
Communication Skills Comparison, P.2
A Pain Management Assignment, P.5
Let’s Think About It is published three times a year by the Center for the Advancement of Teaching and Learning (CATAL) in Mercer University’s College of Pharmacy and Health Sciences. The purpose of CATAL is to support and promote effective and innovative teaching that enhances learning at the College. CATAL’s vision is to create a learning- centered community that promotes a culture of excellence in teaching and learning.
Let’s Think About It has been the newsletter for the Center for the Advancement of Teaching and Learning (CATAL) since February 1997 when Issue 1, Volume 1
was published. For the last several years, Dr. Grady Strom has edited the newsletter.
Dr. Strom has personally contributed numerous articles to the newsletter and shared his
perspectives and vision of innovations in teaching. We are grateful to him for his able
guidance for many years to bring this newsletter to you. Starting with this issue of the
newsletter, Dr. Leisa Marshall will serve as the new editor, and I will assist Dr. Marshall
as the associate editor. Dr. Strom will still continue to provide guidance to the newsletter,
as part of his overall championship of CATAL activities and events, and as chair of CATAL.
The newsletter will continue to provide a forum for faculty to share their experiences in
teaching, and we will bring information from the literature to enhance teaching at the
College of Pharmacy and Health Sciences. We encourage our College of Pharmacy and Health
Sciences faculty to write for the newsletter and send your submissions to Dr. Marshall.
Your submissions can include, but are not limited to, short reflective essays about your
first one or two years teaching in the academy, reports of your pedagogical research,
innovative techniques and approaches that facilitate learning, what works in your class,
or summaries of educational books or articles. Each submission will be reviewed by
the editors and selected members of CATAL. Please consult the CATAL website at
mercer.edu/catal for previous issues of Let’s Think About It and for information about
programs offered by CATAL, such as the Journal Club and colloquy meetings.
This issue of the newsletter features two projects highlighting teaching and learning in the
classroom in the pharmacy program. The first article, authored by Drs. Lisa Lundquist,
Angela Shogbon and Kathryn Momary, provides a comparison of students’ perceptions
and faculty evaluation of students’ communication skills during an oral examination
in a therapeutics module. The second article, authored by Drs. Diane Nykamp and Leisa
Marshall, provides an example of using an existing electronic case study program on pain
management as the basis of an active learning activity in a therapeutics module.
Thank you and I hope you enjoy this issue of Let’s Think About It.
Ajay K. Banga, Ph.D.
Chair, Department of Pharmaceutical Sciences
Mercer University COPHS
Associate Editor
VOLUME 13 • ISSUE 1 • FALL 2011
BackgroundThe Center for the Advancement of Pharmaceutical
Education (CAPE) and the Accreditation Council
for Pharmacy Education (ACPE) both advocate for
patient-centered pharmaceutical care.1-3 The CAPE
Outcomes recommend that pharmacists must be
able to communicate and collaborate with pre-
scribers, patients, caregivers, and other involved
health care providers to engender a team approach
to patient care2 and that pharmacists must apply
effective communication skills in interprofessional
relationships to improve the clinical, economic,
and humanistic outcomes of patients.3
To date, there is little published literature on
communication skills assessment in pharmacy
education.4-5 In a description of the current
practices of communication skills assessment
in colleges of pharmacy, the focus was on com-
munication with patients, not with other health
care providers.4
There are many opportunities to reinforce students’
communication skills with patients in our College
of Pharmacy and Health Sciences through a
communications course, introductory pharmacy
practice experiences, mock patient counseling,
and oral examinations. Opportunities to strengthen
communication skills with health care providers
include introductory pharmacy practice experiences
and four classroom hours of instruction and
application of a framework for presenting clinical
recommendations regarding drug therapy and
specific communication skills to utilize. The majority
of opportunities to improve students’ communica-
tion skills with health care providers are not until
advanced pharmacy practice experiences. In an
effort to evaluate students’ communication skills
with health care providers, we compared second
professional year students’ perceptions and
faculty evaluation of performance of communication
skills during therapeutics oral examinations.
MethodsTwo patient case-based oral examinations were
given to all second professional year students
enrolled in the Cardiovascular/Renal III therapeutics
course. Students were provided with patient cases
prior to each oral examination to allow adequate
preparation time and the cases incorporated
disease states and pharmacotherapy previously
tested in written format. One oral examination
was given individually and one was a group oral
examination with groups of 4 students. During
the oral examinations, questions that were asked
were consistent with clinical practice. The stu-
dents served as the pharmacist developing and
communicating therapeutic recommendations
to the faculty members who served as another
health care provider.
Faculty assessed students’ communication skills
using a scoring rubric in the areas of rapport
(confidence, non-verbal, tone of voice, eye contact)
and presentation of therapeutic recommenda-
tions (concise, pronunciation, well-prepared,
patient-focused). Immediately following each oral
examination, students were asked to rate their
own communication skills using the same rubric.
Communication skills were rated on a 4-point
Likert scale with 1=needs significant development,
2=needs improvement, 3=developing excellence,
and 4=accomplished. Student’s perception of
performance on communication skills during
each oral examination was compared with their
respective faculty’s communication evaluation.
In addition, student’s perceptions of performance
on communication on their respective individual
and group oral examinations were compared.
Faculty evaluation of each student’s communica-
tion performance on the individual and group oral
examinations were also compared.
All data collected were approved by Mercer Univer-
sity Institutional Review Board. Students voluntari-
ly signed informed consent prior to participation.
Students’ perceptions were compared to faculty
evaluation of their communication skills using de-
scriptive statistics and Wilcoxon Signed Ranks test.
ResultsA total of 136 (97.8%) students completed com-
munication self-assessments. Faculty’s evalua-
tion of students in both the individual and group
oral examinations, were statistically significantly
Communication Skills: a Comparison of Students’ Perception and Faculty Evaluation of Performance on Therapeutics Oral Examinations
Lisa M. Lundquist, Pharm.D., BCPS | Angela O. Shogbon, Pharm.D., BCPS | Kathryn M. Momary, Pharm.D., BCPS
Figure 1. Individual Oral Examination: Student Perception and Faculty Evaluation
2 3
Mea
n Co
mm
unic
atio
n Sc
ores
p <0.01
p <0.05*+
*
*
*
*+
higher than the students’ self-assessment of
their communication skills in the following areas:
confidence, respectful tone, absence of obvious
nervousness, and concise and articulate. In ad-
dition, in the individual oral examination, faculty
rated students’ performance on ‘correct profes-
sional phraseology’ higher than the students’ self-
assessment (p<0.05). Students’ self-assessment
of communication increased from the individual
to the group oral examination in the following
areas: confidence, respectful tone, absence of ob-
vious nervousness, individualized approach, well-
prepared, and concise and articulate. Figures 1 – 4
illustrate the comparisons of student perceptions
and faculty evaluation of communication skills in
both the individual and group oral examinations.
DiscussionStudents’ perception of communication skills
were consistently lower than the evaluation scores
provided by faculty in both the individual and the
group oral examinations. A potential cause of stu-
dents’ lower perception of communication skills
may be a lack of practice in the verbal communica-
tion of clinical recommendations, which is sup-
ported by the increase in student perception with
the second oral examination. Another possible
explanation is that students tend to be their own
worst critics. In areas where students tended to be
particularly judgmental with themselves, examina-
tion of faculty evaluations could provide balance.
Students’ perceptions of communication skills
were higher in the group oral examination setting
when compared to the individual oral examina-
tion setting. Since the group oral examination
occurred after the individual oral examination,
confidence in skills and performance of commu-
nicating therapeutic recommendations may have
increased, and the students likely felt more self-
confident with the support of their peers.
Evaluation of students’ communication skills with
health care providers may contribute to a better
comprehension of the practice of pharmacy and
the integration of professional competence, clinical
aptitude and patient care. Greater use of this evalu-
ation method of communication skills may further
Figure 2. Group Oral Examination: Student Perception and Faculty Evaluation
Figure 3. Students’ Individual and Group Oral Examination Perceptions
2 3
Mea
n Co
mm
unic
atio
n Sc
ores
p <0.01
p <0.05*+
**
* *
Mea
n Co
mm
unic
atio
n Sc
ores
p <0.01
p <0.05*+
*+ + * +
contribute to improving student’s confidence and
competence in the verbal communication of clinical
recommendations to health care providers and
better prepare them for practice as future pharma-
cists. In addition, appropriate self-evaluation of
performance is a key component to professional
development. If you have the opportunity in your
course, we encourage you to consider incorporating
communication skills evaluation.
ConclusionStudents’ perceptions of communication skills
were consistently lower than faculty’s evaluation.
Greater utilization of formal case-based oral
examinations may help to improve student’s confi-
dence and perception of their communication skills.
References1. Accreditation Council for Pharmacy Education
(ACPE). Accreditation Standards and Guidelines
for the Professional Program in Pharmacy Leading
to the Doctor of Pharmacy Degree. Available at:
http://www.acpe-accredit.org/pdf/ACPE_Revised_
PharmD_Standards_Adopted_Jan152006.pdf. Ac-
cessed June 17, 2010.
2. Center for the Advancement of Pharmaceutical
Education (CAPE) Pharmacy Practice Supplemental
Educational Outcomes. Available at: http://www.
aacp.org/resources/education/Documents/Pharmacy-
PracticeDEC06.pdf. Accessed June 17, 2010.
3. Center for the Advancement of Pharmaceuti-
cal Education (CAPE), Social and Administrative
Sciences Supplemental Educational Outcomes.
Available at: http://www.aacp.org/resources/educa-
tion/Documents/SocialandAdminDEC06.pdf. Ac-
cessed June 17, 2010.
4. Kimberlin CL. Communicating with patients:
skills assessment in US colleges of pharmacy.
Am J Pharm Educ. 2006 Jun 15;70(3): article 67.
5. Beardsley RS. Communication skills development in
colleges of pharmacy. Am J Pharm Educ. 2001;65:307-14.
Figure 4. Faculty’s Individual and Group Oral Examination Evaluations
4 5
p <0.01
p <0.05*+
*+ + *
Mea
n Co
mm
unic
atio
n Sc
ores
BackgroundIncorporation of varied active learning
techniques has been shown to increase
learning in students enrolled in Doctor of
Pharmacy programs.1-3 Characteristics of
active learning include: students who are
involved in more than listening, student
involvement in higher-order thinking such
as analysis, synthesis, and evaluation, and
students who are engaged in activities, e.g.
reading, discussing, writing.4 All of these
characteristics are needed to meet the Com-
mission to Implement Change in Pharma-
ceutical Education (CAPE) outcomes and
the Accreditation Council on Pharmaceutical
Education (ACPE) standards.5,6 With active
learning, emphasis is placed on exploration
by the students of their own attitudes, values,
and skill development with less emphasis on
transmitting information.4 Didactic lectures
used alone may limit students’ retention
rates.7 A goal of active learning is to hold
students responsible for their own learning
by providing them with opportunities
to practice or utilize concepts and skills
learned in the classroom. Active learning
assignments may be incorporated into the
large classroom setting, allowing students
to demonstrate problem solving or critical
thinking skills after instruction inside or
outside the classroom.3,4 Three components
suggested as necessary for successful active
learning are: explanation of the context of
the activity, student engagement in the
activity, and activity closure via some form
of reflection.3 Barriers or limitations to
active learning assignments include large
class size, lack of technology or faculty
resources, and the time needed to develop
and implement activities.3,4 Faculty use of
previously developed case study programs,
including continuing education programs,
can minimize the faculty resource and time
A Pain Management Assignment Incorporating an Electronic Learning Program
Diane Nykamp, Pharm.D. Leisa L. Marshall, Pharm.D.
barrier. Formats for continuing education
activities available on the Internet include live
webcast, video with slides, short interactive.
case studies, conference coverage, posters
and abstracts, journal articles and practice
guidelines. A variety of these programs can
be used to supplement course content in
the didactic setting.8-11 Most are available
without a fee and are readily accessible to
faculty and students.
This article describes a Pain Management
Activity (PMA) using a professionally devel-
oped Continuing Medical Education (CME)
electronic learning case study program
available on the Internet. The CME case
study program was coupled with a faculty
developed assignment and break-out discus-
sion session designed to incorporate and
assess student problem solving skills in pain
management in a required pharmacotherapy
module, Disorders of the Musculoskeletal
System and Pain Management.
Learning objectives of the PMA included
developing proficiency in:
• recommendingappropriatemedication
therapy and monitoring parameters,
considering patient specific parameters
presented;
• identifyingadversedrugreactionstotherapy;
• identifyingfollow-upplansthatdemon-
strate appropriate and effective practices
for patient care;
• identifyingtreatmentplansthat
demonstrate effective strategies to
overcome or manage treatment-related
side effects.
MethodsThe program used in this project was a CME
program from BiMark Center for Medical
EducationTM entitled CME IDOL (Improve-
ment Demonstration Outcomes Leaders).11
Permission was obtained to use the program
in an educational class setting. The case
study program consisted of clinical reviews of
three patients with chronic pain syndromes.
Student learning and achievement of the
PMA learning objectives were assessed via
performance on the PMA. An 18-item active
learning assignment was developed by faculty
using questions from the medical educa-
tion program, with the addition of questions
focusing on proper medication use and
monitoring, adverse reaction identification,
and proper follow-up and treatment plan
identification. A graded rubric and detailed
answer key for the 18-item assignment were
also developed. Student impression of the active
learning activity was assessed using a faculty
developed 10-item survey and open- ended re-
sponses to three guided questions. The project
was approved by the Institutional Review Board
of Mercer University.
The PMA occurred during the third week of the
four-week module, following didactic lecture
presentations on medicinal chemistry, pharma-
cology, and therapeutic management of acute
and chronic pain. The exercise included an
in-class preview of the electronic learning site
and three cases, student work outside of class
to review the cases and complete the 18-question
assignment, mid-sized group (23-24 students)
break-out case discussion meetings with faculty
facilitators the next day, and voluntary survey
completion. The electronic learning program
cases were: 1) a 70-year-old female with
neuropathic pain, 2) a 48- year-old male with
renal cell carcinoma and hip pain, and 3) a
35-year-old male with a 6-month history of
chronic back pain.11
Faculty facilitators used the provided answer
key and grading rubric for case facilitation and
to begin assignment grading. Course coordina-
tors finished grading the assignment. During
the break-out session, mimicking the American
Idol television show™, students chose, by vote,
the care plan that demonstrated the most
effective patient care practices and the care
plan that provided the most effective strategies
to manage treatment related side effects and
provide proper follow-up care. After the final
results were tallied, the winning results were
announced in class. The voluntary survey
assessing the students’ perceptions of the
activity was administered after the final voting.
Student learning was assessed using student
performance on the 18-item assignment.
Results One hundred percent of the students enrolled
in the course completed the assignment and
attended their assigned break-out case session.
This activity was worth a possible 1% of the
grade in the course. Student performance on
the activity (18 items graded) was good with a
mean of 90.6 (SD 9.26), n=146.
Of the 146 third-year students enrolled in the
course that year, 86 (58.9%) completed the
voluntary questionnaire regarding their
perceptions of the PMA. Several students
failed to answer all 10 items on the survey.
4 5
Mean responses (Table 1) ranged from 2.75
(SD =0.99) to 3.35(SD=1.05), based on a 5-point
Likert scale (1= strongly disagree, 2= disagree,
3=neutral, 4= agree, and 5= strongly agree).
Forty-one (48.8%) students agreed or strongly
agreed that the activity actively challenged
them to think critically about their approach to
pain management. Fifty-three (61.6%) agreed or
strongly agreed that the activity involved them
in the learning process. However, only 28 (33.
7%) agreed or strongly agreed that the activity
was a useful learning tool, and only 18 (22.3%)
agreed or strongly agreed that the active learning
activity would help them to become a competent
pharmacist. The three open-ended survey ques-
tions were: what was the most valuable aspect
of the activity, the least valuable aspect of the
activity, and how would you improve the activity?
Students indicated the use of real live patients
and the opportunity to practice problem solving
skills via patient cases to be the two most valu-
able components, whereas the use of unfamiliar
medical terminology in the cases and taking
time away from studying to complete the activity
were the two least valuable components. The
two suggestions for improvement most often
given were to provide the cases in text, as well
as on the Internet, and to give students more
time to complete the assignment.
DiscussionIn our experience, electronic learning case based
programs can easily be integrated into a pharma-
cotherapy module as one type of active learning
activity. This professionally developed program
designed for health care professionals, physicians,
and pharmacists was chosen as it included content
and pain management guidelines relevant to course
content and learning objectives. Furthermore,
the current generation of students generally like
multi media entertainment, so an electronic
program mimicking the American Idol™ format
had appeal.12,13 The use of other types of game
formats, such as Trivial Pursuit™, Jeopardy™,
and Hollywood Squares™ to analyze and present
patient cases, have been successfully incorporated
into required pharmacotherapy modules with
16-20 student group sections.14 Our students
reported that on demand access to the electronic
program allowed them the opportunity to review
information at their own pace after didactic lectures,
prior to completing the assignment and attending
the discussion session the next day. Students
reported that they appreciated the opportunity
to practice problem solving skills using patient
scenarios based upon real patients, whether
working alone or with other students.
This project was not without limitations, notably
the results of the voluntary student survey (Table
1). According to the Likert Scale, success would
be defined as 4 or 5. The highest ranked question
from this survey was 3.35. The remaining 9 ques-
tions received scores of 2.75 to 3.13. This activity,
however, was the last of 5 graded active learning
activities in the course that year. Four of the five
activities occurred in weeks 3 and 4 of a 4-week
block. The block scheduling of this course, where
class meets 18 hours a week for 4 weeks, presents
time-constraint challenges. Students in the
course may have perceived the activity as extra
work outside of class without value added ben-
efits. Furthermore, two hours of didactic instruc-
tion on pain management was deleted in order
to allow time to have the break-out patient case
discussion sessions. Students were responsible
for reading materials that were not covered in
lecture. As a final limitation, the project design
did not include an assessment of mastery of
learning objectives in the area of pain manage-
ment comparing traditional lecture to the PMA
with a shortened lecture and additional required
outside reading.
ConclusionAn existing electronic case study program can
easily be used as the basis for an active learning
Survey Items
The PMA helped me to learn pain-related subject matter in this course.
The PMA served as a useful supplement to the information provided during the course.
The PMA enhanced my problem-solving skills.
The PMA challenged me to think critically about my approach to pain management.
The PMA involved me in the learning process.
The PMA will help me to prepare for Advanced Practice Experiences.
The PMA will help me to become a competent pharmacist.
The quality of the electronic learning medical education was excellent.
The PMA was a useful learning tool.
The PMA should be made available to future students.
5Strongly Agree, %
1.3
2.5
1.2
3.6
3.5
2.6
2.5
1.2
1.2
2.4
4Agree,
%
33.8
40.7
26.8
45.2
58.1
23.4
19.8
28.4
32.5
34.9
3Neutral,
%
24.7
18.5
35.4
21.4
17.4
42.9
40.7
38.3
36.1
27.7
2Disagree,
%
26.0
25.9
23.2
20.2
11.6
18.2
24.7
21.0
20.5
26.5
1Strongly Disagree,
%
14.3
12.3
13.4
9.5
9.3
13.0
12.3
11.1
9.6
8.4
Average
2.82
2.95
2.79
3.13
3.35
2.84
2.75
2.88
2.95
2.96
6 7
Table 1.
activity to involve students in the learning process.
Further work is needed comparing student
competency in selected topics when graded
active learning activities are employed versus
traditional lecture format.
References1. Brandt BF. Effective teaching and learning
strategies. Pharmacotherapy. 2000; 20 (10):
307S-316S.
2. Kerr, RA. Curricular integration to enhance
education outcomes. Pharmacotherapy. 2000;20
(10): 292S-296S.
3.Van Amburgh JA, Devlin JW, Kirwin JL, Qualters
DM. A tool for measuring active learning in the
classroom. Am J Pharm Educ. 2007; 71 (5):
Article 85.
4. Bonwell C. Eison J. Active Learning: Creating
Excitement in the Classroom. ASHE-ERIC High-
er Education Report No 1. Washington D.C.: The
George Washington University, School of Educa-
tion and Human Development; 1991.
5. American Association of Colleges of Pharmacy,
Center for the Advancement of Pharmaceutical
Education. Available at: http://www.aacp.org/
resources/education/Documents/CAPE 2004.pdf .
Accessed June 18, 2010.
6. Accreditation Council for Pharmacy Education
(ACPE). Accreditation Standards and Guidelines
for the Professional Program in Pharmacy Lead-
ing to the Doctor of Pharmacy Degree. Available
at: http://www.acpe-accredit.org. Accessed 2010
June 18.
7. Machemer PL, Crawford P. Student perceptions
of active learning in a large cross-disciplinary
classroom. Active Learn Higher Education 2007; 8:9-
30.
8. Medscape. Available at: http://www.medscape.
com/pharmacists. Accessed Sept 1, 2009.
9. Free CME. Available at: http://www.freecme.
com/gindex.php. Accessed Sept 1, 2009.
10. Princeton Media Associates. Available at:
http://www.princetoncme.com. Accessed Sept 1,
2009.
11. Optimizing Pain Management, Bimark Center
for Medical Education. Available at: www.bcme-
online.com/cmeidol. Accessed Sept 1, 2009.
12. Gardner SF. Preparing for the nexters. Am J
Pharm Educ 2006; 70(4): Article 87.
13. Grover TP, Groscurth CR. Principles for teach-
ing the millennial generation: innovative practic-
es of U-M faculty. University of Michigan Center
for Research on Learning and Teaching Occa-
sional Papers 2009; Paper No. 26. Available at:
http://www.crlt.umich.edu/publinks/CRLT_no26.
pdf. Accessed Jan 28, 2010.
14. Patel J. Using game format in small group
classes for pharmacotherapeutics case studies.
Am J Pharm Educ. 2008; 72(1): Article 21.
PublisherHewitt “Ted” Matthews, Ph.D.
Dean and Senior Vice President for the Health Sciences
EditorLeisa L. Marshall, Pharm.D.
Associate EditorAjay Banga, Ph.D.
Editorial and Production ManagerDavid Hefner
Graphic Designers Terry Menard
Jenifer Cooper, CooperWorks Inc.
6 7
College of Pharmacy and Health SciencesMercer University3001 Mercer University DriveAtlanta, GA 30341-4155678.547.6232cophs.mercer.edu
Let’s Think About ItPromoting
Effectiveand Innovative
TeachingA Newsletter by Mercer University’s College of Pharmacy and Health Sciences
INSIDE THIS ISSUE
Communication Skills Comparison, P.2
A Pain Management Assignment, P.5
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