An Effective Approach to Teaching Pharmacogenomics in the First Year of Pharmacy Curriculum

Marina Gálvez-Peralta, PharmD, PhD; Grazyna D. Szklarz, PhD; Werner J. Geldenhuys, PhD, BPharm; Paul R. Lockman, PhD, BSN

Disclosures

Am J Pharm Educ. 2019;82(8):6345 

In This Article

Abstract and Introduction

Abstract

Objective: To develop an effective method in teaching pharmacogenomics as a part of a new course, Biopharmaceutics and Pharmacogenomics.

Methods: Teaching effectiveness was measured by quizzes, retrospective pre- and post-surveys, team activities, and journal reflections. Four team activities were included in the course: genomic disease, patient case, genetic counselor and a debate about personalized medicine. Outcomes and course impact were evaluated at the end of the course. The evaluation methods included the assessment of knowledge, students' perceptions regarding the utility of team activities, the impact of the course on students' confidence to discuss pharmacogenomics with health care providers or patients, and long-term knowledge retention, measured in the following P2 semester.

Results: Seventy-six students were enrolled in the course. Multiple assessments during the course demonstrated that students' knowledge of pharmacogenomics improved. The team activities had a positive impact on student learning, and the course improved their confidence level to discuss pharmacogenomics with another health care provider or a patient. While 86% of the students considered themselves "unconfident," "somewhat unconfident" or "neither confident nor unconfident" at the beginning of the course, 91% reported being "confident" or "somewhat confident" by the end of the course. This increase in confidence was statistically significant. Furthermore, students showed knowledge retention six months after taking the course.

Conclusion: Implementation of a new course in pharmacogenomics was effective and well received by the students. It also prepared students for system-based therapeutics courses later in the curriculum.

Introduction

Although the idea of individualized response to treatments was observed by Lucretius in 50 BC defending that "What is food to one man, is bitter poison to others," it wasn't until 1950 when the concepts of "pharmacogenetics" and "pharmacogenomics" were introduced.[1] With the new Accreditation Council for Pharmacy Education (ACPE) Standards, pharmacy students should be prepared to understand and apply pharmacogenomics concepts to patient care.[2]

The National Human Genome Research Institute (NHGRI) of the National Institutes of Health identified five core competencies with respect to pharmacogenomic educational needs for pharmacists: terminology, knowledge, interpretation, communication, and professionalism.[3,4] These core competencies have been endorsed by major health organizations, including the National Coalition for Health Professional Education in Genetics (NCHPEG),[4] the International Society of Pharmacogenomics,[5] the Accreditation Council for Pharmacy Education (ACPE),[2] American College of Clinical Pharmacy (ACCP),[7] the American College of Clinical Pharmacy (ACCP) Educational Affairs Committee, the American Society of Health-System Pharmacists (ASHP),[8] and the NIH-funded Genetic/Genomics Competency Center (G2C2).[2] Following these recommendations, multiple approaches describing the incorporation of pharmacogenomics in the education of health care providers have been published.[9–11] A pharmacist's responsibilities are to educate patients about pharmacogenomic principles and to advocate the rational and routine use of pharmacogenomic testing when indicated.[8]

These recommendations can be assisted by the advances in new technologies and direct-to-consumer testing offered by many companies. However, social media convey the somewhat overly optimistic promises that all diseases will become treatable after the completion of the genomic project.[12] Therefore, pharmacists must become leaders and key professionals who provide valid information about pharmacogenomics to patients and other health care providers.

These scientific and social factors were considered when the new course, "Biopharmaceutics and Pharmacogenomics," was designed. That is why several group activities were included, with the objective of enhancing students' critical thinking and knowledge. This course is offered during the spring semester of the first year (P1) of the 4-year PharmD professional program at the School of Pharmacy at West Virginia University. At WVU, students are accepted after a minimum of two years of pre-pharmacy education.

The PharmD program at the WVU School of Pharmacy underwent a curricular change in 2015 with the integration of basic and clinical sciences within courses. While in the traditional curriculum, pharmacogenomics was taught in the P3 fall course as part of the course "Pharmacokinetics and Pharmacogenomics," in the new curriculum, pharmacogenomics was moved to the P1 spring semester. The ultimate goals of this change were two-fold: first, to provide a basis to understand and to interpret pharmacogenomics information and, second, to be able to apply pharmacogenetic principles in future system-based therapeutic courses offered during P2 and P3 years. With this new model, students would have already acquired a foundation in pharmacokinetics, biopharmaceutics, biotechnology, and biochemical pharmacology prior to or during the same semester that the pharmacogenomics module was offered. The pharmacogenomics section of the course was designed with formal lectures, class discussions, homework assignments, journal reflections, and team activities that included, among others, a debate about personalized medicine and a genetic counselor guest speaker (further details in the method section). The authors of this study hypothesized that the introduction of pharmacogenomics early in the students' curriculum and the use of these specific active learning activities would set the foundations to apply pharmacogenetics concepts in their pharmacy practice.

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