Effectiveness of a Medication Reconciliation Simulation in an Introductory Pharmacy Practice Experience Course

Kathy Komperda, PharmD; Kelly Lempicki, PharmD


Am J Pharm Educ. 2019;83(4) 

In This Article


This simulated learning exercise was implemented in all three quarters in the IPPE III: Clinical course. Over the academic year, 203 students were enrolled in the course and 183 students consented to participate in the study and allow access to their results for research purposes. Demographic information of the students is summarized in Table 2. Overall, 65.7% of students were female and had a mean age of 25.7 years (SD=3.3 years). The majority reported work experience primarily in the chain community setting; however, only a few students reported performing medication reconciliation as part of their employment responsibilities.

Scores on the CSC post-encounter assignment were significantly different between the three groups for both sections of the checklist and the overall score (p≤.01). Detailed results are provided in Table 3. Group B received the highest scores for the reconciled medication list, discrepancies and resolutions, and overall score (73.2%, 77.3%, and 74.5%, respectively). Post hoc analysis found a significant difference (p≤.02) in all three scores between groups B and C. A significant difference was also identified between groups A and B for the medication list (p=.02) and the overall score (p=.03).

Response rates were 99% (182/183) for the pre-survey and 82.5% (151/183) for the post-intervention survey; 78.6% (143/182) of pre- and post-intervention survey instruments were matched for comparison. In general, confidence in completing activities related to medication reconciliation knowledge and skills remained the same or increased, regardless of group assignment (Table 4). A significant increase (p<.05) was found in 11(68.8%) of the 16 criteria when the pre- and post-intervention confidence levels were compared for all respondents. In post hoc comparisons between the three groups, a significant difference (p<.05) was found in nine (56.3%) of 16 criteria. These criteria focused on obtaining detailed medication history information, identifying medication discrepancies, proposing resolutions, preparing a medication list, and performing medication reconciliation. For the majority of criteria where a significant difference was found between the three groups, trends suggest that the mean confidence levels increased for groups A and B but decreased for group C over time.

Student agreement with statements regarding the learning activities that were applicable to their randomized groups are summarized in Table 5. In general, more students in group B indicated "strongly agree" than in group A or group C when asked similar questions. Overall, the students in group B reported high levels of agreement (strongly agree or agree) to the statements: the workshop was a positive learning experience, the workshop improved my ability to perform medication reconciliation, and more workshops like this one should be included in the curriculum (97.7%, 100%, and 97.7%, respectively).

In reviewing written feedback from the post-intervention survey about the different learning activities experienced, students in group B who experienced the lecture and workshop had primarily positive comments about their experience. All students, regardless of group assignments, felt the SP encounter in the CSC was a helpful learning experience. However, more students in group B (n=4) felt prepared for the SP encounter, while more students in group C (n=10) felt unprepared.