Pharmacy Students Teaching Prescription Writing and Nonprescription Product Selection to Medical Students

Sheila M. Allen, PharmD; Marlowe Djuric Kachlic, PharmD; Louise Parent-Stevens, PharmD

Disclosures

Am J Pharm Educ. 2020;84(3):6972 

In This Article

Methods

Two educational endeavors were undertaken. The study protocols for both interventions were approved by the University of Illinois at Chicago Institutional Review Board. For the first activity, second-year medical students participated in a prescription writing workshop, which is a component of the required Essentials of Clinical Medicine course. The workshop was taught by fourth-year pharmacy students who had experience working in a community pharmacy or had completed their community advanced pharmacy practice experience (APPE). The pharmacy students were recruited through an email sent to the class listserv one month prior to the session. Students who volunteered were given the facilitator materials (the exercises with answers as well as the plenary session slides) to review the week prior to the workshop. In the hour prior to the workshop, faculty members reviewed the activities with the pharmacy students involved, including answering their questions and providing tips on delivering the information. The 3.5-hour workshop began with a pharmacy faculty member providing a one-hour plenary session on the critical points of prescription writing to 200 second-year medical students. Materials presented in the plenary session as well as the exercises the medical students completed during the workshop were developed by a group of fourth-year pharmacy students on an academic APPE and one of the faculty members coordinating the workshop. After the plenary session, the medical student were broken up into their usual 12- to 15-person work groups and assigned to separate meeting rooms, where the workshop continued. Two pharmacy students led the medical students in each of the work groups through several exercises illustrating the finer points of prescription writing, such as writing sigs with complicated directions, finding errors in completed prescriptions, writing prescriptions for devices and supplies, and counseling a patient on a new medication. At the end of the semester, all of the second-year medical students completed an objective structured clinical examination (OSCE) where one of the exercises included writing four prescriptions of varied complexity based on different scenarios covered in the workshop.

One week prior to the workshop, a survey (Qualtrics, Provo, UT) was sent to all 200 medical students to assess the following, using a Likert scale: confidence in writing different types of prescriptions, effectiveness of the pharmacy students' teaching, and perception of the role of the pharmacist on the healthcare team. At the conclusion of the workshop, another survey was sent out that asked the same questions as the pre-workshop survey. In addition, the survey asked the medical students to rate the helpfulness of the workshop, as well as provide any comments. The post-workshop survey was open for one week after the workshop.

The day prior to the workshop, the 22 pharmacy students were surveyed about their confidence in facilitating the small-group session on prescription writing and asked to assess how receptive the medical students would be to their teaching. The pre-workshop survey sent to fourth-year pharmacy students also collected information on work history as well as prior experience facilitating a workshop, recitation, or laboratory session. After the workshop, the pharmacy students were asked to complete a post-workshop survey that asked the same questions regarding confidence in their knowledge of the material and perceived receptiveness of the medical students to their teaching, and asked them to provide any comments about the workshop. This survey was also open for one week after the workshop.

The second activity occurred during the required family medicine rotation in the third year of the medical school curriculum. A subset of third-year medical students on this rotation chose to participate in a two-session selective on nonprescription medications. Prior to the first session, all medical students enrolled in the workshop received a slide set created by pharmacist faculty members and students that discussed common nonprescription medications for pain and fever, cough, cold and allergies, and gastrointestinal disorders, as well as selected vitamins and minerals. The first two-hour session involved a case-based discussion of these topics led by a group of fourth-year student pharmacists. For the second two-hour session, each participating medical student developed, answered, and presented a self-identified, case-based clinical question from their rotation related to the use of a nonprescription medication, or vitamin, mineral, or herbal medication.

The participating pharmacy students were completing either an academic or ambulatory care APPE with one of the two pharmacist faculty members who developed the selective at the time of the study. One to two weeks prior to the first session, these students updated the pre-workshop slide set and developed cases for use in the first selective session. These were then reviewed by the pharmacist faculty member who provided feedback and guidance to the students in making any modifications. Discussion during the second session was facilitated by the participating fourth-year pharmacy students.

Prior to the first session of the selective, a survey (Qualtrics, Provo, UT) was sent to all of the third-year medical students completing the Family Medicine clerkship (approximately 25 students every six weeks) with items regarding their knowledge and confidence, using a Likert scale, in counseling patients about and recommending nonprescription medications and herbal products. Medical students who participated in the selective were surveyed after the session about their confidence on recommending and counseling patients on nonprescription medications and herbal products. Pre- and post-survey results from both activities were compared using an independent two-tailed t test to determine significance, which was defined as p<.05.

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