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弥合整合差距:药学专业学生将基础科学、多元化、公平与包容决策、同理心及沟通融入充血性心力衰竭和心律失常管理的试点项目

Closing the Integration Gap: A Pilot for Incorporating Foundational Sciences, DEI-Decision Making, Empathy, and Communication for Congestive Heart Failure and Arrhythmia Management by Pharmacy Students.

作者信息

Malhotra Ashim, Oh Song, Jin Zhuqiu, Feng Xiaodong

机构信息

Department of Pharmaceutical and Biomedical Sciences, California Northstate University College of Pharmacy, Elk Grove, CA 95757, USA.

Department of Clinical and Administrative Sciences, California Northstate University College of Pharmacy, Elk Grove, CA 95757, USA.

出版信息

Pharmacy (Basel). 2022 Jul 1;10(4):77. doi: 10.3390/pharmacy10040077.

DOI:10.3390/pharmacy10040077
PMID:35893714
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9326578/
Abstract

Pharmacists must integrate foundational sciences with pharmacy practice for providing optimal patient care. Pharmacy students need to be trained to provide culturally competent, linguistically accessible, and empathetic care while integrating foundational science principles. However, such holistic integration is challenging to achieve and assess. To bridge this gap, we implemented and assessed an “integrated cardiovascular simulation” (ICS) module for P2 students, employing case-based and team-based learning. ICS focused on congestive heart failure with preexisting arrhythmia and incorporated patient counseling relating to diversity factors such as cultural competency, linguistic challenges, and the impact of population diversity on cardiac diseases. Students learned the SBAR communication technique (situation, background, assessment, and recommendation) and recommended therapy while elaborating on drug MOA and adverse effects. ICS was assessed through pre-and post-session quizzes and perception data immediately after the activity, and after two years, when students progressed to the cardiovascular APPE block. Student performance improved on a post-test (80.2%) compared to the pre-test (66.9%), p < 0.01 paired student t-test, with an increase in symptom and arrhythmia pattern recognition (41.2% and 36.7%, respectively). ICS was effective for teaching (1) arrhythmia pathophysiology (85%), (2) EKG interpretation (89%), (3) drug adverse effects (93%), (4) DEI-clinical decision making (92%), and (5) communication skills (85%).

摘要

药剂师必须将基础科学与药学实践相结合,以提供最佳的患者护理。药学专业学生需要接受培训,在整合基础科学原理的同时,提供具有文化胜任力、语言可及性和同理心的护理。然而,这种全面整合难以实现和评估。为了弥合这一差距,我们为二年级学生实施并评估了一个“心血管综合模拟”(ICS)模块,采用基于案例和团队的学习方法。ICS聚焦于伴有既往心律失常的充血性心力衰竭,并纳入了与文化胜任力、语言挑战以及人群多样性对心脏病的影响等多样性因素相关的患者咨询内容。学生们学习了SBAR沟通技巧(情况、背景、评估和建议),并在阐述药物作用机制和不良反应的同时推荐治疗方案。通过课前和课后测验以及活动结束后立即收集的感知数据,以及在两年后学生进入心血管高级药学实践经验(APPE)模块时对ICS进行评估。与课前测试(66.9%)相比,学生在课后测试中的表现有所提高(80.2%),配对学生t检验p<0.01,症状和心律失常模式识别能力有所提高(分别为41.2%和36.7%)。ICS在教授(1)心律失常病理生理学(85%)、(2)心电图解读(89%)、(3)药物不良反应(93%)、(4)多元化、公平与包容(DEI)临床决策(92%)和(5)沟通技巧(85%)方面是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de71/9326578/06985d83b26b/pharmacy-10-00077-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de71/9326578/91926d80645f/pharmacy-10-00077-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de71/9326578/06985d83b26b/pharmacy-10-00077-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de71/9326578/91926d80645f/pharmacy-10-00077-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de71/9326578/06985d83b26b/pharmacy-10-00077-g002.jpg

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本文引用的文献

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Implementation and Assessment of a Heart Failure Virtual Patient Simulation in a Required Pharmacotherapy Course.在一门必修的药物治疗学课程中实施并评估心力衰竭虚拟患者模拟。
Am J Pharm Educ. 2022 Aug;86(6):8650. doi: 10.5688/ajpe8650. Epub 2021 Oct 25.
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美国与心力衰竭相关的心血管疾病死亡率差异
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Am J Pharm Educ. 2015 Feb 17;79(1):12. doi: 10.5688/ajpe79112.
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