Garling Kristin Ashley, Wong Benjamin
The University of Texas at Austin - College of Pharmacy, Texas, USA.
Heliyon. 2023 May 5;9(5):e15768. doi: 10.1016/j.heliyon.2023.e15768. eCollection 2023 May.
Current literature outlines the documented need for improved communication during patient medication counseling. Although many tools exist, there needs to be a national standardized tool that complies with federal and state law, to objectively measure student pharmacist performance during patient counseling in the community pharmacy setting. The primary objective of this study is to perform an initial analysis of the internal consistency reliability of a patient medication counseling rubric designed with an Indian Health Services theoretical framework. Secondary objectives include measuring changes in student performance over the time of the study. The 18-item rubric was developed to objectively measure student pharmacist performance during patient medication counseling sessions in a 21-h Introductory Pharmacy Practice Experience (IPPE) course. The community-pharmacy-based IPPE patient counseling course evaluates students' communication skills and patient-centered counseling techniques in live and simulated patient counseling sessions. Three pharmacist evaluators assessed a total of 247 student counseling sessions. The rubric's internal consistency reliability was analyzed, and student performance improvement was observed within the course. Students' performance was evaluated as "meets expectations" in most live and simulated sessions. However, an independent groups -test showed that the mean performance score for the live counseling sessions (2.59, SD = 0.29) was higher (p < 0.001) than that for the simulated counseling sessions (2.35, SD = 0.35). Students' performance in the course improved over three weeks [Week 1: mean (SD) = 2.29 (0.32), Week 2: mean (SD) = 2.44 (0.33), Week 3: mean (SD) = 2.62 (0.29); p < 0.001]. A Tukey-Kramer comparison post hoc test found a significant increase in the mean performance scores between weeks (p < 0.05). The overall internal consistency reliability of the counseling rubric was determined acceptable, with a Cronbach's alpha of 0.75. Further study is required, including the assessment of inter-rater reliability, factor analysis, variable analysis, and use in other states with patient confirmation testing necessary to validate the rubric for use with student pharmacists in the community pharmacy setting.
当前文献概述了在患者用药咨询过程中改善沟通的必要性。尽管存在许多工具，但需要有一个符合联邦和州法律的全国标准化工具，以客观衡量社区药房环境中患者咨询期间学生药剂师的表现。本研究的主要目的是对基于印第安卫生服务理论框架设计的患者用药咨询评分标准的内部一致性信度进行初步分析。次要目标包括衡量研究期间学生表现的变化。这个包含18个条目的评分标准旨在客观衡量学生药剂师在为期21小时的药学实践入门体验（IPPE）课程中患者用药咨询环节的表现。基于社区药房的IPPE患者咨询课程在真实和模拟的患者咨询环节中评估学生的沟通技巧和以患者为中心的咨询技巧。三名药剂师评估员共评估了247次学生咨询环节。分析了评分标准的内部一致性信度，并观察到课程中学生表现有所提高。在大多数真实和模拟环节中，学生的表现被评估为“符合预期”。然而，独立样本t检验显示，真实咨询环节的平均表现得分（2.59，标准差=0.29）高于模拟咨询环节（2.35，标准差=0.35）（p<0.001）。学生在课程中的表现经过三周有所改善[第1周：均值（标准差）=2.29（0.32），第2周：均值（标准差）=2.
