University of Michigan Health, Ann Arbor, MI, USA.
Wingate University School of Pharmacy, Wingate, NC, USA.
Am J Pharm Educ. 2024 Apr;88(4):100677. doi: 10.1016/j.ajpe.2024.100677. Epub 2024 Feb 29.
Pharmacists utilize clinical reasoning (CR) to improve patient outcomes via medication optimization. It is critical to develop these skills in student pharmacists, yet optimal pedagogies to teach and assess CR are unknown. Peer feedback may be used to develop CR in student pharmacists, but a certain feedback quality must be reached to be effective. This study sought to evaluate if student pharmacists could provide similar quality peer feedback compared to pharmacy resident teaching assistant (TA) feedback.
This was a retrospective, mixed-methods pedagogical analysis comparing the quality of first-year student pharmacist peer feedback to resident TA CR feedback. The CR comments were defined using the intellectual standards of CR. Quality was assessed for task specification, gap identification, actionability, and process orientation by 2 independent investigators. Student performance and perceptions were also assessed. Mann-Whitney U, t tests, and descriptive statistics were used to analyze data where appropriate.
Clinical reasoning feedback from peers (N = 805) and TAs (N = 206) were analyzed. Interrater reliability for feedback quality was moderate to substantial. Overall, peer CR feedback was of higher quality regarding task specification and process orientation while TA CR feedback was of higher quality regarding gap identification and actionability. Students receiving peer feedback performed better on a final patient case than those receiving TA feedback (95.2% vs 92.3%). Overall, the peer feedback process was well received by students.
Student pharmacists can provide similar quality feedback as resident TAs. Peer feedback offers an alternative to resident TA feedback and has the potential to contribute to improved CR skills.
药剂师利用临床推理（CR）通过优化药物来改善患者的治疗效果。培养学生药剂师的这些技能至关重要，但教授和评估 CR 的最佳教学法尚不清楚。同伴反馈可以用于培养学生药剂师的 CR，但为了使其有效，必须达到一定的反馈质量。本研究旨在评估学生药剂师是否能够提供与药剂学住院医师助教（TA）反馈类似的高质量同伴反馈。
这是一项回顾性的、混合方法的教学法分析，比较了一年级学生药剂师同伴反馈与住院医师 TA CR 反馈的质量。使用 CR 的智力标准来定义 CR 评论。由 2 位独立的调查员评估任务说明、差距识别、可操作性和过程导向的质量。还评估了学生的表现和看法。在适当的情况下，使用 Mann-Whitney U、t 检验和描述性统计来分析数据。
分析了来自同伴（N=805）和 TA（N=206）的临床推理反馈。反馈质量的组内一致性为中等至较大。总体而言，同伴 CR 反馈在任务说明和过程导向方面的质量更高，而 TA CR 反馈在差距识别和可操作性方面的质量更高。接受同伴反馈的学生在最终患者病例中的表现优于接受 TA 反馈的学生（95.2%对 92.3%）。总体而言，学生对同伴反馈过程的接受度很高。
学生药剂师可以提供与住院医师 TA 类似质量的反馈。同伴反馈提供了一种替代住院医师 TA 反馈的方法，并且有可能有助于提高 CR 技能。
