Brim-Dauterman Tonya, Rao Shantanu
Department of Experiential Education, College of Pharmacy, The University of Findlay, Findlay, OH 45840, USA.
Department of Pharmaceutical Sciences, College of Pharmacy, The University of Findlay, Findlay, OH 45840, USA.
Pharmacy (Basel). 2024 May 15;12(3):79. doi: 10.3390/pharmacy12030079.
(1) Objectives: A divergence in self- and preceptor-evaluations of clinical skills has been noted during Advanced Pharmacy Practice Experiences (APPEs). The goal of this study was to determine the domains of overestimation of clinical skills by students during their APPE rotations. (2) Methods: Preceptor-assigned grades for APPE rotations from 2017-2022 were analyzed to identify instances of letter grade B or lower. The self- and preceptor-evaluations of APPE rotation were compared to determine the domains of divergence in evaluation between students and preceptors. (3) Results: Between 2017 and 2022, 305 student APPE rotations were graded as B or lower (~14%) by the preceptors. A statistically significant difference was noted between self- and preceptor-assigned letter grades across all practice settings including ambulatory patient care, community pharmacy, general medicine patient care, hospital/health system pharmacy, and special population patient care APPE rotations. In addition, examining the self- and preceptor evaluation rubric for these rotations revealed a statistically significant overestimation of clinical skills by students in all 9 domains of APPE evaluation. Finally, the divergence in the rating of clinical skills between student- and preceptor evaluation was found to be highest in the domains of planning and follow-up of patient care, disease knowledge, and communication with patients. (4) Conclusions: Students who fail to exhibit exemplary practice readiness during APPEs tend to overestimate their clinical skills in all domains of APPE evaluation. The results from our study support the need for additional avenues to assist in the identification of deficits in student learning before APPEs to increase their self-awareness (metacognition).
（1）目的：在高级药学实践经验（APPEs）期间，已注意到学生自我评估与带教老师对临床技能评估之间存在差异。本研究的目的是确定学生在APPE轮转期间临床技能被高估的领域。（2）方法：分析了2017年至2022年带教老师为APPE轮转给出的成绩，以确定成绩为B或更低的情况。比较了APPE轮转的学生自我评估和带教老师评估，以确定学生和带教老师在评估方面存在差异的领域。（3）结果：在2017年至2022年期间，带教老师将305次学生APPE轮转评为B或更低（约14%）。在所有实践环境中，包括门诊患者护理、社区药房、普通内科患者护理、医院/卫生系统药房以及特殊人群患者护理APPE轮转，学生自我评定的成绩与带教老师评定的成绩之间存在统计学上的显著差异。此外，检查这些轮转的学生自我评估和带教老师评估量表发现，学生在APPE评估的所有9个领域中对临床技能的评估均存在统计学上的显著高估。最后，发现学生评估与带教老师评估在临床技能评分上的差异在患者护理计划与随访、疾病知识以及与患者沟通等领域最为明显。（4）结论：在APPEs期间未表现出模范实践准备的学生往往在APPE评估的所有领域高估自己的临床技能。我们的研究结果支持需要有更多途径来帮助在APPEs之前识别学生学习中的不足，以提高他们的自我意识（元认知）。
