Impact of removing group SOAP note writing from a problem-based learning course series on documentation performance during experiential rotations.

BACKGROUND AND PURPOSE

Documentation is a key component of pharmacy education, and SOAP (subjective, objective, assessment, plan) notes are a common framework. Learners must receive feedback, but the amount needed to achieve desired outcomes on experiential rotations is unknown. This study assessed the impact of discontinuing group-written SOAP notes in a four-course problem-based learning (PBL) series on note scores in experiential rotations.

EDUCATIONAL ACTIVITY AND SETTING

Three cohorts across five graduating classes were compared; group-written SOAP notes in four, two, and no PBL semesters. Note writing scores on inpatient medicine and ambulatory care introductory and advanced pharmacy practice experiences (IPPEs and APPEs) were compared using logistic analysis. The odds ratio (OR) of writing a "high performance" note was determined compared to the reference of zero semesters of PBL note writing.

FINDINGS

Additional PBL SOAP note writing did not impact inpatient medicine IPPE scores; however, four semesters of note writing significantly lowered internal medicine APPE note writing scores (OR = 0.51, 95% CI = 0.31-0.84, P = .008). In contrast, two and four semesters of SOAP note writing improved ambulatory care IPPE note writing (OR = 2.33, 95% CI = 1.17-4.65, P = .02 and OR = 2.48, 95% CI = 1.47-4.16, P < .001, respectively) but there was no difference in ambulatory care APPE note scores.

SUMMARY

Removing opportunities for group-written SOAP notes in a PBL course series minimally impacted students' performance on APPEs. Institutions may consider if current SOAP note feedback is effective in preparing learners for APPEs.