Ability of Pharmacy Students, Pharmacists and Pharmacy Support Staff to Manage Childhood Fever via Simulation

Abstract

Objective. Fever is a common childhood symptom of illness often mismanaged by caregivers.Community pharmacies can provide an influential role in the education and management of fever.This study aimed to ascertain how pharmacy students (novices) and pharmacy staff (experts) respond to a childhood fever scenario.Methods. Data were collected from 65 second year students and 51 fourth (final) year students in an over-the-counter fever scenario during assessment tasks. Data from pharmacy staff were collected via mystery shopping conducted over nine weeks between March-October 2015. All encounters were immediately scored by the trained simulated client, and immediate feedback was provided for pharmacy staff and fourth year students. Questioning scores (WHAT) and proportions of competent participants were collected in all groups. Statistical comparative analyses were made between fourth year students and pharmacy staff. Pharmacy staff scores were also tracked over time.Results. Second year students performed well when questioning, achieving a median WHAT score of 100%. Conversely, pharmacy staff scored 22%. A large proportion of the fourth year students and pharmacy staff achieved appropriate outcomes (92% and 65% respectively), however a smaller proportion of second years performed well (52%). The pharmacy staff achieved statistical improvements over time for median WHAT scores (p<0.001). Conclusions.Protocol compliant questioning appears to decline with experience. However, experienced counsellors are more likely to provide appropriate patient advice. Further improvements in outcomes can also occur when staff are provided feedback and coaching. Mystery shopping simulations can be used as a valuable educational tool.

Feedback for Learning in Pharmacy Education: A Scoping Review

“…Twelve of the included studies focused on feedback given in experiential settings including seven moderate theory talk [ 57 , 58 , 59 , 60 , 61 , 62 , 63 ] and five major theory talk [ 64 , 65 , 66 , 67 , 68 ]. All articles included learners in the final year of their pharmacy program ranging from 13 to 162 participants.…”

“…All articles included learners in the final year of their pharmacy program ranging from 13 to 162 participants. Two articles compared early learners or post-graduate trainees to learners in the final year of the program [ 58 , 60 ]. Most of the studies provided multimodal feedback while the remainder provided written feedback only ( Table 3 ).…”

“…The moderate theory talk articles primarily examined feedback on learner communication through patient medication history and counseling [ 58 , 62 ] or motivational interviewing [ 57 ], patient work up via simulated patient case scenarios [ 60 , 61 ], or student knowledge of pharmaceutical calculations [ 59 ]. One article focused feedback to residents on their provision of feedback to students [ 63 ].…”

The competency of Indonesian pharmacy students in handling a self-medication request for a cough: a simulated patient study

“…This contrasts with the results from an Australian study, in which most of their novice students perform well during the informationgathering process. 32 While it is argued that complete information is not always necessary to be gathered in order to provide appropriate advice, it is safer for novice students to gather complete information for assessing patients correctly and hence appropriate advice. 33 In this case, advice was considered appropriate when students recommended direct medical referral.…”

“…This figure is about similar to findings from an Australian study, which stated that appropriate advice was provided in 52% of their novice students in the case of childhood fever. 32 Other than incomplete information gathered as explained above, these participating students **Examples of non-pharmacological advice or other advice including: enough rest, eat healthy food, drink a lot of water, avoid strenuous exercise, avoid dusty or unhygienic places, drink herbal medicines such as ginger and honey, and advising on follow up (such as go to a doctor if there is no improvement after tyring the suggested medicines, go back to the pharmacist if there is no improvement after trying the suggested medicines). ***No advice suggested meant that the students said that they did not know the answer or said that they did not know how to respond to the scenario in the simulated patient test.…”