The Role of a Simulation-Based Activity on Student Perceptions of Parenteral Nutrition Education

Abstract

Introduction: Parenteral nutrition (PN) education in pharmacy schools and postgraduate programs may not sufficiently prepare future pharmacists for clinical practice. Limited data exist regarding innovative teaching strategies in the area of PN. The purpose of this study was to identify students’ perceptions of a simulated PN activity in a pharmacotherapeutics course. Methods: Second-year Doctor of Pharmacy (PharmD) students from two cohorts (N = 84 for both cohorts) completed a PN assignment using simulated PN materials, which resembled those seen in clinical practice. Before and after the activity, students completed identical surveys about their perceived competence and interest in PN, which were analyzed using Wilcoxon signed-rank tests. Results: Following the simulation, the percentage of students affirming their perceived competence (selecting strongly agree or agree in the survey) in their ability to describe the process of combining ingredients to make a PN admixture (45.2% vs. 83.3%, p < 0.001) and calculate PN-related problems (58.3% vs. 83.3%, p < 0.001) improved. The proportion of students expressing interest in PN increased after the simulation (78.6% vs. 86.9%, p < 0.001). Conclusion: A simulated practicum experience in PN was viewed positively by PharmD students at this university, and may be a valuable active learning experience to incorporate in a PharmD curriculum.

Development and Evaluation of an Online Simulated Hospital Unit for Nutrition Assessment Training

“…Development of diagnosis-specific skill sets via simulation has been demonstrated in the literature. This has included management of type 2 diabetes,38 insertion of small-bowel feeding tubes,39 and preparation of parenteral nutrition 40…”

Comparing the effectiveness of a SNAP simulation given to dietetics students in the classroom versus on the computer

“…8 One study involving a classroom simulation where pharmacy students prepared parenteral nutrition formulas received positive feedback from students, saying the simulation was "engaging," "informative," and "exciting." 37 Another study involving students using VR to learn about the anatomy of the skull received positive feedback on engagement, with the majority sharing they enjoyed learning anatomy using the module. 10 Lastly, almost 91% of participants who viewed a VR simulation putting individuals in the role of an African American man experiencing racism in three scenarios reported feeling engaged during the simulation.…”

“…7 Many studies have shown that simulations, either in VR, a computer, or in-person, facilitate learning and increase students' knowledge, specifically among medical and pharmacy students. 26,37,45,46 One VR simulation called "We are Alfred" showed an increase in medical students' knowledge of medical conditions, specifically macular degeneration (92%) and hearing loss (90%). 47 Nutrition in Medicine online instruction modules teach medical students nutrition concepts and strategies to provide appropriate nutrition education to patients in an adaptive learning format.…”

“…48 Another study found pharmacy students were better able to learn about calculating and mixing parenteral nutrition solutions in an in-class simulation. 37 Additionally, students in an anatomy class increased factual and spatial knowledge of anatomy of the skull after participating in a 10-minute VR simulation. Students also provided positive feedback about the experience, with one student saying "I learned so much by doing this activity -I definitely feel I learned a lot more doing this than learning from a lecture."…”

“…45 Pharmacy students also demonstrated an increase in confidence related to calculating and mixing parenteral nutrition solutions after an inclass simulation; however, there was no control group in this study. 37 Ultimately, simulations have the ability to put an individual in anyplace at anytime, especially simulations conducted in VR. Simulations have the potential to increase student knowledge, skills, competence, and skills.…”