Using Human Patient Simulation to Prepare Student Pharmacists to Manage Medical Emergencies in an Ambulatory Setting

Abstract

Objective. To implement a simulation-based educational experience focused on medical emergencies in an ambulatory pharmacy setting. Design. Second-year student pharmacists were assigned randomly to groups and played the role of pharmacists in a community pharmacy setting in which a simulated patient experienced 1 of 5 emergency scenarios: medication-related allergic reaction, acute asthma attack, hypoglycemia, myocardial infarction, and stroke. The students were expected to use patient assessment techniques to determine which emergency the simulated patient was experiencing and the appropriate intervention. Following each simulation, a debriefing session was conducted. Assessment. Eighty-two student pharmacists completed the simulation activity. Ninety-three percent of student groups correctly identified the emergency. A post-activity survey instrument was administered, and 83% of responders indicated this activity was effective or very effective. Conclusion. Simulation of emergencies seen in an ambulatory pharmacy setting allowed students to assert knowledge, practice communication skills, apply assessment techniques, and work as a team in a low-risk environment.

Pharmacy Students' Learning and Satisfaction With High-Fidelity Simulation to Teach Drug-Induced Dyspepsia

“…7,11,15,17,18,20,27 There appeared to be no published evidence on ideal simulation group size, but in the present study, it was important to determine the maximum group size with which students felt comfortable. Determining that a group size of 8 to 9 students was acceptable to students was a valuable finding in this study, as large class sizes make it prohibitive to have smaller simulation group sizes, if facilitator and "patient" fatigue are to be avoided.…”

“…The 11% of students who failed to provide appropriate treatment to the simulated patient did so because of their inaccurate assessment and nonadherence to treatment guidelines. 7 A key focus of this study was to investigate what impact changes made to the simulation experience as a result of feedback from cohort 1 would have on cohort 2's learning and satisfaction with high-fidelity simulationbased learning. This was evaluated by comparing post -simulation views of the participants in the earlier study (cohort 1) with those of participants in the present study (cohort 2).…”

“…5 Many pharmacy programs have included simulation training only at certain stages in their curricula, while others have successfully incorporated it throughout the curriculum. [6][7][8] High-fidelity simulation is still in its infancy in pharmacy education in the United Kingdom but it is gaining pace. 9 High-fidelity simulation in pharmacy provides a safe and controlled, realistic learning environment in which students can gain "hands on" experience and integrate pharmacotherapy knowledge and skills learned in the classroom into practice.…”

“…Following the intervention, the medication administration error rates of nurses in the study group significantly decreased from 30.8% to 4% (p ,0.001) compared to nurses in a control group whose error rates increased from 20.8% to 36.7% (p 5 0.002) over the same period of time. 14 The value of using high-fidelity manikins in pharmacy has been investigated to teach critical thinking, clinical reasoning, and problem-solving skills 7,10,15,16 ; advanced cardiovascular support 17 ; medical emergencies and critical care management 7,9 ; team-working skills and interprofessional working 16,18 ; end of life care 19 ; technical skills; and performance-based pharmacotherapy principles 15,20 In these studies, simulation was mainly used for formative assessment. Also, a variety of assessment methods was used to qualitatively and quantitatively examine the impact of simulation-based learning.…”

“…The tools used to assess clinical competence, performance-based skills, and attitudes of students, either individually or as a group, included written SOAP (subjective, objective, assessment and plan) notes, pharmacotherapy plan development, skills checklists, and grading rubrics. 7,15,20,21 Student satisfaction survey instruments were the most commonly used research tool to evaluate simulation in pharmacy. While these did not objectively measure the impact of simulation, they provided information about students' attitudes toward and perceived benefits from this novel teaching technique.…”