Perceptions and effectiveness of live simulation-based assessment to evaluate pharmacist primary care skills within a 12-week certificate program

Tuesday, February 7, 2023

5:30 PM – 7:00 PM

Location: Exhibit Hall

Primary Presenter(s)

Kelsey Frederick, PharmD

Assistant Professor
University of Tennessee Health Science Center College of Pharmacy

Slides

Co-Presenter(s)

James S. Wheeler, PharmD, BCPS

Associate Dean, Knoxville Campus; Director of Continuing Professional Development
University of Tennessee Health Science Center College of Pharmacy

Health Care Problem: As the profession of pharmacy continues its transformation toward a practice model centered around direct patient care clinical services, retooling the existing workforce may be required for pharmacists to take on these expanded roles, especially in an increasingly competitive job market. To help meet this need, a 12-week, 30-hour Pharmacist Primary Care Certificate Training Program was developed and implemented in the summer and fall of 2021 and 2022. The initial gap analysis indicated the need for a certificate program that includes a combination of didactic and simulated experiential training and provides the skills needed to care for a variety of patients. The resulting certificate program developed includes ten didactic, home-study modules and four live, virtual simulation assessment activities to meet this need. Simulation-based training is commonly used in health professions education to provide safe, structured, hands-on learning and application for students. Simulation-based skills assessment has been shown to be effective, engaging, and lead to greater learning and clinical performance. Simulation in continuing education is innovative and emerging, though very few published examples exist in the literature, especially related to pharmacy. As the roles and learning needs of pharmacists continue to expand and evolve, simulation assessment activities integrated within a primary care certificate training program may prepare pharmacists to engage in direct patient care and develop the skills and expertise necessary to succeed in the outpatient primary care setting, ultimately enhancing healthcare professionals’ learning outcomes and patient care.

Educational Strategy:

Four live, virtual simulations were designed in collaboration with the study institution's Center for Healthcare Improvement and Patient Simulation, including medication management, chronic disease state management, acute care, and a collaborative practice agreement (CPA) pitch to a provider panel. Learners were provided access to the cases, patient medical records, collaborative practice agreement, and assessment rubrics one week in advance. At the beginning of each simulation, a pre-brief was conducted that included orientation to the virtual learning environment, case and objectives, logistics, clarification of roles, and conveyed a commitment to respecting learners. After participating in the pre-brief, participants completed the simulated patient (SP) encounter virtually with the SP using a videoconferencing platform. After completing each simulation, learners submitted their recorded video encounter, SOAP note, and self-assessment. Time was then devoted for a debrief with the participant’s designated Clinical Coach mentor using the Debriefing with Good Judgement model. Data collected, analyzed, and reported includes learners’ performance on simulation assessment activities as evaluated by their designated Clinical Coaches, simulation self-assessments, and SP evaluation of participants’ communication skills via the Master Interview Rating Scale. Furthermore, p<span style="mso-fareast-font-family: Arial; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; color: black; mso-themecolor: text1;">articipants were surveyed at the end of the certificate program for program evaluation purposes to collect feedback on program design and delivery (including simulations), self-reported change in primary care skills and self-efficacy, and long-term program effect on outcomes such as pharmacist achievement of goals, practice change, and job status. Qualitative results underwent inductive thematic analysis. Quantitative data were analyzed using descriptive and informed statistics.

Patient-Level Outcome(s) Measured:

Twenty pharmacists completed the program, all simulations, and participated in the program evaluation survey (100% response rate). Learner performance was similar across the three patient care simulations (average scores: 91%, 90%, 88%) with an overall communication score average of 90.5%. The average score on the CPA pitch simulation was 88.1% (44.1 of 50 points). The simulation activities were perceived as one of the most valuable components of the program by all participants (100%, n=20), and all agreed that their primary care knowledge, skills, and confidence were strengthened as a result (100%, n=20). Half of the participants reported never having participated in a simulation activity before the certificate program (50%, n=10). According to learners, the simulation activities offered valuable opportunity for realistic application of course concepts and clinical reasoning, practicing patient communication skills, accountability and feedback from Clinical Coaches and SPs, self-reflection, increased confidence in clinical recommendations, and greater retention of information through applied active learning. This innovative, emerging, and advanced learning model tailors to pharmacist practitioners’ needs and evolving responsibilities and assesses skills-based performance via rubric. Because the events were virtual, technology allowed for an expanded geographical reach for participants to be involved, helping evolve, adapt, and meet learners where they are and making continuing professional development accessible for all pharmacists. Data suggests the live, virtual simulations were appropriate and effective for skills assessment of the pharmacists enrolled in the Pharmacist Primary Care Certificate Training Program, which may be used to scale this and other certificate-based training programs.