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INTRODUCTION: Teaching medication history taking or medication reconciliation to students requires practice for students to achieve competency. Practice makes students more confident with the process, but multiple practice opportunities require multiple cases, and creating these new cases can be a tedious and time-consuming process. METHODS: The Medication Mysteries Infinite Case Tool was designed to produce random patient cases using game-like features to allow students to practice medication history taking and medication reconciliation without the need to use and train standardized patients. The tool was created using a random draw card-based system to determine patient personality attributes, drugs they are taking, and confusions they have about their drug-taking behavior. This tool is used in a lab dedicated for the purpose of practicing medication history taking with students being assessed via simulation with standardized patients. This tool is currently used at the University of Florida College of Pharmacy as part of a training program for first-year pharmacy students. RESULTS: Since 2011, seven classes of first- and second-year pharmacy students have participated in this lab. Each year's class contained an average of 280 students divided into lab groups of 18-24 students. In our initial offering of the lab and assessment, 200 students on three campuses completed the individual assessments following the laboratory session. Fifty-eight percent achieved excellence, and 39% achieved competence on the individual assessment. Only 3% were assessed as being deficient on their performance and were required to repeat the assessment. Overall, 86.8% agreed or strongly agreed that the MMICT was an excellent way to experience how to reconcile medication. DISCUSSION: Students enjoy the practice and become proficient with the skills they learn through this process as evidenced by increased self-efficacy and achieved competence on a standardized assessment. The tool and the research associated with the outcome were awarded with the 2012 American Association of Colleges of Pharmacy Innovations in Teaching Award.
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OBJECTIVE: To implement and evaluate the use of a situated-learning experience to prepare second-year pharmacy students to conduct medication history interviews in preparation for introductory pharmacy practice experiences (IPPE) at ambulatory clinic sites. DESIGN: Second-year doctor of pharmacy (PharmD) students (n=200) used the Medication Mysteries Infinite Case Tool, a game-like educational tool in which groups of 3 students assumed the roles of pharmacist, patient, and observer and rolled a die and drew cards to determine the drugs, patient personality, medication problems, and other variables that guided a medication history taking session. ASSESSMENT: After the laboratory session, faculty members assessed students' medication history-taking skills. One hundred sixteen (58%) and 78 (39%) of 200 students achieved excellence or competence, respectively, on the final assessment. Two weeks after the assessment, 53 of 200 (26.5%) students completed a survey instrument. The respondents indicated that their self-confidence in conducting medical history taking significantly improved following completion of the learning experience. CONCLUSION: Using the Medication Mysteries Infinite Case Tool increased students' confidence and skills in conducting medication history taking prior to their clinical IPPE experience.
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Educación en Farmacia/métodos , Anamnesis , Enseñanza/métodos , Actitud del Personal de Salud , Competencia Clínica , Curriculum , Retroalimentación , Conocimientos, Actitudes y Práctica en Salud , Humanos , Aprendizaje , Conciliación de Medicamentos , Preceptoría , Relaciones Profesional-Paciente , Evaluación de Programas y Proyectos de Salud , Autoeficacia , Encuestas y CuestionariosRESUMEN
A rapid method to determine fexofenadine concentrations in human plasma using protein precipitation in 96-well plates and liquid chromatography-tandem mass spectrometry was validated. Plasma proteins were precipitated with acetonitrile containing the internal standard fexofenadine-d6, mixed briefly, and then filtered into a collection plate. The resulting filtrate was diluted and injected onto a Phenomenex Gemini C18 (50 mm x 2.0 mm, 5 microm) analytical column. The mobile phase consisted of 0.1% formic acid, 5 mM ammonium acetate in deionized water and methanol (35:65, v/v). The flow rate was 0.2 ml/min and the total run time was 2 min. Detection of the analytes was achieved using positive ion electrospray ionization and high resolution multiple reaction monitoring mode (H-SRM). The linear standard curve ranged from 1 to 500 ng/ml and the precision and accuracy (intra- and inter-run) were within 4.3% and 8.0%, respectively. The method has been applied successfully to determine fexofenadine concentrations in human plasma samples obtained from subjects administered a single oral dose of fexofenadine. The method is rapid, sensitive, selective and directly applicable to human pharmacokinetic studies involving fexofenadine.