Evolution of Self-care Education
During this 15-year time period, there also have been great strides in self-care within pharmacy education. The blueprint for the North American Pharmacists Licensure Examination (NAPLEX) was revised in 2005 to recognize the importance of nonprescription medicines, eliminating any distinction of importance between prescription and nonprescription medicines. The Journal published a Nonprescription Medicines and Self-Care theme issue in 2006, which featured several articles reinforcing the importance of self-care instruction. Part of this supplement identifies the pharmacist as the "only health professional who receives in-depth formal education and skill development in nonprescription drug therapy." Shortly after this publication, the 2007 Accreditation Standards and Guidelines for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree stated that education relating to nonprescription medicines and self-care should be incorporated throughout the pharmacy curriculum, including introductory and advanced pharmacy practice experiences (IPPEs and APPEs). Guidance regarding the incorporation of self-care and nonprescription medicines into the pharmacy curriculum can be found in Appendix B, C, and D of the accreditation standards. Establishment of the American Association of Colleges of Pharmacy Self-Care Therapeutics/Nonprescription Medicines Special Interest Group (SIG) soon followed, providing another opportunity for self-care faculty to network, learn, and promote the scholarship of self-care education. Practicing pharmacists are also enhancing their self-care knowledge through continuing education opportunities such as the National Alliance of State Pharmacy Associations partnership with NMA to conduct Student Pharmacists Self-Care Championships, which are held nationwide at annual state pharmacy conventions. These events are often led by local self-care faculty members as student teams compete in an event similar to a quiz bowl, during which they answer questions developed by NMA faculty members and which may involve continuing education credit.
Self-care instruction is incorporated into the pharmacy curriculum in many ways. Some colleges and schools require it to be a standalone course, while others offer it as an elective. Still others may integrate the curriculum within existing therapeutics courses, simulation laboratories, or in IPPEs and APPEs. Various methods have been used to assist with self-care instruction in the classroom. Although lecture is still the most common mode of delivery, active-learning strategies appear to be a growing trend. Use of active-learning strategies in the classroom to support and develop a student's ability to critically think and problem solve has been well established. There are several active-learning strategies that could be incorporated into the self-care curriculum from think-pair-share, one-minute reflection, or the muddiest point exercises; to more complex activities, such as role-playing, problem-based learning, case-based learning, and team-based learning. Additionally, there are technology-based active-learning activities, such as audience-response systems, videos, and social media, that can be incorporated to engage students in their learning. Several strategies discussed herein have been incorporated into NMA and SCI programming to assist and encourage faculty members to use various methods to enhance the delivery of self-care instruction. Faculty members are regularly invited to present poster/platform presentations and roundtable discussions to share their innovations in teaching. Faculty resources, including complex cases, assessment questions, grading tools, syllabi, active-learning techniques and strategies are available on the NMA website. The SCI also makes available resources from the annual meetings and editors continually provide updates through the APhA Library and Pharmacy Today articles.
Two key learning components in the self-care curriculum are effective communication and patient assessment. The pharmacist must be able to effectively and efficiently ask the patient pertinent questions to determine the problem, the most bothersome symptoms, other medical conditions, and medications being used. Role-playing and vignettes are strategies that can be used to teach these skills. Scenarios can be created and the students can then act out what they would do for the patient. The faculty member can assess and evaluate the students not only on the process used (ie, communication skills and critical thinking) but also on their nonprescription medication knowledge. Role-playing activities wherein students engage in patient consultations also can be used to develop social emotional competences. There is a growing body of evidence to support the use of this type of active learning in the classroom to meet the educational needs of future pharmacists and ensure they develop necessary skills.
Team-based learning (TBL) is a type of collaborative learning that shifts the focus of classroom time from a lecture format to the application of key concepts. This type of learning is sometimes called the "flipped classroom" because it requires students to acquire the initial content through readings, online presentations, or other resources prior to class. At the beginning of class, students are assessed on the preclass requirements by means of a Readiness Assurance Technique (RAT). Both individual assessments (I-RAT) and group assessments (G-RAT) are completed at the beginning of class. Having both RATs holds the students accountable for being prepared for class. Following the completion of both RATs, the remainder of the class is spent on application-type activities, such as case discussions, ethical dilemmas, and pro/con discussions. Use of TBL is emerging in the development and delivery of self-care therapeutics.
Pharmacy school curricula have expanded to incorporate YouTube projects and Facebook campaigns in self-care and public health courses. This strategy is intended to expand the skills and abilities of pharmacy students in reaching the community at large with succinct self-care messages. The purpose of these messages is to stress the safe use of nonprescription medications and to promote the role of pharmacists in assisting and educating patients regarding self-care products. Example projects, course outcomes, and evidence of student impact have been presented at NMA, enabling other colleges and schools of pharmacy to consider adopting a similar approach in their courses. The use of YouTube for patient education is an area in which further research is needed to determine the impact that videos have on patients' understanding of their medications, improving adherence, and reducing medications errors and adverse events. Social media content could be considered as labeling and advertisement of these products, which is under the jurisdiction of the FDA. FDA guidance and regulations regarding social media messaging will be an important statement for colleges and schools of pharmacy that are using media as an instructional tool to review and integrate into their curricula.
Self-care Education
During this 15-year time period, there also have been great strides in self-care within pharmacy education. The blueprint for the North American Pharmacists Licensure Examination (NAPLEX) was revised in 2005 to recognize the importance of nonprescription medicines, eliminating any distinction of importance between prescription and nonprescription medicines. The Journal published a Nonprescription Medicines and Self-Care theme issue in 2006, which featured several articles reinforcing the importance of self-care instruction. Part of this supplement identifies the pharmacist as the "only health professional who receives in-depth formal education and skill development in nonprescription drug therapy." Shortly after this publication, the 2007 Accreditation Standards and Guidelines for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree stated that education relating to nonprescription medicines and self-care should be incorporated throughout the pharmacy curriculum, including introductory and advanced pharmacy practice experiences (IPPEs and APPEs). Guidance regarding the incorporation of self-care and nonprescription medicines into the pharmacy curriculum can be found in Appendix B, C, and D of the accreditation standards. Establishment of the American Association of Colleges of Pharmacy Self-Care Therapeutics/Nonprescription Medicines Special Interest Group (SIG) soon followed, providing another opportunity for self-care faculty to network, learn, and promote the scholarship of self-care education. Practicing pharmacists are also enhancing their self-care knowledge through continuing education opportunities such as the National Alliance of State Pharmacy Associations partnership with NMA to conduct Student Pharmacists Self-Care Championships, which are held nationwide at annual state pharmacy conventions. These events are often led by local self-care faculty members as student teams compete in an event similar to a quiz bowl, during which they answer questions developed by NMA faculty members and which may involve continuing education credit.
Self-care instruction is incorporated into the pharmacy curriculum in many ways. Some colleges and schools require it to be a standalone course, while others offer it as an elective. Still others may integrate the curriculum within existing therapeutics courses, simulation laboratories, or in IPPEs and APPEs. Various methods have been used to assist with self-care instruction in the classroom. Although lecture is still the most common mode of delivery, active-learning strategies appear to be a growing trend. Use of active-learning strategies in the classroom to support and develop a student's ability to critically think and problem solve has been well established. There are several active-learning strategies that could be incorporated into the self-care curriculum from think-pair-share, one-minute reflection, or the muddiest point exercises; to more complex activities, such as role-playing, problem-based learning, case-based learning, and team-based learning. Additionally, there are technology-based active-learning activities, such as audience-response systems, videos, and social media, that can be incorporated to engage students in their learning. Several strategies discussed herein have been incorporated into NMA and SCI programming to assist and encourage faculty members to use various methods to enhance the delivery of self-care instruction. Faculty members are regularly invited to present poster/platform presentations and roundtable discussions to share their innovations in teaching. Faculty resources, including complex cases, assessment questions, grading tools, syllabi, active-learning techniques and strategies are available on the NMA website. The SCI also makes available resources from the annual meetings and editors continually provide updates through the APhA Library and Pharmacy Today articles.
Two key learning components in the self-care curriculum are effective communication and patient assessment. The pharmacist must be able to effectively and efficiently ask the patient pertinent questions to determine the problem, the most bothersome symptoms, other medical conditions, and medications being used. Role-playing and vignettes are strategies that can be used to teach these skills. Scenarios can be created and the students can then act out what they would do for the patient. The faculty member can assess and evaluate the students not only on the process used (ie, communication skills and critical thinking) but also on their nonprescription medication knowledge. Role-playing activities wherein students engage in patient consultations also can be used to develop social emotional competences. There is a growing body of evidence to support the use of this type of active learning in the classroom to meet the educational needs of future pharmacists and ensure they develop necessary skills.
Team-based learning (TBL) is a type of collaborative learning that shifts the focus of classroom time from a lecture format to the application of key concepts. This type of learning is sometimes called the "flipped classroom" because it requires students to acquire the initial content through readings, online presentations, or other resources prior to class. At the beginning of class, students are assessed on the preclass requirements by means of a Readiness Assurance Technique (RAT). Both individual assessments (I-RAT) and group assessments (G-RAT) are completed at the beginning of class. Having both RATs holds the students accountable for being prepared for class. Following the completion of both RATs, the remainder of the class is spent on application-type activities, such as case discussions, ethical dilemmas, and pro/con discussions. Use of TBL is emerging in the development and delivery of self-care therapeutics.
Pharmacy school curricula have expanded to incorporate YouTube projects and Facebook campaigns in self-care and public health courses. This strategy is intended to expand the skills and abilities of pharmacy students in reaching the community at large with succinct self-care messages. The purpose of these messages is to stress the safe use of nonprescription medications and to promote the role of pharmacists in assisting and educating patients regarding self-care products. Example projects, course outcomes, and evidence of student impact have been presented at NMA, enabling other colleges and schools of pharmacy to consider adopting a similar approach in their courses. The use of YouTube for patient education is an area in which further research is needed to determine the impact that videos have on patients' understanding of their medications, improving adherence, and reducing medications errors and adverse events. Social media content could be considered as labeling and advertisement of these products, which is under the jurisdiction of the FDA. FDA guidance and regulations regarding social media messaging will be an important statement for colleges and schools of pharmacy that are using media as an instructional tool to review and integrate into their curricula.
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