A Single Academic Site Study of Five Years Evaluating Pharmacy Students' Palliative Care Clinical Reasoning Using Script Concordance Testing

一项为期五年的单中心学术研究,采用脚本一致性测试评估药学学生在姑息治疗临床推理方面的能力。

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Abstract

Introduction: This study aimed to evaluate the impact of a Pain and Palliative Care elective didactic course on enhancing clinical reasoning skills among Doctor of Pharmacy (PharmD) students using the Script Concordance Test (SCT). As palliative care education becomes increasingly vital in pharmacy training, assessing its effectiveness is essential for curriculum development. Methods: A 5-year prospective study was conducted between 2018 and 2023 at a single academic institution. The elective course was offered six times, covering various palliative care topics such as opioid management, procedural pain, and end-of-life care. A total of 130 third year PharmD candidate students, completed pre- and post-course SCT assessments. The SCT, administered via an online platform, was used to measure clinical reasoning in ambiguous scenarios, with scores compared to a panel of expert responses. Results: The study found a statistically significant improvement in SCT scores from pre- to post-course assessments (P = 0.04), with a mean score increase of 0.09. The 5-year cohort's average score (0.56) outperformed a previous multisite cohort (0.50), although the difference was not statistically significant. Item analysis highlighted areas where students struggled, such as bowel obstruction and CYP interactions, indicating potential areas for curriculum enhancement. Conclusion: This study demonstrates the effectiveness of a targeted palliative care elective in improving clinical reasoning skills among pharmacy students. The findings suggest the need for ongoing curriculum refinement to address specific areas of difficulty and ensure comprehensive palliative care education.

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