Virtual patients in clinical decision making – A design-based research approach

Background: Medical and pharmacy students are future healthcare professionals who will be on the forefront in dealing with antibiotics in hospitals or community settings. Whether the current medical and pharmacy education in Pakistan prepares students to take future roles in antibiotic use remains an under-researched area. Aim: This study aims to compare medical and pharmacy students’ perceived preparedness, learning practices and usefulness of the education and training on antibiotic use and resistance imparted during undergraduate studies in Pakistan. Design and Setting: It was amulti-centre cross-sectional survey of medical and pharmacy colleges in Punjab, Pakistan. Method: A self-administered questionnaire was used to collect data from final year medical and pharmacy students. Descriptive statistics were used for categorical variables while independent t-test and One-way ANOVA computed group differences. Result: Nine hundred forty-eight respondents (526 medical and 422 pharmacy students) completed the survey from 26 medical and 19 pharmacy colleges. Majority (76.1%) of the pharmacy students had not completed a clinical rotation in infectious diseases. The top three most often used sources of learning antibiotic use and resistance were the same among the medical and the pharmacy students; included textbooks, Wikipedia, and smart phone apps. Overall self-perceived preparedness scores showed no significant difference between pharmacy and medical students. The least prepared areas by medical and pharmacy students included transition from intravenous to oral antibiotics and interpretation of antibiograms. Both medical and pharmacy students found problem solving sessions attended by a small group of students to be the most useful (very useful) teaching methodology to learn antibiotic use and resistance. Conclusions: Differences exist between medical and pharmacy students in educational resources used, topics covered during undergraduate degree. To curb the growing antibiotic misuse and resistance, the concerned authorities should undertake targeted educational reforms to ensure that future physicians and pharmacists can play a pivotal role in rationalizing the use of antibiotics.

Comparison of Suicidal Ideation and Depressive Symptoms Between Medical and Pharmacy Students

An Interprofessional Pediatric Prescribing Workshop

BackgroundInterprofessional education (IPE) at university level is an essential component of undergraduate healthcare curricula, as well as being a requirement of many associated regulatory bodies. In this study, the perception of pharmacy and medical students’ of remote IPE was evaluated.MethodsA series of IPE sessions took place via Zoom and students’ feedback was collected after each session. Both qualitative and quantitative data were collected and analysed.Results72% (23/32) of medical students strongly agreed that the sessions had helped to improve their appreciation of the role of pharmacists, whereas 37% (22/59) of pharmacy students strongly agreed, reporting a median response of ‘somewhat agreeing’, that their appreciation of the role of general practitioners had improved. This difference was found to be statistically significant (p = 0.0143). Amongst students who responded, 55% (53/97) identified remote teaching as their preferred mode of delivery for an IPE session.ConclusionsThe survey demonstrated that the students valued the development of their prescribing skills as well as the ancillary skills gained, such as communication and teamwork. Remote IPE can be a practical means of improving medical and pharmacy students’ understanding of each other’s professional roles, as well as improving the skills required for prescribing.

Introduction: Pharmacovigilance plays a significant role in the rational use of medicines by providing information about adverse drug reactions (ADRs). This study is mainly aimed at evaluating and assessing the knowledge, attitude and practice towards pharmacovigilance and ADR’s amongst Pakistani pharmacy and medical students in various pharmacy and medical colleges in Abbottabad, Pakistan. Method: A cross-sectional study was conducted using KAP questionnaire. The questionnaire comprise of three portions, consisted of a total of 21 questions, 13 (Qs: 1-13) were related to the “knowledge”, 6 (Qs: 14-19) were related to “attitude” and the remaining 2 (Qs: 13-15, 19-20) were related to the “practice” aspects. Results: The total 200 pharmacy and medical students provided their response. More than half of them (n = 103, 51.5%) were females and 48.5% (n = 97) were males. Overall the pharmacy students had a high score (30.50) as compared to the medical students (27.97). Majority of the respondents (n = 189, 94.5%) considered reporting ADR should be made compulsory, also most respondents (n = 168, 84%) accepts reporting ADR as their professional responsibility. Majority of the respondents (n = 128, 64%) were of opinion that reporting is a combined duty of doctors, pharmacists and nurses. Conclusion: As both, pharmacy and medical students showed low KAP scores which indicate that there is a need for regular education and training of the students regarding pharmacovigilance and ADR management.

Background: Self-medication is quite a prevalent public health problem. It can cause serious harm to the person, like adverse drug reactions, toxicity, drug resistance, incomplete cure, drug dependence, etc. Self-medication is associated with incorrect self-diagnosis and inadequate treatment, which can result in disease progression and complications. The primary purpose of this study was to assess the knowledge, attitude, and pattern of self-medication practice among undergraduate medical and pharmacy students. Methodology: A questionnaire-based cross-sectional study was conducted in the College of Medicine and College of Pharmacy. The pre-tested, structured questionnaire was used. All medical and pharmacy students were invited to participate in the study by filling in an online study questionnaire. The study questionnaire consists of three parts. The first part includes personal and health status. The second part is related to the past year’s most frequent conditions participants had self-medication. Participants were also asked about their self-medication knowledge and perception. An electronic survey link was sent out via email. Statistical analysis was performed in SPSS 25 software. Results: Self-Medication is more prevalent among medical students (70.59 %) than among pharmacy students (62.3%). The most important condition was a cough, 83% among medical students and 67% of pharmacy students, and a sore throat, 47.1% of medical students and 44.2% of pharmacy students. The most frequent medication used among medical and pharmacy students was analgesic (paracetamol and NSAIDS). Antibiotics (41% medical and 33% pharmacy students) and Vitamin supplements were next utilized. Pharmacy students used more supplements than medical Students (33.8 percent pharmacy versus 13% medical) Conclusion: Self-medication has been found to be very common among medical and pharmacy students in Oman. The student-ts need to be educated about the harms of self-medication and the responsible use of medicine.

Pharmacy and medical students’ competence and confidence with prescribing: A cross-sectional study

<b>Background:</b> Doctors are role model and most important part of any society to influence tobacco use in community. Very little is known about tobacco prevalence in physicians and surgeons of Pakistan. <b>Objective:</b> comparison of knowledge, attitudes, and practices of shisha use among medical students and pharmacy students Methodologycross sectional study done in four major medical universitiesof Karachi, Pakistan. WHO global health survey questionnaire was used with some modification. <b>Result:</b> Out of 1150 distributed Performa 868 students responded of which 398 were medical students and 470 were pharmacy students. Currently 9.6% pharmacy students and 4.8% medical students use shisha daily(p .000). 3.6% Pharmacy students started shisha use in less then 15 years of age while this number was 29.5% was among medical students(P.000) while 44.6% pharmacy students and 50% medical students were not ready to quit within six months. 24.1% pharmacy students and 20.1 medical students were against the increase in price of Tabacoo products . Ban on advertising of tobacco prodects were opposed by 17.7% pharmacy students and 18.3% of medical students. Passive smoking as cause of lung cancer was negated by 14%in pharmacy students and 20.4% in medical students (P.002). while 23.4% pharmacy students and 33.5% medical students rejected it as cause of heart diseases(p.006).paternal smoking increases the risk of lower respiratory track infection was denied by 21.5% pharmacy students and 28.7% medical students (P.0.038) . <b>Conclusions:</b> Surgeons have more casual attitude towards tobacco use. To control this growing menace, both need to be educated about the health hazards related to its use.

In recent decades the concept of Corporate Social Responsibility (CSR) has been adopted by many business sectors, including the pharmaceutical industry. However, in this and other sectors its application remains variable, particularly between mature and developing economies. Its stakeholders include pharmacy and medical students, their attitude to the involvement of companies in socially responsible activities will be important determinants of public response to the industry.Objective:To investigate the knowledge, attitudes and practices of senior medical and pharmacy students towards the CSR concept in the pharmaceutical sector in mature (Germany) and developing (Russia) markets.Methods:A questionnaire survey was carried out among senior pharmacy and medical students during the summer semester 2008 in two Russian and one German university. In each country 120 questionnaires were distributed. The response rate was 95% in Russia and 93% in Germany.Results:Although the relevance of CSR was widely acknowledged by the students, very few were aware of CSR practices currently performed by companies.The reputation of the pharmaceutical industry was generally poor: less than 15% of respondents gave credence to the information provided in advertisements and fully supported pricing strategies as well as policies towards the developing countries. When choosing an employer more than 90% of respondents consider the policies affecting an employee directly as pivotal. However, for a high proportion of students (59% in Russia and 64% in Germany) socially irresponsible behavior by companies has a significant negative impact.Conclusions:This paper identifies practices which students believe should be a part of the CSR programmes for the pharmaceutical industry, and also some that should be abandoned. It recommends that corporate communication on CSR should be expanded. Key differences are seen in perceptions of students in Germany and Russia towards the extent of irresponsible actions and the variation between them.

BackgroundSelf-medication with over-the-counter (OTC) medications is common among medicine and health science students. For safe use of OTC medications, students are expected to have proper knowledge, attitude, and practice (KAP) towards OTC medications and subsequent adverse drug reactions (ADRs).ObjectiveThe aim of this study was to assess KAP of OTC medications use and related factors among medical and pharmacy students at the University of Gondar, Gondar, Northwest Ethiopia.MethodsA cross-sectional study was conducted. Data were collected using a self-administered questionnaire and analyzed using Statistical Package for Social Sciences (SPSS) version 24. Chi-square analysis was conducted and multivariable logistic regression analysis was used to determine the association between KAP and OTC use and its related adverse effects. A P value of less than 0.05 was used to declare statistical significance.ResultsA total of 380 students (229 medical students and 151 pharmacy students) participated in the study. The majority of the respondents 303 (79.7%) reported that they have the practice of self-medication. Fever 69 (80.2%), headache 21 (24.4%), and abdominal cramp 20 (23.3%) were the most common conditions for which the students go for self-medication while paracetamol 51 (59.3%) followed by non-steroidal anti-inflammatory drugs (NSAIDs) 44 (51.2%) were the most commonly used classes of drugs. An intention for time-saving caused by the waiting time due to crowds in medical consultation rooms 212 (77.4%) and a desire for quick relief 171 (62.4%) were the main reasons for the self-medication practice with OTC medications.ConclusionSelf-medication is widely practiced among medical and pharmacy students. Significant problems and malpractices were identified, such as sharing of OTC medications, the use of expired medicines, doubling the dose of medications when they were ineffective, storage of OTC medications, and not reading labels and expiry dates.

Virtual patients are an active learning pedagogical tool which simulate clinical scenarios in a three-dimensional environment. Their use in pharmacy education is under-researched in comparison to other healthcare professions. In the United Kingdom, pre-registration training refers to a year of workplace based training which pharmacy graduates must complete prior to professional registration as pharmacists. This study aimed to evaluate pre-registration pharmacists' perceptions on the integration, usefulness and enjoyment of completing virtual patient simulations or non-interactive case studies as part of their training. Pre-registration trainees completed three virtual patient simulations or three non-interactive case studies on the topics of: emergency hormonal contraception, renal function and childhood illnesses. Telephone interviews were conducted with twenty pre-registration pharmacists, exploring their perspectives on the use of the virtual patient or non-interactive case studies. Data was analysed using the five-stage framework approach. Four main themes emerged from the data: case study design; usefulness of the case studies as a training tool; support in pre-registration training; utility of the learning tools. Trainees also identified technical issues they had experienced while completing the virtual patient simulations, specifically with keyword recognition. Pre-registration trainees who used the virtual patients provided comments relating to the novelty, realism and enjoyment in completing them. Trainees in both groups reported developing knowledge and skills from completing the case studies; those who used the virtual patient commented on the development of communication skills and an increase in confidence for practice and those who used the non-interactive cases focused on knowledge acquisition and numeracy. Participants were enthusiastic about virtual patients as a novel training tool which provided an opportunity for learners to practice realistic scenarios in a safe environment. Virtual patients offer the potential to 'bridge the gap' in pharmacist pre-registration sector-related training variation, promote learning through reflection on doing and increase overall preparedness for practice.

Background: Virtual patient authoring tools provide a simple means of creating rich and complex online cases for health professional students to explore. However, the responses available to the learner are usually predefined, which limits the utility of virtual patients, both in terms of replayability and adaptability. Using artificial intelligence or natural language processing is expensive and hard to design. This project description lays out an alternative approach to making virtual patients more adaptable and interactive. Methods: Using OpenLabyrinth, an open-source educational research platform, we modified the interface and functionality to provide a human-computer hybrid interface, where a human facilitator can interact with learners from within the online case scenario. Using a design-based research approach, we have iteratively improved our case designs, workflows and scripts and interface designs. The next step is to robustly test this new functionality in action. This report describes the piloting and background as well as the rationale, objectives, software development implications, learning designs, and educational intervention designs for the planned study. Results: The costs and time required to modify the software were much lower than anticipated. Facilitators have been able to handle text input from multiple concurrent learners. Learners were not discouraged waiting for the facilitator to respond. Discussion: The implementation and use of this new technique seems very promising and there are a great many ways in which it might be used for training and assessment purposes. This report also explores the provisional implications arising from the study so far.

Background: The COVID-19 crisis impacted the educational system worldwide, which shifted from face-to-face sessions to online learning modes. However, online delivery should not jeopardise the outcome of students learning from interprofessional education (IPE) and should integrate students from different professional backgrounds closer. Objective: To identify the perception of medical and pharmacy students towards online IPE activity at Taylor’s University, Malaysia. Method: An online cross-sectional questionnaire was distributed to second and fourth-year students from the medical and pharmacy programmes. Students were considered to have a positive perception if their total score was above the median score. Result: More than half of the students (53.6%) showed positive perceptions towards the online IPE programme. Medical students had the highest percentage of students (54.9%) showing greater positive perceptions compared to pharmacy students (52.7%). Both health sciences students possessed the highest score on all the SPICE instrument’s domains. Conclusion: This discovery offers valuable insights into the interprofessional competency of students engaged in online IPE activities at their current academic level. It underscores the imperative of integrating online IPE activities into the curriculum design to equip students with the competence necessary for effective collaboration within an interprofessional team.

To evaluate the knowledge of basic life support (BLS) among students and health providers in Medicine, Pharmacy, Dentistry, and Allied Health Science Colleges at Qassim University. A cross sectional study was performed using an online BLS survey that was completed by 139 individuals. Ninety-three responders were medical students, 7 were medical interns, 6 were dental students, 7 were pharmacy students, 11 were medical science students and 15 were clinical practitioners. No responder scored 100% on the BLS survey. Only two out of the 139 responders (1.4%) scored 90-99%. Both of these individuals were fifth year medical students. Six responders (4.3%) scored 80-89%. Of these, 5 were fifth year medical students, and one was fourth-year medical student. Eleven responders (7.9%) scored 70-79%. Of these, eight were fifth year medical students, two were medical interns and one was a pharmacist. Twenty-three responders (16.5%) scored 60-69%. Of these, 11 were fifth year medical students, 1 was a fourth-year medical student, 3 were medical interns, 2 were medical science students, 1 was a dentistry student, and 5 were pharmacists. Twenty-eight responders (20.1%) scored 50-59%. Of these, 11 were fifth year medical students, 3 were fourth-year medical students, 1 was a third-year medical student, 1 was a second-year medical student, 2 were first-year medical students, 1 was a pharmacy student, 3 were dental students, 1 was a allied health science student, 2 were doctors, and 3 were pharmacists. The remaining 69 responders (49.6%) scored less than 50%. Knowledge of BLS among medicine, pharmacy, dentistry, and allied health science students and health providers at Qassim University is poor and needs to be improved. We suggest that inclusion of a BLS course in the undergraduate curriculum with regular reassessment would increase awareness and application of this valuable life-saving skill set.

There is a lack of empirical studies incorporating background music (BM) and sounds (SFX) to instructional videos to facilitate students’ learning. A design-based research study was conducted to enhance student engagement and motivation including four iterative formative evaluations. In the first iteration, graduate students’ reactions were examined to understand the potential influences of BM and SFX in the learning experience. The second iteration consisted of a small-group session focused on describing students’ levels of engagement, motivation, and learning while using videos that included BM and SFX. In the third iteration, a field test was conducted to explore the effects of BM and SFX on students’ engagement, motivation, and learning. The fourth iteration collected experts’ feedback to inform future research and practice. Results showed beneficial effects of BM and SFX for motivation, engagement, and potential learning. Practical guidelines are suggested for faculty and instructional designers to implement BM and SFX on instructional videos. The paper concludes by posing an emergent theory: the design and integration of BM and SFX need to balance the motivational improvements with the challenges of cognitive dissonance and overload.