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International Journal of Clinical Pharmacy

, Volume 40, Issue 5, pp 1317–1327 | Cite as

PharmAdhere: training German community pharmacists with Objective Structured Clinical Examinations

  • Anna Laven
  • Maira Anna Deters
  • Olaf Rose
  • Holger Schwender
  • Alexandra Smaranda
  • Isabell Waltering
  • Stephanie Laeer
Research Article

Abstract

Background Pharmacists who engage in Pharmaceutical Care need skills to optimise responsible medication use and increase medication adherence. Objectives We developed and evaluated a blended-learning programme for German community pharmacists that focused on conducting consultations in chronic diseases. Setting Community pharmacists in Germany. Method Interventional study with pre-post design. We combined e-learning with Objective Standardised Clinical Examinations (OSCEs) for emergency situations, initiation/implementation of medication therapy and detection of symptoms of four chronic diseases. Specific procedures were defined in the Pharmaceutical Action Plan. Skills were measured with a global analytical marking sheet derived from the Medication Related Consultation Framework and scored with the Canadian criticality/relevancy matrix. Time limits matched real practice scenarios. Main outcome measures Changes in knowledge (difference of test results before and after e-learning) and changes in skills (difference in scores of the OSCEs before and after training). Results 22 out of the 26 pharmacists enrolled, completed the study. The number of correctly answered questions increased significantly after the e-learning for all four indications with a mean number of additional correct answers between 3.86 and 4.9 points out of 15 (p < 0.001). The sums of the analytical checklist points in percentages increased significantly in all topics from the baseline summative OSCE to the final summative OSCE between 6.14 and 31.85% (p < 0.001). The maximum duration of consultation per patient was less than 10 min in all OSCEs. Conclusion The use of e-learning and OSCEs was well received by participants and is a successful method to deliver practical Pharmaceutical Care training.

Keywords

Adherence Blended learning Community pharmacy services Continuing education Counseling Education Germany Pharmaceutical care Pharmacy 

Notes

Acknowledgements

The authors thank Zubin Austin for his support in furthering the understanding of OSCEs, Gerald Friderich for the verification of the Pharmaceutical Action Plan according to DIN EN ISO standard, Ian Millar and John Bradshaw for language edit, Julia Schaefer and the observers for their support in conducting the summative OSCEs.

Conflicts of interest

DM, SH, SA and LS declare that they have no conflict of interest. LA is the owner and CEO of Pharmabrain. RO has received lecture fees and reimbursement of conference fees and travel expenses by Bayer AG, Boehringer Ingelheim, Medac, MSD and Omnicell. WI has received lecture fees and reimbursement of conference fees and travel expenses by Medac, MSD and HRS Pharma. Face-to-face training took part in the training pharmacy of Bayer’s Innovation Academy of German Pharmacists.

Funding

This study was partially paid by the course-participants and partially by Pharmabrain, Berlin.

Supplementary material

11096_2018_710_MOESM1_ESM.docx (51 kb)
Supplementary material 1 (DOCX 51 kb)
11096_2018_710_MOESM2_ESM.pdf (151 kb)
Supplementary material 2 (PDF 154 kb)

References

  1. 1.
    Allemann S, van Mil JW, Botermann L, Berger K, Griese N, Hersberger K. Pharmaceutical care: the PCNE definition 2013. Int J Clin Pharm. 2014;36(3):544–55.CrossRefGoogle Scholar
  2. 2.
    Vrijens B, De Geest S, Hughes D, Przemyslaw K, Demonceau J, Ruppar T, ABC Project Team, et al. A new taxonomy for describing and defining adherence to medications. Br J Clin Pharmacol. 2012;73(5):691–705.CrossRefGoogle Scholar
  3. 3.
    Tan E, Stewart K, Elliott M, George J. Pharmacist services provided in general practice clinics: a systematic review and meta-analysis. Res Soc Adm Pharm. 2014;10(4):608–22.CrossRefGoogle Scholar
  4. 4.
    Patwardhan P, Amin M, Chewning B. Intervention research to enhance community pharmacists’ cognitive services: a systematic review. Res Soc Adm Pharm. 2014;10(3):475–93.CrossRefGoogle Scholar
  5. 5.
    Pringle JR, Boyer A, Conklin MH, McCullough JW, Aldridge A. The Pennsylvania project: pharmacist intervention improved medication adherence and reduced health care costs. Health Aff. 2014;33(8):1444–52.CrossRefGoogle Scholar
  6. 6.
    Greer N, Bolduc J, Geurkink E, Rector T, Olson K, Koeller E, et al. Pharmacist-led chronic disease management: a systematic review of effectiveness and harms compared with usual care. Ann Intern Med. 2016;165(1):30.CrossRefGoogle Scholar
  7. 7.
    Hughes CM, Hawwa AF, Scullin C, Anderson C, Bernsten CB, Björnsdóttir I, et al. Provision of pharmaceutical care by community pharmacists: a comparison across Europe. Pharm World Sci. 2010;32(4):472–87.CrossRefGoogle Scholar
  8. 8.
    Berger K, Griese N. Pharmaceutical counselling: the patient in the centre. Pharm Unserer Zeit. 2012;276–282. (German).Google Scholar
  9. 9.
    Ressing D. Pharmazie studieren—in Deutschland und anderswo. Ein internationaler Vergleich der Lehrpläne. DAZ. 2014;29:73 (German).Google Scholar
  10. 10.
    Bond SE, Crowther SP, Adhikari S, Chubaty AJ, Yu P, Borchard JP, et al. Design and implementation of a novel web-based e-learning tool for education of health professionals on the antibiotic Vancomycin. J Med Internet Res. 2017;19(3):e93.CrossRefGoogle Scholar
  11. 11.
    McKenzie J, Parker N. for the Australian Learning and Teaching Council Ltd, an initiative of the Australian Government. Melbourne: Peer review in online and blended learning environments. Final report; 2011. ISBN 978-1-921856-69-3.Google Scholar
  12. 12.
    Harden RM. What is an OSCE? Med Teach. 1988;10(1):19–22.CrossRefGoogle Scholar
  13. 13.
    Pebc.ca. [Internet]. Toronto: The Pharmacy Examining Board of Canada; c2017. [Cited May 2, 2018]. Available from: http://www.pebc.ca.
  14. 14.
    Austin Z, Croteau D, Marini A, Violato C. Continuous professional development: the Ontario experience in professional self-regulation through quality assurance and per-review. Am J Pharm Educ. 2003;67(2):225.Google Scholar
  15. 15.
    Smith MJ. Adding debriefing to objective structured clinical examinations to enhance disability cultural sensitivity in pharmacy students [dissertation]. Albuquerque (NM): The University of New Mexico; 2016.Google Scholar
  16. 16.
    Sloan DA, Donnelly MB, Schwartz RW, Strodel WE. The objective structured clinical examination. The new gold standard for evaluating postgraduate clinical performance. Ann Surg. 1995;222(6):735–42.CrossRefGoogle Scholar
  17. 17.
    Shirwaikar A. Objective structured clinical examination (OSCE) in pharmacy education—a trend. Pharm Pract (Granada). 2015;13(4):627.CrossRefGoogle Scholar
  18. 18.
    Abda.de. [Internet]. Berlin: Federal union of German associations of pharmacists. Numbers, data, facts 2016. [Cited May 2, 2018]. Available from: https://www.abda.de/fileadmin/assets/ZDF/ZDF_2016/ZDF_16_18_Beschaeftigte_in_Apotheken.pdf. (German).
  19. 19.
    Abda.de. [Internet]. Berlin: Federal union of German associations of pharmacists. Numbers, data, facts 2016. [Cited May 2, 2018]. Available from: https://www.abda.de/fileadmin/assets/ZDF/ZDF_2016/ZDF_16_10_Entwicklung_Apothekenzahl.pdf. (German).
  20. 20.
    Laven A, Schaefer J, Laeer S. Pharmagrips: structured pharmaceutical counselling in the self-medication of the common cold. A randomised controlled study (RCT). MMP. 2014;37(6):209–20 (German).PubMedGoogle Scholar
  21. 21.
    Pugh D, Smee S. Guidelines for the development of objective structured clinical examination (OSCE) cases. Ottawa: Medical Council of Canada; 2013.Google Scholar
  22. 22.
    Marankan FS. Canadian pharmacy exams. Pharmacy OSCE Workbook. Toledo: Phi Publishing; 2016.Google Scholar
  23. 23.
    Consultationskillsforpharmacy.com. [Internet]. London: The Royal Pharmaceutical Society. Medication-related consultation framework. MRCF [Cited May 2, 2018]. Available from: http://www.consultationskillsforpharmacy.com/docs/docj.pdf.
  24. 24.
    Austin Z. OSCEology—a primer on performance-based teaching, learning and assessment in pharmacy: a continuous professional development workshop. Leslie Dan Faculty of Pharmacy Toronto, attended on 29th and 30th July 2016 at the University of Nottingham, UK.Google Scholar
  25. 25.
    R Development Core Team. R: a language and environment for statistical computing. Version 0.99.484 [software]. Vienna: the R foundation for statistical computing [Cited May 2, 2018]. Available from http://www.R-project.org/.
  26. 26.
    Salinitri FD, O’Connell MB, Garwood CL, Lehr VT, Abdallah K. An objective structured clinical examination to assess problem-based learning. Am J Pharm Educ. 2012;76(3):44.CrossRefGoogle Scholar
  27. 27.
    Sloan DA, Donnelly MB, Schwartz RW, Felts JL, Blue AV, et al. The use of the objective structured clinical examination (OSCE) for evaluation and instruction in graduate medical education. J Surg Res. 1996;63:225–30.CrossRefGoogle Scholar
  28. 28.
    Miller G. The assessment of clinical skills/competence/performance. Acad Med. 1990;65(Suppl. 9):S63–7.CrossRefGoogle Scholar
  29. 29.
    Wilkinson TJ, Frampton CM, Thompson-Fawcett M, Egan T. Objectivity in objective structured clinical examinations: checklists are no substitute for examiner commitment. Acad Med. 2003;78(2):219–23.CrossRefGoogle Scholar
  30. 30.
    Smee S. Skill based assessment. BMJ. 2003;326(7391):703–6.CrossRefGoogle Scholar
  31. 31.
    Downing SM. Reliability: on the reproducibility of assessment data. Med Educ. 2004;38(9):1006–12.CrossRefGoogle Scholar
  32. 32.
    Khan KZ, Gaunt K, Ramachandran S, Pushkar P. The objective structured clinical examination (OSCE): AMEE guide no. 81. part II: organisation & administration. Med Teach. 2013;35(9):e1447–63.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Institute of Clinical Pharmacy and PharmacotherapyHeinrich-Heine-UniversityDuesseldorfGermany
  2. 2.College of Pharmacy, Department of Pharmacotherapy and Translational ResearchUniversity of FloridaGainesvilleUSA
  3. 3.Mathematical InstituteHeinrich-Heine-UniversityDuesseldorfGermany
  4. 4.Servicio de Anestesiología y ReanimaciónHospital Central de la Cruz RojaMadridSpain
  5. 5.Institute of Pharmaceutical and Medicinal ChemistryWestfaelische Wilhelms-UniversityMuensterGermany

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