Benefits of Peer-led Study Groups

Cecilia Li, PharmD

PGY1 Pharmacy Resident

University of Maryland Medical Center

As a pharmacy school student, I was involved in peer-to-peer led study groups throughout my didactic training both as a participant, a study group leader, and eventually the student coordinator for the study group program. In this blog post, I am excited to share some of my own experiences with you on the benefits of participating in a peer-led study group from the perspective of a student and a facilitator. As a study group participant, I have found that weekly study group helped me keep up with new lecture material that we were exposed to every week and provided a safe space for students to brainstorm solutions and learn from one another. My institution, along with several healthcare professional graduate programs, have recognized and implemented peer-led study groups as an effective learning tool to supplement and reinforce classroom material outside of the classroom. Doctor of Pharmacy programs are challenging, fast-paced, and require an immense amount of time and dedication in order to successfully complete four years of didactic and experiential training1. Despite a rigorous and selective application progress for admission to a college of pharmacy, students still may struggle with the academic courses. Typically, Student Affairs offices will monitor student performance closely with methods such as tracking exam scores, meeting with faculty and deans, ongoing follow up meetings who may have consistently struggled, and providing counseling and referral to appropriate support services if a student is facing personal or medical concerns outside of class. As part of many PharmD programs, there also are a few ways to obtain academic support depending on the institution. Those opportunities may include meeting one on one with a faculty member or teacher assistant, peer led exam review sessions, or individual tutoring outside of school. However, there are added benefits of study groups for students who are struggling as well as for students would like to reinforce their overall understanding and keep on top of lecture material.

Anecdotally, the three more difficult courses in a PharmD curriculum are medicinal pharmacology, therapeutics, and pharmaceutical sciences or some variation of these core components. My institution offered peer-led study groups for each of these courses in effort to help students succeed academically in these tougher courses. Through study groups, facilitators are able to enrich and tailor student learning more specifically and well as provide opportunities for students to teach materials and help each other learn. This strategy offers an effective and feasible way to reinforce and disseminate knowledge through “active learning, easing faculty teaching burden, providing role models for less-advanced students, increasing intrinsic motivation, and providing peer-leaders with academic experience.”1 Existing literature studying the effectiveness of study groups lie mainly in undergraduate, medical, nursing, and dental education but all uniformly conclude that there is significant benefit to the learner, for student facilitators, as well as for the organization.2-4 While not as abundant, studies regarding pharmacy school study groups have also showed similar results.1,5

Later as a study group leader, I felt that the opportunity to facilitate a small group of students strengthened my overall confidence as a leader and teacher. In addition to students benefiting from study group, being a peer study group leader also has notable benefits, specifically being able to have a large impact on a student’s academic performance. In class, students are presented with large amount of information and material that can be overwhelming to organize and process. Students may struggle with comprehending how the material was taught and could benefit from a different point of view. Therefore, peer study group leaders need to exercise organization, patience, and creativity in order to help their students learn. Leaders at my college of pharmacy were encouraged to create worksheets that help organize course information, example test questions, mock case studies, and use various learning platforms such as Kahoot, Jeopardy, and Google Slides to actively engage their students. Leaders were also challenged to critically think and strengthen their communication skills when students ask questions or request an alternative explanation for a confusing concept.

As a previous study group leader, my role involved a heavy dose of problem-solving and personnel management. I had to learn more about balancing supervision oversight but also allow autonomy of the students to teach each other. At the end of each semester, the feedback I received from participating students were overwhelmingly positive. Students noted that their study group experience enable them to achieve their desired course grade while other voices that working with their peers in a small group setting gave them more confidence to speak out when volunteering answers or asking questions. Other leaders have commented that seeing their peers succeed academically was one of the greatest rewards of this position. Mentorship and the act of paying it forward are key values to the pharmacy profession and having the opportunity to participate in these acts of service can help students establish a strong foundation of being lifelong learners. Overall, the experience of peer-led study groups can contribute to the success of a student in a difficult program as well as provide leadership opportunities for upperclassmen to lead their younger peers. My hope is that more colleges of pharmacy will be able to adapt a similar structure to further academic achievement and student support in rigorous pharmacy programs.

References:

1. Varshney N, Mason NA. Evaluation of peer-led study groups in a PharmD program. Curr Pharm Teach Learn. 2019 May;11(5):485-491. doi: 10.1016/j.cptl.2019.02.005. Epub 2019 May 10. PMID: 31171250.

2. Ten Cate O, Durning S. Peer teaching in medical education: twelve reasons to move from theory to practice. Medical Teacher. 2007;29:591–599. doi: 10.1080/01421590701606799.

3. Clarke B, Feltham W. Facilitating peer group teaching within nurse education. Nurse Educ Today. 1990;10:54-7.

4. Hill E, Liuzzi F, Giles J. Peer-assisted learning from three perspectives: student, tutor and co-ordinator. Clin Teach. 2010 Dec;7(4):244-6. doi: 10.1111/j.1743-498X.2010.00399.x. PMID: 21134199.

5. Etzel AM, Alqifari SF, Shields KM, Wang Y, Bileck NB. Impact of student to student peer mentoring program in first year of pharmacy program. Curr Pharm Teach Learn. 2018 Jun;10(6):762-770. doi: 10.1016/j.cptl.2018.03.009. Epub 2018 Mar 22. PMID: 30025778.

Simulation in Pharmacy Learners

Jessica Curtis, PharmD

PGY1 Pharmacy Resident

Children’s National Hospital

Simulation is the use of patient cases, sometimes including high-fidelity mannequins or actors, to practice clinical assessment or knowledge. It is a teaching tool that allows students the opportunity to practice in a realistic situation to further their learning by building their confidence, fine-tuning their skills and gaining experience.

For physicians, simulation training has been shown to be superior to non-simulation based training for responding to medical emergenices.1 Courses such as advanced cardiac life support (ACLS) utilize simulation to help prepare medical professionals for emergency situations.1 One study by Bastin and colleagues found that pharmacy residents self-reported preparedness for high-stress, high-impact clinical scenarios and medical emergencies was increased by simulation training.1 As a pharmacy student, I participated in a simulation of a public health emergency, where we learned and practiced how to triage patients. I think for many students, emergency medical situations can feel overwhelming and having the opportunity to practice them in a simulated environment can help decrease the anxiety of responding to these situations.

However, the use of simulation as a learning tool can be applied outside emergency situations. A study conducted by Curley and colleagues in New Zealand found that simulation experience could be utilized as a beneficial interprofessional learning experience.2 In their study pharmacy students worked alongside nursing and medical students to assess patients in an acute care hospital setting. They found pharmacy students reported increased confidence in their ability to verbalize recommendations to the team as well as better understanding of their role within the medical team.2 Simulations like this can help increase interprofessional cooperation and help pharmacy students practice interacting with the medical team prior to clinical rotations. By better understanding their role and the role of other medical professionals within the team, students can be better prepared to communicate effectively with their peers. I think this also offers an opportunity to demonstrate to other medical professionals the role and positive impact pharmacists can have on the medical team.

Simulations can be used in many other creative ways as well. One study by Berthod and colleagues utilized an escape room simulation to teach good manufacturing practices.3 Another point made by Basin and colleagues was that they had PGY2 emergency medicine resident’s lead the simulations which not only enhanced their knowledge but also developed their leadership and teaching skills.1There are opportunities to utilize residents or older students for layered learning.

There are other examples out there of using simulations for community pharmacy practice, good-manufacturing, medication error root-cause analysis etc. I think the use of simulations within pharmacy education can help students further apply the knowledge they have in a low-stakes environment. This allows students to become more comfortable and confident in their role as a pharmacist prior to advanced pharmacy practice experiences (APPE). I think this is useful for us to try and utilize simulations in our teaching practices. Maybe we have a patient case that we experience this year that would make an excellent learning opportunity in the future. I think these studies demonstrate that the ability to practice improves student learning and can be utilized in a variety of courses. Also, as more courses shift from traditional didactic lectures to hands-on case-learning or flipped classrooms, understanding how to utilize simulations and drawing upon these examples may be very beneficial.

References:

1. Thompson Bastin ML, Cook AM, Flannery AH. Use of simulation training to prepare pharmacy residents for medical emergencies. Am J Health Syst Pharm. 2017 Mar 15;74(6):424-429. doi: 10.2146/ajhp160129.

2. Curley LE, Jensen M, McNabb C, et al. Pharmacy Students' Perspectives on Interprofessional Learning in a Simulated Patient Care Ward Environment. Am J Pharm Educ. 2019;83(6):6848. doi:10.5688/ajpe6848

3. Berthod F, Bouchoud L, Grossrieder F, Falaschi L, Senhaji S, Bonnabry P. Learning good manufacturing practices in an escape room: Validation of a new pedagogical tool. J Oncol Pharm Pract. 2020 Jun;26(4):853-860. doi: 10.1177/1078155219875504.

Virtual Reality Technology in Education

Obieze Eze, Pharm.D,

University of Maryland Prince George’s Hospital Center

Virtual reality (VR) is a concept that has been at the forefront of technological advancement for many years. However, it has only been in recent times that it has tried to position itself into mainstream applications. Its importance and versatility only become more and more apparent as it finds more opportunities to enhance our daily lives. One of those areas that virtual reality has started to cement its potential in is education. VR technology has been implemented in quite a few ways, from virtual reality field trips to game-based learning.6

An article titled “10 Ways Virtual Reality Is Already Being Used in Education,” highlights some of the many ways that virtual reality has taken shape in education.6 It starts off with the mention of one of the most popular applications of VR technology for learning, known as Virtual Field Trips. These field trips are accomplished with the use of Google Expeditions, a free app download on iOS or Android and the utilization of Cardboard VR headsets that the smartphone is placed inside of. These are low cost headsets that make the realm of virtual reality much more easily accessible to a broader range of schools, as VR headsets can range greatly in price and features. The combination of these technologies has allowed students and teachers to be transported to parts of the globe previously deemed unreachable, such as the peak of Mt. Everest and the depths of the ocean.

Special needs education is another area where VR is starting to find a home and make an impact. The Jackson School for Special Needs Students in Victoria, Australia has been using the Oculus Rift headset with its students in the classroom.2 There, the Technology and Special Education Instructor, Mathieu Marunczyn, noted that meditative virtual reality apps that explore the stars and planets have had a calming effect on his students, many of whom have some form of autism. Marunczyn also stated that the headset has helped spark the imaginations of his students, in addition to giving them the visual insight that they otherwise would have never received. The example he uses is how VR lets his students peek inside of an Egyptian temple or view a jet engine, which gives them a better understanding of how it is put together, making his instruction more hand-on.

In the wake of the current pandemic, online or distance learning has increased tremendously in the past few months.3 This is a major area where virtual reality has potential to shape the landscape of learning. The Stanford School of Business is already offering a certificate program that is delivered entirely through virtual reality. Meanwhile, the University of British Columbia Law School is offering students the ability to enjoy VR lectures using a VR social application called VR Chat. “The application provides virtual online chat spaces where students with a VR headset can project themselves and interact with lecturers and other students.” A study conducted by researchers at Penn State University even showed that this technology can improve learning outcomes for online students.6

Other implementations of the technology in schools is through skills training. This gives students the opportunity to learn and practice important tasks without the risk of dealing with an uncontrolled and/or an unfamiliar environment, leading to fewer potential mistakes while providing a deeper level of understanding of the skill just learned. There was a study conducted by Google’s Daydream labs which found that people who received VR training learned faster and better than those who were solely shown video tutorials.5

The article showcases a few other avenues that VR has found its way into, such as language immersion and virtual campus visits, and more. The Journey of Medical Systems discusses VR application in the example of using it to see through the skin, organs and muscles, to be able to visualize the complexity of the area to be operated. In their article, it is stressed that one of the advantages to virtual reality is having the ability to repeat processes and tutorials as many times as desired, unlike in the real world with limitations of patients, time, resources, etc.3 In my own experience, VR technology is already starting to find its way into pharmacy school curriculums. I was fortunate enough to help facilitate a research project that focused on integrating VR videos into pharmacy course material. This was for the purpose of making interactive and immersive tutorials on topics ranging from how to properly check a patient’s blood glucose via finger stick testing, to proper handling of laboratory equipment and materials in a safe and productive manner underneath a laboratory hood. In addition to that, we were able to have a VR video showcasing a tour of the College of Pharmacy and highlighting many of the opportunities available to students upon admission to the school.

I believe that this marrying of technology and education has the potential to greatly enhance the way we tackle learning. Virtual reality is rapidly becoming a staple in academia and will continue to further cement itself as having an integral role in how and at what pace we learn new information. We as educators should try to find even more ways to integrate VR, in order to foster the advancement of learning by our students.

References

1. Babich, Nick. “How VR Education Will Change How We Learn & Teach: Adobe XD Ideas.” Ideas, 19 Sept. 2019, xd.adobe.com/ideas/principles/emerging-technology/virtual-reality-will-change-learn-teach/.

2. Herold, Benjamin. “Oculus Rift Fueling New Vision for Virtual Reality in K-12.” Education Week, 21 Feb. 2019, www.edweek.org/ew/articles/2014/08/27/02oculus.h34.html.

3. Izard, S.G., Juanes, J.A., García Peñalvo, F.J. et al. Virtual Reality as an Educational and Training Tool for Medicine. J Med Syst 42, 50 (2018). https://doi.org/10.1007/s10916-018-0900-2

4. Li, Cathy, and Farah Lalani. “The COVID-19 Pandemic Has Changed Education Forever. This Is How.” World Economic Forum, 29 Apr. 2020, www.weforum.org/agenda/2020/04/coronavirus-education-global-covid19-online-digital-learning/.

5. MacGillivray, Ian. “Daydream Labs: Teaching Skills in VR.” Google, Google, 20 July 2017, www.blog.google/products/daydream/daydream-labs-teaching-skills-vr/.

6. Stenger, Marianne, et al. “10 Ways Virtual Reality Is Already Being Used in Education.” InformED, 28 Oct. 2017, www.opencolleges.edu.au/informed/edtech-integration/10-ways-virtual-reality-already-used-education/.

Race in the Classroom

Ebony Evans, PharmD

PGY2 Ambulatory Care Resident 

University of Maryland

For a large proportion of American history, the majority of students present in public schools were white, however, that is no longer the case. That being said, while the number of minority students in the public school system is increasing, to now being the majority, the diversity of the teaching force has not kept up, and has remained majority white1, despite research indicating that a diverse teaching staff benefits students of all races, and that Black students specifically see benefits from having even just one Black teacher2. There are several reasons for the disparity in diversity of students as compared to teachers, such as hiring bias and lower retention rates of teachers of color1, however, that is not the focus of this article. The discussion here today is on how to maneuver within these constraints to assure that not only are minority students not being negatively impacted by the lack of diversity in educators, but also to ensure that the health care professionals being prepared to enter into the workforce are able to adequately care for their increasingly diverse patient populations.

It is important for teachers to go out of their way to understand and use cultural differences to benefit their students3, as opposed to ignoring or trying to diminish them. It is imperative that educators encourage students of different backgrounds to embrace and positively identify with their backgrounds and identity by learning to teach to them, instead of forcing all students in a classroom to be cookie cutter learners and simply teaching at them. By ignoring race or pretending not to see color as an educator, you’re failing your students and potentially preventing them from reaching their truest potential. To clarify, this is not implying that minority students need to be coddled, or that they should have lower expectations help for them, but simply that they do often experience the world different, and thus learn and understand things differently.

Being a minority in a classroom isn’t only evident to students when looking at their peers, or even their teachers, but also when looking at what and how they’re being taught. You might think this is most prevalent in younger grades or humanistic classes, but it’s also very prevalent in graduate level health science courses. Although specifically referencing medical students, the article “Teaching medical students to challenge ‘unscientific’ racial categories” does a great job of shining a light not only on how racial stereotypes can be reinforced in the classroom, but how those can then in turn affect patients4. In terms of healthcare, it’s important for race to be taught as a social stratification, not a biological category. There are two good examples in this article of when the ideal method of teaching race in healthcare was not exemplified, and that’s in professors teaching sickle cell as a “Black disease”, and even using different formulas to measure lung and kidney function for different races; or even something from my personal experience as simple as not using pictures of a single person of color in a PowerPoint lecture on dermatology that was completely full of pictures. Health care professionals have a very powerful role in society, so it’s important that their educators don’t dance around the subject of race when teaching, but they discuss it directly. Many healthcare professionals go to school because they want to make a difference, to help people, and many often cite their desire to specifically help undeserved or minority populations… it’s important for students to be taught how to do that.

References

1. Laura Fay. The State of America’s Student-Teacher Racial Gap: Our Public School System Has Been Majority-Minority for Years, but 80 Percent of Teachers Are Still White. The 74 Million. https://www.the74million.org/article/the-state-of-americas-student-teacher-racial-gap-our-public-school-system-has-been-majority-minority-for-years-but-80-percent-of-teachers-are-still-white/. Published August 2018. Accessed October 2020.

2. Matt Barnum. The Power of One: New Research Shows Black Students See Big Benefits From a Single Black Teacher. The 74 Million. https://www.the74million.org/article/the-power-of-one-new-research-shows-black-students-see-big-benefits-from-a-single-black-teacher/. Published April 2017. Accessed October 2020.

3. Larry Stauss. I'm a white teacher with a classroom of minority students. Here's how I teach across race. USA Today. https://www.usatoday.com/story/opinion/voices/2020/01/16/teaching-shortage-education-race-minority-column/4419331002/. Published January 2020. Accessed October 2020.

4. Ike Swetlitz. Teaching medical students to challenge ‘unscientific’ racial categories. Stat News. https://www.statnews.com/2016/03/10/medical-schools-teaching-race/. Published March 2016. Accessed October 2020.

Learning by Teaching

Shawn Coffeen, PharmD

PGY1 Pharmacy Resident 

MedStar Montgomery Medical Center

Take a moment to think back to when you were a student in pharmacy school on one of your first clinical rotations. You might have been told that you would need to do a presentation to an audience outside of your peers. It did not matter if the room was full of practicing pharmacists or full of high school students that knew nothing about pharmacy, you were likely nervous and questioned if you knew the material well enough to teach it. However, you still relied on your prior knowledge to start the early stages of preparing for the presentation. The next step involved doing your own research to prepare the presentation and increase your knowledge for potential questions that might be asked. Overall, at the end of presentation you knew a lot more about the subject than you did before. This process of learning new material through teaching others is known as learning-by-teaching. The purpose of this blog post is to explore recent literature regarding learning-by-teaching.

The effectiveness of this method has been studied over the years. One involved students studying a short lesson on the Doppler Effect with the expectation of later teaching the learned material. Those students were compared to students that did not have that expectation. Paper-based comprehension test was used to assess each groups understanding of the subject. Both groups were provided the same amount of time to learn the material. At the end of the short lesson the teaching group scored on average 8.7 out of 13 possible points. This was higher than the control group which had an average score of 6.2 and this difference was statistically significant. This difference persisted even after 1 week from the lesson with average score of 2.3 points higher than the control group. This study demonstrated the impact of learning-by-teaching is observed even in the setting of a short lesson. Authors of this study suggested that the expectation of teaching encouraged learners to select the most relevant information from the lesson, organize it into meaningful representation, and integrate it with prior knowledge.1

A very similar experiment was completed by the same investigators to further examine the impact of learning-by-teaching. Simple and enhanced lessons of the Doppler Effect were used this time. Authors found that students that had the expectation to teach outperformed those that only expected an exam, regardless of the lesson. Additionally, the authors studied if the teaching effect was strongest in those that prepared to teach or prepare for test before teaching. Half of the students in each group did not perform the act of teaching to further assess if the act of teaching influences performance. It was found that those that prepared to teach and taught outperformed all other groups with a statistically significant difference of about 15% on the delayed exam. This demonstrated that the additional time with the material through teaching did not impact observations in previous experiments. It was the act of teaching coupled with teaching that impacts long-term learning the most.2

It is obvious that teaching has an impact on learning based on these experiments. Preparing to teach impacts short term learning while the combination of preparing to teach with the corresponding action increases long-term learning. The results of these experiments were not unexpected. If you think back to that teaching experience from pharmacy school, you may still remember a lot from it. Now if you were to reflect on material you learned from earlier in pharmacy school like the Krebs Cycle, which your ability to understand was assessed through testing, it is likely that you may not remember much about it. In fact, you may have to look up the actual cycle and review it to be able to effectively recall information about it.

The question is what to do with this information. I suggest that more teaching experiences become offered to students to increase their learning. It does not matter if it is a traditional education setting like a university or untraditional setting involving patients. These experiences do not require large audiences. All that is recommended is setting the expectation of teaching on the learner and have them teach you or others. I personally will be setting the expectation on my patients in a diabetes bootcamp program to teach me how to use their glucometer and what the results mean in later visits.

References:

1. Fiorella L, Mayer RE. The relative benefits of learning by teaching and teaching expectancy. Contemporary Educational Psychology. 2013 Oct 1;38(4):281–288.

2. Fiorella L, Mayer RE. Role of expectations and explanations in learning by teaching. Contemporary Educational Psychology. 2014 Apr 1;39(2):75–85.

The Grading System in Education

Jaden Dickinson, PharmD

VA Maryland Health Care System

The education grading system was implemented over 300 years ago when European universities needed a ranking system to evaluate participants for a tournament.1 Since then, this idea of assigning and ranking students has spread worldwide as a means for evaluating one’s performance and learning. Letter and number grades have been the mainstay on how students are assessed and evaluated for acceptance into higher education.  While this way of assessing learning gives some insight into the knowledge a learner has gained, it is not the most effective means of doing so. By assigning a number/grade to students, this drives conflict, lowers motivation for learning, creates higher stress levels and learning outcomes are less likely to be achieved.1,2  

Our current A-F and percentage grading system leaves room for disagreement on grades and creates conflict between the learner and teacher.1 While A-F is a five rated gradation, it is defined by a number. The more gradations possible the more disagreement is likely to occur, especially if expectations are not laid out prior to assessment of the learner. The greater the likelihood for disagreement on a grade, the greater the potential for conflict to arise. Stress over grades can be related to goals one has in the future, whether it be acceptance into college, receiving a scholarship/award, etc. The lower the grade a student receives, the more likely they are to disagree with the rater and appeal their grades, even when it may not be justified. Resorting to this type of conflict hinders the relationships that students build with educators and creates an unhealthy environment for both parties.

Changing the educational grading system to one of mission-based or rubric-based outcomes motivates students to learn and excel.1-4 The current grading system does a poor job of assessing whether each learning outcome has been achieved. In other words, awarding a student an A doesn’t necessarily mean all the learning objectives were met, it is more related to task-completion. How can a letter grade assess each objective/outcome, and if so, which ones were we assessing? For this reason, many colleges/post-graduate studies have relied less on GPA and more on the whole picture (philanthropy, activities, clubs, etc.). Another way that our current grading system hinders motivation is by creating competition between students and weakening their work ethic. Students know that if they apply this much effort into their education, they will get this for a grade. Middle and higher levels of education are seeing students try to put in the least amount of effort and time to achieve the highest results.3 This may be correlated with cheating or a lazy behavior. Partial credit is a big factor for a student’s motivation to succeed.1 Educators who allow for partial credit encourage students to produce less than satisfactory work while still achieving an acceptable grade. This may be part of what is fueling the lack of motivation for students to put in effort into their education. 

Stress plays an important factor into one’s education, and the intrinsic motivation for success.1 Our current education system puts pressure on the acceptance into colleges for future jobs and financial security. While colleges are slowly moving away from relying on GPA as a means for acceptance, it still plays an important factor. Many students are extrinsically motivated to simply get a good grade, but this does not necessarily mean they are truly motivated to learn. Implementing a mission-based or objectives-based grading system would evaluate students on each aspect of the outcomes and where they stand in each category. While stress would always play some role, students may find relief knowing that they are responsible for their grades. Having a system where a student is assessed on a rubric for how they meet each objective gives a clearer picture of how they can achieve the results they want while allowing for reflection and feedback from the instructor. The focus then becomes less about points, and more about meaningful ways to expand on learning. A rubric allows for less room to disagree on performance, either you didn’t, did or exceeded expectations. In the end, this can reduce stress on the student for not relying on a number to decide whether some objectives were questionably met or not, and less stress on the instructor due to less confrontation and disagreement on progress.

Overall, converting from a number-based to an outcomes/mission-based grading system promotes motivation and a healthier learning environment for teachers and students.1,2  Our current education system is a long way from seeing this change, but it can be seen in certain medical professional programs or areas where you are assessed based on actions. Here, learners are given a specific rubric with criteria for each category of meeting objectives. Rating criteria that is explicitly laid out leaves little room for interpretation and is clearly defined. Rather than focusing on grades, students can work on evaluating how they learn and implement feedback. This relates directly to future education and how to ensure students are getting the most out of their learning experiences. As a potential future educator, I want to move away from this idea of assigning numbers based on work. Pharmacy and medical programs specifically have implemented this type of rating for students when evaluating patient interactions. Students are assessed on whether they met the requirements or not. This practice of grading is clear, and students can take the feedback presented and apply it to future experiences. Changing our current educational grading system to one of objectives and outcomes can increase student motivation, especially when it is not defined by a letter or number grade. 

References: 

1. Nilson, L., 2015. Specifications Grading: Restoring Rigor, Motivating Students, And Saving Faculty Time. Sterling, VA: Stylus Publishing.

2. Barton A, Thomas W. A New Take on Traditional Grading System. National Association of Independent Schools. https://www.nais.org/magazine/independent-school/summer-2017/remaking-the-grade/. Published 2017. Accessed October 13, 2020.

3. Parrish Morgan A. Is It Time to Reexamine Grading?. JSTOR Daily. https://daily.jstor.org/is-it-time-to-reexamine-grading/. Published 2020. Accessed October 13, 2020.

4. Brookhart SM. Chapter 2. Grading on Standards for Achievement. In: How to Use Grading to Improve Learning. Alexandria, VA: ASCD; 2017. 

Bilingual Education: An Opportunity for Cultural Diversity in the Classroom

Danielle Rogers, PharmD

PGY1 Pharmacy Resident

Children’s National Hospital

Bilingual education is defined as the teaching of academic content in two languages, in a native and second language.1 Varying amounts of each language are used depending on the outcome goal of the model. There are different program models used in bilingual education. A transitional model involves the use of a child’s home language when the child enters school, and later changes to the use of the school language only.2 The goal of this model is to transition students into an English-only classroom quickly. Maintenance bilingual education is another model that involves using the child’s home language when the child enters school, and then gradually changes to the use of the school language for some subjects and the native language for teaching other subjects.2 As the United States continues to become more diverse, with 18.4% of the population identifying as Hispanic or Latino, our education system must evolve as well.3 

As I progressed through professional school and begin to interact with patients, I quickly realized that a classroom that offered bilingual education would prove useful for interactions with patients who do not primarily speak English. Medical education focuses on teaching students to be sensitive and aware of other cultures, but we are not exposed to other languages in regard to communication skills and vocabulary.

The growing diversity of the United States provides an opportunity for medical education to amplify cultural diversity in the classroom to better prepare medical professionals for interactions with non-English speaking patients. By implementing bilingual education during professional school, students will be more prepared to provide optimal care. Counseling, medication reviews, and screening patients in their native language will allow for patient satisfaction, increased compliance with medications, and a sense of comfort that the healthcare provider is aware of other cultures.4

The number of non-English speaking residents continues to rise across the nation, the medical community must continue to meet the demand for bilingual or multilingual health care practitioners. Practitioners who speak multiple languages say that they have seen benefits in patient care, as well as personal benefits.4 When applying to medical residency programs, a medical student stated that she was sought out by various programs for her linguistic abilities. Regarding patient care, it has been said that knowing a patient’s language helps you build trust and a connection with your patients.4 This trust can lead to better patient outcomes and improved patient satisfaction.

References:

1. “The Benefits of Being Bilingual.” PracticeLink Magazine, 13 Jan. 2010, journal.practicelink.com/featured/the-benefits-of-being-bilingual/.

2. “Bilingual Education - What Is the Definition?” Renaissance, www.renaissance.com/edwords/bilingual-education/.

3. “Census Data.” Data.census.gov, data.census.gov/cedsci/profile?q=United+States.

4. Kamenetz, Anya. “6 Potential Brain Benefits Of Bilingual Education.” NPR, NPR, 29 Nov. 2016, www.npr.org/sections/ed/2016/11/29/497943749/6-potential-brain-benefits-of-bilingual-education.

The use of electronic health records (EHR) technology in pharmacy curriculum

Megan Fuller, PharmD, MS

PGY-1 Pharmacy Resident

University of Maryland Prince George's Hospital Center

Learning to navigate through an electronic medical record (EHR) can be daunting for any student and while becoming proficient in healthcare technology is a must for those pursing certain careers in healthcare, it takes time and practice in order to fully become comfortable navigating through different systems and networks. 

Medication reconciliation is one of the National Patient Safety Goals set forth by The Joint Commission1. It is defined as a process of comparing the medications a patient is taking (or should be taking) with newly ordered medications1. Poor, or lack of, medication reconciliation constitutes a significant risk for medication discrepancies that can result in adverse drug events, and it has been shown that pharmacist involvement in admission and discharge medication reconciliation can significantly reduce medication errors. However, this requires students not only know how to appropriately gather information, but to also understand how to effectively navigate through electronic health technology as well. 

The goal of meaningful use technology is to improve clinical outcomes by reducing errors related to the patient’s medications through the use of electronic health records (EHR) technology2. In an era where 95% of critical access Medicare hospitals participate in meaningful use technology, and Medicare and Medicaid programs have now offer financial incentives to hospitals and providers that utilize meaningful technology, it is essential for pharmacy students to have exposure to electronic health records (EHR) technology prior to graduating given its high use in the real world2. While advanced pharmacy practice experiences (APPEs) provides students access to EHR technology throughout the year, students are extremely limited given they cannot legally perform final verification checks and the concern for patient safety and privacy, which is where simulation and order verifications activities can bridge the gap2.

Simulation exercises have the potential to provide a more in depth learning experience for students, which has the impact to improve learning outcomes and enhance performance for students not just on APPEs, but also in the classroom. Prior to EHR simulations, many students had reported feeling inadequate with regards to EHR technology. For example, a University reported that approximately 70% of their pharmacy students had stated having some experience in using HER technology, but still possessed low confidence when having to perform typical pharmacist duties3. 

Previous studies on EHR technology in pharmacy describes its use primarily for collecting subjective and objective data in order to develop assessments and plans for SOAP notes2. In 2019, the American Joint Task Force on Informatics (AACP) recognized that EHR technology played a vital role in the pharmacy curriculum and could be used as a tool to ensure new pharmacy graduates are prepared for their duties when “Fulfilling a mediation order4.” 

Recent studies have taken a closer look at EHR simulations to determine their effectiveness in the pharmacy curriculum. In 2018, a prospective study conducted in a cardiovascular therapeutics course set out to evaluate the impact virtual EHR technology had on students capabilities compared to patient based scenarios alone. Students were randomized to use a virtual EHR with patient simulation or to a patient simulation alone. The efficiency of learning was assessed by the time to optimal recommendation for each scenario. The use of the virtual EHR decreased the amount of time needed to provide the optimal treatment recommendations by 25% compared to the control2. The virtual EHR also significantly improved students’ perceptions of their clinical skills, communication, and satisfaction compared to the patient simulation alone2. The virtual EHR established value in learning productivity while also providing students the opportunity to engage with technology comparable to the technology in today’s health care practice2. 

There have been various studies at other institutions, such as McWhorter School of Pharmacy, Concordia University Wisconsin, and even the University of Maryland that have all demonstrated significant changes in performance and confidence in pharmacy students after exposure to simulated EHR technology5. As the field of pharmacy and healthcare continues to change and become more technologically advanced it is crucial that the pharmacy curriculum takes every opportunity to ensure its students can keep up with an ever changing field. 

References:

1. Barnsteiner JH. Medication Reconciliation. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 38.

2. Ives AL, Tucker SR, Trovato JA. Using Electronic Health Record Technology to Teach Inpatient Medication Order Verification to Pharmacy Students. Am J Pharm Educ. 2020;84(8):ajpe7534. doi:10.5688/ajpe7534

3. Coons JC, Kobulinsky L, Farkas D, Lutz J, Seybert AL. Virtual Electronic Health Record Technology with Simulation-Based Learning in an Acute Care Pharmacotherapy Course. Pharmacy (Basel). 2018;6(4):123. Published 2018 Nov 28. doi:10.3390/pharmacy6040123

4. Haines ST, Pittenger AL, Stolte SK, et al. Core entrustable professional activities for new pharmacy graduates. Am J Pharm Educ. 2017;81(1):ArticleS2

5. Skelley JW, Wulz JL, Thibodeaux AM. Implementation of an electronic medical record simulation activity aligned with the Pharmacist Patient Care Process in an ambulatory care elective course. Pharm Educ. 2018;18(1)91-98

Breaking the Cycle of Imposter Syndrome

Samantha Minnick, PharmD 

PGY2 Pharmacy Resident 

Children’s National Hospital

Have you ever felt as though you don't deserve to have your career or educational success? Potentially doubted your own knowledge or skillset; waiting for those around you to discover you're an "imposter" among the group? Like you are waiting for the shoe to drop and be "discovered" for who you really are? If you can relate to any of these concepts you may have experienced a phenomenon called imposter syndrome.

im·post·er syn·drome: (noun Psychology) 1. anxiety or self-doubt that results from persistently undervaluing one's competence and active role in achieving success, while falsely attributing one's accomplishments to luck or other external forces.¹

Pauline Rose Clance and Suzanne Imes from Georgia State University first described "imposter phenomenon" in 1978 through their work in psychotherapy with highly educated women who possessed PhD's, scholastic honors or were respected professionals in their field of work.² They discovered a trend where these women, albeit very successful, did not possess an internal sense of success. They frequently described feeling like an "imposter", being wrongfully admitted to a graduate program, strongly feeling as though they were not as intelligent as others praised them to be and that their success was from luck alone. These women were more likely to project their successes onto a temporary quality or an external factor such as "good timing" or "luck", where men were more likely own their success and experience this imposter phenomenon both less frequently and with less intensity. The authors deemed this imposter phenomenon was mostly plaguing middle class, white women who were high achieving and well accomplished when compared to men.² As the years went on Clance and other researchers acknowledged that these feelings of self-doubt and being underqualified were not unique to women and also affected men at similar rates.³  

Imposter syndrome also affects instructors, specifically higher education instructors, instructional designers and those within an academic system. Kristi Owens, an Idol Courses academy member and instructional designer, conducted an anonymous survey across LinkedIn and Facebook to determine how many other shared the feelings of Imposterism she so frequently felt despite 15 years of experience in education.⁴ The survey population included those from higher education, finance, healthcare, corporate and government job settings to name a few. Nearly 40% of the study population had functioned as an instructional designer for 5 to >10 years, another 40% had practiced for 1-5 years. The results showed that 2/3 of instructional designers who were surveyed reported feeling Imposterism at least once per month.  Those in healthcare instructional design reported feeling Imposterism once per week (30%) or every day (~40%). This group had the highest percentage of experiencing feelings of Imposterism every day.⁴ This is a pivotal statistic to consider as a group of learners actively pursuing a role in instructional design within a healthcare setting. If we ourselves are struggling with feelings of self-doubt or lack of belief in our success it could be extremely difficult to provide the confidence and support we need for our learners.

Maqsood and colleagues presented a cross sectional analysis in the International Journal of Research of Medical Sciences in 2018 to evaluate the frequency and severity of imposter syndrome experienced by medical students to assist in improving teaching and learning methodologies.⁵ The Clance Imposter Phenomenon Scale was used to assess the severity of imposter syndrome among participants. This scale helps to identify common behaviors or thoughts that are seen in imposter syndrome such as perfectionism, fear of failure, overworking and saying phrases such as "I just got lucky" to discredit their achievements. A total of 189 (94.5%) students completed the questionnaire, 38% had moderate severity and 54.5% had severe imposter syndrome. Male students accounted for a larger percentage in both the moderate and severe categories (70.8% and 68.9%) compared to women. Which is an interesting statistic when comparing the rates of imposter syndrome to the original research of Clance and Imes. Imposter syndrome in the setting of medical training can alter learning styles, student participation when compared to those unaffected and reduce the efficiency of a learners work or lead to burnout.⁵ Pharmacy students have only been explicitly described within one study from Henning et al, that surveyed a multidisciplinary school which included nursing, medical and pharmacy students. This study reported 30% of that surveyed reported experiencing imposter syndrome.⁶       

As educators and high achieving members of our fields we have the opportunity to assist our learners in identifying these feelings and providing resources for them to combat these feelings of self-doubt. Much of the recent research surrounding imposter syndrome does provide resources on how to identify and combat feelings of imposter syndrome as instructors, for ourselves and our learners. Some opportunities to overcome imposter syndrome as an educator is to change our own narrative; to tell ourselves instead of "I don't know anything" but rather "I may not know this, but I am capable of finding the answer".⁷ Another opportunity is to use the resources we all have readily available; be it literature, group forums, colleagues or past mentors. This will allow you to explore information you may already know or to find answers you knew you needed. For our learners, it will be crucial to recognize the student population we are engaging with and to recognize the possibility for feelings of imposter syndrome and to design classes or educational opportunities that directly work against behaviors we have discussed above that reinforce imposter syndrome. Examples could include; working in smaller groups to ease the fear of being incorrect, focusing on strengths of the learners to build confidence and a rapport rather than being solely critical of mistakes and to encourage discussion that will allow for a collaborative thought process between peers that can empower those with more self-doubt. By advancing the conversation surrounding imposter syndrome, it will bring with it an increased awareness and an increased acknowledgement of what changes need to occur to break the cycle of these intrusive and self-doubting thoughts.

References

1. Dictionary.com; https://www.dictionary.com/browse/impostor-syndrome

2. Clance PR, Imes S. The imposter phenomenon in high achieveing women: dynamics and therapeutic intervention. Psychotherapy Theory, Research and Practice. 15(3): 1978

3. Dalla-Camina M. The Reality of Imposter Syndrome. Psychologytoday.com. Sep 03, 2018.

4. Olivia K. Do you feel like an imposter? You're in good company. Idolcourses.com. Aug 2020 https://www.idolcourses.com/blog/Imposter

5. Maqsood H et al. The descriptive study of imposter syndrome in medical students. Int J Res Med Sci. 6(10): 3431-3434. 2018

6. Boyle JA, Bonenfant SE. The fear of being found out in pharmacy: how imposter syndrome may be holding us back. Pulses. Published: Jul 23, 2019.

7. Schock G. How imposter syndrome affects students - and instructors. Today's Learner/ Insight for Educators. https://todayslearner.cengage.com/how-imposter-syndrome-affects-students-and-instructors/

Standardized Testing and Predictions for Success in Pharmacy Education

Marisa Rinehart, PharmD

PGY-1/PGY-2 Pharmacotherapy Resident

University of Maryland School of Pharmacy

Standardized testing is an overwhelmingly large part of the American education system. The first form of standardized testing dates back to 1845 as a part of the educational reform that occurred during this time period. Utilization of standardized testing took off in the era of war, as a way to categorize the US military members in World War I. Around the same time, the approval of standardized testing by the National Education Association led to a rapid increase in the development of these assessments. Later in 1935, the invention of scoring machines drastically improved efficiency and decreased costs of tests, further increasing their popularity. Under the Reagan administration, the need for educational reform became a political topic, leading to the passing of many “reforms” that we have today, i.e. No Child Left Behind and Race to the Top. The one common factor that can be seen in all of these education reforms, is the focus on assessing math and reading through standardized testing. It is through these test scores that students are able to be compared.1

On the basis of comparing students, standardized testing is the simplest and easiest formula to use, however it’s not a perfect system. The limitations stem from the lack of evidence supporting standardized tests as an effective measure of learning, as well as the inequality when looking at differences in resources. On the reverse side, these scores allow schools to compare their student bodies and in theory help to motivate students to perform better.2 The standardized tests that come to mind when relating this concept to pharmacy school are the Pharmacy College Admission Test (PCAT), the Pharmacy Curricular Outcomes Assessment (PCOA) and the North American Pharmacist Licensure Examination (NAPLEX). The PCAT exists to determine an individual's likelihood of success in the science based curriculum of pharmacy school. There is no “passing score” for this exam, rather colleges have the flexibility to set their own minimum score for admission applications.3 The PCOA is used to assess students’ knowledge obtained in pharmacy curriculum, and is used in accreditation.4 The NAPLEX was created to determine if pharmacy school graduates are competent enough in the profession to gain a license and practice as a licensed pharmacist.3

The three of these exams have been included in many studies assessing outside factors that can help to predict scores, ultimately attempting to predict passing of the NAPLEX.3-6

Firstly, when looking at the PCOA and PCAT, an article published in the American Journal of Pharmaceutical Education showed that higher PCAT scores, higher undergraduate science GPA and higher cumulative pharmacy GPA correlated to higher PCOA scores. Interestingly, when looking at those who struggled academically, there was a negative correlation (lower PCOA scores) for those students who had academic issues that required them to appear before the college’s progression committee but were not required to repeat course content when compared to those with no academic issues. For the student who repeated course content, their scores did not significantly differ from students with no academic issues.4 

Next let’s take a look at NAPLEX pass predictors. Both higher GPAs and PCOA scores are associated with passing NAPLEX scores. Appearing before the academic review committee, as well as repeating didactic courses is associated with decreased likelihood of passing the NAPLEX. There are also demographic factors that play into NAPLEX pass rates. First-time pass rates are higher in universities within academic health centers, universities established before 2000, public universities, and universities utilizing traditional (4 year) structures.4-6 One of the most significant results from this literature I found was that the success of students who match for PGY1 residency is a strong predictor of first-time NAPLEX pass rates.5 As all of this literature is fairly recent (published in or after 2019), I am interested to see what further studies surface in this area, and if and how pharmacy curriculum changes as a result.

This information can be used in many ways by pharmacy school educators. Overall, our goal is always the success of our students. With these shown correlations, modifications to curriculum can be made to better prepare students for success. Secondly, knowing that those who struggle academically have poorer chances of success can prompt intervention at an earlier time for these students. By having these trends, it allows us as educators to identify those students who may be struggling, intervene, and possibly change the outcomes. By knowing what factors have a negative impact on pass rates, universities as a whole can then modify curriculum to address these factors.

References:
1. Maranto, J. H. (2015). The effect of standardized testing on historical literacy and educational reform in the U.S. academic leadership. Journal in Student Research, (3).
https://files.eric.ed.gov/fulltext/EJ1062724.pdf

2. Kamenetz, A. (2015). The test: Why our schools are obsessed with standardized testing— but you don't have to be. New York, NY, US: Public Affairs Books.

3. Laurenzo, A. (2009). PCAT and NAPLEX: An Overview. US Pharm, (34), 9-11. https://www.uspharmacist.com/article/pcat-and-naplex-an-overview.

4. McDonough, S., Spivey, C., & Chrisholm-Burns, M. (2019, March). Examination of Factors Relating to Student Performance on the Pharmacy Curriculum Outcomes Assessment. American Journal of Pharmaceutical Education, 83(2). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448514/

5. Williams, J., Spivey, C., & Hagemann, T. (2019, August). Impact of Pharmacy School Characteristics on NAPLEX First-time Pass Rates. American Journal of Pharmaceutical Education, 83(6). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6718508/

6. Spivey, C., Chrisholm-Burns, M., & Johnson, J. (2020, February). Factors Associated with Student Pharmacists’ Academic Progression and Performance on the National Licensure Examination. American Journal of Pharmaceutical Education, 84(2). https://www.ajpe.org/content/84/2/7561

Mentorship: A Source of Motivation in Andragogy

Elodie Tendoh, PharmD, MSc.

PGY-1 Pharmacy Resident

University of Maryland Baltimore Washington Medical Center

“A mentor is someone who allows you to see the hope inside yourself” Oprah Winfrey During my time in pharmacy school, I was met with many opportunities that required me to make critical decisions and there were many people who trusted me and gave me the confidence l needed to pursue the opportunities that came my way. In my second year, one of the student leaders motivated me to pursue a leadership position which I thought of as a being above my capabilities. This fellow student saw in me what I couldn’t see in myself and encouraged me to pursue the opportunity. Because I trusted this senior student’s observation, I accepted the challenge. This exposed me to numerous opportunities and taught me skills that aided in my professional and personal development.

Andragogy which is defined as the art and science of adult learning sets expectations for learners to excel in their learning experience through intrinsic and extrinsic motivational factors1. Stephen Pew in his article on pedagogy and andragogy as foundational theory for student’s motivation discussed the importance of intrinsic motivators in andragogy and their role in fostering the learner’s ability to employ strategies that demand more effort and enable them to process information more deeply1. Mentorship plays a vital role in nurturing these intrinsic learning behaviors.

Fruiht and Chan, in their study on naturally occurring mentorship in a national sample of first-generation college goers, found that this was a promising portal for academic and developmental Success2. The study had 4181 participants and their primary objective was to find a significant interaction between having a parent who attended college with having a mentor. They expected that mentoring would moderate the relationship between parental educational attainment and one’s own educational attainment. They also compared the primary functions of mentoring relationship in first generation college students to the mentoring functions received by continuing generation students and young people who did not attend college. Seventy-six percent of the participants reported having natural mentors whose role included but not limited to support for goal striving, explicit identity development, and teaching social skills. The participants used words like coach, parent-like, friend, etc., to describe their mentor’s role in their lives.

Having a college degree is important to secure future financial stability and positive developmental outcomes in adulthood3.Parents play a vital role as motivators to their adult children however parents who did not attend college are not able to play this role. That is why mentoring relationships are very important and they have been demonstrated to promote positive academic and developmental outcomes for young people of many backgrounds4. The findings of this study suggest that mentors can serve as compensatory resources to first generation college students. The authors concluded that naturally occurring mentorship relationships equalize the social and cultural capital which young people garner from their communities and it predicts long term academic success.

Pharmacy education recognizes the need for mentorship for both students and junior staff members. Sharif in an article on mentoring in pharmacy education and practice expand on the benefits of mentoring to the mentor and the mentee5. He believes that in a good mentoring relationship, the mentor learns and grows from their mentee as they help them to problem solve and develop professional and personal goals. He also points out the role of peer mentors to pharmacy students, pairing experienced senior students with junior students to ease their integration and aid in familiarizing them with the curriculum and general expectations.

Several pharmacy schools including the University of Maryland Baltimore, the University of North Caroline Eshelman School of Pharmacy, etc. have embraced the role of peer mentors by creating mentorship programs between their students and undergraduates who are interested in pursuing a career in Pharmacy. Creating these personalized relationships foster connections and increase the prospective students access to knowledge ensuring that they make informed decisions.

Mentorship is very important in the development of adult learners whose training and learning is highly dependent on factors such as their level of motivation. Having a mentor who is well accomplished inspires learners and builds the confidence they need to achieve their educational and professional goals.

References:

1. Pew S. Andragogy and Pedagogy as Foundational Theory for Student Motivation in Higher Education. Eric.ed.gov. 2020. https://eric.ed.gov/?id=EJ864274. Accessed October 3, 2020.

2. Fruiht V, Chan T. Naturally Occurring Mentorship in a National Sample of First-Generation College Goers: A Promising Portal for Academic and Developmental Success. Am J Community Psychol. 2018;61 (3-4):386-397. doi:10.1002/ajcp.12233

3. Trostel PA, Chase M. It’s not just the money: The benefits of college education to individuals and to society. Lumina Issue Papers. 2015 Retrieved from https://www.luminafoundation.org/files/resources/its-not-just-the-money.pdf.

4. Miranda-Chan T, Fruiht V, Dubon V, Wray-Lake L. The Functions and Longitudinal Outcomes of Adolescents' Naturally Occurring Mentorships. Am J Community Psychol. 2016;57(1-2):47-59. doi:10.1002/ajcp.12031

5. Sharif SI. Mentoring in Pharmacy Education and Practice. J Pharma Care Health Sys. 2014; 1: e115. doi:10.4172/2376-0419.1000e115

The Arts in a Science Curriculum

Dora Linkoff, PharmD

PGY1 Pharmacy Resident

Children’s National Hospital

The arts have often been viewed as a category outside of science, or even as an opposing force, rather than as a complementary discipline. In an effort to downplay the merits of arts courses within a general education curriculum, critics have argued that the arts are a less lucrative or productive career option. These sentiments are often coupled with, or borne out of, calls for increasing students’ exposure to STEM (science, technology, engineering, and math) education; ultimately, this focus has led to sharp decreases in funding for arts classes in the past decade1. 

This outcome is unfortunate because an education in the arts can help to produce better students. This claim is backed by popular sentiment, as 93% of respondents to a Harris Poll on the attitudes of Americans towards arts education agreed that an education in the arts produces more well-rounded individuals2. This idea that students gain from exposure to arts has also been supported by empirical research in early education, with improvements in students’ reading and language, mathematics, cognitive skills, social skills, and motivation to learn as well as in the creation of a positive school environment2. Arts classes not only serve to enhance soft skills (as is often cited), but provide additional crossover benefits to other subjects such as literacy and math. 

Paralleling findings in younger students, skills cultivated by arts courses are often transferrable into other areas of learning and achievement at a higher level of schooling. One study illustrates this in its finding that high school students who take arts classes have “higher math and verbal SAT scores” compared to students who do not take arts classes1. Specifically, music instruction has been shown to correlate with higher scores on standardized math tests and better performance in grade 12 math classes. This finding has been replicated in students from low-income families as well3,4, which has been proposed to be due to the fact that musical training “emphasizes proportion, patterns, and ratio expressed as mathematical relations.3” There is a scarcity of data on the contributions of the arts to PCAT exam performance, however, aside from an ostensible benefit of English composition on the reading and verbal sections of the PCAT exam.

In addition to increasing performance on standardized testing at a high school level, the arts can serve as a supportive learning environment. In secondary education, a stage where development is critical, the arts can facilitate an environment with “constructive acceptance of criticism and one where it is safe to take risks.2” Studies have shown that high school students who participated in dance perform better than non-dancers in assessments of creative thinking and abstract thought2. Arts also foster a desire to learn via encouraging active participation and engagement, discipline, and persistence.3

These benefits can also be conferred to professional training. In medicine, a background (or at least supplemental courses) in the arts help to foster a “tolerance for ambiguity and individual difference” as well as an insight into and appreciation for an individual’s unique perspective4. For example, as literature “enriches the language and thus the thought processes of practitioners,” it thereby provides a vocabulary with which to articulate a patient’s care4. 

Medicine has been characterized as both an art and a science. Panda (2016) describes the interplay as such: “Medicine…is an applied science, and its practice an art.5” The applied science of medicine refers to medicine’s fundamental purpose in diagnosing and treating disease in an individual, while the art of medicine encompasses the nuanced, empathetic and personalized care of patients, or in other words, the human side of medicine1. This definition encapsulates how clinicians can help understand an individual’s unique circumstances, and identify with a patient’s subjective life experience4. Literature in the pharmacy sphere echoes these sentiments, emphasizing the perceived benefits of coursework in the humanities as cultivating the attributes of “communication, ethics, moral reasoning, and critical thinking abilities” in pharmacy students.6 These attributes directly align with the American Council for Pharmacy Education (ACPE)’s standards for patient care, which include problem solving, patient advocacy, cultural sensitivity and communication.7

Therefore, arts courses have been shown to be beneficial to a range of professional students, refining cognitive and soft skills, and developing an appreciation for nuance and an individual’s humanity. Aside from admitting students who have backgrounds in humanities and the arts to health professions programs, how else can educators and employers ensure that the clinicians of tomorrow are well-rounded providers? 

A possible solution is to implement the use of arts strategies in a professional curriculum. Strategies to enhance providers’ “whole person approach” interweave artistic media into the standard material, drawing upon pedagogy associated with the arts1. This is because artistic activities may offer stimulation outside of what is typically employed in a traditional medical or scientific course. 

For example, the use of literary works and film in healthcare ethics classes can serve as a “consciousness raising activity” and can be more engaging than the standard curricular reading material4. Another teaching strategy is to assign readings for discussion from the Journal of the American Medical Association (JAMA) website dedicated to “The Arts and Medicine,” a series that explores the intersection of “arts, culture and medicine” and may provide educators with ways to link course topics with interdisciplinary areas of interest. Another method of engagement could be to encourage professional students to review winning entries into the “Dance Your PhD” contest. This contest, sponsored by Science magazine and the American Association for the Advancement of Science (AAAS), encourages researchers to explain their projects through interpretive dance9. Students can choreograph an expressive, visual representation of their research or coursework. Or students may participate in performing arts service organizations which provide them with “a creative outlet, leadership opportunities, and patient contact experiences that can increase their compassion and empathy and better prepare them to be practicing clinicians.10” 

To quote Albert Einstein, “The greatest scientists are artists as well.3” Educators and students should take this to heart in designing or completing professional education.

References: 

1. Braund, M., Reiss, M.J. The ‘Great Divide’: How the Arts Contribute to Science and Science Education. Can. J. Sci. Math. Techn. Educ. 19, 219–236 (2019). 

2. S.S. Ruppert. Critical evidence: How the arts benefit student achievement. 2006. Available from http://nasaa-arts.org/critical-evidence/.

3. Izadi, D. (2017). Arts in science education. Canadian Journal of Physics, 95(7), xliii–xlvi.

4. Scott PA. The relationship between the arts and medicine. Med Humanit. 2000;26(1):3-8. doi:10.1136/mh.26.1.3 

5. Panda SC. Medicine: science or art?. Mens Sana Monogr. 2006;4(1):127-138. doi:10.4103/0973-1229.27610 

6. Boyce EG, Lawson LA. Preprofessional curriculum in preparation for doctor of pharmacy educational programs. Am J Pharm Educ. 2009;73(8):155. doi:10.5688/aj7308155

7. https://www.acpe-accredit.org/pdf/Standards2016FINAL.pdf 

8. https://jamanetwork.com/collections/44037/the-arts-and-medicine 

9. https://www.sciencemag.org/projects/dance-your-phd 

10. NewsRx. Study Results from Appalachian College of Pharmacy Update. Understanding of Pharmaceutical Education (A Community Service Organization Focused On the Arts To Develop Empathy In Pharmacy Students). Education Letter. June 10, 2020; p 533.