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.