Integrating patient-centred care by a blended learning approach; student perspectives of the virtual family model in pharmacy

Abstract

Background: Pharmacy schools have the responsibility to ensure that graduates have a patient-centred approach to care to optimise healthcare outcomes and meet current professional standards. Recent pharmacy academics' experience from an Australian University highlighted that students tend to view patients as 'disease states,' rather than applying a patient-centred approach. A method that can be used to develop students' approach to patient-centred care in a positive, risk-free, learning environment is the use of a virtual family. Thus, an intergenerational, multicultural 'virtual family' was introduced to students online in 2012, allowing them to apply course theory and investigate health problems within the social, cultural and medical context of the family member. Objective: To assess student opinions of the integration of the virtual family into two second-year pharmacy practice courses. Methods: Twelve family members were introduced to the students via photos, videos and their medical/social histories. The family scenarios were constructively aligned with the topics and outcomes of both courses. Family members were integrated via a blended learning approach, using lectures, workshops and online modules. Students were allocated a case study involving a family member, which required them to devise and role-play questions, and actively listen to the responses. The role-plays were video-recorded. Students were also required to write an individualised care plan. Second year students (n=68) finishing both courses for the first time, were invited to complete an online survey evaluating the use of the family, particularly in relation to the above assessment items, i.e. role-play and care plan. Institutional ethics approval was granted. Results: The response rate to the blended learning survey was 88.2% (60/68). The majority of respondents were female (n=36, 60%). The responses to "I understand the importance of interviewing a patient before the supply of an OTC (over-the-counter) medication," were the most positive, followed by, "I could use information databases to assist with patient enquiries". The majority (n=58, 96.7%) of students, strongly agreed or agreed with these responses. The average effectiveness rating for the virtual family in relation to helping "Apply my OTC medicine knowledge", "Develop an empathic approach to patient care" and "Reflect on my communication skills" was 69.0%. Written responses to open questions indicated that students liked applying what they had learnt to a 'real' case in the written report, but would rather it had been graded instead of pass/fail. Role plays helped them to practice their communication skills, however students would have preferred asking their questions spontaneously (similar to what would happen in a pharmacy setting), rather than the requirement to produce a script. Conclusion: Overall, feedback concerning the integration of the virtual family into pharmacy practice courses was positive. Assessment items requiring the application of knowledge and skills taught in the courses to case studies, i.e. practice simulation, were seen by students as valid and valuable. Students' feedback noted a preference for 'real life' scenarios.