I once heard
a classmate say: “I don’t have to know this off the top of my head.” “Just
Google it” and “Hey Siri” are other common phrases that I hear quite often from
pharmacy students. Honestly, I have been guilty of expressing statements
similar to these when I was a student. However, as a pharmacist now, I approach
this form of thinking quite differently.
When I was
enrolled in pharmacy school, I had the opportunity to hear many professors speak
about their educational experiences when they were a student. These
conversations helped me understand the differences in the learning methods and examination
processes between my professors’ experiences compared to mine. Each of these
conversations always seemed to have one commonality; they did not have access
to online resources and smartphones like pharmacy students have today. The Internet
and smartphones have become a huge part of American culture over the past ten years.
The Pew Research Center reports that about 96% of people in the United States
own some kind of cellphone and the vast majority of those people own a
smartphone.1
Icons made by Smashiconsfrom www.flaticon.com |
Pharmacy
students should be taught to utilize tertiary resources such as Micromedex®,
Clinical Pharmacology, and Lexicomp®. Each of these sources has a personalized
mobile application that can be readily accessible in the palm of a hand. But how should we teach student pharmacists
to appropriately use these applications? I have found it effective to first
explain some purposes of these applications which include: finding dosing
recommendations, looking up drug interactions, adjusting medications for renal
and hepatic dysfunction, and understanding how to explain adverse effects and
counseling points to patients. Once the purpose of these applications is
understood, teaching students how to use and apply the information is
a vital skill.
The
University of Mississippi School of Pharmacy has partnered with my residency
site, Baptist Memorial Hospital-North Mississippi, to host second-year student
pharmacists as they complete their Introductory Pharmacy Practice Experiences
(IPPEs). Some of the educational activities that the student pharmacists
complete include: gathering a medication history and performing a medication
reconciliation, reviewing medical records for laboratory monitoring data, and participating
in discharge counseling. As a preceptor for these student pharmacists, I have
taught them how to use Micromedex®, Clinical Pharmacology, and
Lexicomp® to complete these activities.
1. Medication history with reconciliation
a. Using these applications to look up
medications that are unfamiliar to the student pharmacists and understanding their
indications for use
2. Chart review with laboratory
monitoring
a. Reviewing a patient’s lab values and
using these applications to look up important monitoring parameters of each
medication to ensure the medication is safe and effective for each patient
3. Discharge counseling
a. Looking up every medication the
patient is expected to take after hospital discharge and using the counseling
section of these applications to ensure all information is discussed before
discharge
However, there
will be certain situations in clinical practice where instant drug recall is
needed. Examples include: treating cardiac arrest, stabilizing critical care patients,
and creating repertoire with other health care professionals when pharmacy
specific questions are needed immediately. In these situations, we should teach
student pharmacists that using these smartphone applications is not feasible and
being able to respond immediately is critical.
When else
should students be taught they cannot use smartphone applications? That would
be for examinations that prepare students for licensure: the NAPLEX®
and MPJE®. The NAPLEX® first-time pass rate was 94.9% in
2014 and dropped to 89.5% in 2017.3,4 In a recent commentary published
in AJPE, the authors discuss possible explanations for the decreasing pass
rates, including diminished exam preparation, declining academic ability, and the
increasing difficulty of the NAPLEX®.3 Additionally, the
authors speculate that smartphones may be affecting students' ability to apply
and recall information.3 In a
recent study, the investigators found that "when people expect to have future access
to information, they have lower rates of recall of the information itself and
enhanced recall instead for where to access it."5 It's true that
smartphones are capable of replacing some cognitive functions.6 But
student pharmacists should be taught early in their pharmacy school curriculum
that smartphones are not allowed on the NAPLEX® and MPJE®.
Therefore, immediate recall of information learned during pharmacy is required to
successfully pass the board examinations.
Learning or
memorizing all the information about every single drug available is impossible.
Smartphone applications obviously have a role. Therefore, student pharmacists
should be taught about how to effectively use tertiary resources such as Micromedex®,
Clinical Pharmacology, and Lexicomp®. However, they should
understand the difference between when it is appropriate and not appropriate to
use smartphone applications. All student pharmacists should have a strong fund
of knowledge that is not dependent on checking a smartphone and should be lifelong
learners.
References:
- Pew Research Center Internet and Technology. Mobile Fact Sheet. 2019 June 12.
- Ventola CL. Mobile Devices and Apps for Health Care Professionals: Uses and Benefits. PT. 2014 May;39(5):356-364.
- Fjortoft N, Getting J, Verdone M. Smartphones, Memory, and Pharmacy Education. American Journal of Pharmaceutical Education. 2018;82(3) Article 7054.
- National Association of Boards of Pharmacy. NAPLEX Pass Rates August 2019.
- Sparrow B, Liu J, Wegner DM. Google effects on memory: cognitive consequence of having information at ourfingertips. Science. 2011;33396043):776-778
- Wilmer HH, Sherman LE, Chein JM. Smartphones and Cognition: A Review of ResearchExploring the Links between Mobile Technology Habits and Cognitive Functioning. Front Psychol. 2017;8:605.
No comments:
Post a Comment
Thank you for your comment to the Educational Theory and Practice blog. It will be submitted for review and approval. Only those comments that substantially enhance the value of the blog site will be released and posted.