Pandemic Lessons

UB School of Pharmacy and Pharmaceutical Sciences faculty went into action, quickly and creatively revamping content delivery, rotational experiences and clinical skills development. Nicole Albanese, PharmD, PharmD program director, and Richard O’Brocta, director of experiential education, give their insights into how we shifted, the lessons learned, and how they moved forward better prepared for the 2020-21 academic year.

In hindsight, we did the best we could during the spring 2020 semester, but it was not optimal. As educators, we were worried about how we “taught” and at times may have lost sight of how students would “learn” during a pandemic. We now know we needed to take a step back and consider the entire educational process. This means assessing inputs: student and professor characteristics, along with outputs: student achievement, all while including pandemic stressors: psychosocial [factors], relentless news and rapidly shifting health policy guidance. We made assumptions about how to run a “virtual” block schedule curriculum that seemed logical at the time, without realizing how outside stressors would affect everyone. Many students had to work irregular shifts or take care of younger siblings while their parents went to work, making attending block scheduled classes nearly impossible.

What we learned in the spring was what not to do in the fall. But we also learned that our students are pretty resilient and able to put some of these outside forces aside and be successful. Most importantly, we learned that the old way of standing in front of a class, reading our slides and expecting students to learn was not going to work in this virtual environment. It forced us to throw all our old pedagogical methods out the window and start with a blank slate that put student learning first, along with reevaluating how we assess learning.

Spring was rough for hands-on, practical psychomotor skills. Luckily, the shutdown occurred mid-March, so most required material had been delivered, especially in the compounding lab. For remaining clinical skills (patient assessment, pharmaceutical care), it forced us to really think about how students should model skills and how faculty should assess these skills. So we had students make videos of themselves completing clinical skills along with patient counseling. The use of video resulted in better student performance. Allowing students time to prepare and rerecord themselves improved their mastery of the clinical skill.

The successful use of technology and novel pedagogical approaches were cornerstones of our Fall 2020 planning. These successes allowed us to examine specific curricular content and evaluate its role in meeting both SPPS and AACP program outcomes. We asked, “Is this vital for a generalist pharmacist to know to be a practice-ready graduate?" These opportunities allowed us to streamline course material and implement exciting new delivery methodologies, resulting in students becoming active participants, as opposed to passive classroom listeners.

Pharmacotherapeutics is the largest clinical sequence, spanning over two and half years, and a critical component of our curriculum. Over the spring semester, we learned that students were craving interaction and connection with the faculty and their classmates, so we decided to apply some unique and creative approaches to address this. We moved all knowledge-level content to prerecorded asynchronous lectures with embedded questions, allowing students to actively engage and reflect on course material. We also started synchronous recitation classes for group work and clinical cases. Delivering course content in this way was not something the students were used to. They had to shift how they prepared and interacted, which allowed them to take on a more active learning role. Using Bloom’s Taxonomy Scale for distinguishing human cognition, we are now teaching and assessing students at the “apply” and “analyze” levels instead of the ”remember” and ”understand” levels, thus allowing for higher cognitive retention.

Additionally, pharmaceutical care activities had to be re-imagined. In the past, students counseled a standardized patient on how to use a blood glucose monitor, a fairly routine counseling activity. The students would prepare by watching the professor use the meter, practice using it, and then counsel and be evaluated. For Fall 2020, we completely transformed the activity with outcomes in mind. Students now watch a video of the professor counseling on the meter and use a rubric for grading. The students are then evaluated on how well they appraised the counseling session, along with their constructive feedback. Maya Angelou once said, “When you learn, teach.” That quote is the backbone of re-imagining these activities.

We are very fortunate to have an amazing group of preceptors who are dedicated to student success, even through a pandemic! Our faculty, community and volunteer preceptors went “above and beyond” while also assuring that learning outcomes were achieved. Preceptors took more students, embraced flexible scheduling and utilized Zoom and other online platforms. Overall, our dedicated preceptors are the primary reason for our success!   

The EE Office staff worked 20-plus-hour days along with employing really out-of-the-box thinking to ensure that all students received the needed number of experiential hours, while maintaining all required learning outcomes. I am so grateful for my EE team. I cannot thank Bill Prescott, Nick Fusco, Kris Jordan and Pam Coniglio enough for the efforts they made to make the experiential curriculum work.

We really worked hard to address the need for social distancing at sites, while maintaining experiential learning objectives. We found that telemedicine was an efficient way for sites to deliver care while still engaging student learning.