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Virtual patients as a tool for training pre-registration pharmacists and increasing their preparedness to practice: A qualitative study.

ABSTRACT: Virtual patients are an active learning pedagogical tool which simulate clinical scenarios in a three-dimensional environment. Their use in pharmacy education is under-researched in comparison to other healthcare professions. In the United Kingdom, pre-registration training refers to a year of workplace based training which pharmacy graduates must complete prior to professional registration as pharmacists. This study aimed to evaluate pre-registration pharmacists' perceptions on the integration, usefulness and enjoyment of completing virtual patient simulations or non-interactive case studies as part of their training. Pre-registration trainees completed three virtual patient simulations or three non-interactive case studies on the topics of: emergency hormonal contraception, renal function and childhood illnesses. Telephone interviews were conducted with twenty pre-registration pharmacists, exploring their perspectives on the use of the virtual patient or non-interactive case studies. Data was analysed using the five-stage framework approach. Four main themes emerged from the data: case study design; usefulness of the case studies as a training tool; support in pre-registration training; utility of the learning tools. Trainees also identified technical issues they had experienced while completing the virtual patient simulations, specifically with keyword recognition. Pre-registration trainees who used the virtual patients provided comments relating to the novelty, realism and enjoyment in completing them. Trainees in both groups reported developing knowledge and skills from completing the case studies; those who used the virtual patient commented on the development of communication skills and an increase in confidence for practice and those who used the non-interactive cases focused on knowledge acquisition and numeracy. Participants were enthusiastic about virtual patients as a novel training tool which provided an opportunity for learners to practice realistic scenarios in a safe environment. Virtual patients offer the potential to 'bridge the gap' in pharmacist pre-registration sector-related training variation, promote learning through reflection on doing and increase overall preparedness for practice.

SUBMITTER: Thompson J

PROVIDER: S-EPMC7458319 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Virtual patients as a tool for training pre-registration pharmacists and increasing their preparedness to practice: A qualitative study.

Thompson Jessica J White Simon S Chapman Stephen S

PloS one 20200831 8

Virtual patients are an active learning pedagogical tool which simulate clinical scenarios in a three-dimensional environment. Their use in pharmacy education is under-researched in comparison to other healthcare professions. In the United Kingdom, pre-registration training refers to a year of workplace based training which pharmacy graduates must complete prior to professional registration as pharmacists. This study aimed to evaluate pre-registration pharmacists' perceptions on the integration, ...[more]

PMID: 32866197

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Project description:BackgroundSince 2015, pharmacists have been integrating into English general practices and more recently into primary care networks. General practice-based pharmacists provide a range of patient-facing services, such as medication reviews, management of long-term conditions and minor ailments, prescribing duties and answering queries over the telephone. Literature reports patients' satisfaction with general practice-based pharmacists' services, however, previous research captured only limited experiences. The aim of the current study was to pursue an extensive exploration of patients' experiences of pharmacists in general practice.MethodsGeneral practice-based pharmacists, working in practices in West London, Surrey and Berkshire, handed invitation packs to patients seen during consultations. Patients that wanted to take part in the study were invited to undertake a qualitative, in-depth, face-to-face, semi-structured interview within the practice with which each patient was registered. Interviews lasted from 15 min to more than 1 h and were audio-recorded. Recruitment continued until data saturation. Audio-recordings were transcribed verbatim and transcripts analysed thematically.ResultsTwenty participants were interviewed. Four themes were discerned: awareness ("I had been coming to this practice for 24 years and I didn't know that there was a pharmacist"); accessibility ("People ring for a GP [general practitioner] appointment … it's Monday and they [receptionist] tells you 'We can slot you in on Friday' … with a pharmacist on board, they can [instantly] look at you"); interactions ("I've always had a really good interaction with them [pharmacists] and they listen and they take on board what I'm trying to say"); and feedback ("It's easier [to collect feedback instantly] because I could have forgotten half of what they [pharmacists] have told me in an hour or so's time").ConclusionsFindings indicate that pharmacists' integration into general practices could improve accessibility to, and the quality of, care received. The findings will assist policy development to provide general practice-based pharmacists' services as per patients' needs.

Project description:BACKGROUND:In England, since 2015, there has been a formal drive to integrate pharmacists into general practice as a new healthcare service. Research efforts have offered insights into how general practice-based professionals and patients view the service, however, they took no account of community pharmacy teams' opinions. There have been anecdotal statements about opposition from community pharmacies to the service, due to fears of losing business. The aim of the current study was to identify the experiences and perceptions of community pharmacy teams regarding pharmacists' presence in general practice. METHODS:The National Health Service Choices website was used to identify community pharmacies within a radius of two miles from eight West London general practices. The search resulted in 104 community pharmacies which were all contacted via telephone. Pharmacy staff who verbally expressed their interest to participate were then provided with the study's documents. Qualitative, face-to-face, semi-structured interviews were conducted inside the pharmacy from which each participant was recruited. Interviews lasted 30 to 45?min and were audio-recorded. Audio-recordings were transcribed verbatim and transcripts analysed thematically. RESULTS:Forty-eight community pharmacy staff participated. Four themes were discerned: awareness ("I knew that [pharmacists] have already been implemented [in general practice] but I haven't really followed it … where does the pharmacist role come?"); interactions ("I'm just so pleased that there's a pharmacist professional in the general practice … because we speak the same language!"); patient care ("if I was a patient knowing that there is a general practitioner and a pharmacist [in general practice], I would … think 'nothing can go wrong at the moment'"); and funding challenges ("if general practices take on the extra responsibility of stop smoking or flu vaccination campaigns … financially, this would affect this pharmacy"). CONCLUSIONS:The current study revealed the perceived impact of general practice-based pharmacists on community pharmacies would be improved communication between pharmacies and practices. Findings will inform policy so that any future framing of pharmacists' presence in general practice considers the needs of community pharmacies.

Project description:BACKGROUND:Technology-mediated neurorehabilitation is suggested to enhance training intensity and therefore functional gains. Here, we used a novel virtual reality (VR) system for task-specific upper extremity training after stroke. The system offers interactive exercises integrating motor priming techniques and embodied visuomotor feedback. In this pilot study, we examined (i) rehabilitation dose and training intensity, (ii) functional improvements, and (iii) safety and tolerance when exposed to intensive VR rehabilitation. METHODS:Ten outpatient stroke survivors with chronic (>6 months) upper extremity paresis participated in a ten-session VR-based upper limb rehabilitation program (2 sessions/week). RESULTS:All participants completed all sessions of the treatment. In total, they received a median of 403 min of upper limb therapy, with 290 min of effective training. Within that time, participants performed a median of 4713 goal-directed movements. Importantly, training intensity increased progressively across sessions from 13.2 to 17.3 movements per minute. Clinical measures show that despite being in the chronic phase, where recovery potential is thought to be limited, participants showed a median improvement rate of 5.3% in motor function (Fugl-Meyer Assessment for Upper Extremity; FMA-UE) post intervention compared to baseline, and of 15.4% at one-month follow-up. For three of them, this improvement was clinically significant. A significant improvement in shoulder active range of motion (AROM) was also observed at follow-up. Participants reported very low levels of pain, stress and fatigue following each session of training, indicating that the intensive VR intervention was well tolerated. No severe adverse events were reported. All participants expressed their interest in continuing the intervention at the hospital or even at home, suggesting high levels of adherence and motivation for the provided intervention. CONCLUSIONS:This pilot study showed how a dedicated VR system could deliver high rehabilitation doses and, importantly, intensive training in chronic stroke survivors. FMA-UE and AROM results suggest that task-specific VR training may be beneficial for further functional recovery both in the chronic stage of stroke. Longitudinal studies with higher doses and sample sizes are required to confirm the therapy effectiveness. TRIAL REGISTRATION:This trial was retrospectively registered at ClinicalTrials.gov database (registration number NCT03094650 ) on 14 March 2017.

Dataset Information

Virtual patients as a tool for training pre-registration pharmacists and increasing their preparedness to practice: A qualitative study.

Publications

Virtual patients as a tool for training pre-registration pharmacists and increasing their preparedness to practice: A qualitative study.

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