- MyDispense can be used to practice law topics related to pharmacy practice, such as appropriate documentation, differentiating between store policy and state/federal laws, and proper controlled substance prescription processing.
- Students find using MyDispense for law topic review challenging and relevant.
- Implementation of MyDispense for new class activities can also serve as a platform for learner-based research.
A functional understanding of both state and national pharmacy laws and regulations is vital in pharmacy practice and is assessed through the Multistate Pharmacy Jurisprudence Examination (MPJE) as part of pharmacy licensing in the United States. In 2016 at the University of Connecticut (UConn) School of Pharmacy we experienced a downward trend of our graduating students MJPE exam scores, indicating a potential need for new and different preparation methods. At that time, pharmacy students received instruction on law for one semester in the second professional year, then sat for the MPJE after completion of the fourth professional year and graduation. No formal lecture or follow-up on legal topics existed until students were provided with an optional examination review course at the time of graduation. Thus, we determined it was necessary to incorporate legal topic reviews throughout the curriculum.
As his research project, he evaluated the baseline gap in functional understanding of pharmacy practice laws and students’ perceptions of this method.
We chose a third professional year integrative course in which students apply knowledge from other courses throughout pharmacy to case studies and clinical scenarios. This course encourages student participation and teamwork to formulate solutions that are then discussed as a group. This process facilitates critical thinking using prior knowledge to generate possible solutions and follows up with discussion on the solutions generated in order to correct or explain any unclear points. Students are separated into four sections of approximately 20 to 25 students each, and are further separated into groups for collaboration within each section.
Eight pre-class exercises covering laws for controlled substance dispensing, inventory and recordkeeping requirements, dosage form substitution, and prescriptive authority were utilized for the 2017 session.
In class, students completed 5 exercises in small groups centered on human and animal prescriptions, emergency filling of controlled substances, patient counseling requirements, and antiepileptic medication substitutions. Feedback was provided to students on performance in each exercise. Students received immediate scoring of their performance as correct, partially correct, or incorrect through MyDispense, with pre-filled feedback on the appropriate law and reasoning behind the mark given. At the end of each in-class session, students were provided with additional clarification on particularly challenging exercises and any unclear points raised throughout the class.
The research aspect of this implementation was the opportunity for students to complete a survey about their perception of the class. The survey was administered anonymously through QualtricsXM (Provo, UT). This was announced during each class period with an information sheet stating the purpose, risks, and benefits of the study. A series of questions graded using a Likert scale were used to quantitatively evaluate student perceptions. Feedback sought included their thoughts on the timing of this practice, the content of the exercises, and alterations that could be made to improve the applicability or comprehensiveness of the simulations.
- Students felt MyDispense was more enjoyable than a lecture-based format and focused on challenging areas of practice law (mean scores over 3 on a 4-point Likert scale).
- Most students felt the exercises improved recall (86.5%) and were helpful in practicing understanding of laws (92.1%).
- A series of short-answer questions regarding applicability and changes to exercise content or focus were included. Responding students (n=16) felt that DEA recordkeeping requirements (n=4) and controlled substance prescriptions (n=4) were the most applicable subject areas. In correlation, responding students (n=22) wanted more exercises on controlled substance-related activities (n=6) and documentation requirements (n=6). Students (n=16) wanted less focus on prescription fraud and verification (n=7).
- Other responses included the need for an additional formal law review prior to scenario-based instruction with MyDispense.
This feedback was used to improve the exercises for the 2018 course and subsequent offerings and allowed us to continually assess law instruction. The identified gap in knowledge following formal instruction has prompted change to the professional curriculum. Pharmacy law has moved from 2nd professional year fall to 3rd professional year spring semester and an increase credit load from 1 to 3 credits due to the significance of this subject and the implications it has on licensing of future pharmacists. Furthermore, a student interested in research was able to use this study as part of his honors thesis and contributed to the increasing scientific evaluation of MyDispense.