Pharmacy OSCEs: A revision guide

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Referral to a specialist pharmacist, medical consultant, GP or nurse if you have reached your level of competence and require additional input Practicability: OSCE allows the use of simulated patients and clinical materials, thereby decreasing the need for real patients during the examination. Yoon JH. Strategies for the improvement of pharmacy practice experiences education: focused on clinical pharmacy practice experiences. Korean Association of Pharmacy Education. 2018. If an underlying organic cause of ED is identified and reversible, the probability of curing ED is greatly increased. However, if refractory to various treatment modalities, patients with ED are at increased risk for psychiatric co-morbidities such as anxiety and depression. This may further generate relationship and interpersonal struggles, significantly affecting a patient’s quality of life. Moreover, ED is known to be a risk factor in itself for CV disease, therefore if left untreated, could predispose the patient to greater risks of stroke and coronary artery disease. 3

At this stage of the consultation, you should revisit any concerns the patient may have about their current medication regime. It’s also important to provide the patient with the opportunity to raise any additional concerns about their medication. This OSCE model can evaluate nine of the 11 pre-APPE core domain competencies of the ACPE: patient safety; basic patient assessment; medication information; identification and assessment of drug related problems; mathematics applied to dose calculation; professional and legal behavior; general communication abilities; counseling patients; and drug information analysis and literature research [ 6, 7]. Unlike the Korean IPPE curriculum, the one in the US mainly includes off-campus practice in community and hospital pharmacies as along with in-class simulation training [ 6, 7]. The Pharmaceutical Common Achievement Tests Organization in Japan presented five OSCE competency areas, including patient counseling, dispensing, dispensing audit, aseptic dispensing, and provision of drug information [ 17]. The OSCE core domains in this study areas were developed after considering the IPPE curriculum and its official textbook, utilized by most Korean pharmacy schools [ 3, 25]. Counselling patients for complex dosage forms (i.e., respiratory inhalers or self-injection devices) or OTCs, has been a key competency for clinical pharmacists to provide effective health and medication information to patients, and confirm their understanding of it [ 6, 7, 25, 33]. By assessing students’ ability towards patient care and prescription review, we could evaluate their basic knowledge, critical thinking, and problem-solving competencies, for assessing patient conditions and DRPs in the community or hospital pharmacy. The competency of time bound drug information analysis and literature research, could be assessed by the area of drug information service, which required the use of adequate drug information resources and evidence-based pharmacotherapy, to provide safe and effective pharmacotherapy [ 6, 7, 15, 25, 26]. You might also be interested in our OSCE Flashcard Collection which contains over 2000 flashcards that cover clinical examination, procedures, communication skills and data interpretation. Grover SA, Lowensteyn I, Kaouache M, Marchand S, Coupal L, DeCarolis E, et al. The Prevalence of Erectile Dysfunction in the Primary Care Setting. Arch Intern Med. 2006;166(2):213.

Decreased bias: Student performance in each station is marked by independent examiners on a predetermined marking template that is customized to each patient scenario, thus reduces the variability of examination. Broader content coverage: Unlike the conventional short or long case examination format, multi-station OSCE allows broader content and domain coverage.

Yeung, E (April 2, 2017). "Sharing of information in objective structured clinical examinations -- does no evidence of difference mean evidence of no difference?". BMJ Open. 6 (10): e012541. doi: 10.1136/bmjopen-2016-012541. PMC 5073653. PMID 27729351.

Examination Day

The OSCE stations with standardized patients or physicians were appropriate since pharmacy students have been recommended to complete a specific clinical task often in an interactive environment [ 21, 33, 34]. The students’ average performance was the lowest at 32.1% in the case of counseling the patient with the inhaler, and the highest at 79.7% in the OTC counseling. This might indicate towards the insufficient readiness of students, for counseling patients with prescribed inhalers at the community or hospital pharmacies. Contradictorily, the students found the cases related to prescription review and pharmaceutical care service, as well as patient counseling, difficult. In Korean pharmacy schools, the IPPE curriculum is operated as in-class simulation of prescription review, dispensing, medication therapy management, patient counseling, and drug information provision, while the APPE courses are conducted as field training at community or hospital pharmacies [ 2, 3]. Since participating students had not yet started APPE courses, the OSCE cases proved difficult, which resulted in their performance rate dropping below 80%, in certain criteria of all OSCE areas. Malaysian pharmacy students also considered the OSCE areas related to patient counseling, drug dosage review, and drug information service relatively difficult, compared to the areas related to drug-related problems or pharmacokinetics [ 19]. Despite pharmacists being required to counsel patients within the expected duration, and verify patients’ medication knowledge according to the pharmacist-conducted patient counseling guidelines and the textbook used in the Korean college of pharmacy, no student met the relevant assessment criteria [ 25, 34, 35]. This study also showed that students portrayed weaknesses at the beginning and end of the communication in clinical pharmacy practice. Contradictorily, Japanese students showed excellent outcomes in most communication skill areas, which was probably affected by the list of tasks provided a minute before the advanced OSCE [ 36]. The standardized IPPE curriculum applied to all colleges of pharmacy in South Korea is limited. It was reported that the incorporation of simulation based IPPE made pharmacy students more confident on technical and communication skills, and more aware of medication errors and other patient safety issues [ 15]. Therefore, Korean pharmacy colleges’ IPPE education should strengthen their curriculum based on simulation education, for applying the knowledge to actual clinical situations related to the five key competency areas, and involve the preceptors as reviewers to reduce the differences in the outcome assessment. Location: The location for the exam should recreate a real clinical encounter. The testing area should be illustrated with a diagram that clearly depicts the stations and flow patterns. The bell to indicate the time for station change should be audible throughout the examination centre. The assessment of pharmacy students’ readiness to begin APPE education in clinical pharmacy settings continues to gain increasing attention [ 4, 5]. The Accreditation Council for Pharmacy Education (ACPE) in the United States (US) has emphasized the importance of competency assessment with comprehensive, formative, and summative testing [ 6, 7]. Since pharmacy practice training was first implemented eighth years ago in South Korea, preceptors and students have raised concerns related to experiential education, such as differences in IPPE educational content and quality among 37 colleges of pharmacy and differences in students’ competence in translating knowledge levels into practice [ 8, 9]. Despite the apparent need for a competency assessment program to assess students’ readiness for experiential learning, there are no established standardized examinations or evaluation criteria to assess students’ clinical performance consistently and accurately. Bibliographical notePrescribing medicines to a patient remains the most common intervention made by the National Health Service (www.england.nhs.uk).

Information about the prescriber that is required by the person signing the prescription is discussed below. Name Erectile dysfunction (ED) is defined as an inability to obtain or maintain an erection sufficient for penetration and for the satisfaction of both sexual partners. Increasingly, primary care physicians are managing ED with medical therapies alone. 6 However, depending on the cause of ED, surgery may be warranted in specific cases. Both medical and surgical therapies for ED are discussed further below. 16 Modification of risk factors inclusion of competency-based learning and assessment in the form of OSCEs. The increasing interestType C statistical effects: typically only seen at cohort level when patients have been using medication for a long period of time (e.g. gastric ulceration with NSAIDs) including the United States Medical Licensing Examination, the Medical Council of Canada Qualifying Prescriptions represent a request from one healthcare professional to another to administer or supply medication to or for a patient. Some medications do not require a prescription as they are considered safe enough for patients to use without professional supervision and these are legally classified as general sale list medications (GSL). Medications that are considered less safe and require supervision by healthcare professionals are classified as prescription only medications, referred to as POMs and can only be used under the supervision of a prescribing healthcare professional. Anything that is not a GSL or POM is classified as a pharmacy medication or P medicine, which is only available under the supervision of a pharmacist. This is an important part of taking a medication history, as many of these products will influence the pharmacodynamic and pharmacokinetic properties of prescribed medication. For example, St John’s Wort can increase the metabolism and therefore reduce the efficacy of oral contraceptives. Undergraduate pharmacy students are required to know how to make and administer medicines, design and deliver medicines as well as diagnose and optimally treat illnesses. Patient care and safety is paramount during the undergraduate degree and beyond into pharmacy practise.

Talk me through a typical day, from when you wake up to when you go to bed and how your medications fit into that?”Evaluations of the competence of healthcare professional students, including undergraduate pharmacists, using simulated assessments including Objective Structured Clinical Examinations (OSCEs) and Criterion Referenced Assessments (CRAs) are increasingly commonplace. Patients may be referred to an endocrinologist for hormone replacement if a deficiency in reproductive hormones is found on laboratory testing (e.g. low testosterone). Penile prosthesis