Pharmacy education is no exception.
"Pharmacy practice, science, and technology never stop evolving; therefore, neither should pharmacy education," notes Associate Dean and Professor of Pharmacy Lynda S. Welage, BSPharm'81, PharmD. "Our main job as pharmacy educators is to anticipate the changes that are reshaping pharmacy practice and science, and then make corresponding changes in our curriculum so that our students enter the job market prepared to contribute.

"We are training them to be thinkers, problem solvers, innovators, leaders. That makes the job a little more complex."

Sometimes, refining the PharmD curriculum entails a major curriculum revision, as was last the case at the College in 1996 when the entire course structure was reconfigured. More typically, curriculum changes consist of fine-tuning what is already one of the finest PharmD programs in the U.S.

The latter scenario describes what's been going on at the College over the past few years — a change Welage and Experiential Training Program Director Nancy Mason, BSPharm'76, PharmD'81, depict as "curricula realignment versus major revision."

Here's a brief overview of recent changes in the PharmD curriculum:

One of the bigger changes has been to introduce clinical experiences earlier in the curriculum.

Before the 1996 revision, students' clinical experiences began the third year of the PharmD program. The 1996 revision brought clinical experiences down to second year. With the newly revised pharmaceutical care course sequence, PharmD students now begin developing their clinical skills their first year.

"Accelerating clinical experiences was done in order to better correlate the information we are covering in class with actual practice application," Welage states. "This emphasis has been implemented across the PharmD curriculum. By reinforcing content and application as we go along, we believe students will learn more, that there will be better carry-over from course to course over four years, and that students will derive even greater benefit from their P-4 rotations."

An example of this greater emphasis on application is a medication history exercise in Pharmacy 351: Pharmaceutical Care I (PC 351), the first of six courses in the revised pharmaceutical care sequence: one course per term, two terms a year, P-1 through P-3 years.

"An objective of PC 351 is to introduce the interpersonal skills pharmacists need to communicate effectively," says Mason, who teaches the course. "One way we accomplish this is to have firstyear students role-play with standardized patients: actors who have been trained to play the part of patients. What the actors evaluate is students' professional conduct. Did the student present a professional demeanor and appearance? Were they caring? Did they ask relevant questions and listen well to the responses? Did they stereotype the patient, or breeze past the patient's concerns? What did the pharmacist's body language convey? And ultimately, would I come back to this pharmacist or follow this pharmacist's advice?

"It's very realistic and students learn a lot from the experience, in part because they are receiving a performance critique from an 'impartial' third party, as opposed to hearing it from a professor," Mason says.

The newly renovated and expanded Charles R. Walgreen Jr. Dispensing Laboratory, and the neighboring instructional technology classroom, will be a boon to teaching these and other clinical skills, Welage explains. The reconfigured dispensing lab space, which will come online in time for the start of fall term 2005 classes, will encompass 2,200 sq. ft., and will be the primary meeting place for the six-part pharmaceutical care lab series.

The center of the pharmaceutical care lab will be open classroom space, with dispensing and compounding benches around the periphery of the room. Across the hall will be an IV prep room, and a patient interview room equipped with videotaping facilities — all state-of-the-art.

In similar fashion, the instructional technology laboratory will be reconfigured and re-equipped to allow greater programming flexibility, and permit more students to use the lab, simultaneously, for small and large group projects. [See "Technology: Adding New Dimensions to Learning," below.]

From the start of their four-year PharmD experience, students are indoctrinated in the code of professionalism. It takes public form early in the fall term with the College's White Coat Ceremony, a ritual in which P-1 students don the symbol of their profession, assisted by upperclassmen. The message of succession and tradition is built into the ritual. After accepting their white coats, P-1 students recite the American International Health Alliance (AIHA) pharmacy student code of ethics: a pledge to abide by the highest professional and ethical standards.

"We define professionalism as the caring aspects of pharmacy practice — that caring underlies the science," Mason explains. "Pharmacy is a profession steeped in integrity, honesty, responsibility, public trust, and we require our student pharmacists to conduct themselves in a manner consistent with these expectations. In just a few short years, they will be practicing pharmacists. Now is the best time to start acting and thinking like the professionals they soon will be."

The concept of professionalism is woven into every pharmaceutical care course, and many others as well, Mason says. For example, in Social and Administrative Sciences 301: Introduction to Pharmacy, a first semester, fall term course taught by SAS Department Chair and Associate Professor Caroline Gaither, students are introduced to the theoretical aspects of pharmaceutical care and explore such questions as what defines a profession, and a professional. As part of the course, students visit pharmacists at various practice sites to interview them about their work and to see how they conduct themselves.

To reinforce professional skill development, communication exercises (e.g., taking patient histories, counseling patients, making case presentations to other health professionals) are included in every pharmaceutical care class.

The greater emphasis on professionalism has also resulted in the creation of a new P550: Careers in Pharmacy course, initiated by Welage and now taught by Clinical Assistant Professor Michael Kraft, PharmD'99.

"With the curriculum revision of 1996, we added more elective opportunities in the P-4 year," explains Welage. "That didn't work well from a continuity of patient care standpoint, so we've eliminated fourth year electives. In their place, we've moved the Careers in Pharmacy course to the third year, with a continuation in the fourth year."

The course is an essential primer for career development. As part of the course, students learn how to prepare for a job search, how to manage an interview, how to analyze the job market for the best career match, how to negotiate an employment contract, even how to plan investments.

The course formerly known as Pharmacy 330: Scientific Literature and Drug Information has been reconstituted as Pharmacy 330: Evidence Based Medicine. As the new moniker indicates, the course has become more clinical in nature, and has also moved up in the curriculum chain to first year, second semester.

"Pharmacy 330: Evidence Based Medicine now sets the stage for clinical decision-making; that is, how do you use all the information that's available, and then weigh its value to make informed decisions?" notes Welage. "The lessons learned in this course are then reinforced throughout the curriculum. Consequently, Pharmacy 330 is a lot more integrated with the rest of the curriculum than in the past."

Academic year 2004-2005 witnessed the introduction of the portfolio: a personal experience log kept by P-4 students throughout their clinical clerkship cycle to help them (and faculty) track student progress toward the mastery of core clinical skills.

"The portfolio achieves two important goals," explains Mason. "First, it helps us to quantify what students have done on rotation through a combination of student self-assessments and preceptor evaluations. Secondly, it facilitates preceptor-student and preceptorpreceptor communication."

At the outset of each rotation, students share their written reflections and previous preceptor summary evaluations with their new preceptor. By reviewing the document together, the preceptor can see what others have said about the student; how well a student mastered core skills, as indicated by previous preceptors; and student commentary, including areas where the student feels he or she needs improvement. The new preceptor thus knows where to focus emphasis.

"Anything we can do to help the preceptor will have an immediate impact," notes Mason. "It typically takes one to two weeks for a preceptor to know a student well enough to identify what clinical or personal skills need improving. Since a rotation lasts only four weeks, we need to shorten the learning curve. Our hope is that by jump-starting the learning process at each rotation site, students will get more out of every experience."

The majority of P-4 students have embraced the portfolio concept, Mason says.

"Students have told us that the portfolio offers them a clearer understanding of what they've done, what they've learned on rotations," she notes. "Some are even using their portfolios as an experience reference for job interviews. That's a use we hadn't anticipated."

Technology continues to play a growing role, both in the development of course content and in the way College faculty teach it.

"Technology makes good teachers better," Welage explains. "Technology will never be a substitute for good teaching, nor is it a substitute for the personal, one-on-one teaching that characterizes a Michigan Pharmacy education. What technology offers educators is one more way to package knowledge so that it's more exciting for students to learn.

"Our College is a national leader in the use of instructional technology precisely because we continue to create new and better ways to use technology to extend the reach of the classroom and laboratory, and to add new dimensions to learning."

Case in point: Mustapha Beleh, Department of Medicinal Chemistry lecturer, has developed Web-based assessment modules to identify students who are struggling in specific math or science areas. His goal: To provide tutorial or remedial support, quickly, so that students can keep up with course demands. [more about Beleh's Web-based applications.] Beleh's innovative use of technology has just netted him a Computerworld Information Technology Award (the College's 11th) and a development grant from the Gilbert Whitaker Foundation.

"Many of the Web-based modules we've developed over the past several years have been refined, sorted into their respective places, and are thoroughly integrated into the overall curriculum. Every department — Clinical Sciences, Pharmaceutical Sciences, Medicinal Chemistry, Social and Administrative Sciences — is using technology in different ways, each according to their special requirements. The demand for new and better applications continues to grow as faculty develop more familiarity with the technology, and start to see improved student performance as a result."

To keep pace with faculty and student demand for innovative technology applications, the College hired media specialist, John Johnston, last fall. Like most other College staff, Johnston wears more than one hat. (In addition to being the College Webmaster, he's also the media lab guru and IT jack-of-all-trades.) However, much of his time is devoted to helping faculty and staff use computer technologies to enhance instruction and streamline work tasks. Prior to joining the College, he was part of the University development and support teams that created CourseTools and SiteMaker, two workhorse software applications that drive the University's own instructional technology programs.

Johnston is also an educator in his own right. He's active in the campus-wide academic technology community as a member of the AT Commons Planning Committee, the Teaching with Technology Institute, the Sitemaker Administration Team, and as a presenter in the Enriching Scholarship Program. "Our College has a reputation for innovative use of technology in pharmacy education," Johnston observes. "My job is to help translate good ideas into successful applications. I'm lucky to be here because I've got so many good ideas to work with."