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Global Conference
Innovations in Pharmacy Education Activity Number: 0217-0000-15-150-L01-P, 1.50 hours of CPE credit; Activity Type: A Knowledge-Based Activity Wednesday, October 21, 2015 9:45 a.m. to 11:15 a.m. Continental Ballroom 5 Moderator: William A. Kehoe, Pharm.D., FCCP, BCPS Professor of Clinical Pharmacy and Psychology; Chair, Department of Pharmacy Practice, University of the Pacific Stockton, California Agenda
9:45 a.m. Re-engineering Pharmacy Education: How Can we Best Prepare Graduates for Clinical Pharmacy Practice Now and In the Future
Paul O. Gubbins, Pharm.D., FCCP Associate Dean, Vice Chair & Professor, UMKC School of Pharmacy at MSU Division of Pharmacy Practice & Administration, University of Missouri-Kansas City, Springfield, Missouri
10:30 a.m. ”Flip this Classroom”: Exploring the Use of the Flipped Classroom Model
in Pharmacy Education Mary T. Roth McClurg, Pharm.D., MHS, FCCP
Associate Professor, Division of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina
Jacqueline McLaughlin, PhD, MS Assistant Professor, Educational Innovation and Research; Director, Office of Strategic Planning and Assessment, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
Conflict of Interest Disclosures Paul O. Gubbins: no conflicts to disclose. William A. Kehoe: no conflicts to disclose. Jacqueline McLaughlin: no conflicts to disclose. Mary T. Roth McClurg: no conflicts to disclose. Learning Objectives
1. Review the emerging roles of clinical pharmacists in the healthcare environment and how these relate
to preparation of pharmacy graduates in the next 20 years. 2. Discuss the impact of new accreditation standards on development and modification of pharmacy
curricula to meet the needs of the changing healthcare environment. 3. Discuss the role of interprofessional and service learning experiences in the experiential training of
student pharmacists.
© American College of Clinical Pharmacy 1
Global Conference
4. Explain the pedagogical benefits of using the flipped classroom model for delivery of pharmacy education compared to traditional teaching methods.
5. Explore the challenges of using the flipped classroom model. 6. Discuss the required resources and best approach to incorporating flipped classrooms into pharmacy
curricula, particularly for teaching therapeutics. Self-Assessment Questions
Self-assessment questions are available online at www.accp.com/gc15.
© American College of Clinical Pharmacy 2
Re-engineering Pharmacy Education: How Can we Best Prepare Graduates for Clinical Pharmacy Practice Now and In the FuturePaul O. Gubbins, Pharm.D., FCCPOctober 21, 2015
2015 ACCP Global Conference on Clinical Pharmacy
© American College of Clinical Pharmacy 3
Conflict of Interests
The presenter has no conflicts of interest to report
© American College of Clinical Pharmacy 4
Learning Objectives
Review the emerging roles of clinical pharmacists in the healthcare environment and how these relate to preparation of pharmacy graduates in the next 20 years.
Discuss the impact of new accreditation standards on development and modification of pharmacy curricula to meet the needs of the changing healthcare environment.
Discuss the role of interprofessional and service learning experiences in the experiential training of student pharmacists.
© American College of Clinical Pharmacy 5
Pharmacy Practice(History)
Profession’s role in U.S. healthcare system continues evolving from
product focused
to patient “oriented”
to frontline of patient-centered care, wellness & disease prevention
Shord SS, et al. Pharmacotherapy 2013;33(4):e34–e42)
© American College of Clinical Pharmacy 6
Pharmacy Practice(History)
Clinical pharmacists’ value as integral interprofessionalhealth care team member proven…. again….
& again….
& again……
“Maximizingtherolesandscopeofpharmaciststodeliveravarietyofpatient‐centeredprimarycareandpublichealth,incollaborationwithphysicians,isaprovenandexistingparadigmofcarethatcanbeefficientlyimplemented.”
GibersonS,etal.AreporttotheU.S.SurgeonGeneral.Washington,DC:U.S.PublicHealthServiceOfficeoftheChiefPharmacist;2011 Dec .
“Maximizingtherolesandscopeofpharmaciststodeliveravarietyofpatient‐centeredprimarycareandpublichealth,incollaborationwithphysicians,isaprovenandexistingparadigmofcarethatcanbeefficientlyimplemented.”
GibersonS,etal.AreporttotheU.S.SurgeonGeneral.Washington,DC:U.S.PublicHealthServiceOfficeoftheChiefPharmacist;2011 Dec .
© American College of Clinical Pharmacy 7
Pharmacy Practice(Forces driving change)*
Technology
An aging population
Continued evolution of healthcare reform
Pharmacy workforce supply & demand
* In no particular order
© American College of Clinical Pharmacy 9
Technology(Internet)
Low cost, fast method for many to access medical care & locate health resources
Empowers patient to actively participate in managing their health with their provider
Allows institutions, health professionals, health providers, & the public to interaction & collaborate (distance education, telemed, etc)
Srivastava S, et al. Comput Math Methods Med. 2015;2015:894171. doi: 10.1155/2015/894171
© American College of Clinical Pharmacy 10
Technology(Mobile Platforms)
7 billion (≈ 95.5% of world pop.) mobile subscriptions worldwide
64% of Americans own smartphones, & for many it is a key entry point to the online world
Pew Research Center, April, 2015, “The Smartphone Difference” Available at: http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/ Accessed September 18, 2015
© American College of Clinical Pharmacy 11
Technology(Mobile Platforms)
62% of smartphone owners use it to access health information
Generations differ in readiness to adopt technology, which will evolve over time
Practitioners must be cognizant of differences & adapt to patient preferences
LeRouge C, et al. J Med Internet Res. 2014 Sep 8;16(9):e200. doi: 10.2196/jmir.3049.
© American College of Clinical Pharmacy 12
Aging Population(Impact of Baby Boomers)
Entire generation will be ≥ 65 in 2030
U.S population 65 +
2010: 13%
2030: 19%
Drive pop ≥ 65 to more than double from 2010 to 2050
The Next Four Decades The Older Population in the United States: 2010 to 2050. U.S. Department of Commerce Economics and Statistics Administration, U.S. Census Bureau, May 2010
© American College of Clinical Pharmacy 14
Chronic illnesses & medication use common
hypertension 43%; anti-hypertensives 35.4%
dyslipidemias 73.5%; dyslipidemics 25.9%
diabetes 15.5%; anti-diabetics 11.3%
Obesity common (38.7%)
Infrequent regular exercise or no regular physical activity common
Aging Population(Health of the Baby Boomers)
King DE, et al. JAMA Intern Med. 2013;173(5):385-6
© American College of Clinical Pharmacy 15
Health Care Reform(The PPACA)
Largest change in U.S. health policy since Medicare & Medicaid enacted in 1965.
Main provisions firmly established in U.S. health policy
Shaw FE, et al. Lancet 2014; 384: 75–82
© American College of Clinical Pharmacy 17
Health Care Reform(Basic Goals)
Provide security of health insurance to uninsured Americans
Increase the quality of care
Restrain the growth of costs
Advance population health
Shaw FE, et al. Lancet 2014; 384: 75–82
© American College of Clinical Pharmacy 18
Health Care Reform(Impact on Practice)
Added ≈ 16 million to insurance rolls so far
CBO estimates ACA will add 26 million to insurance rolls by 2017
Shaw FE, et al. Lancet 2014; 384: 75–82
© American College of Clinical Pharmacy 19
Health Care Reform(Impact on Practice)
Creation & evaluation of new clinical care models (i.e. ACO)
Provisions that strengthens link between cost of care & quality of care
Hospital Readmission Reduction program
Healthcare-Acquired Condition program
Shifts spending from rewarding volume of care provided to rewarding value provided
Shaw FE, et al. Lancet 2014; 384: 75–82
© American College of Clinical Pharmacy 20
0
2000
4000
6000
8000
10000
12000
14000
16000
First Professional (B.S. & Pharm.D.) Total*
Pharmacy Graduates(1996-2014)
Contains Pharm.D. degrees conferred for all years and professional B.S. degrees conferred prior to July 1, 2005
http://www.aacp.org/resources/research/institutionalresearch/Pages/TrendData.aspx
© American College of Clinical Pharmacy 22
Pharmacy Workforce 2014(Practicing Pharmacists)
75% of all licensed pharmacists
≈ 32% ≤ 40 years old
≈ 31% ≥ 55 years old
Full-time professionals averaged 44.2 hrs/wk
Gaither CA, et al. 2014 National Pharmacist Workforce Survey. http://www.aacp.org/resources/research/pharmacyworkforcecenter/Pages/default.aspx
© American College of Clinical Pharmacy 23
Pharmacy Workforce 2014(Practice Settings)
SettingProportion of Pharmacists
(%)Change from 2009
Community (i.e. independent, chain, mass merchandiser, & supermarket pharmacies)
44.1 ↓
Hospital 29.4 ↑Other Patient Care 16.7 ↑Other Non-Patient Care 7.5 ↑
Gaither CA, et al. 2014 National Pharmacist Workforce Survey.http://www.aacp.org/resources/research/pharmacyworkforcecenter/Pages/default.aspx
© American College of Clinical Pharmacy 24
Pharmacy Workforce 2014(Work Place Activities)
FT Pharmacist Activity 2014 Time of Effort (%)
2009 Time of Effort (%)
Patient care services associated with medication dispensing 49 55
Patient care services not associated with medication dispensing*
21 16
Business/organization management 13 14
Education 7 5Research 4 4Other Activities 6 5
*35.3% of community pharmacist indicated time spent on patient care increased
Gaither CA, et al. 2014 National Pharmacist Workforce Survey.http://www.aacp.org/resources/research/pharmacyworkforcecenter/Pages/default.aspx
© American College of Clinical Pharmacy 25
Pharmacy Workforce 2014(Current Services Provided)
Most common: MTM (60%), immunizations (53%) & adjusting meds (52%)
48% in chain sites & 57% in supermarket sites offer health screenings.
77% of hospitals offered Med Rec
> 25% of other patient care settings & hospital pharmacies have CPAs in place
Gaither CA, et al. 2014 National Pharmacist Workforce Survey.http://www.aacp.org/resources/research/pharmacyworkforcecenter/Pages/default.aspx
© American College of Clinical Pharmacy 26
Pharmacy Workforce 2014(Pharmacist Workloads Perceptions)
Nearly two-thirds believe workload high or excessively high
Full-time pharmacists workload 64% believe it increased or greatly increased in
past year 45% believe it had negative or very negative
effects on mental/emotional health
In chain & mass market settings workload negatively impacted time spent with patients
Gaither CA, et al. 2014 National Pharmacist Workforce Survey.http://www.aacp.org/resources/research/pharmacyworkforcecenter/Pages/default.aspx
© American College of Clinical Pharmacy 27
Pharmacy Workforce 2014(Work Place Labor Reductions)
Work Place Adjustment 2014 (%) 2009 (%)Restructuring of pharmacist work schedules to save labor costs 35 26
Mandatory reductions in pharmacist hours 17 13
Pharmacist layoffs 9 6Early retirement incentives for pharmacists 6 4
Gaither CA, et al. 2014 National Pharmacist Workforce Survey.http://www.aacp.org/resources/research/pharmacyworkforcecenter/Pages/default.aspx
© American College of Clinical Pharmacy 28
Pharmacy Workforce 2014(Aggregate Demand Index-Jul 2015)
Region Index ValueAll Regions 3.62Northeast 3.53Midwest 3.71 South 3.64West 3.56
Pharmacy Workforce Center. “Time-based Trends in Aggregate Demand Index.” http://pharmacymanpower.com/trends.jsp Accessed 09.19.2015
© American College of Clinical Pharmacy 29
Health Care Reform &the Pharmacy Workforce
Profession in midst of dynamic times
Direct patient care services increasing
Opportunities for new roles likely to increase
“Iftheroleofpharmacistschangeswherepharmacistsspendsubstantiallymoretimeprovidingpatientcaremanagementservices,thendemandwillbehigherthanprojected.”
Department of Health and Human Services Health Resources and Services Administration Bureau of Health Professions. The Adequacy of Pharmacist Supply: 2004 to 2030. Rockville (MD): December 2008. Available at: http://bhpr.hrsa.gov/healthworkforce/reports/pharmsupply20042030.pdf, Accessed September 9, 2015
“Iftheroleofpharmacistschangeswherepharmacistsspendsubstantiallymoretimeprovidingpatientcaremanagementservices,thendemandwillbehigherthanprojected.”
Department of Health and Human Services Health Resources and Services Administration Bureau of Health Professions. The Adequacy of Pharmacist Supply: 2004 to 2030. Rockville (MD): December 2008. Available at: http://bhpr.hrsa.gov/healthworkforce/reports/pharmsupply20042030.pdf, Accessed September 9, 2015
Gaither CA, et al. 2014 National Pharmacist Workforce Survey.http://www.aacp.org/resources/research/pharmacyworkforcecenter/Pages/default.aspx
© American College of Clinical Pharmacy 30
EMERGING ROLES OF CLINICAL PHARMACISTS IN THE HEALTHCARE ENVIRONMENT
© American College of Clinical Pharmacy 31
Medication Management(Unmet Needs)
Medication Related Problems Examples
Clinician-influenced gaps in care
• inappropriate prescribing • ineffective prescribing• lack of care coordination• and inconsistent monitoring
Patient-influenced gaps
• health beliefs• health illiteracy• past medication
experiences• nonadherence
Systematic Gaps• processes lacking for
medication reconciliation• poor care transitions
Smith M, et al. Health Affairs 2013;32 (11):1963-1970
© American College of Clinical Pharmacy 32
Medication ManagementServices (MMS) Build “gold standard” list of current prescribed
& self-care medications
Assess appropriateness, efficacy, safety, & adherence of each med to achieve optimal therapy goals
Develop personalized medication action plan
Document & communicate actionable recommendations to patients & providers
Smith M, et al. Health Affairs 2013;32 (11):1963-1970
© American College of Clinical Pharmacy 33
Pharmacy MMS(Integrated, Team-based Care)
Partner with patients, families, & providers to focus on patient specific issues that are key to achieving desired outcomes
Manage medication related problems, prevent ADE to avoid preventable medication related hospitalizations & ED
Help ensure optimal drug therapy outcomes during care transition
Smith M, et al. Health Affairs 2013;32 (11):1963-1970
© American College of Clinical Pharmacy 34
Pharmacy MMS Models(Employed Model)
Employed by practice as a clinician staff member
Suitable for large group practices or integrated delivery systems
Must be able to afford hiring pharmacists for non-dispensing activities
Smith M, et al. Health Affairs 2013;32 (11):1963-1970
© American College of Clinical Pharmacy 35
Pharmacy MMS Models(Embedded)
Employed, (usually part time), at practice site via partnership between practice & a hospital pharmacy or pharmacy school
Has responsibility for training pharmacy students & residents in team-based care & medication management
Affordable: partner & practice share responsibility for pharmacist’s compensation
Smith M, et al. Health Affairs 2013;32 (11):1963-1970
© American College of Clinical Pharmacy 36
Pharmacy MMS Models(Regional)
Employed by health system or physician organization & serves several practices in a geographic area
Typically focused on population health, may develop & deliver MMS in the practices
Can be involved in educational programs, quality improvement services, & outcomes research
Smith M, et al. Health Affairs 2013;32 (11):1963-1970
© American College of Clinical Pharmacy 37
Pharmacy MMS Models(Shared Resource Network )
Contracted by a provider group, ACO, or payer to provide MMS for specific patients
Meets with a patient in person in variety of settings, or via telemedicine connection
Attractive to smaller MD practices, ACOs, community-based health teams, & payers, network responsible for personnel
Smith M, et al. Health Affairs 2013;32 (11):1963-1970
© American College of Clinical Pharmacy 38
Integrated health care delivery system
Serves > 530,000 members (Denver/Boulder & its metro area, Colorado Springs, Pueblo, Loveland, & Ft. Collins)
Clinical pharmacists provide primary & specialty patient care as part of a PCMH
Centralized clinical pharmacy telephonic services also provided
Regional Model Example(Kaiser Permanente Colorado-KPCO)
Heilmann RMF, et al. Ann Pharmacother 2013;47:124-31.
© American College of Clinical Pharmacy 39
Regional Model Example(Kaiser Permanente Colorado-KPCO)
Clinical pharmacists knowledge & skills
complement other care team members
foster a collaborative team-based environment
Evidence-based patient care enabled through CDTM agreements with physician partners
Heilmann RMF, et al. Ann Pharmacother 2013;47:124-31.
© American College of Clinical Pharmacy 40
Pharmacist Activities(KPCO)
≈70% effort devoted to consulting with PCP or providing direct patient care
≈ 25% effort devoted to addressing regional & clinic-specific pop. management initiatives
≈ 5% effort devoted to non-patient care activities
Heilmann RMF, et al. Ann Pharmacother 2013;47:124-31.
© American College of Clinical Pharmacy 41
Large, urban, academic medical center partner with state department of corrections
Provides care for inmates in 28 adult correctional facilities using a interprofessionalapproach
Technology enables interactions similar to traditional face-to-face clinic visit
Shared Resource Example(UIC HIV Telemedicine Clinic)
Badowski M, et al. Am J Health-Syst Pharm 2012;(69):1630-3
© American College of Clinical Pharmacy 42
Patient education
MMS addressing med adherence, identifying and managing medication induced AEs, managing drug interactions, & making therapeutic recommendations
Subsidized via contract & savings from 340B program
UIC HIV Telemed Clinic(Pharmacist Role)
Badowski M, et al. Am J Health-Syst Pharm 2012;(69):1630-3
© American College of Clinical Pharmacy 43
CURRICULAR MODIFICATIONSTO MEET THE NEEDS OF THE CHANGING HEALTHCARE ENVIRONMENT
Standards 2016:
© American College of Clinical Pharmacy 44
Meeting Practice NeedsThrough Standards Revision
Current & future competencies of pharmacists
Practices to assess student learning & the quality of professional pharmacy programs
“The status quo is not an option” in pharmacy practice, pharmacy education…“We must continue to advance the roles of pharmacists to meet the future needs of patients”
Opening remarks by Robert S.Beardsley, PhD, President of ACPE, at the ACPE Consensus Conference on Advancing Quality in Pharmacy Education September 12-14, 2012, Atlanta, GA.
“The status quo is not an option” in pharmacy practice, pharmacy education…“We must continue to advance the roles of pharmacists to meet the future needs of patients”
Opening remarks by Robert S.Beardsley, PhD, President of ACPE, at the ACPE Consensus Conference on Advancing Quality in Pharmacy Education September 12-14, 2012, Atlanta, GA.
Zellmer WA, et al. American Journal of Pharmaceutical Education 2013; 77 (3) Article 44.
© American College of Clinical Pharmacy 45
Standards 2016(What’s Different) Philosophy and Emphasis based on stakeholder feedback refined to ensure that graduating students are
“practice-ready” & “team-ready” greater emphasis on CAPE outcomes & the level
of student achievement of these outcome emphasize assessment as a means of improving
the quality of pharmacy education Formatting, organization, guidance, more
innovationAccreditation Council for Pharmacy Education. Standards 2016. February 2, 2015. Chicago, IL
© American College of Clinical Pharmacy 46
CAPE Outcomes(Version 4.0) Influenced by 3 pillars of pharmacy education
& consistent with IOM core competencies pharmaceutical care, management of medication-
use systems, public health
Added attention to affective domain of pharmacy practice (e.g.
communication, professionalism, etc.,) patient safety interprofessional health care.
Medina MS, et al. Am J Pharm Ed 2013; 77 (8) Article 162.
© American College of Clinical Pharmacy 47
CAPE Outcomes(Version 4.0) Focused on the end product of Professional
Pharmacy program (i.e. the knowledge, skills, & attitudes all entry-level graduates should possess
Define the curricular priorities of the Doctor of Pharmacy programs
Aspirational & emphasize increased program expectations
Medina MS, et al. Am J Pharm Ed 2013; 77 (8) Article 162.
© American College of Clinical Pharmacy 48
CAPE Outcomes(Version 4.0)
Purposefully constructed around 4 broad domains to guide education pharmacists who possess: foundational knowledge that is integrated
throughout pharmacy curricula essentials for practicing pharmacy & delivering
patient-centered care effective approaches to practice & care the ability to develop personally and professionally
Medina MS, et al. Am J Pharm Ed 2013; 77 (8) Article 162.
© American College of Clinical Pharmacy 49
CAPE Outcomes(Affective Domain) Included to recognize importance of
professional skills & personal attributes to practice emphasizes self-awareness, innovation
leadership, & professionalism needed for practice bridges foundational scientific knowledge with
essential skills & approaches to practice & care
Enables pharmacists to transform knowledge & skills into positive outcomes in all settings.
Medina MS, et al. Am J Pharm Ed 2013; 77 (8) Article 162.
© American College of Clinical Pharmacy 50
Standards 2016(Team & Practice Ready)New or ImprovedElement
Contribution to Preparing Students for ChangingHealth Care Environment
Earlier experientialexperiences
• Foundational knowledge throughout curriculum, patient interactions, patient safety
• Communication, interacting with patients & other professionals about medicines
• ProfessionalismInterprofessionalEducation
• team-based skills (clinical expertise, developing collaborative relationships, accountability for patient outcomes)
• IPE competencies & professionalism,Enhanced assessment • Critical thinkingPharmacy Curriculum Outcomes Assessment
• Assessment outcome achievement• Foundational knowlege
Co-curriculum • Professionalism, leadership, critical thinking, personal & professional Development
© American College of Clinical Pharmacy 51
CONTRIBUTION OF IPE & SERVICE LEARNING IN THE EXPERIENTIAL TRAINING OF STUDENT PHARMACISTS
© American College of Clinical Pharmacy 52
The Value of IPE Activities
Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessionalcollaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative.
““When students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes” Who (2010)
““When students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes” Who (2010)
© American College of Clinical Pharmacy 53
Importance of Co-CurricularActivities in Pharmacy Education
Standard 4.2 requires program to develop student leadership (“..demonstrate responsibility for creating & achieving shared goals, regardless of position”) emphasizes “..importance curricular AND co-
curricular experiences in advancing professional development of students”
Key element 12.3 - develop means to document competency in the affective domain-related expectations in Std 3 & 4
Accreditation Council for Pharmacy Education. Standards 2016. February 2, 2015. Chicago, IL
© American College of Clinical Pharmacy 54
Realizing the Value of Co-curricular Activities Health care reforms created greater patient care
& disease management roles Leadership within profession needed to close
gap between the vision of ideal practice & current practice requires within the profession
Exposing students to leadership concepts & professionalism provides skills needed to identify opportunities & deal with challenges in their careers
Chestnut R, et al. Am J Pharm Ed 2013; 77 (10) Article 225
© American College of Clinical Pharmacy 55
Perceived Benefits toCo-curricular Assessments Educates “the whole student”
Allows for the integration of academic, professional, & personal development
Foster the development of student knowledge & personal development outside of the classroom
Activities often provide leadership opportunities
Leadership is teaches beliefs & skills that will be useful in patient-centered team based practice
Fontaine SJ, et al. Online Journal of Distance Learning Administration, 2014; 17(3) Available from http://www.westga.edu/~distance/ojdla/fall173/fontaine_cook173.html University of West Georgia, Distance Education Center. Accessed: September 20, 2015© American College of Clinical Pharmacy 56
Perceived Drawbacks toCo-curricular Assessments
Co-curricular activities have been considered “extra-curriculuar” (i.e. voluntary based upon individual student interest(s)) not required
“Curricularizing” these activities will encourage students to enage in them for the wrong motives (“have to” not “want to”)
New infrastructure needed to develop & perform assessment of these activities
© American College of Clinical Pharmacy 57
Concluding Remarks
Several forces driving change have havecreated a dynamic era for pharmacy practice
Education & training standards are responding to prepare students for emerging new practice models & opportunities
Learners of today will practice in a patient centered, team-based environment that will be supported by health-information and patient focused technology tomorrow
© American College of Clinical Pharmacy 58
Flip this classroom: Exploring the
use of the Flipped Classroom Model
in Pharmacy Education October 21, 2015 9:45-11:15
© American College of Clinical Pharmacy 59
Presenters
Mary Roth McClurg, PharmD, MHS
Associate Professor
Jacqui McLaughlin, PhD, MS
Assistant Professor, Educational Innovation and Research
Division of Practice Advancement and Clinical Education
UNC Eshelman School of Pharmacy
Chapel Hill, NC
© American College of Clinical Pharmacy 60
Learning Objectives
Explain the pedagogical benefits of using the flipped
classroom model for delivery of pharmacy education
compared to traditional teaching methods.
Explore the challenges of using the flipped classroom
model.
Discuss the required resources and best approach to
incorporating flipped classrooms into pharmacy
curricula, particularly for teaching therapeutics.
© American College of Clinical Pharmacy 61
What does “flipped classroom” mean?
Bergmann & Sam (2012)
instructors post material online for students to learn on their own so that
class time can be dedicated to student-centered learning activities, like
problem-based learning and inquiry-oriented strategies
Also called: inverted, backward, or reverse classroom
Examples in physics, economics, medicine, etc.
Lage (2000) J Econ Educ
Deslauriers (2011) Science
McLaughlin, JE, et al. (2014). The flipped classroom: A Course redesign to foster learning and engagement in a health professions
school. Academic Medicine, 89(2), 1-8.
Flipped Classroom:
Defined
© American College of Clinical Pharmacy 62
Flipped Classroom:
Structure
1. Pre-class learning
2. In-class active learning
3. Assessment
Necessary but not mutually exclusive
Many variations of the flipped classroom are
described in the literature
Constructive Alignment
© American College of Clinical Pharmacy 63
Table 1. Characteristics of ten flipped courses at
UNC Eshelman School of Pharmacy (2012-2014)
ID Year/Course
type
Pre-Class Learning
Format
In-Class Learning
Strategies
Graded
Assessments
1 Year 1/ Science Text Case-based learning (CBL) Quizzes, exams
2 Year 1/ Science Video Peer discussions,
structured problem solving Quizzes, exams
3 Year 1/ Science Video & text Clickers, CBL Quizzes, exams
4 Year 1/ Science Video & text Clickers; peer discussion Quizzes, exams
5 Year 1/ Science Video Clickers, CBL, micro-lectures Quizzes, exams, paper
6 Year 1/ Science Video Clickers; micro-lectures Quizzes, exams, paper
7 Year 2/ Science Text CBL, micro-lectures Quizzes, exams
8 Year 2/
Pharmacotherapy Text Clickers, CBL, micro-lecture Quizzes, exams
9 Year 2/
Pharmacotherapy Text Clickers, CBL, micro-lecture Exams
10 Year 2/
Pharmacotherapy Text Clickers, CBL, micro-lecture Quizzes, exams
© American College of Clinical Pharmacy 64
Flipped Classroom:
Examples
1. McLaughlin, JE, et al. (2014). The
flipped classroom: A Course redesign
to foster learning and engagement in a
health professions school. Academic
Medicine, 89(2), 1-8.
2. McLaughlin JE, et al. (2013). The
flipped satellite classroom: Student
engagement, performance, and
perception. American Journal of
Pharmaceutical Education, 77(9), Article
196.
© American College of Clinical Pharmacy 65
PHCY 411
Quantitative Approach (quasi-experimental)
N = 162
1. Exam grades and course evaluations from 2011 (traditional) and
2012 (flipped)
independent t-test
2. Pre-post survey responses from 2012 class prior to start of first
class and at conclusion of last class (n = 150)
paired t-test
© American College of Clinical Pharmacy 67
PHCY 411
Primary findings
Flipped class in 2012 performed
better than traditional class in 2011
on final exam (p <.01)
Course evaluation metrics
significantly higher in 11/14 items
(p< .05)
In pre-survey, 73% of students
preferred lectures. In post-survey,
only 15% of students preferred
lectures to the flipped model
(p<.001)
Inn
ate need
s
Intrinsic Motivation
Self Determination Theory
(Deci & Ryan, 2002)
1. Autonomy
2. Relatedness
3. Competence
© American College of Clinical Pharmacy 68
Required Resources
Technological support
Pre-class materials
In-class activities
Assessments
Educator development
Time
Teaching assistant?
Others?
© American College of Clinical Pharmacy 70
Questions
Mary Roth McClurg, PharmD, MHS - [email protected]
Jacqui McLaughlin, PhD - [email protected]
© American College of Clinical Pharmacy 71