The main goal of the instructor for the III session was to design learning tools for students so that they learn how to estimate major patient-specific pharmacokinetic parameters after this route of administration. To accommodate the requirements of some Advanced Pharmacy Practice Experience rotations that students be able to estimate the kinetic parameters using the patient chart data and plasma concentrations taken from two intervals, learning tools were designed with special emphasis on these requirements. The performance data presented in Figures 4 and 5 suggest successful achievement of this goal using the instructional tools developed for this topic. The students’ use of the reading notes and the practice problem on their own before attending the class combined with the activities during the class session resulted in a significant improvement in the performance of the students, which was demonstrated by a substantial improvement (P < 0.001) in the posttest grades (60%), compared with the pretest grades (11%). This suggests the effectiveness of the reading notes, practice problem, and classroom activities. Additionally, a significant improvement in the students’ performance in the take-home assignment (89%), compared with the posttest (60%), suggests the effectiveness of the designed take-home assignment with the immediate feedback and unlimited opportunity to practice.
It could be argued that the students’ performance in the take-home assignment is inflated relative to the other tests because of two main differences between the assignment and other tests. First, other than a due date and time, the assignment lacked the time stress present for the other tests. Therefore, students could spend as much time as they needed for each question while answering the assignment questions. Second, whereas the pretest, posttest, and mid-term exam were not open book (except for provision of an equation sheet), students had access to all course materials for the take-home assignment. Therefore, one might expect that the performance of the students in the mid-term exam to be lower than that in the assignment. Although the grades of students in the mid-term exam (83%) were lower than those in the assignment (89%), this difference did not reach statistical significance (Figure 4A). Nevertheless, the significant improvement in the grades between the posttest and mid-term exam (Figure 4A) indicates that the events between the two assessments, including the students’ work on the assignment, improved students’ learning of the subject.
At Texas Tech School of Pharmacy, the courses offered during the first and second year of the pharmacy curriculum are delivered synchronously to Amarillo and Abilene campuses. The instruction may be initiated from either campus depending on the location of the instructor. For the Pharmacokinetics course, all the sessions initiated from Amarillo. Therefore, the Abilene campus was considered the distant campus. To assure equality of performance between the two campuses, all the performance data were routinely monitored separately for the two campuses. As shown in Figure 4B, there were no significant differences between the two campuses in terms of performance in the tests, and the performance data for each site mirrored that for the whole class (Figure 4A).
The performance data on the individual questions (Figure 5) were surprising. Although students had ample opportunity to calculate k or half life using the data from the same interval and were familiar with the concept of repeating peak and trough values at steady state, only 4.8% of them were able to calculate k correctly in the pretest using the data from two intervals. Despite this very low performance in the pretest, the educational activities designed in this course resulted in an astonishing 93% correct answer in the take-home assignment (Figure 5). Interestingly, this high level of performance was retained even under the time-sensitive and non-open book environment of the mid-term exam, when students scored 92% for answering k correctly (Figure 5). This data clearly show the importance of practice in learning pharmacokinetic calculations or concepts. If we, as instructors, would like students know how to estimate a k value based on a peak and trough from two separate intervals, we must create opportunities for them to practice this method before assessing them. Nevertheless, the data in Figure 5 clearly show that having utilized the learning tools described here, a large number of students (>92%) are capable of estimating k using samples from two intervals under the time-sensitive and stressful conditions of formal examinations.
Although the trend for the Cmin data was similar to that for k in that the performances of students in the take-home assignment and mid-term exam were similar, the number of students who answered the Cmax or V questions correctly in the mid-term exam was significantly lower than that in the take-home assignment (Figure 5). Indeed, the lowest performance during the mid-term exam belonged to the V question as 70% of students answered this question correctly. This is most likely related to the complexity of the equations for the estimation of V. Therefore, manual calculation of V using the complicated equations (5) or (6) under time-sensitive conditions, such as formal exams, is associated with more error than estimation of other parameters, which use simpler equations.