We implemented and evaluated the educational efficacy of the lifesaving-training program for pharmacy students. The program made use of a high-performance patient simulator, which simulated a patient with cardiac arrest being rushed into a hospital outpatient care, and it placed emphasis on the pharmaceutical interventions. Our evaluation of the program indicated that it deepens the participants’ understanding of emergency measures, including pharmaceutical measures, and that it increases their confidence in their ability to perform pharmaceutical interventions. The results also yielded a new finding that item of “selection of medicine should be changed in order to improve the training content.
Emergency care involves a distinctive form of diagnostic care of emergency and serious patients, which differs from general diagnostic care. Emergency care is a relatively recent discipline in Japan, and many pharmacists are not adequately aware of its distinctive nature. This situation must be improved as soon as possible. Hence, there is an urgent need to enhance and spread education on clinical emergency care among pharmacists. An effective educational strategy is off-job simulation training for emergency care. In this study, we tested the participants’ level of acquired knowledge of the content of the lifesaving skills training in order to measure the learning outcomes of our pharmaceutical lifesaving skill-training program. The results indicated that the post-training overall correct answer rates were significantly higher than the pre-training overall correct answer rates. Moreover, in the post-training questionnaire survey, the participants showed a high level of understanding of all items (emergency measures gathering information on medicine taken, preparing injection/intravenous drip, and selecting medicine). It has been reported that when teaching CPR to medical students, high-performance patient simulators provide a greater sense of realism than traditional simulators and deliver better learning outcomes . In addition, we prepared a scenario based on the type of cases experienced daily by pharmacists employed in emergency care settings. Therefore, we believe that this scenario reflected real-life clinical practice and led to better learning outcomes.
The participants’ confidence in their ability to perform pharmaceutical interventions to emergency patients was markedly higher after the training. The fact that the training increased the participants’ confidence in their ability to perform pharmaceutical interventions, should have a positive impact on their proactivity, which is indispensable for promoting the involvement of pharmacists in outpatient emergency care in the future. The sense of accomplishment felt by the students when they succeeded in restarting the high-performance patient simulator’s heartbeat after a collaborative process of trial and error probably caused a major boost in their self-confidence.
The item that had the greatest impact on the participant’s confidence in their ability to perform pharmaceutical interventions was probably “selecting medicine”. One probable cause of this result is the way we designed the training. That is, we gave the participants enough time to consult among themselves while referring to the available sources of information (such as the notes attached to the drugs and emergency treatment guidelines) that would help them figure out how to treat the case. We also set up the simulator patient so that it would die if an inappropriate procedure were performed. In other words, the participants probably recognized that an understanding of how each drug should be used in emergency cases would be useful when performing pharmaceutical interventions for actual emergency patients. Doctors and nurses in emergency outpatient care must administer drugs while performing various emergency procedures, so it is difficult in many cases to select the optimum medicine for the patient’s condition. Therefore, the students who participated in our lifesaving skills training program will improve the quality of their pharmacotherapy skills with respect to the selection of medicine for emergency outpatients, and thereby promote proper use of drugs and the prevention of excessive administration.
Subsequently, we analyzed the training content we provided using a Customer Satisfaction (CS) analysis in order to find out how we can improve the training in the future. According to the CS analysis, the item most in need of improvement is “selecting medicine”. On the CS graph, this item was positioned in the improvement required category, denoting that the item was poorly understood and negatively affected the overall evaluation. The training did not provide the participants with knowledge on which medical treatments will have a beneficial effect on emergency patients. It was the pharmacy students’ first time selecting drugs to administer to the emergency patient, so their lack of familiarity with the process may have caused this result. This aspect should be improved by familiarizing the participants as much as possible during the training. For example, the participants can be given a lecture on the CPR-related drugs that are covered in the training. In light of the results of the CS analysis, we concluded that the content of “Selecting medicine” should be changed in order to improve the pharmaceutical lifesaving skills training program.
A limitation of this study is the lack of participation by doctors and nurses, who play a vital role in the delivery of emergency procedures. It cannot be stated that the universal efficacy of the program has been shown completely by only analyzing the evaluation of the small number of participants. Using the present pharmaceutical lifesaving skill training program as a reference, we would like to develop a practical pharmaceutical lifesaving skill training program based on interdisciplinary collaboration.