Physical assessment educational programs for pharmacists and pharmacy students: A systematic review

Abstract

Introduction The scope of pharmacy practice has evolved to include physical assessment (PA) as part of the management of drug therapy. Objective To describe programs developed to teach pharmacists/pharmacy students PA and identify factors associated with improved knowledge, skill, confidence, and utilization. Methods A librarian‐assisted search was performed of MEDLINE, Embase, and Cumulative Index to Nursing and Allied Health Literature using the terms “pharmacist,” “student,” and “physical examination,” supplemented with manual reference searches. Studies published exclusively as abstracts were excluded. No language restrictions were applied. Extracted data included design, location, participants, methods of instruction, PA skills taught, assessment, utilization, and follow‐up. Results The search yielded 635 unique citations, which were independently reviewed by two authors. Twenty‐eight articles were reviewed in full and 16 were included. Most studies were conducted in the United States or Canada. Thirteen studies enrolled pharmacy students (mainly second or third year), which focused on comprehensive PA skills or blood pressure measurement. Length of instruction ranged from a single session to a full‐year course. Generally, any type of instruction improved knowledge and confidence with PA. Students preferred pharmacist instructors to other clinicians, and live subjects to simulators/manikins. Three studies evaluated courses for practicing pharmacists, which included comprehensive PA instruction and consisted of 2‐30 contact hours. Participants' confidence with performing PA improved from precourse to postcourse surveys. One study showed improved confidence with performing PA 6 months after the course, while another study showed no improvement in confidence but increased PA use at 6 months postcourse. Utilization of PA after 6 months ranged from 49% to 66%. Conclusions A variety of programs have been developed to teach PA skills to pharmacists/pharmacy students. Limited data suggest that sessions which included pharmacist instructors and live subjects to practice PA skills were preferred. Courses for practicing pharmacists improved confidence with performing PA, but persistent confidence and utilization at 6 months were variable.

Setting priorities for physical examination in pharmacy education: A Delphi study

“…Our panelists also strongly agreed to exclude male and female genitalia and breast and prostate examinations from pharmacy programs. These results were not surprising, considering that very few pharmacy schools include these examinations in their curriculum 8 , 18 despite their being listed in patient assessment references. 19 Some of these examinations are considered invasive and could therefore not be performed in community pharmacies in Quebec, as stipulated in the current legislation.…”

“…7 Over the last decade, many initiatives have attempted to develop specific PE training for pharmacy practice. 8 Most of this training has demonstrated mixed results in terms of transfer of learning and persistent use in practice.…”

Designated prescribing practitioners: a theory-based cross-sectional study of stakeholders’ views on implementation of a novel pharmacy regulator mandated preceptorship model

“…However, respondents in this study did not anticipate issues. This may be a consequence of increased coverage at undergraduate level in the UK [34] and internationally [35]. There has also been an increase availability in such training at post-graduate level through both work-based learning and simulation [36][37][38].…”

Virtual physical assessment training during the COVID-19 pandemic - student pharmacists’ performance & perceptions

“…This finding is expected, given that many students previously reported the lack of a household member to practice PA on during the end of this semester. Literature suggests that pharmacy students prefer to learn PA skills on fellow peers or standardised patients over a mannequin or other simulation method (Barry, Turgeon & Ellis, 2020).…”

“…While the PA curriculum greatly varies amongst Pharm.D. programmes, vital signs are one of the most covered PA topics in addition to pulmonary and cardiovascular systems (Spray & Parnapy, 2007;Barry, Turgeon & Ellis, 2020). In contrast, the least amount of confidence was reported when performing cardiovascular (76%) and neurologic (77%) assessments.…”