Evidensbasert undervising

"Ideen om evidensbasert undervising - eit filosofisk forsvar"

submitted
In the debate about evidence-based teaching one often encounters philosophical arguments. Such arguments are characterized by being principled and general, in the sense of not resting on whether meta-analyses or randomized controlled experiments are well or poorly executed. In this article I look at several such philosophical arguments against evidence-based teaching and the relevance of RCT’s for education: instrumentalism, normativity, judgment, contextuality, complexity, and identification. I conclude that none of these arguments are valid. This does not mean that evidence-based education is unproblematic, but it does mean that the best arguments are practical rather than philosophical.

Key words: Evidence-based teaching, RCT, instrumentalism, contextuality, philosophy of science

The Political Conception as Educator

"Rawls' idea of the Political Conception as Educator"

European Journal of Political Theory, forthcoming
This paper explores John Rawls’ strangely neglected notion, the political conception as educator, which captures how the public political culture can educate citizens. The aim is to elucidate both the idea itself and above all its function in Rawls’ Political Liberalism. After first surveying its main content and some historical parallels, the main body of the paper explores why Rawls places so much trust in the educative effect of institutions and, apparently, so little in schools. Along the way we shall discuss the relation between political liberalism and republicanism, the border disagreement between political conception and comprehensive doctrine, Mackie’s distinction between wide and narrow morality, and the importance of trust in Rawls’ view of society.

R-E-S-P-E-C-T Find Out What it Means to Me

By: Theresa Carboni, Pharm.D. PGY-1 Pharmacy Practice Resident, Baltimore VA Medical Center

I remember the day I received my acceptance letter to pharmacy school. “This was it!”  I told myself.  With the letter in hand, I was now well on my way to achieving my goal of becoming a pharmacist.  As I prepared to move 500 miles away, sacrifice 4 years of my life, and pull out a loan the size of a mortgage, I never thought I’d have to earn the respect of my professors (and future colleagues). I had been accepted to the school.  If I were unqualified, I wouldn’t be here, right? Well, on the very first day, I was quickly put in my place by one of my professors.  After I tried to clarify some of the course requirements, he stated, “You will do exactly what I say. Once you have your license in hand, then maybe I will consider what you have to say.”  This incident and a few similar situations, set the tone for the next 4 years with that professor.  And, unfortunately, with a few others too. Based of this experience, I wanted to understand the impact that respect between teacher and student has on learning.

Respect is defined as a state of honor or esteem wherein there is a demonstrated willingness to show consideration or appreciation.¹  Respect is an important component of professionalism.²  A professional shows respect for patients and their families, peers, and other healthcare professionals.   Key documents in the pharmacy literature define the standards by which pharmacists and pharmacy students should demonstrate professional behavior and attitudes. These documents include the Code of Ethics for Pharmacists, Pledge of Professionalism, and Oath of a Pharmacist.²   The word respect is literally written into our professional codes of conduct, the standards by which both pharmacists and pharmacy students should live up to.  Shouldn’t these codes of conduct apply to the interactions between students and teachers in (and outside) the classroom?

Indeed, respect is clearly important and a requirement within the  standards for pharmacy education. According to the Accreditation Council for Pharmacy Education (ACPE) 2007 Standards for the Professional Degree Program in Pharmacy (Standard No. 25: Faculty and Staff – Qualitative Factors), “The college or school must have qualified faculty and staff who, individually and collectively, are committed to its mission and goals and respect their colleagues and students.”³ Additionally, it goes on to state that [faculty] “should provide strategies to develop consistent socialization, leadership, and professionalism in students throughout the curriculum.”³ If faculty are required to respect students and to ensure that students uphold the standards of professionalism, then it seems imperative that it be effectively demonstrated by everyone in the academic community (administrators, faculty, staff, and students).

If respect is important, how can teachers effectively demonstrated it?  What does respect look like?  In his book “What the Best College Teachers Do”, Kenneth Bain devotes an entire chapter on how the best teachers treat their students.⁴  He goes on to describe how the best teachers display an investment in their students. Moreover, the best teachers have a strong sense of trust in their students by believing that students want to learn, and assume, until proven otherwise, that they can.  Above all, the best teachers treat their students with simple decency.  Teachers should treat students in the same manner they would treat a colleague - with fairness, compassion, and concern.  Bain observed that the best teachers incorporated this approach into everything they did – including what they taught, how they taught, and even how they evaluated students. In other words, the best teachers did not use their power to bend students to their will but rather attempted to build common ground based on trust, decency, and respect for what each other brought to the classroom experience.⁴

Pharmacists and pharmacy students are bound by our Code of Ethics⁵ “to respect the values and abilities of colleagues and other health care professionals.” Since we commit as professionals to uphold these standards, I feel it is imperative we start when a student enters pharmacy school  … and not wait until graduation.

References:

1. Webster’s Dictionary for word respect. Accessed on December 15, 2010.

2. Hammer DP. Professional attitudes and behaviors: the “A’s and B’s” of professionalism. Am J Pharm Educ 2000; 64: 455-464

3. Accreditation Council for Pharmacy Education: Accreditation Standards and Guidelines for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree. Available at: http://www.acpeaccredit.org/pdf/ACPE_ Revised_ PharmD_ Standards_ Adopted_Jan152006.pdf. Accessed on December 15, 2010.

4. Bain K. What the Best College Teachers Do. Harvard University Press. Cambridge, Massachusetts.

5. Code of Ethics for Pharmacists. American Pharmacists Association. 1994 

Pick Me! I Was a Pharmacy Technician

by Kasey Dumas, Pharm.D., PGY1 Pharmacy Practice Resident, Sibley Memorial Hospital 

Many universities consider previous pharmacy work experience to be a predictor of better academic performance in pharmacy school.  Attesting to this fact is that some pharmacy schools include information on their websites implying that work experience may enhance an applicant’s chance of acceptance.  For example, the University of Maryland School of Pharmacy website states, “Work experience is not required for admission.  However, it can show commitment to the field of pharmacy or can demonstrate the well-roundedness of an applicant.”¹ The Virginia Commonwealth University’s School of Pharmacy website states that previous work experience is not required but, “exposure to pharmacy practice is desirable” and “ideally, successful candidates have some exposure to the health care system and patient care involvement.”²  This is a interesting hypothesis, but what needs to be tested is whether previous pharmacy-related work experience results in improved academic outcomes.

A study conducted in April 2010 at the Touro University College of Pharamacy evaluated the impact of previous pharmacy work experience on academic success.  This study was looking at both academic and clinical performance.  A survey was used to determine the type and quantity of pharmacy work experience.  The survey results from 206 responding students were then correlated with grade point average (GPA), high-stakes examination grades, and advanced pharmacy practice experience (APPE) grades.  The researchers also stratified the data by student demographics.  The results of this study showed no difference in academic performance between students with previous work experience and those without previous work experience.³ 

Unfortunately, the results of this study may not be generalizable to other pharmacy schools (or health professional disciplines).  The average age of respondents in the Touro study was 26 years in respondents with no work experience and 27.3 years in respondents with work experience.  Some institutions accept students immediately from high school into 6-year programs.  Thus, the effects of work experience may be different if the average age is much younger (or older).  Also, assessment strategies and grading methodologies differ between institutions.  Finally, surveys in general have poor response rates and may not accurately represent the entire student body.

One explanation as to why work experience does not translate into better academic outcomes is that working as a technician or intern teaches you technical skills, but not clinical skills, which are now the focus of pharmacy curriculums.³  Although academic performance does not appear to be effected by work experience, previous experience in a pharmacy may indicate that a perspective student is more sure of their future and may be more dedicate to the profession.^1,2  In the future, it may be beneficial for researchers to examine other benefits that previous work experience may confer.

Previous work experience may be a useful way to select between students and it may predict some other desirable attribute(s).  In my experience, working as a pharmacy technician made me more confident when I entered pharmacy school, more certain that I had made the best career choice, and made studying for many of the technical aspects easier, such as learning brand and generic names of medications.  Also, during my clinical experiences, I was already comfortable interacting with members of the pharmacy team and speaking with physicians and nurses.

In conclusion, although experience has not been shown to improve academic performance, other benefits may be afforded to students (and the schools that accept them) who have previous work experience.  I believe that universities should continue to use previous work experience as one the criteria to select applicants but we need further studies to better understand how previous pharmacy-related experience impacts short and long-term outcomes.

References

1.      University of Maryland School of Pharmacy.  PharmD Admissions: Prerequisites.  Accessed: Dec 2010.

2.      Virginia Commonwealth University School of Pharmacy.  Pharm. D. Program FAQ: Academic info.  Accessed: Dec 2010.

3.      Mar E, Barnett MJ, Tang TTL, Sasaki-Hill D, Kuperberg JR, Knapp K.  Impact of previous pharmacy work experience on pharmacy school academic performance.  American Journal of Pharmaceutical Education.  2010; 74 (3): Article 42.