Pedagogy

The pharmacy curriculum being followed at the time the new course was developed included 2 optional management courses, one in hospital practice management and the other in community practice management (3 credits each). Two mandatory courses covered law and ethics and the health care system. Before the reorganization, both the hospital and the community practice management courses were taught by means of traditional classroom lectures, and student performance was evaluated by multiple-choice final exams. The following principles guided the reorganization of the content of the management courses: the courses should retain, in part, a traditional classroom teaching approach; a teaching case based on a real-life situation should be added; opportunities for discussion among students should be created; the methods of student evaluation should incorporate not only participation but also the relevance of that participation; and a Web-assisted approach to teaching the course should be implemented and evaluated. The hospital pharmacy management course was taught by the same team at both universities.

A new 3-credit course was developed, with twelve 3-h modules of traditional classroom teaching. The following general learning objectives were defined: at the end of the course, the student should be able to define and understand health care networks and the positioning of a hospital pharmacy department; the student should have acquired basic management knowledge and be able to apply that knowledge to hospital pharmacy practice; and the student should be able to analyze the key external and internal elements of the health care environment relevant to pharmacy practice and to identify opportunities, threats, strengths, and weaknesses related to hospital pharmacy practice. The modules were developed according to the following themes: organization of a pharmacy department within the health care system (i.e., organizational aspects of the health care system as a whole, the hospital specifically, and the pharmacy department itself1) applied financial management, applied human resource management, risk and quality management, stock management, pharmacy distribution services, clinical pharmacy services, and information technology.1 Each module had a minimum of 15 specific learning objectives with 15 to 20 pages of relevant content in the course learning materials. Three suggested readings per module were provided for classroom and Web-based forum discussions. The course materials were made available on the Web to maximize students’ use of suggested hyperlinks in the text; however, because high-quality printers are not available to students at either university, a professionally printed copy of the course materials was also given to each participant. These course materials were not edited for optimal Web-based learning, but if the course eventually becomes an online-only course, they will have to be re-edited. Students were expected to attend all classroom sessions.

Table 1. Guidelines for Use of Electronic Discussion Forums
Reach agreement on the expected frequency of forum access by each participant (e.g., daily, every other day, weekly)
Identify the main discussion subjects, to focus the students’ contributions to forum discussions
Ensure that the students master the forum’s main functionalities (e.g., how to reply with historical background, how to attach a signature, how to insert a document)
Avoid initiating several discussions at once within the same subgroup; refrain from starting new discussions before previous discussions have concluded
Identify a moderator for each subgroup; this person should summarize the ideas discussed before closing the subject
Avoid unnecessary messages; in the case of an opinion poll, ask the participants to reply through e-mail and present the compiled results after a predetermined deadline
Encourage participants to present brief messages and respect the following rules: limit each paragraph to 1 idea, limit each message to a maximum of 2 ideas, present a clear conclusion (i.e., restate the question asked, identify the new information added to the discussion, and indicate approval or disapproval of the idea under discussion)
Identify beforehand the “Netiquette” rules applicable to the group; specify whether participants play a role or simply offer their personal opinions; specify what should be kept confidential
Indicate explicitly the forum’s participants; specify if other teachers, observers, or students from other groups will have access to the platform
Encourage students to keep their passwords confidential and to change passwords if needed to maintain confidentiality
The nature and frequency of the teacher’s role must be specified beforehand (Is the teacher acting as a moderator? an informant? a referee? How often will the teacher read the posted messages?); intervene in an appropriate and foreseeable way

The course included a business case covering 7 pharmacy issues. Student teams (consisting of 5 to 7 students, depending on the number of students enrolled in the course) were formed, and each team was assigned to work on 1 of the 7 issues. One team was assigned to examine the management of the pharmacy department, in addition to analyzing its assigned pharmacy issue. The business case was based on data from a real pharmacy department in a teaching institution. The students were given the hospital’s annual report, the pharmacy’s annual report and financial statements, and other relevant documents. From this large amount of data, the students had to efficiently identify the key elements and figures relevant to their pharmacy issue, prepare a written report, and make an oral presentation at the end of the course. Each team was asked to present recommendations, taking into account the strategy of the pharmacy department, the department’s budget, the institution’s needs, and the professional context. Each team had a leader (elected by the group members), who was responsible for managing the group during the semester; this included moderating discussions related to the oral presentations, choosing and exercising a leadership style, determining an appropriate approach for feedback, informing group members, and reporting decisions. Students were encouraged to make decisions by consensus.

The pharmacy issues covered in the course included the following: Should the pharmacy department automate its activities? Should the pharmacy department implement point-of-care dispensing technology (e.g., drug cabinets)? Should the pharmacy department reorganize its research services? How should the pharmacy department plan and implement a new clinical pharmacy service in a specific clinical sector (e.g., surgery)? What strategies should the pharmacy department adopt to improve drug utilization? Pharmacy issues for the business case were selected from real issues that the pharmacy department had faced. The professor (J.-F.B.) assigned topics to groups, taking into account each team’s interest. Because the course workload was substantial, the teams were strongly encouraged to delegate tasks, according to the strengths and weaknesses of each team member. Tasks to be asssigned included reporting to the team leader, conducting a literature search, writing the final report, and producing the material for the oral presentation.

Finally, students were asked to participate in their group’s Web-based forum. The following learning objectives were set for this component of the course: students should be able to participate actively in group discussions, share personal experience relevant to the topic under discussion, and provide relevant input and suggestions to the group. At the beginning of the course, the professor presented a 60-min session on how to use the platform, and a printed copy of a 5-page technical tutorial was given to all students. Guidelines for use of the forum were also provided (Table 1). Participation in the forum was on an individual basis (i.e., not on behalf of the student’s team) to encourage everybody to participate and to avoid dominance by team leaders. Participants were expected to discuss the business case not only on the basis of the data provided, but also in relation to their personal experience as a member of pharmacy organizations in community or hospital practice (e.g., as pharmacy technicians). Each student was expected to read all messages posted for each discussion topic. The forum was structured with a section dedicated to each pharmacy issue. Within a section, students were encouraged to discuss one topic at a time, and the team leader was responsible for summarizing the opinions expressed. The forums were public (i.e., available to all students registered in the management course), and the role of the professor was limited to observation and facilitation.