Across the Patient Care Practitioner Threshold: Identifying Threshold Concepts and Evaluating the Teaching of the Pharmacists’ Patient Care Process

Abstract

Abstract Background. The practice of the pharmacy now has a specific Pharmacists’ Patient Care Process (PPCP) to be utilized by pharmacists and pharmacy educators. There may be threshold concepts associated with students’ learning the PPCP. A threshold concept is idea or concept that transforms the learner’s way of thinking about a certain topic or discipline. They are often troublesome for the learner, but once identified, can influence the teaching of or be used in the evaluation of the teaching of the PPCP. The first aim of this study was to identify threshold concepts associated with pharmacy students learning the PPCP. The second aim was to create, validate and test an instrument based on the previously identified threshold concepts to evaluate to what extent the PPCP is taught across pharmacy curriculum. Methods. The first phase of this study convened five focus groups to identify possible threshold concepts. The data was analyzed by deductive content analysis and confirmed by an expert consensus panel using the Nominal Group Technique. In phase two, the Patient Care Threshold Concepts Evaluation Instrument (PCTC-EI) was created using the identified threshold concepts. A Content Validity Index was calculated for the items on the PCTC-EI. The PCTC-EI was then administered to a purposive sample of pharmacy faculty and students at one institution. Results. Five threshold concepts, including Threshold Concept #4 Discern a patient’s medication experience and incorporate his or her individual knowledge and beliefs in to the care provided (Medication Experience), were identified from the focus groups and confirmed by the expert consensus panel. Thirty-eight (38) students and faculty, of the 59 invited (64.4%) provided responses to the PCTC-EI. Only 42.1% of respondents stated the average graduate’s ability regarding Medication Experience was Very Good or Excellent. Discussion. The five patient care threshold concepts identified are related to key concepts in pharmaceutical care and complement the PPCP. They can be used in a variety of ways within a pharmacy curriculum. In addition, the results of PCTC-EI illustrate the extent of teaching the PPCP and demonstrate the value of curricular-level evaluation.