(75) Impact of Capstone Simulations on Student Knowledge and Self-Perceived Confidence in Managing Cardiovascular Diseases

Primary Author(s)

Sara F. Mahmoud, Pharm.D., BCCCP (she/her/hers)

Assistant Clinical Professor of Pharmacy Practice
University of the Pacific
Stockton, CA, California, United States

Co-Author(s)

Jasmin Prasad, PharmDcand (she/her/hers)

PharmD candidate
University of the Pacific, Thomas J. Long School of Pharmacy, California, United States
JAHNAVI YALAMANCHILI, PharmD (she/her/hers)

Graduate Student, Master of Science
University of the Pacific, United States
Caroline L. Ko, Pharm.D., BCCCP (she/her/hers)

Associate Clinical Professor of Pharmacy Practice
University of the Pacific
Stockton, California, United States
Vista Khosraviani, PharmD, APh

Associate Clinical Professor of Pharmacy Practice
University of the Pacific, United States
VP

Vicky Phung, PharmDcand

PharmD student
University of the Pacific, Thomas J. Long School of Pharmacy, United States
TP

Thao Pham, PharmDcand.

PharmD student
University of the Pacific, Thomas J. Long School of Pharmacy, United States
JS

Jessica Song, MA, PharmD

Department Chair, Professor of Pharmacy Practice
University of the Pacific, Thomas J. Long School of Pharmacy, United States
Marcus C. Ravnan, PharmD

Professor of Pharmacy, Associate Dean
University of the Pacific, Thomas J. Long School of Pharmacy
Stockton, California, United States
Deepti Vyas, Pharm.D.

Professor and Director Interprofessional Education
University of the Pacific, Thomas J. Long School of Pharmacy
Stockton, California, United States

Objective : To assess the impact of capstone simulations on student knowledge and self-confidence in managing cardiovascular diseases.

Methods: Second-year pharmacy students enrolled in a Cardiovascular Therapeutics course were eligible for this study. All course content was taught by week 12 of the 14-week trimester and assessed on one of three multiple-choice exams. The subsequent 2 weeks were utilized for timed and graded in-class capstone simulations. Three video games were developed in Twine, depicting: 1.) ischemic stroke, 2.) heart failure (HF), and 3.) venous thromboembolism (VTE). Finally, a mannequin depicted HF and atrial fibrillation. Instructors led a debrief after each simulation. At the end of the course, a multiple-choice final exam was administered. Exam questions were categorized by disease and performance on exam I, II or III was compared to the final. A mixed-methods approach was used to assess self-confidence. All students completed a pre/post self-confidence survey. Fifteen students also participated in pre-/post-simulation focus groups. Focus group statements were coded by independent analysts and a thematic analysis was performed. A paired t-test was used to analyze the confidence surveys.

Results: A total of 486 students participated in this study. Significant improvements were observed in confidence levels for managing all diseases covered in the simulations. Exam scores improved for questions related to HF (52.9% versus 66.5%), stroke (61.9% versus 71.5%) but not VTE (72.9% versus 71%). Post-simulation focus groups (34 statements) revealed increased confidence in assessing disease state, creating tailored therapeutic plans and improved advanced pharmacy practice experience (APPE) readiness. However, students mentioned that the timed aspect caused added stress.

Conclusions: Capstone simulations were a successful strategy for improving student confidence and exam performance.