(21) Attention to Detail: Preparing Students to be Detail Oriented with Medication Reconciliations

Objective : Enhance student pharmacist abilities to handle interruptions in their workplace through reflection and identification of effective methods to maintain accuracy
Discuss common errors made when updating a medication list while simultaneously performing a medication reconciliation when interruptions occur

Methods: First and second year pharmacy students in an accelerated, three-year pharmacy program individually updated an existing patient medication list by utilizing a mock facility Medication Administration Record. Students reconciled it against medications the physician already ordered for the patient and documented changes that would need to be addressed with the prescriber. No therapeutic recommendations were required. Once during the first case, students were interrupted with tasks that required them to move to another location, and complete a different activity as a group before returning to the medication reconciliation case. When time expired, a short discussion on findings and techniques for conducting a medication reconciliation was held. Students conducted a similar activity with a similar interruption for a second patient case. A final discussion was held upon completion of this round and students reflected on what they had learned about their attention-to-detail.

Results: Students showed improved attention-to-detail between the two activities during each session. The number of total errors made dropped by up to 42%. The number of students making no errors also improved between the two activities with up to 52.5% of students creating an accurate list with accurate reconciliation. The most common types of errors were the failure to remove an old medication and medication omissions. Survey data suggests student confidence in handling interruptions improved at completion of these activities.

Conclusions: Students’ attention-to-detail and confidence in personal methods improved with practice of medication reconciliation activities and focused discussions.