A Closer Look at the Women's Health PRN
Overview of the PRN
The ACCP Women’s Health PRN aims to lead in patient care, education, training, and scholarship pertaining to women’s health while advocating women’s health issues in the public policy arena to ensure access to safe and effective health care services and medications. The Women’s Health PRN was officially formed in 1998, at which time it not only embraced obstetric and gynecologic care but also addressed differences in pharmaceutical care between the genders, promoted advances in health care for women in all areas, advocated that future research should include women, and examined the woman’s role as a health care practitioner.
Today, the PRN has 220 members from across the globe, with practice areas focused in a variety of settings, including obstetrics and gynecology, family practice, geriatrics, ambulatory care, and public health. Members’ interests range from pregnancy and prenatal care to the aging issues of osteoporosis and heart disease to gender-related pharmacokinetics. The PRN’s purpose is to provide ACCP members who are interested in women’s health with a smaller community for the exchange of practice ideas and an opportunity for collaborative research. The PRN’s most exciting current endeavor is the recent creation of its new Instagram account, @ACCPWHPRN. The PRN’s goals are to provide innovative and practical education at ACCP meetings and a newsletter that serves as a journal watch for current women’s health literature.
Opportunities and Resources
The ACCP Women’s Health PRN welcomes the participation of student, resident, and fellow members, with opportunities to network in their areas of interest and specialty throughout the year. Members contribute to the Women’s Health PRN through many avenues, including involvement in PRN committees, participation in virtual journal clubs, attendance at virtual panel speaker events, submission of content to its social media outlets, and participation in and attendance at national meetings. The diverse committees and projects join new and seasoned members alike in supporting the PRN and ACCP. Through the Awards Committee, the PRN offers funding for student and resident/fellow travel to attend the ACCP Annual Meeting and deliver a presentation to the membership. The Women’s Health PRN enriches student and postgraduate learners’ experiences and provides a space for developing relationships to further support clinical practice, scholarship, and research.
Current Issue in Women’s Health: Promoting Active Learning in Women’s Health Pharmacy Education Through Debates
By Kayla Mitzel, Pharm.D. Candidate 2023, Midwestern University College of Pharmacy – Downers Grove; and Pauline Tran, Pharm.D., Specialty Pharmacist at COMMUNITY, a Walgreens Pharmacy
A similar version was originally published in the April 2022 ACCP Women’s Health PRN Newsletter.
Pharmacy practice that focuses on women’s health is continually evolving, and with this evolution, pharmacists are encountering more ethical situations. Women’s health is an area with many ethical topics, and pharmacists are expected to rationalize through these situations using evidence-based medicine and doing no harm to the patient.1 In addition, ethical situations within women’s health can bring out strong emotions, but by learning how to research multiple viewpoints and rationally communicate the information, pharmacists can improve their skills in advocating for women’s health. Pharmacy schools must prepare students for their future careers and the situations they will encounter. One way for curricula to ensure that students can work through ethical situations involving women’s health is by implementing active learning through debates. Debates can develop skills and teach students about controversies in women’s health that traditional didactic lectures cannot. Oral communication and presentation skills can also be improved through debates. In addition, debates require active participation and promote critical thinking skills while allowing students to practice their research skills.2 Teamwork, self-directed learning, and problem-solving techniques can be demonstrated too.3
Psychology theories also that promote the use of active learning in the classroom. Bloom’s taxonomy suggests that remembering is the lowest level of learning, whereas evaluating and creating are the highest level.2 Miller’s triangle is another model that explains the levels of learning in increasing order: knows, knows how, shows how, and does.3 Listening to a lecture and taking a test is an example of the lowest level (knows), whereas students being required to research a topic, verbally articulate their stance with evidence, and then defend against objections is an example of the highest level of learning (does).3 When providing care to women, situations will arise that have no clear answers.4 Pharmacists must be able to use higher levels of learning for the safety and well-being of their patients. Pharmacy accreditation organizations also recognize the importance of active learning in the classroom and the need to continually improve critical thinking skills after graduation. The Accreditation Council for Pharmacy Education (ACPE) has an objective requiring the ability to practice using ethical standards, and professional development must be established in the curriculum.4 Skills crucial in order to practice evidence-based medicine are judgment, medical information evaluation, communication, and clinical problem-solving, according to the American College of Clinical Pharmacy (ACCP).1 The Center for the Advancement of Pharmacy Education (CAPE) also acknowledges that, on graduation, pharmacists must be able to explore strategies to problems, implement solutions, and educate others on the decisions made.1 Because of the skills required after graduation and the ethical decisions that pharmacists encounter in pharmacy within women’s health, pharmacy schools must incorporate active learning into the curriculum, and previous studies have shown that debates are effective for actively teaching ethical dilemmas within women’s health.1-5
Past studies have shown that incorporating debates into the pharmacy school curriculum has not only enhanced students’ learning but also has been greatly enjoyed by students.1,4 In one study, 83% of students reported that the use of debates better improved their knowledge of controversies in women’s health care than other methods.4 In this study, 75% of students reported that debates improved their ability to address clinical situations without a clear-cut answer.4 In another study, students completed pre- and post-surveys on how they evaluated their skills. After the debate, there was a statistically significant increase in critical thinking (p=0.002), public speaking (p=0.009), research methods (p=0.007), and teamwork (p=0.045).1 This shows that debates allow students to demonstrate the skills necessary to deal with dilemmas regarding controversies in women’s health. In addition, in this study, the facilitator created pre- and post-debate quizzes to assess understanding of the content for both students presenting and students observing. After every debate, scores improved drastically (p<0.05).1 Other studies have surveyed students with a short-answer question to analyze how the students felt about having debates in the curriculum after participating in a debate. The most common themes were that students appreciated being able to develop communication skills and use teamwork, had an increased understanding of complex topics, improved their research skills, and learned how not to let personal feelings affect professional judgment.3,5 These skills are all essential in ethical situations involving women’s health and cannot be demonstrated in traditional classroom learning. Finally, when asked whether “debates helped [them] understand both sides of a controversial topic,” more than 80% of students responded with agree or strongly agree.4 Pharmacy students learning about the pros and cons of controversial topics in women’s health promotes understanding of multiple viewpoints and enhances critical thinking.
These earlier studies show the importance of debates in increasing student knowledge about ethical decision-making skills in women’s health, and the authors also discuss the best practices for implementing debates in pharmacy schools. One best practice is to have students do the research and debate topics before a didactic lecture. This requires students to have self-directed learning.1 Students’ viewpoints could be biased if given a lecture on the topic before debating it. Overall, self-directed learning encourages students to use their research skills while evaluating resources and analyzing articles.1 Previous studies also asked students to incorporate a written portion consisting of a paper or presentation that was submitted before starting the debate so that the professor knew that all the necessary material would be covered in the debate.2 Ensuring that the debate topics are more ethical scenarios than clinical scenarios elicits more thought-provoking debates.1 When designing the structure of the debate, previous studies had both teams begin with an opening statement. The first team then gave their main argument, and the second team gave their rebuttal. This was then followed by the second team giving their main argument, and the first team rebutting. The classmates observing were then allowed to participate, after which each team gave their closing statement.2 The observing students found the most engagement when they were allowed to grade their peers’ skills at debating.2 When surveyed, students self-reported that they learned more by participating in the debate than by observing it; however, when assessed with a quiz, students’ scores did not differ on the basis of whether they were participants or observers in the debate.1
Although many benefits of using debates in classrooms to enhance the understanding of women’s health have been reported, there are some limitations. One study stated that creating and restructuring the course was incredibly time-consuming. There was difficulty with implementing debate sessions while still having enough didactic lectures.1 Next, the facility reported difficulty with creating new and engaging topics every year. This is important to keep discussions relevant to ethical situations that are occurring and prevent students from reusing previous students’ work.1 Another limitation is that it is difficult to compare traditional classroom learning with debate-based learning. Each method uses different skills, and the assessments used to grade each differ.2 Finally, for a debate learning style to be effective, each student must be willing to actively participate.1,4 To combat this challenge, the facility had students use peer evaluation rubrics for their group members.1
In summary, using active learning in the classroom by adding debates, pharmacy students are provided with the opportunity to work through ethical situations and develop skills for when they encounter dilemmas pertaining to women’s health. These skills range from teamwork, communication, critical thinking, problem-solving, and analyzing research to practice with evidence-based medicine. The development of these skills is required to meet the accreditation objectives for ACPE, ACCP, and CAPE. With the evolution of pharmacy within women’s health, institutions must adapt to providing their students with opportunities to demonstrate proficiency in the necessary skills. This ensures that women are getting the best possible health care. Using debates to teach women’s health topics is especially useful because it provides students with the skills to evaluate and interpret evidence from both perspectives of an ethical dilemma.
1. Lampkin S, Collins C, Danison R, et al. Active learning through a debate series in a first-year pharmacy self-care course. Am J Pharm Educ 2015;79:25.
2. Peasah S, Marshall L. The use of debates as an active learning tool in a college of pharmacy healthcare delivery course. Curr Pharm Teach Learn 2017;9:433-40.
3. Hanna LA, Barry J, Donnelly R, et al. Using debate to teach pharmacy students about ethical issues. Am J Pharm Educ 2014;78:57.
4. Griffin B, Vest K, Raney E, et al. Student perceptions of debates in a women’s health elective. Poster presented at: Midwestern University; Downers Grove, IL.
5. Hogan S, Dunne J. Evaluating the effectiveness of a focused debate on the development of ethical reasoning skills in pharmacy technician students. Am J Pharm Educ 2018;82:6280.
Sarah A. Kain, Pharm.D., BCACP
Women’s Health PRN Secretary/Treasurer 2020–2022 and Communication Chair
Clinical Pharmacy Specialist, Ambulatory Care, Community Health Network