(384) Impact of a New Clinical Decision-Making Activity in a Capstone Course

Trainee Category: Student Pharmacist

Objective : Determine if student performance on application-based exam questions improved after a clinical decision-making activity.

Methods: This new activity, modeled after script concordance tests, was implemented in a capstone course for third-year (P3) students. Students completed a one-hour activity that focused on gout, osteoarthritis (OA), pain, and rheumatoid arthritis (RA). Pre- and post- exam scores (2022) were compared, along with the corresponding exam from a previous cohort (2021). Individual responses to multiple-choice and select-all-that-apply questions from the topic areas, as well as all application-based questions, were analyzed. Anonymous student feedback on the activity was collected.

Results: Seventy-nine students completed the 2021 exam, 69 completed the 2022 pre-exam, and 67 completed the 2022 post-exam. Overall exam performance, as well as application-based question performance, was statistically significant different across the 2021, 2022 pre-, and 2022 post-exams (overall: 78.8% vs 81.6% vs 67.2%, p< 0.0001, respectively and application-based: 71.9% vs 81.6% vs 61.8%, p< 0.0001, respectively). When comparing question performance between the 2021 and 2022 post-exam, 2021 exam performance was lower for gout and pain (67.1% vs 88.8%, p=0.01411 and 85.0% vs 85.8%, p< 0.0001, respectively). There was no statistical difference between performance for OA and RA. On a scale from 1 (lowest) to 5 (highest), students reported that the activity was beneficial (4.266) and should be continued (4.317).

Conclusions: While student feedback indicated a perceived benefit to the activity, overall exam and application-based exam question performance were lower following the implementation of a clinical-decision making activity compared to the previous year’s cohort.