APPE preparedness after implementation of a clinical thinking and documentation guide in the curriculum

Objective : To evaluate how implementation of a guide for clinical thinking and subjective/objective/assessment/plan (SOAP) writing across a four-semester sequenced problem-solving course affects student clinical thinking and SOAP writing on advanced pharmacy practice experiences (APPEs).

Methods: Faculty and instructional designers developed a SOAP template and companion glossary guide detailing the significance of each SOAP section with corresponding clinical thinking prompts. The guide was implemented in a sequenced integrated problem solving (IPS) course during P2 and P3 years. The first two classes (2022 and 2023) to progress to APPEs who had used the new guide were surveyed in their P4 year to determine its effect on clinical thinking and documentation skills during APPEs.

Results: There were 51 respondents (20% response rate). Using a Likert scale, the following percentage of respondents agreed to survey statements: I understood the components of writing SOAP on APPEs - 94% (n=48); I understood the process of SOAP writing during APPEs – 86% (n=44); IPS prepared me to write SOAP on APPEs – 80 % (n=41); I felt confident when writing SOAP on APPEs – 78 % (n=40); SOAP is a valuable communication and clinical thinking tool – 73 % (n=37). Student comments highlighted how academic SOAP writing was more detailed compared to clinical practice, and that academic SOAP writing supported clinical thinking on APPEs.

Conclusions: Utilizing a clinical thinking and documentation guide is an effective method for teaching students about the process of SOAP writing and clinical reasoning. The differences in complexity of academic SOAP writing compared to variations encountered on APPEs was viewed by students as a limitation of this teaching model.