Pharmaceutical interviews and prescription discussions simulation: a new analysis methodology during debriefing

Introduction: setting, background and identification of needs leading to the initiative
Simulation is increasingly playing a role in the training of health sciences students. Applied to the training of future
pharmacists, it is an effective tool for teaching non-technical skills such as communication and interprofessional
collaboration. The debriefing constitutes a key moment in the participants’ learning experience. This project is a fact
analyzing method during the simulation scenario that the activity “Pharmaceutical interviews and prescription
discussions simulation” will describe. It can serve as an alternative to the Good Judgment method because it focuses
more on the process of building a shared decision than on what pushed the participant to act in a particular way.
Description of initiative and approach/methods used
The prescription discussion activity has been held many times every year at the University of Liège since 2017 with
small groups of around 20 pharmaceutical science students. The theoretical framework of the activity is based on the
Kolb cycle (1984) and includes a phase of exploration of a patient case including his drug prescription. It is followed by
the observation of a first simulation between supervisors playing the role of the patient and the pharmacist, the latter
providing inappropriate care. During the active experimentation phase, students become actors in the simulation, with
the same simulated patient. They interact with the patient in a more tailored way than in the previous interaction to try to
reach a shared decision. Observers are asked to observe the effects of the actions taken by their peers involved in the
role-playing scenario and the resulting effects on the patient.
This experiential learning echoes real-life situations and includes authentic prescriptions.
The debriefing framework is inspired on the VET&PHARM model recently published: (1) pharmacist’s feedback on his
own actions, their perceived effects, and his feelings during the interaction; (2) factual observations of actions by the
observers (words, attitudes), (3) construction of a timeline of the interaction, tipping point making the scenario evolve
towards or away of a shared decision or not; (4) patient feedback on his intentions, and his perception of having reached
a shared decision with the pharmacist.
Discussion of the impact/outcome, and novelty of the initiative
Unlike Good Judgment debriefing which includes an investigation of mental models and a conversational technique to
highlight the instructor's opinion and the learner's thought patterns, this new type of debriefing focuses on tipping points
that impact the unfolding of the situation. It also illustrates the concept of evidence-based practice by also showing the
patient's understanding and intentions.