Justification for study: With the pandemic ongoing, students from all health fields have been facing difficulty for their clinical rotations, laboratory studies, clerkships and interactive learning. Use of technology has helped learners to continue their case-based learning amid the pandemic. Case Based Learning is a teaching mode used for effectively providing better understanding of practical aspects using live or simulated patient cases to solve, or examine a clinical problem, with the guidance of a teacher and stated learning objectives which helps in better patient care and knowledge building. Due to the absence of bed side learning amid the pandemic, virtual ward rounds are used as a new learning tool which simulates a ward round on a hospital ward. It engages the students in an active decision-making process on medical treatment using a standardized set of medical cases. When enhanced with the aid of audiovisual elements, e-learning can offer educational content and various tests supporting these contents, can facilitate access to necessary relevant information, and most importantly, provide an interactive environment for students and the faculty. Thus, through this study we aim to understand students’ perspective of importance of ward rounds in covid situation and evaluate different modalities of case-based learning. The findings will help identify the required changes in the current scenario and make it more practical and effective.
Aims & objectives: To understand students’ perspective on importance of ward rounds in COVID situation and to evaluate different modalities of case-based learning.
Methodology:
This is an interventional study in PharmD students comparing the standard and an interventional group.
• Standard group: Follows the traditional SOAP analysis by collecting cases during ward rounds.
• Interventional group: Follows comprehensive virtual case-based learning consisting of assessment of case through virtual simulation consisting of audio-visual conversation and obtaining the relevant information along with SOAP analysis, ADR assessment, drug information and patient counselling for specific case scenarios.
Step 1- Need assessment for implementation of comprehensive virtual case-based learning: This will be assessed through a semi-structured in-depth interview for which an interview guide was developed.
Development of interview guide- with the literature review and expert opinion a draft interview guide was developed which consists of different aspects like your concerns, needs, expectations, barriers and experiences faced in the current pandemic scenario.
Step 2- Validation: Validation of interview guide will be done by interview protocol refinement methodology. There are four different phases in validation:
1. Confirming the alignment of interview questions and the research questions: This will be achieved by mapping the interview and research questions in the form of a matrix.
2. Building an inquiry-based conversation: An inquiry-based conversation will be achieved by incorporating introductory questions, transition questions, key questions, closing questions.
3. Collecting feedback on interview guide: Feedback will be collected to obtain an expert opinion on the developed interview guide.
4. Piloting the interview guide: To see whether there is proper feedback obtained from participants and ease of understanding of the participants.
Step 3-In Depth interview: Interview process- Telephonic/ face to face interview will be conducted for approximately 30-45 minutes using a validated interview guide. Interview session will be recorded only with their consent and transferred into a password protected laptop. The audio recordings will be transcribed verbatim and validated and the transcripts will be analyzed using NVivo software for theme generation.
Step 4- Development of comprehensive virtual case-based learning: Five diseases will be selected for development of a comprehensive virtual case-based learning tool. An audio conversation will be recorded as the case scenario where a physician will present the case along with patient and pharmacist conversation. Each case scenario will consist of complaints on admission, medical history, medication history, social history, family history, physical examination, general vital signs, provisional diagnosis, final diagnosis, drug treatment chart and discussions regarding any treatment modality overlapping with the pharmacist. Patient profile form will be prepared by students from the audio conversation based on which they will present SOAP analysis, ADR assessment, drug information and patient counselling for specific case scenarios. Each case will be about a 30-minute conversation recorded in English. The five diseases selected are Hypertension, Diabetes, Asthma, Iron deficiency anemia, Deep Vein Thrombosis. Validation of the tool: Once the tool is developed it will be validated by a physician and different experts in the area of pharmacy practice regarding its clarity, authenticity, by using feedback forms.
Step 5- Implementation of the comprehensive virtual case-based learning Vs standard SOAP practice: Once the tool is developed, 30 students from 4th Year PharmD and 30 students from 5th Year PharmD will be divided into 2 groups. One group will be asked to collect the cases from the ward in 5 different topics. Case will be recorded from case sheets from ward and they will be presenting cases in normal SOAP format. Another group will be receiving a comprehensive virtual case-based learning tool where 15 members will be divided into equal groups and each group will perform the following task. Developing PPF from audio visual conversation, SOAP analysis, ADR assessment, patient counselling, drug information. This experiment will be conducted for 5 different cases as per the standard group. Each group will be exposed for a total time duration of 2 months and then cross-overed. Feedback is taken through a qualitative interview.