COVID-19 in the Classroom: Challenges and Opportunities

As we continue to face the uncertainty of the coronavirus disease 2019 (COVID-19) pandemic, the 2020 academic year brings prolonged and new challenges to many pharmacy students. From navigating online classes to adjusting to either cancelled or switched experiential learning rotations, the pandemic has changed the lives of pharmacy students worldwide.

Team-Based Learning

Per local and national public health guidelines, many pharmacy schools have moved to providing either fully online or hybrid courses. These changes have particularly affected first- through third-year students who use a team-based learning (TBL) structure.

TBL is an instructional strategy that uses student teams, which are typically composed of 5-7 members per team, to facilitate deepened learning through active communication and engagement among the students.¹ Students must be prepared for the materials that will be covered in the course, which involves taking both individual and team readiness assurance tests prior to each class.¹

They spend class time working together on case studies and applications to apply their knowledge. TBL has gained popularity due to its high satisfaction among both faculty and students in many nursing and medical schools.¹

Normally, the TBL classes take place in a physical classroom in which each student can interact with each other face-to-face. However, with the outbreak of COVID-19, students who are still in their didactic courses of pharmacy curriculum have scattered out to online classrooms.

The rapid adaptation to an online TBL class revealed several learning challenges, such as technological difficulties and maintaining student engagement. Specifically, slow internet connectivity and technological literacy among students and faculty were common problems in the online TBL format.

Multiple technologies must now be utilized, including test taking software programs, sharing of documents, and materials. This may be especially overwhelming for first year students who are still acclimating to a rigorous pharmacy program because meeting team members for the first time through a computer screen can cause difficulty in promoting active peer engagement and building relationships.²

Lab Classes

The online platform of learning also heavily affected the skills lab classes in which hands-on experiences are desired. To provide appropriate lab experiences while maintaining social distancing, lab courses are now extended with only a certain number of students being allowed at a time in the lab.

Students are also given take-home compounding kits for activities that do not require a sterile hood or extensive lab equipment to continuously meet the objective of the course via online learning. Although adjusting to the challenges that COVID-19 brought to the lab courses helped the faculty and students to be creative learners, the extra cost and time it took to plan and coordinate the classes cannot be ignored.

The Accreditation Council for Pharmacy Education recently announced that the lab courses do not need to be completely cancelled at this time of online learning; however, it was encouraged that the actual portion of the hands-on experiences should be performed when students are able to be present on campus.³ If the COVID-19 pandemic causes the learning platform to move completely online for longer than expected, additional challenges may arise for the faculty and students as they consider how the hands-on courses should be conducted. For example, simulation labs in which students gain interprofessional experiences may have to be offered fully online.

Simulation labs involve a wide range of hands-on and face-to-face professional experiences, such as handling critical medical conditions or providing patient counseling. Adjusting a component of learning virtually can be abnormal for many students, as the presentation of a serious illness or medical condition might not be captured as realistically online.

Introductory Pharmacy Practice Experiences (IPPE)/Advanced Pharmacy Practice Experience (APPE) Rotations

One of the most immediate changes COVID-19 has brought is the cancellation or switching of clinical experiences. Many hospitals and community pharmacies halted on IPPE and/or APPE students due to safety concerns. Students were faced with challenges such as last-minute cancellations and rotation experiences moving to an online platform, which placed a huge burden on both students and experiential faculty who had to find new placements for students.

Additionally, all international APPE rotations were cancelled, and the transition did not come without a cost. It was a struggle to recoup the costs invested prior for flights and hospitality. Students in their last year of pharmacy school needed to quickly adapt to the change and stay positive towards re-envisioning a collaborative care in the midst of a pandemic.

The worries for the future regarding how the altered APPE rotation plans will impact students’ personal and professional development, along with potential residency and fellowship interviews, have taken a toll on their mental and physical well-being.

Opportunities

Although we all still face difficulties that have been presented due to the effects of the COVID-19 pandemic, there are some positive opportunities we can seek during this time. For example, implementing an online technology to the TBL can provide a unique way of allowing us to develop adaptability.

Understanding and overcoming the challenges of distant learning can put the concept of interprofessionalism to the test, as remote collaboration over telemedicine is trending toward the future of pharmacy.⁴ Research shows that telehealth is the “new normal” in many sectors of health care, and pharmacists play an important role in delivering appropriate medical services.⁵

Many pharmacy services, such as medication counseling, addressing adherence issues, and drug therapy problems, can be delivered virtually.⁵ Being familiar with online technology and adapting to the new means of providing health care can allow us to become prepared medication experts in the future.

Further, we are able to learn how to be innovative and resilient. As we adapt to the unique challenges created by the COVID-19 pandemic, we are asked more than ever to demonstrate innovative ways of thinking, regarding how we exhibit our teamwork and learning skills. Making a smooth transition to online classes and finding a positive attitude while IPPE and/or APPE rotations constantly change teaches us the resilience that an in-classroom lesson may not teach us. Learning to be independent and figuring out challenges often cannot be taught by books, but instead must be experienced.⁶

COVID-19 brought many unexpected changes; however, the pandemic has given the classes of 2021 through 2024 various opportunities to adapt and grow into future pharmacists and leaders with problem solving skills and self-advocacy.

References

1. Nelson M, Allison SD, McCollum M, et al. The regis model for pharmacy education: A highly integrated curriculum delivered by team-based learning^TM (TBL). Curr Pharm Teach Learn. 2013;5(6):555-563. doi:10.1016/j.cptl.2013.07.002

2. Jumat MR, Wong P, Foo KX, et al. From Trial to Implementation, Bringing Team-Based Learning Online—Duke-NUS Medical School’s Response to the COVID-19 Pandemic. Med Sci Educ. August 2020:1-6. doi:10.1007/s40670-020-01039-3

3. Accreditation Council for Pharmacy Education Issues Guidance | NEOMED. https://www.neomed.edu/news/accreditation-council-for-pharmacy-education-issues-guidance. Accessed August 20, 2020.

4. Ferrel MN, Ryan JJ. The Impact of COVID-19 on Medical Education. Cureus. 2020;12(3):7492. doi:10.7759/cureus.7492

5. Elbeddini A, Yeats A. Pharmacist intervention amid the coronavirus disease 2019 (COVID-19) pandemic: From direct patient care to telemedicine. J Pharm Policy Pract. 2020;13(1). doi:10.1186/s40545-020-00229-z

6. Medina MS, Plaza CM, Stowe CD, et al. Center for the advancement of pharmacy education 2013 educational outcomes. Am J Pharm Educ. 2013;77(8). doi:10.5688/ajpe778162