USING PEER LONGITUDINAL CASE STUDY TO TEACH PHARMACOLOGIC CONCEPTS
Background: The National Research Council notes the importance of collecting meaningful data about active learning strategies. To date, several studies have evaluated the use of problem-based learning in teaching pharmacy students. Research has focused recently on using case studies in nursing pharmacology courses.
Methods: The study is a descriptive design that used a convenience sample of baccalaureate nursing students enrolled in two pharmacology courses. All participating students answered warfarin case-study questions based on information provided on case-study handouts. Students completed a self-demographic questionnaire, a knowledge pretest and posttest, and a satisfaction questionnaire after the activity, which evaluated students’ knowledge and perceived knowledge on 11 warfarin concepts. The results were analyzed by prelicensure, postbaccalaureate, and the two groups combined. Statistical analyses included frequencies and percentages for nominal variables and medians, maximum, and minimum values for continuous and ordinal variables, derived from questionnaires and tools. Fisher’s exact tests compared distributions by groups. Within groups, pretest and posttest scores were compared by Wilcoxon signed-rank tests, and between groups, comparisons by Mann-Whitney tests. A Pearson correlation evaluated the relationship between the total posttest and total satisfaction scores.
Results: For all students (N = 89), the number of correct answers improved significantly between pretests and posttests for Items 2-11 (p < .0001), which evaluated students’ knowledge on warfarin’s site of action, associated laboratory values, use of vitamin K, and food-drug interactions. However, no significant difference was seen in the number of correct answers for the first question, which asked about warfarin’s mechanism of action. Comparing prelicensure and postbaccalaureate groups, no significant difference was seen for pretest total scores (median 7.00, n = 55; median 7.50, n = 34; respectively; p = .399). Similarly, no difference was seen for posttest total scores by groups (prelicensure: median = 9.00, n =54; postbaccalaureate: median = 10.00, n = 32; p = .344). For both groups, there were no significant differences in answers on the satisfaction questionnaire, which evaluated students’ perceived knowledge of warfarin concepts; the medians for both groups were 4.00 for all 11 items. Students agreed that they could identify and explain these concepts. The Pearson correlation between the total posttest and total satisfaction scores for the combined group was .338 (p = .003), showing a low but significant correlation between students’ posttest total scores and their perceived warfarin knowledge, as evaluated by the satisfaction questionnaire.
Implications: Overall, there is a statistically significant improvement between nursing students’ scores on the pretests and posttests on warfarin knowledge when utilizing a peer-presented longitudinal case study. Nursing students agreed overall that they were knowledgeable about warfarin after being taught by a peer. Further research in peer-led case studies is needed to evaluate this active-learning technique in different student populations and environments.