Assessment of feedback factors affecting pharmacy student patient counseling self-efficacy.

摘要

Student learning is a major outcome associated with every higher education institution. Many factors influence student learning, including student motivational beliefs, student self-efficacy, and the learning environment. Feedback is designed to provide students with the tools to restructure their understanding, develop their skills, and build upon their ideas and capabilities. Positive and constructive feedback can have varied effects on students' selfefficacy and personal goal orientation toward learning. The objectives were to assess students' self-efficacy relative to counseling skills based on: (1) type of feedback and the sequence received during a patient counseling session, (2) personal goal orientation, (3) personal goal orientation and the feedback sequence, and (4) demographic variables. First and third professional year students (N=299) participated in the study during a regularly scheduled patient counseling laboratory. A training session for evaluators and standardized patients was developed to promote consistent feedback and performance across students. Students were randomized to receive formative feedback by one of two sequences: positive then constructive or constructive then positive. Rubrics were constructed to provide consistency among evaluators in patient counseling assessment. Prior to the patient counseling exercise, students completed a 43-item survey regarding personal goal orientation (e.g. mastery, performance), self-efficacy in counseling skills (e.g. verifying patient information, understandable wording), and demographics. A five-point Likert scale was used to assess personal goal orientation (1=strongly disagree, 2=disagree, 3=neutral, 4=agree, and 5=strongly agree) and patient counseling self-efficacy (1=not at all confident, 2=not very confident, 3=moderately confident, 4=very confident and 5=extremely confident). A 46-item retrospective pretest/posttest allowed students to re-evaluate their confidence after completing the patient counseling exercise. Descriptive statistics, analysis of variance and repeated measures analysis of variance were performed to assess the influence of feedback and goal orientation on student pharmacist patient counseling self-efficacy. Results of this study revealed that the majority of students exhibited a mastery orientation. A mastery goal orientation provides support for the objectives and goals of pharmacy education, where life-long learning is critical to the professional graduates' ability to maintain current knowledge in the profession. Based upon feedback sequence in this study, a trend toward higher self-efficacy was shown in students who received positive feedback prior to constructive feedback; however, neither feedback sequence was statistically significant in effecting patient counseling self-efficacy. Study results showed students who lacked experience in the retail/ community setting had lower confidence on all self-efficacy subscales and third professional year students had a higher score than first professional year students on the post-confidence scale. By increasing the number of opportunities for patient counseling, students may be able to increase their patient counseling self-efficacy which could result in increased patient communication and the establishment of effective patient relationships. This study gathered information regarding student patient counseling self-efficacy to provide a foundation on which future steps can be taken to enhance the academic abilities of pharmacy students. Further studies can be conducted to examine changes in patient counseling self-efficacy of pharmacy students over the course of the didactic curriculum. The results provided in this study may only be applicable to the study population; therefore, studies are needed to provide evidence in other student populations in other areas. In addition, future studies evaluating the impact of pharmacy experiences and education upon students' perceptions of self-efficacy may prove to be beneficial in helping pharmacy educators design their curriculum.