The learner-centered approach to teaching may improve student motivation and enthusiasm, and promote more in-depth learning. It may be especially valuable to teaching health profession students since this method may promote lifelong learning, which these students will need to develop to serve their patients in the future. While the learner-centered teaching strategy is supported by previous educational literature, its effectiveness in professional pharmacy education, while expected to be favorable, remains undocumented.
Pharmacotherapy is the appropriate use and monitoring of drug therapy. Integrated Therapeutics (PHAR 744) is a third-year required course in the four-year Doctor of Pharmacy (Pharm.D.) program. This course is the last of four courses in the pharmacotherapy series, a core component of the Pharm.D. professional curriculum. Being last in the sequence, the objectives of Integrated Therapeutics is to build upon the prior three-semester pharmacotherapy sequence and to refine the student’s ability to address drug therapy problems in patient situations that are more complex, conflicting, or ambiguous than previously encountered. Faculty at the School of Pharmacy have observed that there is room for improvement in the motivation and enthusiasm for learning among pharmacy students.
Motivation for learning, and hence the desire for life-long learning, need to be cultivated early on while students are still in training, rather than allowed to be stumbled upon during these future pharmacists’ career by happenstance. The objective of this project is to determine whether learner-centered teaching improves pharmacy students’ motivation in learning and their development in learning strategies. This project was funded by the VCU Center for Teaching Excellence and approved by the VCU Institutional Review Board.
The course was restructured such that:
- Students had more control of their learning by having more options in the type of assignments. Various group and individual optional assignments were offered. These optional assignments were designed to either deepen the students’ learning (e.g. revision of previously submitted case workups), or to offer practice opportunities on other clinical skills (in the areas of chart note/ clinical documentation writing), and learning new disease states (in creating a patient case and providing recommendations for treatment on a new disease state).
- Students used content by applying it in solving actual patient cases.
- Self-directed and collaborative learning styles were utilized, and development of problem solving skills were emphasized, with the coordinator and instructors serving as guides rather than lecturers.
- Extensive use of formative feedback, homework revisions, and debriefings after students’ case presentations was utilized to introduce learning processes in evaluations.
A questionnaire to determine students’ motivation and learning strategies was administered before the course began, and at the end of the semester. The Motivated Strategies for Learning Questionnaire (MSLQ) was used. The MSLQ is an 81-item instrument which consists of 6 motivation subscales (on intrinsic goal orientation, extrinsic goal orientation, task value, control of learning beliefs, self-efficacy for learning and performance, test anxiety) and 9 learning strategies scales (on rehearsal, elaboration, organization, critical thinking, metacognitive self-regulation, time and study environment management, effort regulation, peer learning, help seeking). This is a validated instrument and has been utilized in numerous studies, including research in pharmacy professional education. The instrument was administered in class and took approximately 25-30 minutes to administer.
The scores on these subscales at the end of the semester were compared to baseline. In addition, the effect of students’ characteristics (level of preparation before class, self-reported GPA, gender, prior degree, career plans) on these motivation and learning strategies attributes were also examined. Finally, students also completed course evaluation.
Compared to baseline, students at the completion of PHAR 744 demonstrated improved motivation. Specifically they reported improved intrinsic goal orientation (p<0.0001), and improved self-efficacy for learning and performance (p>0.0001). They also demonstrated improved control of learning beliefs (p<0.0001)--i.e. students believed that success in the course depended on there own effort, rather than external factors such as the professor or luck.
In addition, students reported that their learning strategies improved with PHAR 744. They demonstrated improved critical thinking strategies (p<0.0001). They also reported improved metacognitive self-regulation (p=0.01), which is students’ use of strategies that assist in regulating their own cognition (e.g. setting goals, planning, monitoring of one’s comprehension, and regulating such as adjusting study methods according to the task).
- 71% of students either agreed or strongly agreed that their ability to learn the material presented was enhanced
- 88% of students either agreed or strongly agreed that they felt they were able to learn the material and obtain the grade they desired
- 60% of students either agreed or strongly agreed that they were able to focus on learning rather than just getting a good grade.
- 76% of students either agreed or strongly agreed that the assignments helped reinforce the material more than studying alone.
- 75% of students either agreed or strongly agreed that they would rather take a pharmacotherapy course using the learner-centered approach
Finally, we also examined the student factors that determined motivation and learning strategy scores. Students who reported their desire to enter a clinical practice, and students that spent more time preparing for class had higher motivation and learning strategy scores than students reporting a non-clinical career plan or students who spent less time preparing for class.
In summary, to our knowledge, this is the first project to date in the education literature that examined the effect of the learner-centered teaching strategy in a health-professional course. In PHAR 744, the learner-centered approach seems to improve students’ attitudes and motivation, as well as critical thinking strategy. The learner-centered approach will be continued in next year’s class. Given the above data, the learner-centered approach may be considered in other courses in the pharmacy curriculum.
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