Clinical Decision Making by Fourth-Year Pharmacy Students: Understanding Their Uncertainty
Notice bibliographique
Résumé
Clinical decision making is a critical process underpinning much of a pharmacist’s daily activities. Pharmacists in Alberta have a scope of practice that includes prescribing medications, and prescribing includes clinical decision making. Ensuring pharmacy education actively prepares students for clinical decision making is therefore a priority. While it is known that pharmacists hesitate to make decisions, it remains unclear whether pharmacy students experience similar hesitancy. Clinical decision making is dependent on many factors, such as knowledge and experience, that need to be considered when investigating hesitancy and uncertainty in decision making by pharmacy students. Adult learning theories of experiential education and reflective practice are applicable to the pedagogy of decision making given that experience is considered a critical influencer in clinical decision making. This study was designed from a social constructivist paradigm using case study methodology. The purpose was to investigate issues related to hesitancy in clinical decision making by fourth-year pharmacy students. Data was collected through observation of students engaging in simulations, post-simulation interviews, and written reflections. Data analysis included multiple stages of coding, followed by pattern identification and discovery of interrelationships. The primary themes relating to issues in pharmacy student clinical decision making were relational factors, teaching and learning, degree of certainty, and personal characteristics. These themes represent elements that affected decision making before the final stage where the students were either willing or unwilling to make a decision. Pharmacy students construct their decision making primarily by using the patient care process, through repeated practice, and by observing role models. Students felt facilitated in their decision making when there were positive relationships with patients and physicians, practise in the skills lab, and development of comfort with ambiguity. Students discussed that strategies for responsible decision making were complex and related to many of the previously mentioned themes. Students struggled with responsibility taking for decisions both throughout the curriculum and in experiential education. Future research plans include investigating how Albertan students compare with those in other jurisdictions and investigating the training of preceptors to include building student comfort with ambiguity by creating education underpinned by adult learning theories of experiential learning.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,010 | 0,027 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,004 | 0,005 |
| Communication savante | 0,013 | 0,004 |
| Science ouverte | 0,002 | 0,007 |
| Intégrité de la recherche | 0,002 | 0,006 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».