Would You or Wouldn't You?: Using Script Concordance-style Questions to Enhance Clinical Reasoning and Online Discussion

Concurrent Session 4

Brief Abstract

Script concordance-style (SC) vignettes were used to enhance critical thinking and discussion among students in a fully-online pharmacy therapeutics course. Students independently responded to SC cases, then posted answers on VoiceThread®. Responses from peers aided students in selecting final answers. Reflections were included in weekly assessments.Script concordance-style (SC) vignettes were used to enhance critical thinking and discussion among students in a fully-online pharmacy therapeutics course. Students independently responded to SC cases, then posted answers on VoiceThread®. Responses from peers aided students in selecting final answers. Reflections were included in weekly assessments.

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Presenters

Katie Cardone is an associate professor in the Department of Pharmacy Practice at Albany College of Pharmacy and Health Sciences in Albany, NY, specializing in kidney disease. She practices at an outpatient dialysis facility, where she provides medication management services. Dr. Cardone’s research focuses on optimizing medication outcomes in the dialysis population, and has included both pharmacokinetic studies and outcomes research related to pharmacy practice. Dr. Cardone serves as the course coordinator and faculty in required and elective nephrology courses for students in their 3rd professional year of the doctor of pharmacy program. She has taught in traditional lecture and small classroom settings, provided sychronous teaching to a satellite campus, and designed and taught hybrid and fully-online courses. Dr. Cardone serves as the director of a post-graduate pharmacy residency program specializing in nephrology.

Additional Authors

Maree Michaud-Sacks is an instructional designer at Albany College of Pharmacy. She supports faculty through developing creative and innovative instructional solutions to help students engage in the learning process and course material. In addition, Maree assists faculty in implementing various instructional technologies into teaching and learning. Prior to her role at ACPHS, Maree supported technology implementation in K-12 schools and was also an instructional designer/project manager who developed corporate eLearning courses that were deployed worldwide to General Electric employees. Maree holds a bachelor’s degree from Rensselaer Polytechnic Institute, in Electronic Media, Arts, and Communication. She also recently earned a master’s degree in Curriculum Development and Instructional Technology as well as a Certificate in Online Learning and Teaching from SUNY Albany.

Extended Abstract

Robust online discussion among students is an integral part of online course design. Script concordance (SC) tests have traditionally been used for assessment of critical reasoning. A SC test presents a short scenario or case, followed by three parts: 1.) “you were thinking of [insert intervention here],” 2.) “but then you learned [insert new piece of information here],” 3.) “How would that influence your thought process or action?” In the third step, students choose from one of 5 options: I am now much more likely to keep my original plan, I am now somewhat more likely to keep my original plan, This does not affect my original plan, I am now somewhat more likely to change my original plan, or I am now much more likely to change my original plan.

In our fully-online pharmacy therapeutics course in nephrology, SC-style vignettes were used as a teaching tool to promote clinical application of course material. After initial exposure to module content (prerecorded videos and assigned readings), students independently responded to SC cases as a short quiz within the learning management system (Blackboard®). Points were awarded to students for submitting initial answers by the due date, not for submitting correct responses. Students then posted their initial SC answers with rationale for their assigned questions on VoiceThread®, a software interface that facilitates the capture and archiving of multimedia comments. Responses from peers over the course of several days aided students in selecting final answers to SC questions. Meaningful participation in discussion was expected for all students and was included in the course grade. Assignment reflections were integrated into weekly summative assessments.

Student participation was 100% in assignments. Reflections indicated that students benefited from discussion with peers and were positively influenced by others’ comments. Discussions allowed faculty to readily identify ‘muddy points’ and correct student misconceptions prior to the weekly assessments. A weekly blog was created by course faculty to address areas of difficulty for students.

We plan to engage conference participants by providing various examples of SC-style vignettes. We will discuss with participants how SC questions might be integrated into various course types.