Pharmacy Students' Competency Regarding Medicare Part D
Pharmacy Students' Competency Regarding Medicare Part D
Using a pre- and post-test design, a survey instrument was administered on the first and last day of class and at the completion of outreach events. The survey instrument was developed to evaluate students' (1) attitudes, beliefs, and knowledge related to Medicare Part D, (2) confidence and skill in performing MTM and administering the influenza vaccine, and (3) proficiency using the Plan Finder Tool. Appendix 2 provides an example of the case study used to assess students' proficiency with the Plan Finder Tool.
The survey instrument was completed by the 33 students enrolled in the course. The first section had 13 demographic questions (Table 1). In the next section, students rated their level of confidence in assisting patients with their Part D plan, performing MTM, and providing immunizations, using a 5-point Likert scale (1 = strongly agree to 5 = strongly disagree), (Table 2). The following section presented students with a list of 10 services that might be provided as part of a typical MTM session (Table 3). Students were asked to indicate their perception of the importance of each of these services using a 100-point summative scale on which students distributed a greater number of points to services they felt were most important. Students were then given 16 knowledge-based questions about various aspects of the Part D benefit (Table 4) and a timed skills-based case study about which they had to answer a series of questions using the Plan Finder Tool (Appendix 2).
Descriptive statistics were used to summarize student demographic characteristics. The Friedman test was used to determine if there was a difference in students' self-reported confidence among the 3 measured time points. Because the Shapiro-Wilk test revealed that the MTM summative scale data were not normally distributed, the Friedman test was used to measure time-point differences. Students' knowledge about Part D, as measured by the number of questions answered correctly, was also non-normally distributed, requiring use of the Friedman test. In all 3 cases in which a Friedman test was used, significant differences were followed up with a post-hoc analysis with the Wilcoxon Signed-Rank test with a Bonferroni correction. Finally, the mean time to complete the Plan Finder Tool exercise was compared among the 3 time points using repeated measures analysis of variance. Significant results were further analyzed using the Bonferroni post-hoc test. All significance calculations were based on a 95% confidence interval at α = 0.05. Data analyses were performed using SPSS, version 18.0 (Chicago, IL).
Table 2 describes the demographic characteristics of the 33 pharmacy students who were enrolled in the class and completed the study. Students were predominantly female and of Asian background with an average age of 25 years. Most of the students worked in a pharmacy setting an average of 4 hours per week, and almost all had completed 80 hours of community introductory pharmacy practice experience (IPPE). Ten students had no previous experience with Medicare Part D, and the majority of students had no previous experience with either performing MTM or administering vaccines.
Table 3 reveals how students' self-reported confidence in providing assistance with Part D plan, MTM, and immunizations changed over the 3 evaluated time points. Lower scores indicated that students strongly agreed with the statement that they were confident in providing each service. Significant results were found for students' confidence with Part D plan assistance, providing MTM services, and performing immunizations. A significant improvement in confidence was found between the first and last day of class and between the first day of class and completion of outreach for both Part D plan assistance and MTM. Students were significantly more confident in providing immunizations after the last class compared with after the first class. Pharmacy students were able to assist 401 Medicare beneficiaries during the 9 events. On average, each student assisted 12 beneficiaries with their Part D plan and performed 11 MTM interventions during scheduled outreach events. The maximum number of influenza vaccines administered by any one student was 3 (data not shown).
Table 4 lists the 10 services that may be provided as part of an MTM session. They are ranked in order of their importance, as perceived by pharmacy students after completion of outreach activities. There was a significant change in the perceived importance of MTM services between the first day of class and the last day of class and between the first day of class and completion of the outreach activities. On average, students thought that identifying interactions and identifying drugs contraindicated for use were the most important components of the MTM intervention and that identifying expired medications was the least important aspect.
Table 5 lists the 16 content areas in which students' knowledge about Medicare Part D was assessed. A significant increase in the knowledge test score was found between the first and last day of class and the first day of class and following completion of the outreach activities. The mean time to complete a simulated Plan Finder Tool exercise was evaluated at 3 different time points. On the first day of class, students spent an average of 14.6 minutes, compared with 7.8 and 8.6 minutes on the last day of class and after outreach, respectively. The mean time decreased significantly between the first and last day of class and between the first day of class and following completion of outreach events.
Qualitative data were collected through student reflections completed at the end of the course. Overall, students reported overwhelmingly positive reactions, including that they found the course to be challenging but rewarding, eye-opening, and inspiring. The applicability of the knowledge learned in the classroom to the provision of patient care was by far the most frequently reported strength of the course. All students felt that the classroom component was successful in preparing them for outreach. While assisting patients, students described being apprehensive and uncomfortable at first but, by the end, feeling competent, confident, and fulfilled. Furthermore, students repeatedly stated that by being well prepared and knowing the answers to patients' frequently asked questions, their self-confidence soared, greatly enriching their ability to build trusting patient relationships. The majority of students noted that they would not cease to provide Part D assistance to patients just because the course had concluded. They indicated that it was a service they felt passionate about continuing after graduation.
Evaluation and Assessment
Using a pre- and post-test design, a survey instrument was administered on the first and last day of class and at the completion of outreach events. The survey instrument was developed to evaluate students' (1) attitudes, beliefs, and knowledge related to Medicare Part D, (2) confidence and skill in performing MTM and administering the influenza vaccine, and (3) proficiency using the Plan Finder Tool. Appendix 2 provides an example of the case study used to assess students' proficiency with the Plan Finder Tool.
The survey instrument was completed by the 33 students enrolled in the course. The first section had 13 demographic questions (Table 1). In the next section, students rated their level of confidence in assisting patients with their Part D plan, performing MTM, and providing immunizations, using a 5-point Likert scale (1 = strongly agree to 5 = strongly disagree), (Table 2). The following section presented students with a list of 10 services that might be provided as part of a typical MTM session (Table 3). Students were asked to indicate their perception of the importance of each of these services using a 100-point summative scale on which students distributed a greater number of points to services they felt were most important. Students were then given 16 knowledge-based questions about various aspects of the Part D benefit (Table 4) and a timed skills-based case study about which they had to answer a series of questions using the Plan Finder Tool (Appendix 2).
Descriptive statistics were used to summarize student demographic characteristics. The Friedman test was used to determine if there was a difference in students' self-reported confidence among the 3 measured time points. Because the Shapiro-Wilk test revealed that the MTM summative scale data were not normally distributed, the Friedman test was used to measure time-point differences. Students' knowledge about Part D, as measured by the number of questions answered correctly, was also non-normally distributed, requiring use of the Friedman test. In all 3 cases in which a Friedman test was used, significant differences were followed up with a post-hoc analysis with the Wilcoxon Signed-Rank test with a Bonferroni correction. Finally, the mean time to complete the Plan Finder Tool exercise was compared among the 3 time points using repeated measures analysis of variance. Significant results were further analyzed using the Bonferroni post-hoc test. All significance calculations were based on a 95% confidence interval at α = 0.05. Data analyses were performed using SPSS, version 18.0 (Chicago, IL).
Table 2 describes the demographic characteristics of the 33 pharmacy students who were enrolled in the class and completed the study. Students were predominantly female and of Asian background with an average age of 25 years. Most of the students worked in a pharmacy setting an average of 4 hours per week, and almost all had completed 80 hours of community introductory pharmacy practice experience (IPPE). Ten students had no previous experience with Medicare Part D, and the majority of students had no previous experience with either performing MTM or administering vaccines.
Table 3 reveals how students' self-reported confidence in providing assistance with Part D plan, MTM, and immunizations changed over the 3 evaluated time points. Lower scores indicated that students strongly agreed with the statement that they were confident in providing each service. Significant results were found for students' confidence with Part D plan assistance, providing MTM services, and performing immunizations. A significant improvement in confidence was found between the first and last day of class and between the first day of class and completion of outreach for both Part D plan assistance and MTM. Students were significantly more confident in providing immunizations after the last class compared with after the first class. Pharmacy students were able to assist 401 Medicare beneficiaries during the 9 events. On average, each student assisted 12 beneficiaries with their Part D plan and performed 11 MTM interventions during scheduled outreach events. The maximum number of influenza vaccines administered by any one student was 3 (data not shown).
Table 4 lists the 10 services that may be provided as part of an MTM session. They are ranked in order of their importance, as perceived by pharmacy students after completion of outreach activities. There was a significant change in the perceived importance of MTM services between the first day of class and the last day of class and between the first day of class and completion of the outreach activities. On average, students thought that identifying interactions and identifying drugs contraindicated for use were the most important components of the MTM intervention and that identifying expired medications was the least important aspect.
Table 5 lists the 16 content areas in which students' knowledge about Medicare Part D was assessed. A significant increase in the knowledge test score was found between the first and last day of class and the first day of class and following completion of the outreach activities. The mean time to complete a simulated Plan Finder Tool exercise was evaluated at 3 different time points. On the first day of class, students spent an average of 14.6 minutes, compared with 7.8 and 8.6 minutes on the last day of class and after outreach, respectively. The mean time decreased significantly between the first and last day of class and between the first day of class and following completion of outreach events.
Qualitative data were collected through student reflections completed at the end of the course. Overall, students reported overwhelmingly positive reactions, including that they found the course to be challenging but rewarding, eye-opening, and inspiring. The applicability of the knowledge learned in the classroom to the provision of patient care was by far the most frequently reported strength of the course. All students felt that the classroom component was successful in preparing them for outreach. While assisting patients, students described being apprehensive and uncomfortable at first but, by the end, feeling competent, confident, and fulfilled. Furthermore, students repeatedly stated that by being well prepared and knowing the answers to patients' frequently asked questions, their self-confidence soared, greatly enriching their ability to build trusting patient relationships. The majority of students noted that they would not cease to provide Part D assistance to patients just because the course had concluded. They indicated that it was a service they felt passionate about continuing after graduation.
Source...