Student pharmacists level of confidence in providing DSME prior to entering P4 rotations Meredith Tate, PharmD Candidate 2016; Kristi Kelley, PharmD, FCCP, BCPS, CDE, BC-ADM Auburn University Harrison School of Pharmacy Background According to The National Standards for Diabetes Self- Management Education (DSME) and Support, pharmacists are among the preferred healthcare professionals responsible for designing education curriculum and participating in diabetes education [1]. Diabetes education is often a skill that fourth year pharmacy students will utilize during rotations so it is crucial that third year students learn the proper tools to effectively deliver diabetes education. Previous studies have indicated that providing students with educational programs during the third year of pharmacy school improves students' level of confidence in their abilities providing diabetes education [2,3]. Purpose To assess the confidence in knowledge and ability of third year student pharmacists in the Harrison School of Pharmacy in preparation for fourth year Advanced Pharmacy Practice Experience (APPE) rotations. To identify how much education students are provided during school and how many opportunities they have had to provide DSME outside of school. Methods Population included third year student pharmacists in the Harrison School of Pharmacy Students were emailed an invitation to participate anonymously in a survey via Qualtrics All participants consented to terms and conditions Data collected from 11/12/15 through 12/4/15 IRB approval granted 10/25/15 through 10/26/18 Methods, Cont. Students were asked to answer questions pertaining to the following Diabetes Self-Management Education counseling points: 1. Mechanism of Action of Diabetes Medication 2. Administration of Medication (Including Oral and Injectable) 3. Storage & Disposal of Insulin Pens & Needles 4. Self-Monitoring Blood Glucose 5. Glucose & HbA1c Goals 6. Signs, Symptoms, & Treatment of Hypoglycemia 7. Signs, Symptoms, & Treatment of 8. Diabetic 9. Exercise Recommendations 10. (Immunizations, Aspirin & Statin Use, Screenings, etc.) 11. Diabetic 12. Referral to Ophthalmologist & Podiatrist as Necessary 13. 14. 15. Insulin Adjustment Results Number of PPE Patients with Diabetes Mean Areas Students Feel They Have Not Had Enough Exposure Range Type 1 Diabetes 0.14 0-1 Type 2 Diabetes 0.89 0-4 20 18 16 14 12 10 Results 8 6 4 2 0 Referral Adjustment of Insulin Administration of Meds Mechanism of Action Conclusions More than half of students reported feeling confident or very confident in all DSME 15 counseling points. Students reported feeling least confidence in counseling patients on nutrition, mechanisms of action of diabetes medications, healthy coping, preventative care, and referring patients to ophthalmologists and podiatrists. Many of the areas students feel the least confidence in counseling patients are also the areas to which students feel that have had the least exposure (e.g., referral, preventative care, and healthy coping). Although student reports confidence in counseling patients in all 15 categories, the majority of students have only had between 1 and 5 opportunities to counsel patients on DSME. This information can be used to identify areas of educational need for pharmacy students. PPE Opportunities to Provide DSME None 1 to 5 Outside of PPE 5 to 10 >10
Confidence Insulin Adjustment Referral Exercise Hypoglycemia Not Confident Somewhat Confident Confident Very Confident Glucose/HbA1c Goals Self-Monitoring Blood Glucose Storage of Pens/Needles Administration of Meds Mechanism of Action 0 5 10 15 20 25 30 35
Of the above subjects, which do you feel you have not been exposed to (not at all or not enough) in school? 0 2 4 6 8 10 12 14 16 Referral to Opthalmologist/Podiatrist Adjustment of Insulin Doses Administration of Medication Mechanism of Action of Medication
Students Feel They Have Not Been Exposed to Enough or At All Referral Adjustment of Insulin Administration of Meds Mechanism of Action
Number of PPE Patients with Diabetes Mean Range Type 1 Diabetes 0.14 0-1 Type 2 Diabetes 0.89 0-4
20 18 16 14 12 10 8 6 4 2 Opportunities to Provide DSME None 1 to 5 5 to 10 >10 0 PPE Outside of PPE
Additional Stats 100% of students reported feeling confident or very confident in counseling patients on glucose and HbA1c goals and self-monitoring blood glucose. 96.6% of students reported feeling confident or very confident in counseling patients on hypoglycemia, storage and disposal of insulin pens and needles, and exercise. 86% of students reported feeling confident or very confident in counseling patients on hyperglycemia.