Student Pharmacists Provide Similar Quality Clinical Reasoning Feedback as Resident Teaching Assistants

Abstract

Objective: Pharmacists utilize clinical reasoning (CR) to improve patient outcomes via medication optimization. It is critical to develop these skills in student pharmacists, yet optimal pedagogies to teach and assess CR are unknown. Peer feedback may be used to develop CR in student pharmacists, but a certain feedback quality must be reached to be effective. This study sought to evaluate if student pharmacists could provide similar quality peer feedback compared to pharmacy resident teaching assistant (TA) feedback.

Methods: This was a retrospective, mixed-methods pedagogical analysis comparing the quality of first-year student pharmacist peer feedback to resident TA CR feedback. The CR comments were defined using the intellectual standards of CR. Quality was assessed for task specification, gap identification, actionability, and process orientation by 2 independent investigators. Student performance and perceptions were also assessed. Mann-Whitney U, t tests, and descriptive statistics were used to analyze data where appropriate.

Results: Clinical reasoning feedback from peers (N = 805) and TAs (N = 206) were analyzed. Interrater reliability for feedback quality was moderate to substantial. Overall, peer CR feedback was of higher quality regarding task specification and process orientation while TA CR feedback was of higher quality regarding gap identification and actionability. Students receiving peer feedback performed better on a final patient case than those receiving TA feedback (95.2% vs 92.3%). Overall, the peer feedback process was well received by students.

Conclusion: Student pharmacists can provide similar quality feedback as resident TAs. Peer feedback offers an alternative to resident TA feedback and has the potential to contribute to improved CR skills.

Keywords: Clinical reasoning; Feedback; Peer feedback; Quality feedback.