Grant recipients and project team:
Jeff Nagge, School of Pharmacy
Sherilyn Houle, School of Pharmacy
Rosemary Killeen, School of Pharmacy
Cynthia L. Richard, School of Pharmacy
Marie Lippens, Centre for Extended Learning
(Project timeline: September 2017 - August 2018)
Anticoagulation therapy is used by individuals who have an elevated risk of death or disability from blood clots. The most commonly used anticoagulant in out-patient settings in Canada is warfarin. Warfarin is a very effective anticoagulant, but it can be difficult for clinicians to manage as there are several drug, disease, and lifestyle interactions that may require warfarin dosage modifications. In 2007, a blended learning Continuing Professional Development (CPD) course was launched in partnership between the School of Pharmacy and the Centre for Extended Learning. The Management of Oral Anticoagulation Therapy (MOAT) course is for health professionals who want to provide anticoagulation services in community settings. MOAT combines self-paced, online learning with experiential training in an anticoagulation clinic with real patients under the supervision of a clinical expert. The primary objective of this study was to determine the value of including practical experience.
We wanted to determine whether the experiential component of MOAT was valuable enough to learners that it was worth the extra resources required to offer it. The specific questions that we asked former participants in MOAT were which aspect of MOAT they found the most important, and to what extent did each aspect of the course contribute to their confidence to provide anticoagulation-related services.
The Management of Oral Anticoagulation Therapy (MOAT) course is a blended learning continuing professional development course for pharmacists who want to provide anticoagulation services. MOAT combines online learning with experiential training in an anticoagulation clinic under the supervision of a clinical expert. The primary objective of this study was to determine the value of including practical experience. An email survey was sent to 186 graduates of MOAT and 125 surveys were completed, for a response rate of 71.4%. Participants reported a progressive increase in their confidence in providing anticoagulation services on a seven-point Likert scale from baseline (mean score, 2.9), after completing the online component (mean score, 5), and after the experiential training (mean score, 6.2) (p < 0.001 for all comparisons). 90% of participants indicated the experiential component was the most important aspect of MOAT. The experiential component of MOAT was a highly valued complement to online case-based learning.
Dissemination and Impact
- At the institutional (uWaterloo) level: Our team presented a research poster at the University of Waterloo Teaching and Learning Conference in the Spring of 2018.
- At the national and/or international levels: Our team gave an oral presentation at the Canadian Association for University Continuing Education in Halifax, NS in the Spring of 2018. Our team presented a research poster at the International Pharmaceutical Federation (FIP) World Congress of Pharmacy and Pharmaceutical Sciences in Glasgow, Scotland in September 2018. We have an article under consideration for publication in the American Journal of Pharmaceutical Education (submitted August 2018).
Impact of the Project
- Teaching: Given the results of our study indicating learners found the experiential portion of MOAT extremely valuable, a new version of MOAT was created in February 2018 that replaced clinic visits with a virtual anticoagulation clinic comprised of eight artificially intelligent patients. Instead of attending the live clinic in Kitchener, learners remotely assess these eight patients in 64 different clinical scenarios over the course of 11 days. This virtual clinic overcomes some of the issues with the traditional clinic visits (e.g. course capacity is increased, the learning can be completed entirely at a distance). This new version of MOAT is called MOAT-Online. It has been offered twice in 2018 and will be included as a fourth-year undergraduate elective in the School of Pharmacy in Winter 2019.
- Connections with people from different departments, faculties, and/or disciplines about teaching and learning: We have had preliminary discussions with a faculty member at a School of Pharmacy in Australia who is also using patient simulations in pharmacy education. Our approaches are complimentary, and future collaboration is likely.
Project Reference List (PDF)