Implementing a choose your own adventure activity to improve insulin decision making

The objective of this educational activity was to evaluate the impact of a virtually simulated Choose Your Own Adventure (CYOA) activity on pharmacy student knowledge and confidence of insulin management.

An online CYOA activity was created using TypeForm, version 2 (TypeForm SL) for a third-year pharmacy school diabetes elective with 16 enrollees over two course offerings. Through use of interactive storytelling, students used critical thinking skills to make decisions in six simulated patient's care including initiation, counseling, conversions, and titration of multiple types of insulin. Instructor-created surveys were administered to students before and after the activity to assess satisfaction, confidence, and knowledge.

Ten students (62.5%) completed the activity and both pre- and post-surveys. Average total scores on the five-question insulin knowledge quiz improved significantly from 46% to 68% (P = .02). High satisfaction scores were recorded for each item in the post-survey. Student confidence improved in all aspects related to insulin management (P < .001). No differences in knowledge, confidence, or satisfaction were found between students who completed the activity in an in-person vs. virtual classroom.

CYOA activities can be successfully implemented in an in-person and virtual pharmacy classroom using a digital platform. Students viewed the CYOA activity as an enjoyable, low-stakes learning tool to increase confidence in their decision making. This small study did find knowledge improvements, but further research is needed to fully establish the validity of the knowledge assessments and ensure knowledge gains are sustainable.