Embracing uncertainty in pharmacy student clinical reasoning: A simulation-based approach

Area of Science:

• Pharmacy Education
• Clinical Reasoning
• Healthcare Simulation

Background:

• Managing uncertainty is a critical skill for pharmacists.
• Pharmacy curricula need effective methods to develop students' ability to handle ambiguous clinical situations.

Purpose of the Study:

• To evaluate if simulation-based exposure to ambiguous patient scenarios, coupled with structured reflection, enhances pharmacy students' clinical reasoning.
• To assess students' ability to manage uncertainty in simulated clinical environments.

Main Methods:

• Third-year Doctor of Pharmacy (PharmD) students participated in two simulation exercises over two weeks.
• Students engaged in shared decision-making (Simulation 1) and managed an unexpected adverse outcome (Simulation 2), followed by structured reflections.
• Data were analyzed using descriptive statistics and inductive thematic analysis.

Main Results:

• Students reported increased likelihood to adjust medication choices when faced with new, uncertain information.
• Experiencing unexpected adverse outcomes during simulations induced discomfort, but students ultimately trusted their clinical reasoning processes.
• A total of 259 students from two Canadian universities participated.

Conclusions:

• Structured simulation and reflection effectively reinforce clinical reasoning amidst uncertainty.
• Students learned that unpredictable outcomes do not automatically signify flawed decision-making, fostering confidence in their judgment.
• This educational approach supports the development of resilient clinical decision-making skills in pharmacy students.