NURS 3015 – Pathopharmacology Essay Paper

NURS 3015 – Pathopharmacology Essay Paper

NURS 3015 – Pathopharmacology Essay Paper

The primary aim of teaching pharmacology to medical students is to train them on rational and scientific basis of therapeutics. Pharmacology teaching is facing a major challenge in the medical science due to constant reformation. Generally, there is a opinion that teaching pharmacology in medical schools has failed to keep in pace with the rapid changes in medical practice. Attempts have been made all over India to make teaching of pharmacology more interesting and relevant (Gitanjali.B.et.al. 2006). To make pharmacology teaching more innovative and interacting learning experience, efforts have been made by formulating new educational strategies to meet the educational objectives. Educational objectives can be evaluated by assessment procedures and timely feedback to achieve the learning goal.

In Meenakshi Medical College and Research Institute, Pharmacology teaching comprises mostly of a series of didactic lectures using power point presentations covering general, systemic pharmacology and practical pharmacology which includes animal experiments and clinical pharmacology sessions spread over the academic year. To evaluate the student’s progress we conduct monthly internal assessment tests consisting of multiple choice questions, essay questions, short notes and ultra short notes for 3 hr time duration including model practical exams conducted twice in a year. Regular viva voce exams follow the monthly internal assessment test to develop their communication and interaction skills.

Apart from this regular schedule of assessment, we also introduced a method of assignment on classification of drugs after each system. To reinforce the learning process, we implemented weekly test on the first hour of every week based on the lectures delivered over the previous week. The test was conducted for one hour which covered various portions of the chapter in detail testing the levels of knowledge.

After completing the above schedule meticulously, at the end of the year to understand the beneficiaries’ opinion we planned to collect the student’s feedback. Currently the student’s feedback represents the primary means used by different programs to assess their methodology (Richardson B.K.2004). Feedback helps in correcting mistakes, reinforcing good performances and incorporating students view in teaching methodology. It is accepted that reviewing the teaching and evaluation methods by feedback from students and modifying of methodologies accordingly is very important for the undergraduate medical teaching. (Ruth N 2000, Victoroff KZ 2006).

Thus the present study is an effort to obtain and analyze critical appraisal on,

The student attitude toward teaching and learning pharmacology in Meenakshi Medical College and Research Institute, Enathur, Kanchipuram.

Assessment of pharmacology teaching using student feedback.

Methods to improve the teaching of pharmacology.

Materials and Methods:

A questionnaire was designed to obtain feedback and finalized after a departmental discussion with concurrence of Medical Education Unit. The study subjects were 115-second year MBBS students of 2011 batch studying in Meenakshi Medical College and Research Institute, Enathur, Kanchipuram.

All the students enrolled in the study were requested to fill up the questionnaire. The study was conducted at the end of their academic year in Department of Pharmacology. A ten-item multiple choice questionnaires and an open ended question for suggestion were provided to explore the student’s opinion on teaching and learning methods imparted. The questionnaire was analyzed by two observers. The questionnaire was designed in such a way to assess the knowledge, their attitude and skills developed during their one and half year course in pharmacology. Both the theoretical and practical pharmacology practiced by different methods during their study period were evaluated from the feedback form. NURS 3015 – Pathopharmacology Essay Paper

Statistics:

Descriptive statistics was used for analysis of data. Frequency was shown as percentage.

Results:

One hundred and fifteen students of II MBBS participated and responded in the questionnaire study. Based on the pattern of studying pharmacology,48.69% studied pharmacology once or twice a week on regular basis and 34.78% opted studying only for monthly tests and viva voce exams which reflects on their regular preparation for monthly internal assessment test(TABLE-1).54.75% of students preferred lecture notes and text books as the source of studying pharmacology.

TABLE -1

Majority (87.82%) of students approved writing and maintaining classification of drugs. 53.91% have opined that the assignments had improved in better understanding about the different classes of drugs.43.47% of them have reported its usefulness to memorize and reproduce in the test and also to apply in their clinical postings.

Among the assessment methods, 54.78% of students favored monthly internal assessment test for their significant improvement in their academic performance. In the weekly test conducted, 72.17% of students found weekly lectures correlating with weekly tests, 51.30% of students mentioned that the true or false part of the weekly tests created interest.

Majority (66.95%) of students preferred regular tests in clinical pharmacology sessions when compared to the experimental pharmacology. Most (93.64%) of the students have mentioned regular viva-voce exams following monthly internal assessment test had improved their communication skills.

Among the teaching – learning methods practiced, 52.17% of students preferred theory lectures followed by clinical pharmacology sessions 46.95% and group discussions 45.21%

Feedback is defined as a response within a system that influences continuous activity or productivity of that system. In the present study on educational context, it would mean a response from the learner about the teaching learning process. Feedback is essential to find out the effectiveness of the process, the need to change it, as well as, to evolve strategy for its improvement.

From the feedback evaluation obtained, it is observed that students like to study pharmacology by regular test / viva and interactive classes so by these way students understand the subject properly (Nilesh Chavda 2011 et.al). This is very much correlating in the present study feedback results.

It was found that students preferred writing and maintaining classification of drugs throughout their academic year, which were corrected periodically by the faculty, who played the role of mentor for the given group of students to cultivate and sustain the habit. Writing classification of drugs by medical school learners has helped them to understand the different classes of drugs and also to systematically memorize and reproduce in the written test as well as the knowledge application in clinical rotations .

Students opined that monthly internal assessment test was mostly useful than the weekly written test for their academic performance in theory exams, the reason for the following may be monthly internal assessment pattern is similar to that of university examination. The weekly written test has definitely kept the students in pace with the portions being completed every week. By answering the weekly test their preparation, facing and performing monthly internal assessment had become extremely comfortable and confident . The weekly test had various parts, students considered true or false part of the weekly test has created interested in them, the fact to get such a feedback may be the chances of getting the wrong answer is only 50%. Also they have mentioned that, Match the following with extended responses have stimulated their thought process to find the correct response. The feedback also emphasized the student’s interest towards more interactive sessions on Clinical pharmacology exercises and felt it should be given regular emphasis than the animal experiments. According to Gibbs G et al, 1987 active review during the lecture, involving students in structured discussions, using questionnaires and asking them to summarize are the three most important things to be followed and practiced for a effective teaching-learning process.

To conclude though the teaching learning method implemented in the present study required a lot of strenuous hard work from the faculty particularly preparing questions, organizing test and more importantly correcting all the papers in a week period, it has created an interest in learning pharmacology among students. The feedback from learners has clearly exhibited their likeliness for the variety or different methodological approach instead of regular didactic lectures offered by the department of Pharmacology.

Walgreens in one of the largest drugstore chains in the United States. Walgreens has always maintained a simple strategy. Although the strategy changed over the years to mention newer innovations, the basic principles of the strategy have remained similar. It has become more than just your ordinary pharmacy it invest heavily in high tech store and distribution systems which drive service up and costs down, and offer an on-line drugstore web site totally integrated with other retail stores. Walgreens also have three Pharmacy Care Call Centers one in Alabama, Florida, and in Tuscan.

Choose the two (2) segments of the general environment that would rank highest in their influence on the corporation you chose. Assess how these segments affect the corporation you chose and the industry in which it operates.

I believe that the two segments of the general environment that would rank highest in influence for Walgreens are the two segments, demographic and technological. If I were to be honest, I believe that all of these segments are important to the success of a drugstore, but because the question asked for which ones I considered being the highest I chose these two. Let me go into details to explain my reasoning for choosing these two. NURS 3015 – Pathopharmacology Essay Paper

The reason why I choose the demographic segment is because demographics play an important role in mostly every corporation. Marketers can use the variables that make up demographics to create a demo graphic profile, which helps provide them enough information to create a mental picture of who the typical members of society are. Once these profiles have been constructed, they can be used to develop a marketing plan and strategy. The five types of demographics that corporations focus on for their marketing are age, gender, income level, race, and ethnicity.

As humans, our bodies are prone to get sick every now and then, and when it does we most likely have to rely on taking medicine to get over the illness. It does not matter if it is over the counter or prescription medicine, we just need something to rid us of the illness. That is when we most likely turn to the drugstores to purchase our medication, such as Walgreens. However, while we are there to just go get our medicine, the store has much more merchandise to offer than just that. They have stuff that touch on almost every type of demographics, from: having merchandise for different ages, having products for each gender, cheaper brands of prescription medicine for their lower income customers, and much more. Considering the five (5) forces of competition, choose the two (2) that you estimate are the most significant for the corporation you chose. Evaluate how well the company has addressed these two (2) forces in the recent past. Of the five forces of competition, the intensity of existing rivals within the industry.

The retail drug industry contains many companies, but the most notable are Wal-Mart, CVS, and Rite Aid. These are just a few of Walgreens’s competitors there are other stores like Kmart, Target, Publix and different grocery store pharmacy chains. Pharmaceuticals are a high demand industry, with fairly high margins. The margins are decreasing, and competition constantly adapts to changing approaches. Many competitors now choose to handle customer interaction on the web. Many people have started to do mail orders because it is cheaper for them. Also, insurance companies find it cheaper for the consumer to do mail orders then going into the actual store. The only thing is that some of the mail orders do not make it in time, which causes the consumer to still have to deal with an actual pharmacy. At Walgreens call center they have a mail order department that assist the consumer with mail orders. Walgreens have these call center to be able to assist more consumers then their competitors.

The second of the five forces that is the most significant for Walgreens would be the bargaining power of suppliers. The textbook states, “The bargaining power of suppliers refers to the ability of suppliers to raise input prices, or raise the costs of the industry in other ways-for example, by providing poor quality inputs or poor service.”(Hitt, Ireland, and Hoskisson p.54: NURS 3015 – Pathopharmacology Essay Paper)The generic market has a lot more bargaining power. If a generic manufacturer decides not to sell to a particular retailer, then the stores could easily pick another generic supplier. Generic drugs have less exclusivity than prescriptions, so suppliers must give-in to the chains’ demands. There are so many medications that you once had to have a prescription for that are over the counter drugs now will hurt the prices on the generic drugs. Walgreens and other pharmacies have come up with ways that customer can save money on prescriptions by offering prescriptions savings cards for people that do not have insurance. Wal-Mart, CVS, and Target offer certain medications at discounted prices. With the same two (2) forces in mind, predict what the company might do to improve its ability to address these forces in the near future.

In the future Walgreen needs to be able to sell their medication at a cheaper price then all of its competitors. The only thing about this is that some customers have learned that some medication that are manufacturer by different companies do not work as well as others. Regardless if it is brand or generic customers will ask for medication by certain manufacturers. While trying to lower prices for consumers the pharmaceutical have to make sure that the medication is working for the consumer. Not having the most requested manufacturers could cause a business to lose business therefore you have to make sure the stock is complete with medication that people need on demand. Assess the external threats affecting this corporation and the opportunities available to the corporation. Give your opinions on how the corporation should deal with the most serious threat and the greatest opportunity. Justify your answer.

In the highly competitive prescription drug market, Walgreen’s biggest threats come from its intertype competitors. With them no longer competing just against other drug stores and pharmacies, retailers such as grocery stores and discounters are starting to increasingly proving to be quite the formidable competitors. Discounters especially, are proving an to be quite a threat when it comes to prices. The emphasis on low cost and economies of scale possible through large companies such as Wal-Mart, mean that Walgreens cannot compete against discounters and their prices.

Walgreens is also at a disadvantage compared to their retail competitors, such as Target and Wal-Mart, because retailers carry a much broader assortment with significantly more SKUs and that they also have more consumers who visit the store on a regular basis.” It is estimated that 138 million Americans shop at Wal-mart weekly and that they find it more tempting to go and fill their prescriptions there as well, so that they can meet all their needs in one place” (Lasnti, 2005). Although Walgreens itself does consist of more than just medicine, their assortment of products comes nowhere as close as Wal-Mart and other popular retailers, so they just cannot compete against them in that department.

Furthermore, Walgreens’ reliance on prescription drugs, a highly regulated and controlled entity, makes it vulnerable to changes in laws and regulation. This is exemplified by recent changes to Medicare prescription drug plans which, while on one hand made the price of prescription drugs the same for consumers no matter where they chose to purchase it, also further regulated dispensing fees thereby decreasing profit margins for shops, like Walgreens. While Walgreens has not been impacted too adversely by these changes, the aging of the Baby Boomer generation and concerns over the future of Medicare mean that further reform will be a topic of continuous debate. Under these circumstances additional modifications and reforms which may potentially 12 reduce the profitability of prescription drugs are not unexpected. Walgreens relies heavily on prescription drug sales, and dependence on a category whose regulation is mainly beyond its control leaves it vulnerable.

As for opportunities, it appears as if Walgreens greatest opportunities to increase their sales lie in changing composition of American population. With the Baby Boomer generation on the verge of hitting a significant demographic shift, they will surely impact the pharmaceutical industry more than any other. “In fact, Walgreens expected a 30% increase in demand from their senior customers’ prescriptions in years on down” (Merrick, 2006: NURS 3015 – Pathopharmacology Essay Paper).” They had a good reason to think so since 30% of prescriptions and 42% of sales revenue from it came from seniors in 2002, and they were expected to expand up to 95 million by the time it was 2010 (“SIC 5912,” 2006). Increase for the demand of prescription drugs, which is Walgreens’ largest category and is most known for, potentially means an increase in sales and profit for the company.

Further opportunities that Walgreen has is to benefit from lies in international markets. Currently in the United States, only domestic businesses in the market have become saturated, and Walgreens will be forced to look internationally for expansion. While cultural differences and government regulations will likely prove challenging given Walgreens’ nature of its business, international markets provide significant opportunities for expansion in the market. Furthermore, there other main competitors that falls into the same category as them, such as Rite Aid and CVS, have yet to enter the international markets. Beating these competitors to reaching and entering into international markets could ensure that Walgreens stays a step ahead and remain the market leader of the three. This would also help Walgreens stay competitive against the larger chains, such as the ever popular Wal-Mart, with many of them already having a significant presence in the international market.

REFERENCE

Merrick, A. (2006, June 21). Walgreens found way to profit drug plan. The Wall Street Journal. Retrieved February 2, 2014 from LexisNexis Academic database on the World Wide Web:http:0web.lexisnexis.com.oasis.oregonstate.edu/universe/document?_m=402elf7d8438 “SIC 5912

Drug Stores and Proprietary Stores.” (2006). Referenceforbusiness.com. Retrieved February 2, 2014 from /industries/Retail- Trade/Drug-Stores-Proprietary-Store.

Hitt, M., Ireland, R. D., & Hoskisson, R. (2013). Strategic Management – Concepts and Cases. Mason: Cengage Learning.

Clinical decision support tools and explanation

I would choose the CPOE process because of the built in clinical decision support. Alerts will appear when orders are entered for medications that may contain pencillin. If the patient were to be prescribed a mediciation that may cause a reaction that could result in the patients death.

Scenario 2

Sepsis is a serious medical condition that many times sneaks up on clinicians because the vitals are not easily monitored. To recognize this condition, a trend of vital signs is needed so if the patient is deteriorating, the clinical team is able to recognize the need to intervene rapidly. If the vital signs are captured electronically, how could the system be leveraged to assist the clinical team in knowing they need to immediately help the patient? Consider trending of results, alerting, and communication devices.

Clinical decision support tools and explanation

When the vital signs are entered for each visit when a pattern in the vital signs are detected and alert will go off in the system. The doctors will be notified by built-in alerts that vital signs are following a certain pattern that may mean there is something serious going on.

Scenario 3

A patient has Cochlear implants in both ears. She is not able to have any radiology exams done to her that use a magnet, as the implants could get pulled out of her ears. (They are surgically inserted.) How might the system help to notify the physician when he or she is ordering radiology exams on this type of patient? Additionally, is there any way to leverage the radiology system to let the radiology technician know of the potential issue with the implants?

Clinical decision support tools and explanation

Medical professionals are able to input information about patients. Therefore that information will be updated in CPOE which will prompt alerts if another physician inputs an order to have radiology exam an alert will pop up.

Scenario 4

HIV is a serious infectious disease that must be reported to the state as soon as it is identified to prevent exposure and understand the incidence of the disease. How might the EHR help to communicate this to the government more rapidly? Consider how the system might share ranges of values across institutions.

Clinical decision support tools and explanation

I would choose to use a Drug/Drug Interaction tool, so we would be aware when there could be a severe reaction when a patient is prescribed both DRUGx and INTERAx. This tool would notify the appropriate individuals when someone wanted to prescribe both of these medications to a patient. I would have it alert the physician as soon as he or she entered the order in CPOE so they could have an opportunity to select another drug that would be appropriate for the patient. NURS 3015 – Pathopharmacology Essay Paper