A challenging time for pharmacology educators
This article focuses on the current challenges facing pharmacology
educators across the globe as they try to develop and embed a strong
pharmacology curriculum. New pharmacology educators face a backdrop of
an ever-expanding knowledge base, interdisciplinarity pressure and the
need to adapt pharmacology to fit multidisciplinary programmes, while
simultaneously ensuring innovative and engaging delivery. We argue that
concept-based curricula are a rational response to these challenges. We
explore the development of concept-based curricula in other fields and
discuss the development in this field to date, and consider the mutual
benefits of this approach to pharmacology educators and future
pharmacology graduates.
First and foremost, pharmacology educators must deal with the challenge
posed by the ongoing inexorable increase in scientific disciplinary
knowledge. Pharmacology graduates require an integrative comprehension
of basic biological sciences such as biochemistry, physiology, and
pathology, in addition to mathematical and physical sciences, to be
adequately prepared for the modern-day workplace. They need to be able
to combine this knowledge and integrate a substantial amount of
information, as well as concepts about medicines and their uses into
those fundamental conceptual frameworks. Finally, having completed each
of these tasks, they must be able to apply the concepts of pharmacology
and its underpinning disciplines in novel patient or medication-related
contexts. The requisite body of knowledge has grown exponentially over
the past century, and the resultant “information overload ”,
entertainingly referred to as “curriculomegaly” by Guilbert [1],
has exercised the minds of educators for many years [2]. It is
unsurprising that this information glut has led to an overdependence on
didactic teaching by academics and rote learning by students.
A range of strategies have been used to address this problem. The
development of explicit core curricula has helped to define the
knowledge that students require [3-5]. Student-centred approaches
such as problem-based learning have been used extensively in medical
education to change the focus from surface learning to application of
knowledge in context. A move away from traditional information-transfer
teaching and rote-learning studying to constructive study practices is
occurring in some institutions [6]. These evidence-based initiatives
have been highly effective [7] but can actually add to the challenge
of finding sufficient time-on-task, given that learning-centred
strategies themselves require a reduction in content in order to provide
students with adequate time for both engagement and interaction.
Despite these important efforts, studies indicate that many current
graduates lack fundamental pharmacological knowledge, particularly in
the health professions [8]. Even though many fundamental
pharmacology concepts have remained unchanged throughout the years [9,
10], they are frequently misunderstood by students when applying them
in practice [11]. A study that assessed the pharmacology knowledge
of medical and pharmacy students [12] found distinct knowledge gaps
in these cohorts, and concluded:
“Both pharmacy and medical students should have appropriate
pharmacology and pharmacotherapy knowledge at the end of their
undergraduate training in order to provide safe medical care. Although a
gold standard of sufficient knowledge is not available, the test
represents the learning goals of international core curricula and might
be used as such a standard.”
An additional challenge for pharmacology educators relates to their
workplace context. With the rise in integration and amalgamation of
dedicated pharmacology departments into broader higher education
structures comes increasing complexity and the need to fit content into
a shrinking curricular time allocation. This can lead to loss of the
identity of one discipline in the quest to ensure broad coverage of a
range of inter-linked disciplines [13]. These challenges are
inter-related, increasing the degree of difficulty for potential
solutions. Vallance and Smart [14] suggested that the consequences
of this shift will be greater for pharmacology education and training
than pharmacological research.
Further challenges exist for educators designing and customising
pharmacology curricula for degree programmes across different student
cohorts, including medical, dentistry, pharmacy, veterinary and nursing,
science, and biomedical science degrees, and at undergraduate and
postgraduate levels.
Given the aforementioned challenges, it is not surprising that novice
educators struggle when designing foundational pharmacology courses. We
argue that pharmacology educators should consider structuring
“Pharmacology 101” courses around the big fundamental ideas of our
discipline, namely the enduring core concepts that are required to solve
problems and predict outcomes. We contend that this approach provides a
conceptual framework within which new educators can help students
harness the tools they will need as graduates who work with medicines.
Such a move towards teaching the essential core curriculum, without
oversubscribing content, is essential for students’ ability to transfer
the key pharmacology concepts into applied professional contexts such as
safe prescribing practices and patient safety. Employing a concept-based
curriculum (CBC) for teaching pharmacology would encourage educators to
highlight interdisciplinary connections, helping students see the
relevance and applications of core concepts of pharmacology in
real-world contexts.