Traditional Lecture versus Case-Based Learning in a Therapeutic Drug Monitoring Course within an Integrated Pharmacy Curriculum

Background: Case-based learning has been shown to increase student perception and performance in multiple topics in pharmacy education. However, no studies have evaluated the impact of virtual patients and case-based learning on student knowledge and knowledge retention of therapeutic drug monitoring and dosing. Innovation: Due to a curriculum overhaul promoting integration and application-based learning, the traditional third-year (P3) therapeutic drug monitoring course was reduced from four (4) credit hours to two (2), in order to add time to pharmacotherapy and skills labs. In order to adapt to this change, the course was shifted to a case-based learning format utilizing virtual patients within a simulated electronic health record (EHR) where the course grade distribution shifted in favor of patient cases versus exam questions. An analysis of student knowledge and knowledge retention of antibiotic dosing and monitoring was conducted comparing students who completed the traditional course versus those who completed the case-based course. Findings: Despite the decrease in credit hours, there was no significant difference shown in the initial knowledge assessment between the traditional and case-based courses (87.0 vs 85.5%). Knowledge retention actually improved in the students who completed the case-based course (78.1% vs 82.5%). Conclusion: Utilizing case-based instruction to teach antibiotic dosing and monitoring was successful in preparing students for these skills during their experiential rotations. Even though students had half the instruction time, they were able to perform calculations and retain knowledge as well as students in the traditional curriculum.