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.