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The Transform your Teaching podcast is a service of the Center for Teaching and Learning at Cedarville University in Cedarville, Ohio. Join Dr. Rob McDole and Dr. Jared Pyles as they seek to inspire higher education faculty to adopt innovative teaching and learning practices.
It's about making sure the students are ready to move on, and I don't want to keep them any longer than I have to. So it's not about lengthening education, and it's not necessarily about shortening education. It's having students dwell in time in the area they need the most.
Narrator:This is the Transform Your Teaching podcast. The Transform Your Teaching podcast is a service of the Center for Teaching and Learning at Cedarville University in Cedarville, Ohio.
Jared:Welcome back to the Transform Your Teaching podcast here on the campus of Cedarville University in Cedarville, Ohio. My name is Jared Pyles, with me is Dr. Rob McDole.
Rob:Good afternoon.
Jared:Good afternoon, Doctor. McDole. We are continuing our series on competency based education. During this series, we received an email from a faculty member here on our campus talking about just how much in her area CBE is starting to make an impact. So I emailed her back and said, hey, do you wanna come on the podcast?
Jared:And she immediately said no.
Rob:There's We some got her we got her anyway.
Jared:But because she, you know, humbly, she's like, don't wanna angle myself into doing I don't know. That wasn't what you were planning on doing. Just wanted to have you on because we're we wanna get all perspectives on
Rob:Yep.
Jared:Someone in the midst of it, someone and you are considering let me introduce I'll introduce you here in a second.
Dr. Chen:Uh-oh.
Jared:And you are considering it in your field because it's growing, it's a growing thing in your field. Joining us is Doctor. Aleda Chin, who's the Associate Dean and Professor of Pharmacy Practice here at Cedarville. Hello, Doctor. Chin.
Rob:Welcome. Hello,
Dr. Chen:thanks for having me.
Rob:We're glad you're here.
Jared:Doctor. Chin, what's your background?
Dr. Chen:So I'm a pharmacist, which makes sense since I teach in the School of Pharmacy. But so I have my Doctor of Pharmacy degree, and then I also did some additional training in education related to learning how to do research and social behavioral aspects of pharmacy before I came to Cedarville in 2011. So this is my thirteenth year here at Cedarville, and yeah.
Rob:Well, what brought you to Cedarville?
Dr. Chen:So I always loved teaching. I didn't know if I wanted to be a faculty member, but then I got an opportunity to do some teaching while I was a pharmacy student and found I really liked it. I also thought that research was only in a lab, then I realized there's a whole ton of other research outside the lab, and I got an opportunity to do that and enjoyed it. So I went and I got additional training while I was at Purdue. But I ended up at Cedarville because one of my former faculty members, I connected with him at a Christian Pharmacist Fellowship meeting at a pharmacy education conference, and he's like, Hey, I'm starting pharmacy at Cedarville.
Dr. Chen:And I had actually interestingly come to Cedarville in junior high for a band competition.
Jared:Oh, no
Dr. Chen:way. Back in the day where the girls wore a long skirt
Rob:and chapel with an apple.
Jared:Oh, really? That that young.
Dr. Chen:I'm not young. So I
Jared:I mean, that was actually my next question,
Rob:so I'm
Jared:glad you
Rob:hit How how old are you?
Jared:How remember old are
Dr. Chen:eighties music. Let's put it that way. So yeah, so I jumped at the opportunity to join the advisory council. And then after two years on the advisory council, I finished up my Ph. D.
Dr. Chen:And they said, Hey, want to be a faculty member? And so my husband and I prayed about it and doors really opened for us to move to this area and I've been here ever since.
Jared:That's cool. Yeah. Alright, now tell me about CBE and its impact in pharmacy because I'm in those early stages, not entirely sure. You're approaching it there as well. What are you thinking?
Jared:What are you seeing in pharmacy?
Dr. Chen:Yeah, well I think you're really in line with a lot of people in pharmacy, so you're not alone in being hesitant.
Jared:Thank goodness. Okay.
Dr. Chen:So in health professions, CBE competency based education has been talked about a lot since really 2010. A lot of the work has been done in medicine and also veterinary medicine. So both of those areas have moved towards competency based education as part of it, and so pharmacy has finally caught up with the times and we are considering it. So we haven't decided to move toward it, but we in 2021 we put together a task force of faculty to explore what is competency based education and what might it look like in pharmacy. And so that task force finished up its work in 2022, and then now it became an actual professional committee.
Dr. Chen:So we started our work in last July and this is a two year committee, so we're going to start year two this July and work towards it. But we're really working through what does it look like to do this in pharmacy and are we going to adopt all the elements of it? Because I've heard the one that bothers you the most is the time variable aspect, and that's the question among all health professions right now.
Jared:So Oh, no. Rob Rob's locked in. Go ahead, Rob.
Rob:Sounds like you have a good place to to continue on with the conversation, the time variable.
Dr. Chen:Yes.
Rob:So in your committee work, what have been those things that, yeah, they you you came to them and they're like, oh, wow. This is tough. But then as you all worked it out, you moved kind of beyond it. And how did you do that?
Dr. Chen:Yeah. So what we've talked through as the committee is first, we've got to start with a common definition of competency based education, right? Because we all have to talk about the same thing. Sometimes we call it something, but it's not really that. It's not really just having a competency, right, or having an outcome in a course.
Dr. Chen:It's really the whole thing of students progress when they've mastered a certain skill or they've achieved that desired level of competency. It doesn't have to be mastery. It could be introductory. It could be a lower level, but they have to achieve it. So a lot of us think we do it, but we're not fully doing it because time variable is in every definition of competency based education.
Dr. Chen:But interestingly, most health professions, when they move towards it, they've removed that variable because it's very hard to make traditional curriculum move to a time variable approach. So they'll do it within the context of a semester. You have to retest until you achieve it within the context of a semester. A lot of that is because students do progress on to other training like residencies, and how do you start a residency six months earlier, three months early. There's a lot of difficulty with early accident entry points.
Dr. Chen:However, there are some programs that have done that, and those are unique cases to look at, too.
Rob:So time as the instead of being the constant, just for our listeners.
Dr. Chen:Yes.
Rob:One of the things you've heard on this podcast so far, if you've been listening to the CBE, as you've heard me say, competency, the big issue is in normal, you know, teaching and learning, time is the constant, education is the variable.
Jared:Correct.
Rob:Here, what she what we're talking about when we use these terms is education is the constant and time is the variable. And so that is one of the things that people just really hit. And it's interesting. You're talking about doing something inside of a still doing something inside of a semester.
Dr. Chen:Right.
Rob:And so for our listeners, you're experimenting or you're looking into you guys haven't piloted anything yet, right?
Dr. Chen:Yeah. So where we are, the first iteration of the task force really looked at what's the definition that pharmacy education should agree upon based on the literature. We spent time looking at what are the enabling and driving factors of it, and we used implementation science, which just isn't a systematic approach to figure out everyone who's done it, what have been the best practice like it synthesizes it into best practices. What do you need to drive it organizationally, competency wise, etc? And how do we get that information from it?
Dr. Chen:And so we finished that up, published that work, and then now in this iteration, we've done over 30 focus groups and interviews with people across the world to look at competency based education, people who have done it, and then all the stakeholders within health professions and pharmacy education to say, what are you seeing in our graduates? Are they ready to take care of patients? Do they meet society needs? Because one of the big things with competency based education is the goal of your education is not whatever you have dreamed up as an educator, it's to meet patient and society needs and health care needs. And so we need to really see is what we're doing now working or do we have something that we need to fix?
Dr. Chen:And so the work of this is preparing really to start changing behavior among faculty and pharmacy programs to get them excited about the possibilities of competency based education or if the science tells us no, then no. But so far, I will say a little prelude to our our work that we're synthesizing right now. It's probably going to be that some things need to change.
Rob:Now you're hurting his heart right
Dr. Chen:now. I know. Can I wish the podcast picked up the nonverbals right now?
Jared:He dropped. If I could, I could lean I'll just lean back in my chair and just look off in his face. He's he might he might faint. It's not that I'm against it.
Dr. Chen:Didn't you use writing as the example?
Jared:I did use writing. I used anything that's subjective.
Dr. Chen:Yeah. So let's actually take writing as a great example. So a student can I've actually had this happen. A student can write a really thought provoking paper, but and they can pass, right? But if their grammar and spelling is atrocious, are they competent in writing?
Jared:No, they're not.
Dr. Chen:So should they stay and continue writing until their grammar and spelling are correct too? Absolutely. Or just get past when they master that. So that's something we love about competency based education in pharmacy because you can go and you can pass a test, but that doesn't mean that you got every single knowledge domain or every single skill set passed. You might be really gifted at choosing the right medication for a patient, but you can't talk to a patient.
Dr. Chen:And it's really bad if I send you out and you have to actually talk to people. Yeah, it's
Jared:kind of important.
Dr. Chen:So I did pay attention to your podcast.
Jared:Yeah, appreciate that.
Rob:Or maybe he doesn't.
Jared:No, it's
Dr. Chen:But I see your point. I understand because there's something about the semester that makes sense. Right? We're used to that progression. That's how we're all trained.
Dr. Chen:I mean, I've never done anything outside of a semester. Right?
Rob:Right.
Dr. Chen:But it's about making sure the students are ready to move on and I don't want to keep them any longer than I have to, so it's not about lengthening education and it's not necessarily about shortening education, it's having students dwell in time in the area they need the most.
Jared:That is excellent. That's a great way of putting it. You hit on the society needs and the personal needs that a pharmacist needs to have. Do you think that's the main shift across the country that you've seen pharmacy programs go to CBE Or do you is there another reason why you've in all your research that you've done, what has been the main motivator to go to CBE?
Dr. Chen:Well, I think we're all seeing that traditional models of healthcare education don't necessarily produce the very best health care professionals. They produce excellent health care professionals. I'm not saying that there aren't great health care professionals out there, but it's really hard for education to match the pace of what's changing outside of us, particularly within health care professions, because every day there's new drugs developed, there's new therapies, there's new advances in science, and so we can't create students anymore with this specific domain of knowledge. We have to generate students that have skill sets and that also have this idea and concept of lifelong learning and development so that they can keep up with the needs of health care and society. So we might be able to graduate them and they're pretty close because they're trained a lot in the workplace.
Dr. Chen:So competency based education health care professions, you spend more time in the workplace getting assessed and getting competent. And so they're better prepared when they leave. But I think that a lot of the impetus for this is getting students ready to be adaptable, to be innovative, to be self directed lifelong learners so that they can continue to keep up and make sure they're delivering the very best care for patients.
Jared:In the current traditional model, how many years until someone becomes a pharmacist?
Dr. Chen:So you have to do all your prereq work, depending on what that is. That's usually somewhere between two to a four year degree. And then you have about four years time in seat because it's a doctor of pharmacy program. There are some accelerated programs that you get down to three, you go year round. It's an interesting approach, but it's a good approach, too.
Dr. Chen:So at minimum, you're looking at, you know, six to eight years really to get your PharmD, and that's assuming you don't do additional education afterwards in a residency that can be anywhere from one to two years.
Jared:Follow-up. Yeah. You may be too early at this point, but what would a CBE length of time would it take someone to be a pharmacist?
Dr. Chen:So the best analogy I can use is from some medical programs that have actually used the time variable curriculum. There's a pediatrics one that did it, and they found that some students got about six months early into their pediatrics residency. So if you think about a medical curriculum is also four years like pharmacy, So you're talking about six months time off for some students, but most students ended up seemingly about the same time a few students got to go early because they were able to accelerate through the curriculum. But it was really about focusing and preparing them for practice.
Rob:Gotcha. Just well, I'm also very curious. I've been sitting here thinking about some of the statements you made earlier about the things that you found when you were doing, you know, doing the work. What are those best practices? What did you find?
Rob:Because I'm sure our listeners would be interested to know, like, are those hurdles? What are those things that you need to address in some of those conversations just like we're having now. Right? Yeah. And Jared's got some good questions and you've had some good some good answers.
Rob:So speak to that a little bit more, if you would.
Dr. Chen:So your Center for Teaching and Learning becomes your best friend. Hey. Hey.
Jared:We stay employed.
Dr. Chen:You do. And in fact, the role of people with assessment and curriculum expertise gets heightened quite considerably in this model. Because if you think about it, if you're assessing students, you need to make sure that they're validated assessments, right? You can't just slap together not that we ever do this in education, have to use proper rubrics that are well developed, right, that actually measure what you're intending to measure. You need to have real time data and assessment practices, so you need to have the appropriate technology to be able to look at how a student is progressing and the student it needs to be transparent with the student.
Dr. Chen:So your assessment and curriculum things need to be really well in place and in collaboration with people that can understand data, can understand education and all of that. Another key component is making sure it's a team based approach. No one person goes in it alone because you're looking at triangulating assessments, you're looking at building out the strengths of the team. And another big thing, particularly for health care professions, is making sure that you have people in the workplace that can provide really good assessments of students and training for students because you need that partnership. Because it's great if they can do it in the classroom, but they have to be able to do it in the real world.
Dr. Chen:And that's another key component.
Jared:It sounds like enrichment all the way around because not only are you wanting to focus on creating quality students that go out there, but also the mentors that they're eventually going to be with in their residency or wherever else they end up.
Dr. Chen:Absolutely. So everyone needs to have kind of this growth mindset and really be focused rising to the top of what they can learn and what they can grow and do. And really, it's a partnership and collaboration between everyone to help a student be successful.
Rob:It's interesting. I know this seems far afield for me to even say this, but it's very reminiscent what you're talking about. It's very reminiscent of the Toyota way in terms of business development and some of the things that they do as a company. Because what you're really talking about here is continuous improvement and letting the team, number one, say, okay, if you're gonna actually do this thing called being a pharmacist, there are certain things that hopefully you should be able to do, like you just said a little while ago, talk to a person?
Dr. Chen:Yeah.
Rob:That's good.
Dr. Chen:Yes.
Rob:How many pharmacists have I met who don't know how to talk to people?
Dr. Chen:Well, and those are really key things. And a part of this is developing that core, right? You have to develop the core of what every single entry level pharmacist needs to know. Not the pharmacist that's been out five or ten years in the field that's a specialist, but the entry level. But then as we go out in the concentric circles, then we need to decide that for other dimensions of pharmacy and other times down the field.
Dr. Chen:But you're right. It's really a lifelong plan. Right? Just for the student improvement.
Rob:But for everybody involved. It kind of raises the C level, if you will, because your instructors also have to continually push themselves.
Dr. Chen:Absolutely.
Rob:You know, they can't just sit and like, well, I'm just gonna throw that that slide deck out there I've been throwing out there for the past five years.
Dr. Chen:Yeah.
Rob:You know? And we'll call it good.
Dr. Chen:Yeah. No. Within that, you see in the very best competency based education programs that there is a plan and a competency framework for the educators themselves of what they need to be able to do. And most of it does not actually relate to your clinical knowledge because that's an assumed, right? It's really related to your ability to provide feedback, reflect, develop yourself, educate students, and really make sure that your assessments are effective.
Jared:How would you assess someone talking? I'm just curious, like at what point would you do that? Because let's say hypothetically we do, and thank you for humoring me in this. Let's say hypothetically, they go through this program by themselves, right? They've showed mastery of all this stuff.
Jared:And then they finally end up in a residency program partnered with a pharmacist or a doctor. I'm not really well versed in the pharmacy world, but they end up at that point. And then at that point, four to five years into this, they realize this person has no people skills or no verbal skills whatsoever. Is that too late or is this something Oh, you
Dr. Chen:it's far too late.
Jared:But then how do you assess it earlier if they're by themselves?
Dr. Chen:We do actually start it way earlier. So I'll use our pharmacy program because I The know first semester they're on campus, they're already learning communication skills. They take an over the counter medication class. Every week they go into a skills lab. They're assessed.
Dr. Chen:They get feedback with a rubric that's actually been validated. Yes.
Jared:Did you do that rubric, Rob? No. Oh, I thought you're just looking like More you validated
Rob:than likely, she's done it, but she's heard me talk about it enough. She knows that that's like a hot button topic for me.
Dr. Chen:Maybe I did. But Yeah.
Rob:Yeah. I'm sure you did.
Dr. Chen:But we use that, and they get feedback from near peer. So it's one year above students. And then they actually have a summative assessment at the end of the semester. We do what's known as objective structured clinical examinations every semester where students meet with a standardized patient who is an actor and that's their job and they role play a patient and they are actually rated on different skill sets, one of which always is communication skills. So they will get a hard stop each academic year and have to remediate and get warning signs halfway through the year if they already can't talk to a person, because that is one of the core skills a pharmacist needs to possess.
Dr. Chen:And there's other ones. There's math skills, there's finding information quickly. There's also drug knowledge because that's kind of what a pharmacist needs to know. All those things.
Rob:You know. Drugs.
Dr. Chen:And then they are actually out starting their first semester every week in the community working with a preceptor, and that preceptor gives us feedback on their performance.
Jared:So this is the first CBE program that I've heard that actually has a face to face component to it?
Dr. Chen:So if you look at CBE within pharmacy and we're not doing CBE yet, no pharmacy program is doing it yet, but we're we're thinking about it, right? We've got entrustable professional activities, which is a component of CBE. We've got some milestones. We're making progress towards it within pharmacy, but all pharmacy programs do have components of in person. They're not online programs.
Dr. Chen:There could be portions of it that are delivered online. There's there are some distance pathways within pharmacy, some virtual online programs. It's really more for the knowledge components, for skills assessments, for things like that, for there's we have a requirement of like seventeen hundred hours of clinical learning. They have to do that with people before they graduate. So those are all things that have to be done in person.
Dr. Chen:This is not a virtual learning experience. It could have elements that are virtual, but the majority of it's in person.
Rob:Yeah, that makes sense.
Dr. Chen:So that probably makes you feel a little bit more comfortable.
Jared:It does actually.
Rob:Yes.
Dr. Chen:AI is not writing their assignment for them and then they're turning it in. I mean, that can still happen, but we try and avoid that.
Jared:All I ask is that when you do those face to face things and you have the actor there, have the actor hand them a paper and go, look, your grammar here is really bad, and you gotta work on your punctuation here and all this stuff. And when
Rob:you're presenting your ideas,
Jared:just throw that
Dr. Chen:in there. That's okay. I have reflections to grade today for the end of the semester. So as as I'm marking out their grammar, I will think of you.
Jared:Okay. I appreciate that I very
Rob:don't know if that really matters.
Dr. Chen:Well, my grandmother was an English teacher, so I'm a little bit of a stickler.
Jared:That's fine. I appreciate that.
Rob:That's good.
Jared:I appreciate that. Well, this has just done nothing but confuse me more about my thoughts on CB.
Rob:CB isn't all on virtual.
Dr. Chen:But a lot of the places that have adopted it or the early adopters outside of health professions have virtual. So I think that's one of the common things that is thought of with it, but I will say health professions have done it in person.
Jared:Well, I appreciate you coming on, Doctor. Chin. I will tell I tell you this, this is the most convincing argument I've heard for CBE thus far. So I tell you what, if you need some CTL help here at the university, call me first because
Dr. Chen:Sounds good.
Jared:I wanna be with you in this journey of going into it because I think if I had an entry point, like a fresh perspective on doing it, maybe that would make me see, especially with the face to face component to it. I think that's where I can reside, I think, in that area of CBE.
Rob:I think you'll find that you will move into it, pretty naturally because the work I've seen you do, if I if I can say this
Jared:Okay.
Rob:And not have it edited out.
Jared:We'll see. The work Twenty seven minutes, Jacob.
Rob:The work the work that you do will lend itself directly to the work that she's already doing and that that her committee is doing. So in the homework section of our podcast as we end this
Dr. Chen:Yeah.
Rob:Tell our listeners, you know, maybe they're maybe like Jared, they've been sitting on the fence. But the more they've heard this, the more they're listening to it, they're like, oh, okay. Maybe I'm ready to step up this a little bit. Tell them where's a good place to start? What's something they could do?
Dr. Chen:Well, I think I've I looked at some of your previous homework and some of this relates to just within your own class. What is your goal with your class? Like, what are you producing? So I have a class with students that's related to getting them ready to go out to their full year of clinicals. And a really big thing is making sure they have all the top 200 drug knowledge.
Dr. Chen:So I've redone that section of my class to make it more of a competency based assessment. They move on when they master that. Right? So what is there something that's really super crucial in your class that you can kind of pull out and students get multiple tries until they are successful with it versus just they hit the the threshold on the exam to pass the class and move on? Can you start with a small step of making sure your students are competent in something that you feel is best for their future career?
Rob:That's really good.
Jared:Well, thank you, Doctor. Chin, for joining us today on the podcast.
Dr. Chen:Oh, it's delightful. Thank you so much for having me, and I enjoyed the conversation. And I do want to say, you know, part of what we do cannot even happen without the partnership of Centers for Teaching and Learning because they are hugely successful to make sure we educate super well.
Rob:Oh, wow.
Jared:That's so nice of you. Yeah. You're hired.
Rob:And we did not bring
Dr. Chen:her on to say that. We did not. Paid x amount of doll no.
Rob:I'm kidding. Here's that
Jared:Benjamin I'm sliding across the table too. Well, that's gonna do it for us on the Transform Your Teaching Podcast. Thanks so much for listening. Be sure to like and subscribe on your favorite podcast platform. Send us an email at CTLPodcastcedarville dot edu.
Jared:Check out our blog at cedarville.edu/focusblog and join us on Flip to discuss our ongoing series. Thanks so much for listening.