The entire module and evaluative tests were pilot- tested by 2 pharmacy clinical practice leaders, 2 pharmacy managers, and 1 inpatient pharmacist. Rates of completion of the educational module were determined relative to the total number of eligible inpatient pharmacists. The primary educational end points were change in pharmacist knowledge overall, change in knowledge about the triage process of P. falciparum infection, and change in knowledge of procedures for procuring supplies of IV quinine. User satisfaction with the module and the comfort level of each pharmacist in processing malaria orders were assessed qualitatively.
On both the pre- and the post-tests, the user was asked to enter his or her name, number of years of hospital experience, and e-mail address, and to quantify any prior experience with cases of malaria. This section was followed by a series of 12 multiple-choice questions assessing the pharmacist’s knowledge of the triage process for P. falciparum malaria (10 questions) and the procedures for procuring supplies of IV quinine (2 questions). The post-test also included, in addition to the same 12 knowledge questions, 6 Likert-scale questions to evaluate user satisfaction. Once completed, all test results were automatically forwarded (via e-mail) to a secure e-mail account and were then manually entered into a database (Microsoft Access 2003) for analysis.
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Nonpharmacist staff (technicians and assistants) and pharmacists who did not work in inpatient dispensaries (managers, outpatient pharmacists, clinical practice leaders, and the pharmacy director) were excluded from the analysis. Of a total of 182 pharmacists in the Calgary Health Region, 122 pharmacists were working in inpatient dispensaries as of March 1, 2007, and were eligible for participation in the study. Pharmacists who did not complete both the pre- and post-tests properly and in the correct order were excluded from some analyses.
Preliminary sample size calculations were not undertaken because the educational module was not intended to achieve a prespecified change in pharmacist knowledge or a prespecified target level of pharmacist knowledge. Data were obtained from a fixed volunteer sample, and completed pre- and post-test results were analyzed according to each defined end point. Pre- and post-test questions were scored according to a standardized key, and the percentage of correct answers was determined for each pharmacist; the percentage of pharmacists with the correct answer was also determined for each question. The test results were also analyzed by subsection (triage process for malaria and procedures for procuring supplies of IV quinine). Changes in knowledge were calculated as post-test score minus pre-test score, and descriptive summary statistics were evaluated. Confidence intervals were determined for the mean test results and the mean score changes. Mean score changes were evaluated by the Student t test (with p < 0.05 considered significant). suhagra