Setting priorities for physical examination in pharmacy education: A Delphi study

Marie-Laurence Tremblay, Marc-Antoine Guay, Alexandre Lafleur
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Abstract

As the scope of pharmacy practice is expanding, a growing number of pharmacists perform physical examination (PE) to gather additional information to monitor the effectiveness and safety of their patients’ therapy. This professional activity calls for the development of comprehensive and valuable PE training. We sought to determine by consensus which PE tests should be given teaching priority in pharmacy education. Using existing PE literature in pharmacy, we conducted an online Delphi survey from December 2021 to April 2022 with 16 pharmacists who practise in a variety of settings and/or who are considered experts in PE. After 2 Delphi rounds, consensus was reached to either include or exclude 27 PE tests in entry-to-practice programs. One last round allowed prioritizing the agreed-upon PE tests in terms of educational needs. Clinicians agreed that measuring blood pressure is indispensable and should be given teaching priority, followed by pulse rate, weight and blood glucose measurements. Endocrine system and head and neck examinations should be included in pharmacy programs, but their clinical usefulness was considered less important. We compared our results with PE literature in other health care disciplines. We found that only a few PE tests truly influence drug therapy management, that some examinations can be quite difficult to perform accurately and that without proper training and opportunities to retrain, skill decay can lead to dangerous misinterpretations. Pharmacy programs should consider focusing on teaching PE tests supported by evidence as having an impact on drug therapy management. Can Pharm J (Ott) 2024;157:xx-xx.
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确定药学教育中体格检查的优先事项:德尔菲研究
随着药学实践范围的不断扩大,越来越多的药剂师通过进行体格检查(PE)来收集更多信息,以监测患者治疗的有效性和安全性。这项专业活动要求开展全面而有价值的 PE 培训。我们试图通过共识来确定哪些 PE 检查应在药学教育中列为教学重点。利用现有的药学 PE 文献,我们在 2021 年 12 月至 2022 年 4 月期间进行了一次在线德尔菲调查,调查对象是 16 位在不同环境中执业的药剂师和/或被认为是 PE 专家的药剂师。经过两轮德尔菲调查后,我们就 27 项 PE 测试是否纳入执业准入计划达成了共识。在最后一轮讨论中,根据教育需求对商定的 PE 检查项目进行了优先排序。临床医生一致认为,测量血压是不可或缺的,应在教学中优先考虑,其次是脉搏、体重和血糖测量。内分泌系统和头颈部检查应纳入药学课程,但其临床实用性被认为不太重要。我们将研究结果与其他医疗学科的 PE 文献进行了比较。我们发现,只有少数 PE 检查能真正影响药物治疗管理,有些检查很难准确进行,而且如果没有适当的培训和再培训机会,技能衰退会导致危险的误判。药剂学课程应考虑重点教授有证据支持的、对药物治疗管理有影响的 PE 检查。Can Pharm J (Ott) 2024;157:xx-xx.
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