A model for implementing diagnostic instruction within Doctor of Pharmacy degree programs

Introduction: Health care needs in the United States (US) are expanding along with projected primary care physician shortages by the year 2030. Pharmacists' training and broad accessibility make them well positioned to provide primary care for basic medical conditions. As the profession advocates for greater patient care roles, a critical consideration in pharmacist training is a broader introduction to diagnosis; thus, instructional models will need to be developed for US pharmacy curricula. Objective: Describe logistics and evaluation of one model for teaching differential diagnosis in a Pharm.D. curriculum. Methods: A retrospective pre-post survey measured students' opinions regarding the utility of diagnostic-related instruction and perceptions regarding its impact on their practice-based skills and abilities. Objective course performance was also evaluated to determine if students' perceptions reflected their actual abilities. Wilcoxon signed-rank was used for quantitative data to compare overall total scores and individual survey items pre-post. Qualitative data were analyzed by exploratory thematic analysis using constant comparative analysis and grounded theory methodology. Descriptive statistics were used to describe objective student performance. Results: The survey response rate was 63% (n = 172). On all survey items, students reported improvements in their perceived abilities related to differential diagnosis after completing the course (P <.05). Student performance data indicated successful achievement of differential diagnosis knowledge, skills, and abilities for the vast majority of the class, which is congruent with their perceptions. Three themes were identified from qualitative data in terms of the applicability of diagnostic training for (a) patient assessment, (b) interprofessional communication, and (c) clinical decision-making. Conclusion: Diagnostic instruction should be considered in terms of advancing the profession. Considering benefits related to patient assessment and critical thinking skills, diagnostic instruction enables the use of a common language, fostering interprofessional communication, and understanding of scopes of practice and patient care contributions among pharmacists and diagnosticians.