THE PERIPHERAL BRAIN - A TOOL TO FOSTER HIGHER-ORDER THINKING IN ABILITIES-BASED COURSES

Student-centered educational strategies that stress problem-solving ap pear to be more effective than traditional, instructor-based methods i n preparing students to practice pharmaceutical care. To address this issue, an abilities-based approach was developed in which students com pile a reference handbook, or ''peripheral brain'' (PB), to increase o pportunities to practice higher order thinking skills in pharmacothera py courses. Criteria for the compilation and evaluation of the PB were created collaboratively by students and instructors and were then use d to assess and provide feedback to students. In order to determine th e impact of PBs on exam content, a retrospective analysis was performe d to evaluate the types of questions asked in pharmacotherapy midterm and final exams prior to and after implementation of the PB system. To evaluate the effect of the peripheral brain on student performance, p harmacotherapy exam questions were classified according to Bloom's Tax onomy of Thinking and students' percentage scores on exams of varying taxonomic content were evaluated. Exam questions more frequently teste d higher order thinking skills post-PB compared to pre-PB (94 vs 44 pe rcent, respectively). Although post-PB exams were more challenging, po st-PB and pre-PB mean exam scores did not differ (75 and 73 percent, r espectively, P = ns), Analysis of post-PB exams revealed a significant inverse correlation between student exam performance and number of hi gher order taxonomic questions (r = -0.78, P < 0.05). Continuous asses sment and feedback significantly improved the quality of the students' PBs (P < 0.001), suggesting that higher order thinking skills also im proved. It is concluded that the PB serves as an effective learning to ol for improving students' higher order thinking skills in pharmacothe rapy courses. However, while the PB serves to facilitate the practice of problem-solving, by itself it is not sufficient to develop critical thinking skills.