The Development and Pilot Testing of a Community-Practice, Clinical Pharmacy Decision-Making Assessment Instrument

The development and pilot testing of a computerized, simulation-based instrument, designed to analyze the community-practice, clinical decision-making skills of seniorpharmacy students, is described. Four communitypractice clinical scenarios were simulated. A microcomputer unobtrusively collected information-searching data and the decisions made. The instrument's purpose was to describe decision-making processes in order to understand these and eventually improve instruction in this area. The reliability of the instrument was assessed as acceptable. Content validity was assured during development and confirmed through a panel of clinical judges, pharmacy practitioners, and pilot-test students. Construct validity was demonstrated, whereas concurrent validity was only partially evidenced. From preliminary observations, it appeared that expert practitioners took longer and occasionally accessed more information than did students when making clinical decisions. This instrument has potential value as a teaching and diagnostic tool in pharmacy decision making.