A class ‘drug list on a web site: Pluses and minuses

1. A class ‘drug list on a web site: Pluses and minuses Frank F. Vincenzi University of Washington vincenzi@u.washington.edu

2. Ambivalence “n. (ambi- and valence) in psychology, the simultaneous existence of conflicting emotions, as love and hate, in one person, toward another person or thing” Webster’s New Universal Unabridged Dictionary

3. Common challenges to professors of pharmacology • How to teach? ….often dictated to us • What to teach/what not to teach? ...G&G is too much ”We ain’t going to buy it and we ain’t going to read it.” • We need some boundaries

4. A small sample of the Association for Medical School Pharmacology (AMSP) Knowledge Objectives Drug List http://girch2.med.uth.tmc.edu/druglist/druglist.html PRIMARY DRUGS and secondary drugs

5. Goal: Create a readily available, specifically designed list of drugs • Guide to student learning • Emphasis on correct names • Site and mechanism of action • a drug list as a teaching instrument, not as a reference database

6. University of Washington School of Medicine WWAMI Program • Students accepted from and do both basic an clinical training in: Washington Wyoming Alaska Montana Idaho (Covers approximately 25% of the US land mass) Learning resources online…….

7. Informational methodology: Textbooks & Physician’s Desk Reference • Decide on drugs to be listed - no distinction between primary and secondary drugs (About 150 drugs for course with 42 contact hours) • Name, trade name, site of action, mechanism of action • For clinically used drugs, indications, contraindications, adverse reactions, etc.(most difficult; decide what to include)

8. Operational methodology: • Enter data into an Excel spreadsheet (limit = 255 bytes per field) • Additional notations • Transfer data to a series of text files in HTML tables (one file too big for downloading by modem)Add structures and pronunciation files • Upload to a server

9. Front page of our introductory pharmacology course web site

10. Links to Online Resources and Drug List

11. A list of drugs for the course...

12. At the other end of the alphabet

13. But wait! There’s more - or rather less

14. Some examples of lack of consensus • Neutral “If you want to create and post information for my drugs, go ahead, but I am not going to do it.”.” • Downright negative “I do not want the drugs that I teach put onto the drug list. The students learn by making their own flash cards.” “If I put together a list of all the information you suggest it will be a substitute for the syllabus and one more place for misinformation or lack of information to confuse the students.”

15. More lack of consensus • “Students may say, ‘Dr. Xxxxx, the side effect you mentioned in your exam question was not listed on the WEB site…can I get full credit for not listening in class?’ ” • “I would not want to try to list indications, bacterial infections, tumors, etc. I don’t teach them and it changes every few months anyway.” • “The students should be responsible for making their own crib notes!”

16. What is not on the drug list? • Dosage • Detailed pharmacokinetics • Drug interactions • Controlled substance status • FDA Use-in-pregnancy ratings • A searchable database

17. Some advantages of a drug list • Reduction in student anxiety • Students prefer guided study - even to the point of some submitting data for a drug list in another pharmacology course • Improved focus of students on prototype drugs • Emphasis on sites and mechanisms of action

18. Some disadvantages of a drug list • Product rather than mechanistic orientation • Inability to concisely summarize drug interactions • False sense of security for students • Lack of faculty consensus on the list or the approach

19. Summary • A web-based drug list was created for an introductory course in medical pharmacology • The drug list is available to all Internet users • http://eduserv.hscer.washington.edu/hubio543/druglist/index.html • The drug list has been well received by students at the University of Washington