Pharmacists are often required to solve ill-structured problems aimed at achieving optimal health outcomes at the patient, population, and institutional levels. Given the complexity of pharmacists’ clinical decisions, educators are exploring ways to foster complex problem-solving and higher order thinking in the classroom. One emerging strategy includes problem-based learning (PBL), which asks learners to collaboratively solve ill-structured cases that are representative of the types of problems faced by practitioners. Case-based reasoning argues that understanding and interpretation of a case is incremental and dynamic; that is, the lessons learned from one case might change in view of new experiences and across a case-based curriculum. While much of the literature is focused on how learners solve a single problem, it is unclear how learners construct their knowledge across multiple cases presented in PBL. To address this gap, this study focused on learners’ perception of case sequencing and how that design influenced the development of their internal case library. Because we are focused on formative assessment, we used qualitative analysis to understand the nuances of our design and explored its implications for programmatic changes. The feedback from the participants focused on index generation, index prioritization, alignment with prior knowledge, and reflection. Implications for theory and practice are discussed.

中文翻译：

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通过案例排序在药房中支持基于案例的推理

经常需要药剂师解决结构不良的问题，以期在患者，人群和机构层面实现最佳健康结果。考虑到药剂师临床决策的复杂性，教育者正在探索在课堂上培养复杂的问题解决方案和高阶思维的方法。一种新兴的策略包括基于问题的学习（PBL），它要求学习者共同解决结构不良的案例，这些案例代表从业者所面临的问题的类型。基于案例的推理认为，对案例的理解和解释是渐进的和动态的。也就是说，从一个案例中学到的教训可能会根据新的经验和基于案例的课程而改变。尽管许多文献都集中在学习者如何解决单个问题上，尚不清楚学习者如何在PBL中提出的多个案例中构建自己的知识。为了弥补这一差距，本研究着重于学习者对案例排序的理解以及该设计如何影响其内部案例库的开发。因为我们专注于形成性评估，所以我们使用定性分析来了解我们设计的细微差别，并探讨了其对程序更改的影响。参与者的反馈集中在索引生成，索引优先级排序，与先验知识的对接和反思上。讨论了对理论和实践的影响。因为我们专注于形成性评估，所以我们使用定性分析来了解我们设计的细微差别，并探讨了其对程序更改的影响。参与者的反馈集中在索引生成，索引优先级排序，与先验知识的对接和反思上。讨论了对理论和实践的影响。因为我们专注于形成性评估，所以我们使用定性分析来了解我们设计的细微差别，并探讨了其对程序更改的影响。参与者的反馈集中在索引生成，索引优先级排序，与先验知识的对接和反思上。讨论了对理论和实践的影响。