Integrating a PKPD computer simulation in the BPharm course

Coagulation is an important process in haemostasis. It involves a complex interaction of clotting enzymes and proteins and includes numerous feedback and feedforward reactions. Warfarin, a widely used anticoagulant, has a complex dose-response relationship in addition to large between subject variability. Recently, a simulation software (CoaguSim) was developed in-house to simulate the time course of warfarin effect using a published complex system model of coagulation (the Coagulation Network). CoaguSim was developed as a teaching tool.

To implement and evaluate the effects of a computer simulation-enabled workshop on students’ understanding of the time course of warfarin effect.

CoaguSim was used in a haematology workshop where final year pharmacy students (Otago) explored warfarin dosing in a fictional patient with a recent thrombotic event. The case included different genotypes and compliance patterns. Students’ interactions during the workshop were documented and a pre- and post-workshop test was undertaken. Following the workshop, a focus group interview (8 students) was conducted and discussions were recorded and transcribed.

115 Bachelor of Pharmacy students participated in this study. Their mean scores for five multiple choice questions (MCQs) on warfarin pharmacokinetics and pharmacodynamics increased significantly from 45% (pre-test) to 81% (post-test). The focus group interview provided support that students learned by generating and testing their hypotheses via CoaguSim during the workshop.

The CoaguSim-enabled workshop improved pharmacy students’ understanding of the dose-response relationship of warfarin. Further development of the simulation to include other drugs is underway.