Background:
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.
Aim:
To implement and evaluate the effects of a computer simulation-enabled workshop on students’ understanding of the time course of warfarin effect.
Method:
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.
Results:
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.
Discussion:
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.