Nursing students and educators alike indicate that pharmacology is one of the most challenging courses for undergraduates, which our spring 2025 educator survey confirmed. This has negatively impacted National Council Licensure Examination (NCLEX®) scores1 and client safety.2
Key reasons students struggle to build a pharmacological foundation include:
- Difficulty prioritizing safety-critical information and other essentials
- Overwhelming volume of content leading to rote memorization without understanding
- Overexposure to new, complex terminology and drug nomenclature
- Traditional, lecture-based courses that fail to keep students meaningfully engaged
By understanding and addressing these challenges, educators can help nursing students focus on essential drug information, which in turn better prepares them for the NCLEX and ensures safer and more effective client interactions.
Strategies to Address Shortcomings in Pharmacology
To reduce nursing errors and enhance client safety, educators have taken a closer look at how to improve student engagement and learning outcomes in pharmacology courses. Findings of 4 studies provide a near-holistic view of the existing literature.
1. Active Learning and Technology-Inspired Engagement
Fasinu and Wilborn investigated the utility of active learning strategies, such as team-based learning (TBL), problem-based learning (PBL), and case-based learning (CBL), complemented with personalized learning and technology-inspired engagement methods.
- TBL has received positive feedback from students and improved test performance. It traditionally involves 3 phases:
- Individual student preparation using instructor-provided resources
- Readiness assurance to ensure core concepts are understood
- Application of team activities that require deep content knowledge
- PBL has improved student performance, competencies, and interest in learning pharmacology. Similar to TBL, it is meant to be learner-centered and teacher-facilitated. Learners should be given opportunities to identify their knowledge deficiencies and apply prior knowledge to solve problems.
- CBL can inspire high-level learning, help students grasp difficult concepts, and improve clinical problem-solving. It features real-world scenarios that often require a multidisciplinary approach.
- Personalized learning can facilitate learning drug names, mechanisms of action, clinical applications, etc. It is an adaptive framework that tailors learning to individual students based on their progress and understanding.
- Technology, such as videos, interactive eBooks, online quizzes, and the audience response system (ARS), can enhance attention and participation. It has similar benefits as games and activities that can improve attendance and learning.
Overall, sustained curricular integration beginning earlier in the program, a continued focus on active learning, and technology-inspired engagement methods can boost learning and retention.3
2. Games and Case Studies
Thomas and Schuessler considered ways to keep baccalaureate nursing students engaged and interested when teaching pharmacology. They noted that a student-centered approach using games and case studies improved standardized test scores and student evaluations over a traditional, lecture-only approach. By incorporating these strategies, students displayed a higher level of engagement in the learning process.4
3. Cognitive Load Theory (CLT)
Kaylor explored the use of cognitive load theory (CLT) as an instructional design framework for an undergraduate pharmacology course; 4 instructional strategies were used:
- Opening review activities
- Providing students with lecture notes
- A “top 5” prototype approach
- Deciphering “need to knows” from “nice to knows”
Students provided positive feedback in response to these strategies, which were shown to promote a student-centered environment and active learning.5
4. TBL, PBL & CBL, and Flipped Classrooms (FC)
Chen-Lin et al. analyzed the efficacy of 24 pharmacology education strategies. They concluded that TBL, PBL combined with CBL, and flipped classrooms (FC) are the most effective pharmacology teaching methods (although rankings vary among outcome measurements).6
- TBL was strongest when measured using students' satisfaction and experimental test scores. It was second when measured by the proportion of students' satisfaction. It improves students' interest in learning and their learning abilities.
- The PBL and CBL combination was strongest when measured using theoretical and subjective test scores. It enhances students' ability to analyze and learn pharmacology applications.
- FC was the strongest when measured using the proportion of students' satisfaction, and performed well in improving theoretical test scores. However, it scored under 50% in the other measured categories. It requires students to put in more effort, with fewer readymade solutions provided by instructors, and allows opportunities for better academic feedback.
Additional Strategies and Resources
Beyond these findings, educators can use these additional classroom activities and methods for teaching pharmacology prioritization:
- Simulations for medication administration scenarios, with charting and error prevention, can reduce failure rates and build confidence in high-risk drug handling.
- Mnemonics and visual aids can simplify drug classes and effects. One example is the “Medication Mansion,” where medications and their characteristics are organized into rooms of a house.
- Infographics and multimodal resources, such as drug pathways via GIFs or 3D models, can boost engagement and understanding of pharmacokinetics and pharmacodynamics.
- Collaboration with pharmacists in a group session or simulation mirrors interprofessional care to build confidence in drug management and ethical considerations.
Emphasizing Safety-Critical Information
In addition to implementing these teaching strategies into their programs, nurse educators have UWorld on their side to help students succeed in learning and retaining pharmacology content. Our comprehensive pharmacology course is designed to capitalize on educational best practices and save instructors time. It leverages active learning principles and built-in flexibility to supplement or replace traditional textbooks, enhance classroom and online instruction, and improve learning outcomes.
Using UWorld to prioritize drug information and increase engagement:
- Cognitive Load Theory: Concise lecture videos and UGuides summarize need-to-know information, such as medication classes, mechanisms of action, adverse effects, and clinical implications.
- Problem- and Case-Based Learning: Knowledge check questions and NCLEX-style items require students to apply lessons in real clinical scenarios. Detailed rationales explain answer options from a nurse's perspective.
- Team-Based Learning and Activities: NCLEX items can be presented live in class or through a polling feature, giving instructors multiple ways to improve participation and gain immediate feedback.
- Flipped Classroom: Instructors can assign high-yield videos, custom quizzes, premade PowerPoints, targeted instructor notes, and visual UGuides to students anytime.
Additional prioritization strategies and teaching frameworks that UWorld facilitates:
- Emphasize major adverse effects, contraindications, and monitoring parameters.
- Place initial focus on drugs that are high-risk or frequently tested on the NCLEX.
- Incorporate frameworks such as “what do I monitor, when do I hold, and what do I report?”
- Use our nursing topic comparison tool to help students differentiate between similar concepts.
- Use our flipped classroom template to organize blended learning resources.
Mitigating Persistent Challenges for a Positive Future
While nurse educators are making substantial progress in addressing the root of pharmacology shortcomings, challenges such as high workload, fatigue, and distractions will likely continue. However, medication errors can be significantly reduced through better initial training and integration with developing technologies. Together, let's empower future nurses with the knowledge, skills, and confidence they need for safe and effective care.
References
- National Library of Medicine (Apr. 2013). Standardized mastery content assessments for predicting NCLEX-RN outcomes retrieved from https://pubmed.ncbi.nlm.nih.gov/23407195/
- National Library of Medicine (June 2024). Empowering Nursing Students to Prevent Medication Error-Related Harms: A Step Toward Improving Patient Safety retrieved from https://pubmed.ncbi.nlm.nih.gov/38764993/
- National Library of Medicine (Feb. 15, 2024). Pharmacology education in the medical curriculum: Challenges and opportunities for improvement retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC10869893/
- National Library of Medicine (June 2016). Using Innovative Teaching Strategies to Improve Outcomes in a Pharmacology Course retrieved from https://pubmed.ncbi.nlm.nih.gov/27405202/
- SLACK Incorporated (Jan. 22, 2014). Preventing Information Overload: Cognitive Load Theory as an Instructional Framework for Teaching Pharmacology retrieved from https://journals.healio.com/doi/10.3928/01484834-20140122-03
- Frontiers Media S.A. (Mar. 14, 2023). Multidimensional evaluation of teaching strategies for pharmacology based on a comprehensive analysis involving 21,269 students retrieved from https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2023.1145456/full
