Scaffolded Medication Therapy Management in a Pharmacy Skills Laboratory: A Structured Approach to Skill Development.

Abstract

Pharmacists are increasingly expected to deliver medication therapy management (MTM) services, yet many pharmacy students report insufficient confidence and preparedness in executing these complex tasks. This study evaluated a scaffolded MTM instructional series integrated into a second-year pharmacy skills laboratory, aiming to enhance student competence through progressive, structured learning. A mixed-methods design assessed changes in self-reported confidence, performance-based outcomes, and reflective insights among 154 students across three educational tracks. The 14-week intervention included sequential activities such as medication history interviews, drug-related problem (DRP) identification, care plan development, and comprehensive MTM simulations. Pre- and post-intervention surveys revealed statistically significant improvements in all 18 confidence domains, with the greatest gains in therapeutic recommendations and prescriber communication. Effect sizes ranged from small to very large (Cohen's d 0.33-1.05), indicating gains that were both statistically reliable and educationally meaningful. Performance assessments showed consistent proficiency across MTM components, with average scores ranging from 90% to 96%. Qualitative reflections reinforced these findings, highlighting growth in communication, individualized patient care, and professional identity formation. The scaffolded approach aligns with accreditation standards and instructional design theory, offering a model for pharmacy curricula. Despite limitations such as lack of a comparator group and potential response bias, the study demonstrates that scaffolded MTM instruction effectively supports skill acquisition and confidence, preparing students for real-world clinical practice.