From the Faculty of Pharmaceutical Sciences, Assistant Professor Ali Reza Ladak created a team including Jocelyn Micallef, Manager of Educational Development, to redesign a first-year pharmacy practice skills lab. In this interview, Ali and Jocelyn discuss the changes their team made, and the value of UDL in the more structured and competency-based discipline of pharmacy education.
How have you applied UDL to your course?
Ali: This year, we piloted the redesign of one of our lab sessions where we focus on developing technical and clinical skills through a lot of authentic simulations and small group activities. We ended up applying UDL in multiple ways across the lab: For example, we created a welcome video to clarify what was going to happen in the lab, set a welcoming tone, and highlight the importance of the material and its relevance to future practice. In the lab itself, we offered students various options for how they could present their work.
We also had some playful elements, such as an activity where the students got to apply sunscreen and then use a UV camera to see how good of a job they did with the application, which was meant to inform their future ability to provide good patient education and also just to let them have a good time. We also gave them more flexibility for one of their assessments, which was an Over-the-Counter (OTC) consultation, where we had a pharmacist role-play a patient coming into the pharmacy with a minor complaint. Students were required to assess the scenario and provide a recommendation, but they were able to choose the topic. While this choice isn’t available in practice, it was highly engaging and supported learner agency and autonomy. We also added some unboxing videos of pharmaceutical products that are used for dermatological conditions, included more links to reference materials on canvas, and had students complete self-reflections to assess their own learning.
What motivated you to start incorporating UDL principles in your lab?
Ali: To be honest, it was skepticism. I was never part of the UDL Fellows Program, but UDL was mentioned in one of our Faculty meetings, and I’d heard a couple of presentations about it at our Faculty’s academic retreat. Initially I didn’t like the sound of it – it felt vague and a bit idealistic. It was at odds with the structured, performance-based, professional approach that I’ve previously taken in labs, and that pharmacists generally aspire to. That tension is what initially intrigued me. I thought, if I don’t like it and I don’t understand it, but there’s definitely some value in it that other people see, then I want to try and reconcile this or at least learn a little bit more about it. Once I learned more, I started thinking about how it could come together with my expectations of clinical education and skill development. How do we get the benefits of UDL while still prioritizing authenticity, clarity, and the high expectations for performance from pharmacy students? From there, it turned into quite a commitment.
What started as skepticism eventually grew to a place of advocacy.
Did you experience any challenges with implementing UDL and how did you overcome them?
Jocelyn: One of the common concerns, especially in practice skills labs is that the students needs to graduate and be able to put these skills into practice as pharmacists. The challenge was how do we add flexibility when there’s defined criteria to be met and a clear outcome is desired for very good reasons? In terms of the OTC assessment, in prior years, students counselled on a subset of topics that they’d encountered already, but they didn’t know which one they were going to be tested on. In a real pharmacy, you don’t know who’s going to come in and what issue they’re going to have, but in the first year of pharmacy school, do students need to have all of those pieces together all at once? We had to think about whether it was the uncertainty that was really important in that activity or if it was the ability to counsel on any topic and develop those foundational counseling skills. It’s not about making it easier but figuring out what the most important learning outcome is and designing flexibility for that outcome.
Ali: This was a large part of my skepticism, because we couldn’t add options to have students do a final podcast or a presentation – they needed to be able to complete an OTC consult in practice. We had to work around this expectation, and it was Jocelyn’s idea to let students choose their own topic. This ended up putting the focus on skill development rather than the topic, which was something that we’ve been trying to do in the skills lab the whole time. This allowed us to achieve that goal while incorporating more student choice and autonomy. Students weren’t as worried about the topic since they chose it themselves and were instead able to put their energy into perfecting their counselling skills. It was a challenge at first to accommodate, but became a really strong and engaging aspect of the lab.
How have students benefited from the UDL strategies you implemented?
Jocelyn: The labs are set up with three different stations within the lab which students rotate through, so one group starts on the sunscreen activity, another starts on the assessment, others startson counselling, rotating each hour. In past years, instructors observed and students have mentioned that those who didn’t start on the assessment were doing a lot of thinking about the assessment as they were going through the other stations, which prevented them from properly engaging with other activities that were happening. After we made changes to the lab, instructors noticed a major shift in the room since students knew what their topic was going to be and were observed to be less stressed than previous cohorts. The students were able to be much more present and engaged with the rest of the rotations, possibly because they had more choice and thus felt more prepared.
Ali: I would agree with that – usually students are balls of stress until they’ve completed their assessment. Personally, I really could feel that the stress in the lab had decreased. We did an evaluation where 91% of students agreed that choosing their own topic helped them take ownership of their own learning, and when asked about whether they think other labs in our program should be designed the same way, more than 90% strongly agreed. I think that in itself speaks volumes about how the students felt about the lab and the changes that we made. Students also left multiple comments in our evaluation saying that they want to learn more about sunscreen because of the activity we had, while others found the unboxing videos super helpful because they gave the students a comprehensive idea of what the medications looked like and how they’re handled prior to the lab.
Do you have any tips or resources you’d like to share with anyone implementing UDL for the first time?
Ali: Having a good support system is incredibly important if you want to succeed. UDL can feel really overwhelming: 3 principles, 9 guidelines, and 36 considerations. It’s just massive, and I wasn’t sure how I was going to unpack it at first. Having the project team with a couple of people who had gone through the UDL Fellows Program before, like Jocelyn, made everything feel so natural..
Jocelyn: I like the idea of starting by reflecting on the things you’re already doing. I will often have the CAST matrix up when I’m working through something and comparing what I have already implemented with what I have yet to do. It really helps with picking a starting point and making things seem a lot more manageable. If you’re just looking through the website and you don’t have a dedicated project or support, start by thinking about your landscape and where UDL fits within that. From there, you can think about what changes will make the greatest impact for students while also aligning with your capacity and skillset.
Thank you to Ali and Jocelyn for sharing their story