Lessons learned from a formative study evaluating student pharmacists' experience with a case-based learning “choose your own adventure” activity

Background: A case-based learning "Choose Your Own Adventure" (CBL-CYOA) activity was designed to support students in learning to identify drug-related problems and make clinical decisions related to drug therapy management. The purpose of this study was to describe student pharmacists' experiences in order to understand, from their perspective, which design features of the CBL-CYOA activity were valued as useful for developing clinical decision-making skills in an Applied Pharmacy Practice I course. However, several limitations with various features of study design minimized the usefulness of results. Impact: In retrospect, methodological limitations with both the survey and focus group designs negatively impacted the interpretation of results in this study. Recommendations: Attention to thoughtful survey development with better alignment to the purpose of the study and neutral questions may produce more useful results. Further, additional focus groups and a purposeful sampling strategy may add to increasing the credibility of the findings in this study. Discussion: Overall, formative studies like this one have the potential to produce insights into how innovative instructional designs operate in real-world contexts. They also have the capacity to output results that provide an evidence base for refining and improving those designs. We hope that our reflections in this paper may be useful to other educators and researchers working to plan similar projects in the future.