Unveiling pedagogical effects of blended multimedia and slide-based approaches on students' self-efficacy and performance in over-the-counter medication counseling: an explanatory mixed methods study.

BACKGROUND: Addressing healthcare communication skills through a multimedia approach may enrich undergraduate pharmacy students' medication counseling competence. This study explored the impacts of a blended classroom teaching approach (incorporating newly designed video-based materials into conventional slide-based lectures) on students' self-efficacy and performance in over-the-counter (OTC) medication counseling services. METHODS: Using a sequential explanatory mixed methods approach, two cohorts of undergraduate pharmacy students enrolled in the 16-week Introduction to Community Pharmacy course were investigated. The cohort expected to graduate in 2025 served as the control group and received 4 weeks of conventional instruction using PowerPoint slides to introduce professional communication and counseling skills. In contrast, the intervention cohort expected to graduate in 2026 received 3 weeks of PowerPoint-based instruction, followed by an additional week of video-rich learning in OTC counseling. Pre- and post-course questionnaires were administered to assess students' self-efficacy in OTC counseling. Moreover, their counseling performance was evaluated through role-playing exercises with standardized patients during the final week of the course. Multivariate regression analyses determined the effectiveness of each teaching approach in enhancing self-efficacy and counseling performance. Semi-structured interviews were conducted and analyzed using inductive thematic analysis to gain insights into students' perspectives and experiences with the two teaching approaches. RESULTS: Both cohorts exhibited enhanced self-efficacy in medication counseling through the two approaches. However, the group that received the blended multimedia approach showed significantly greater improvement in counseling performance than its counterpart (p = 0.007). Students in the intervention cohort appreciated how video-based instruction provided visual and auditory cues, helping them grasp the structured flow of OTC counseling. Witnessing real-case scenarios in videos facilitated their understanding and appreciation of counseling techniques in real-life pharmacy settings. CONCLUSION: The study highlights that integrating multimedia instruction, particularly videos, significantly improved pharmacy students' OTC counseling performance, while self-efficacy showed improvement without a significant difference compared to traditional slide-based lectures. To better support the development of counseling competence, a blended instructional approach that combines video-based learning with conventional lectures is recommended.