This work represents the first study of its kind in that is uses a drug pronunciation learning program to directly assessing the perceptions and capabilities of a Pharmacy student cohort in pronouncing drug names. Our findings demonstrated that the DrugSpeak Program could deliver significant improvements in drug pronunciation in terms of accuracy, suggesting that it increased student proficiency in decoding and encoding drug names to generate verbal fluency. The study differs from many other pronunciation research articles in that it focuses on the explicit pronunciation of single drug names, rather than drug name recognition or recall, as is the case with LASA drugs. The quality of student pronunciation of short sentences and paragraphs has been assessed , but even in this case student language awareness shows improvement, but not pronunciation skills. A recent study utilised a cloud computing model to compare student English pronunciations with reference word pronunciations in real time, to produce continuous pronunciation quality assessments . While these represent an attempt to provide general improvements in student verbal English performances, the DrugSpeak Program focuses on drug name pronunciations as an important graduate attribute that is specific to future health professionals.
DrugSpeak also produced almost identical increases (~18%) in student proficiencies in pronunciations of drug names that were included within the course learning material (Treatment drug set), as well as drugs not included in the course (Untreated set). This may have been driven by a global enhancement of student strategies in drug pronunciations, rather than improvements in drug names that are more familiar. Nonetheless, some item-specific effects from exposure can be argued as the Treated drug names had higher chi-square values suggesting a greater effect. Interestingly, students showed even greater increases (27%) in pronunciation ability for drugs not yet on the market and this were completely unfamiliar to them (New Word set), however this increase was found to be insignificant. Again, it is possible that non-specific increases in skills caused this response. However, only 10 drug names were included in the New word set, and research has revealed that a small samples size may influence research outcomes which could produce a non-significant increase, contrary to observation .
Factors such as student gender or native language were not primary parameters of focus in this report. Studies are inconclusive on gender since pronunciation ability is multifactorial [32, 33]. One may assume that native language may predict drug pronunciation ability, however all students are required to meet minimal English language levels upon entry to university. Furthermore, drug names hold a cross-similarity to the English language as there are no drug names that fall outside the (approximate) 45 sounds produced in the English language . As such, factors outside of gender and native language are likely to have more impact on drug pronunciation ability. One example may include prior learning, such as phonetics training in secondary schooling, and student motivation and attitudes towards the importance of correct drug pronunciations in their desired careers.
Students were surveyed on six paired questions both before and after the DrugSpeak program on their perceived confidence, anxiety, learning ability, and competence of other health professionals in terms of drug pronunciation. Only those questions pertaining to student confidence and learning ability demonstrated significant improvements following DrugSpeak. This indicates that DrugSpeak equipped students with the strategies and approaches they needed for correct drug pronunciations, translating to increased student confidence and ability to learn in this regard. This is supported by the data in our study which showed increases in student drug pronunciation accuracy. Indeed, higher levels of student self-confidence leads to enhanced performances and increases in positivity in problem-solving . Contrastingly, statistical differences were not observed for student questions relating to the importance of drug pronunciation and competencies of other health professionals. This is likely due to the high baseline levels of these perceptions prior to intervention with the DrugSpeak program, revealing the generally high level of value placed on drug pronunciations by Pharmacy students even prior to the use of DrugSpeak.
The overall feedback from students on the DrugSpeak Program was very positive. Most participants agreed that it increased their knowledge of phonetics and that it enhanced their confidence in drug pronunciations. Additionally, students recommended DrugSpeak be incorporated into the curricula of the course for future students and even introduced into coursework of other health degree programs. We are currently integrating DrugSpeak into our postgraduate degree program and seek to further broaden its impact by incorporating it into the Medicine and Nursing degrees. Ultimately, we anticipate that this will reduce the frequency of medication errors within the health sector, with enhancements in health practitioner fluency have downstream effects of higher patient satisfaction and quality of care .
Further complications arise in spoken pronunciations of drug names due to the requirement for health professionals to wear surgical masks . This factor is more prominent than ever given the emergence of the Covid-19 pandemic. Since masks obscure the mouth, reduce voice projection, and reduce articulatory clarity to a degree, they add to the confusion as to which specific drug medications are being spoken by the mask-wearers . This is further hampered by the noisy work environment and other distractions that are common in crowded pharmacies and various clinical settings [3, 12, 39] where clear, precise verbal drug communication practices are essential. Drug pronunciation programs such as DrugSpeak seek to provide further assistance in this regard to prevent medication errors that arise from mispronounced drug names.
As the DrugSpeak program was a pilot study, there were several limitations to this study which should be addressed in future iterations of the program. Firstly, a control group of students who possess minimal exposure to drug names (e.g. students enrolled in programs unrelated to medicines) may help determine the effects of the program on drug pronunciation. Secondly, prior exposure of students to drug names through popular culture, advertising, previous drug-related work or study, own prescription drug use or awareness may all contribute to baseline proficiencies in drug pronunciations. This should be accounted for when collecting sociodemographic data in future. Thirdly, levels of student exposure to drug names between the first and second audio recordings should be standardised, as this is likely to directly influence student performances in the second recording. This may be difficult to control, as it is dependent upon student motivation and attitudes towards drug pronunciations. To remedy this, it may be necessary to conduct the final audio recordings immediately following the DrugSpeak workshops rather than during the final week of the course.