Evaluating student understanding of core pharmacokinetic concepts

Both educators and graduates have expressed concern about a perceived pharmacology knowledge gap that includes difficulty applying fundamental principles to clinical and research problems. Consequently, we sought to determine the extent to which current students can explain the meaning of, and appropriately apply, a subset of core concepts, and to identify any misconceptions arising from the responses. Of the twenty-four pharmacology core concepts arising from the recent international collaboration, four pharmacokinetic concepts were chosen, namely drug bioavailability, drug clearance, volume of distribution, and steady-state concentration. A total of 318 students from 11 universities across seven countries chose to participate in this study. Expert analysts identified the essential elements for each concept, then independently assessed each student's response. Teams of two experts compared their evaluations to reach a consensus and grouped misconceptions thematically. For each core concept, less than 30% of students provided responses that encompassed all essential elements. Participants found drug clearance most challenging, generally conflating it with the rate of elimination, whereas they demonstrated a better understanding of drug bioavailability. There were 34 misconception themes coded in a total of 813 statements, with volume of distribution and drug clearance producing the highest numbers (13 and 12, respectively). Overall, results suggest that students found it easier to apply the concept than to explain its meaning, which might reflect the shift from didactic to active learning approaches. These findings may be useful for educators who are developing introductory pharmacokinetic courses by providing conceptual focus and revealing common misconceptions to explicitly address.