In my former academic life on the faculty at the Purdue University School of Pharmacy and Pharmaceutical Sciences, I had the distinct pleasure to teach the elective nonprescription medicines course, 3 credit hours. It was challenging and creating examinations became difficult, especially when I was an elected officer of one of our national pharmacy organizations. That meant I would have to travel extensively and yet, maintain my teaching load. Reflectively, I came to the conclusion that the semester I taught, I would not administer examinations in the course. Previously, during the prior 15 years that I had taught the course, there were three formative examinations and one final examination. Instead, as I told the students on the first day of the course, their grade would be based on reflective writings at the end of each lecture presentation and ten homework assignments. The reflective writings were based on two questions, "If there was one thing that I learned today, it was..." and "if there was one thing I did not understand, it was..." Reading these after lecture then afforded me to answer some of these during the first five minutes of the next lecture. As an educator, you could imagine the look I received from the students when I indicated that there would be no examinations. "Wow, this is different, but why?" some asked. Simply, I responded, "I want to put the onus for learning on you." In addition, to the aforementioned concern about time to write examinations, I also knew that there was more than one right answer to solve a self care problem. There is more than one laxative, more than one allergy product, etc., that would be appropriate for the patient. I wanted to give my students the latitude to come up with more than one correct or alternative answer.

Ultimately, ten homework assignments were crafted, each with a patient case scenario that "connected" to what was taught. For the first section of the assignment, the students were instructed to list five questions they would ask the patient or caregiver and state the rationale. For the second section of the assignments, they were to share how they solved the problem with their rationale.

The semester started and the homework assignments were handed in for grading. Feverishly, the graduate teaching assistants (GTAs) assigned to me (all were registered pharmacists), graded the assignments thoroughly and in exemplary fashion after we agreed upon key items that should have been included in the response. Along the sides of the homework assignment, the GTAs wrote questions and comments and probed further asking for more explanation, etc. The process, however, was not iterative and there was no way to get the assignments back reworked. Course evaluations demonstrated that the students liked this type of learning, but interestingly, half the class wanted to know "what they knew" and requested there be at least one or two examinations during the course which was implemented during the following year's course offering.

For the next offering, in addition to the lecture reflections (28% of the final grade), there were 5 homework assignments (38% of the final grade) and two semester examinations (19% of final grade) in addition to the final examination (15% of the final grade). A nagging reality, however, was that the students never really read the comments nor the suggestions offered on the homework assignments. Too many of them, all that was important was "what grade did I earn?" This troubled me because they were not gaining insights from the registered pharmacist GTAs who were working hard for not a whole lot of reward. So, the following year, I did the same. However, I instructed my students that they would receive their homework assignments back, but without a grade. They were told to read their assignments again with all the markings and then write at the top of the assignment what they thought their grade would be and turn it back in. Suffice it to say, there were some disgruntled students. Interestingly, research from the latest course offering involving about 150 students demonstrated 78% of the students could predict their scores within +5% of their actual score. Fourteen percent undervalued their scores and 7% overvalued their scores.

From this alternative way to deliver a nonprescription course, two manuscripts were published in the American Journal of Pharmaceutical Education. My point here is to illustrate how if one reflects on teaching, how content is taught, how student learning is evaluated, etc., one can innovate and create. However, once the individual does, it is important for the person to share new knowledge with his/her colleagues for their benefit and that was my goal. So, my recommendation to you is to reflect and dream of what could be in your course. Do not hesitate to innovate and create and do not be dissuaded by the "nay" sayers who share that "it has been tried before and failed." Who knows, "maybe it was ahead of its time." My recommendation to you is to try. As Michael Jordan said, "you miss 100% of the shots you do not take." So, take them and you will be the richer for it. But remember, when you discover you must share with the rest of us.