SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
January – April 2018
Spring Preceptor Workshop A great turnout of preceptors came to Newberry, SC, in March to learn about experiential education updates, opioid use and abuse in students and peers, and preceptor burnout. Thank you to everyone who came and participated, and we look forward to seeing you again at our fall preceptor workshop in October!
MANY THANKS TO OUR PRECEPTOR PANEL! Laura Holden, PharmD, BCPS (Palmetto Health) Bradley White, RN, PharmD (McLeod Health) Doug Furmanek, PharmD, BCPS (Greenville Health System) Lee Dailey, PharmD, BCPS, BCGP (Laurens County Memorial Hospital)
Ashley Castelvecchi, PharmD, BCGP (VA Outpatient Clinic Greenville
SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
January – April 2018
The Mental Health of our Students The March Preceptor Workshop examined two important topics in experiential education and the pharmacy profession as a whole: burnout and drug abuse. These issues affect pharmacists, preceptors, and students in a variety of ways. A preceptor who is burned out is not just stressed or overwhelmed but has reached a state of apathy and discontent. Students are also under a great deal of stress and commitments and may reach out to chemical dependency to cope. Dr. Steven Scott, President of American Association of Colleges of Pharmacy (AACP), recently wrote an open letter to the Council of Faculties highlighting how student mental health and wellness has impacted his teaching. He has allowed us to share his letter with you here and we hope that you realize how important your direct interaction is so important with each student. Dear AACP Colleagues‌ A post in today's edition of Inside Higher Ed highlights a new study in Nature Biotechnology that warns of a mental health "crisis" in graduate education. The results of the study show that graduate students are more than six times as likely to experience depression and anxiety as compared to the general population. An awareness of a mental-health crisis on college campuses and especially in professional degree programs has grown during the past several years and has resulted in a greater focus on student well-being. Research connecting student well-being to effective learning strategies and professional development has likewise come to the forefront. At the beginning of my presidential year, I charged the Student Affairs Standing Committee to focus on student wellness and examine declining student resilience. I asked them to identify best strategies and practices addressing student well-being and suggest initiatives AACP might take to assist it member institutions to increase awareness of key issues regarding the mental and physical health of our students. The committee has made significant progress to date addressing their charges and making recommendations to AACP for programing and initiatives. I have pledged my support to the committee that their work will set the stage for an ongoing effort by AACP to address this key issue as it will continue to be a major concern in the years to come. In my 40 years as a pharmacy educator, I have had many conversations with students who, from time to time, have revealed the issues that cause them anxiety, stress, and depression plus distract from their role as a student learner. I can say with confidence that during the past few years, many more students come to campus with their backpacks filled with much more than just books. In addition to the stress associated with transitioning and then succeeding in a rigorous professional program, many of today's students are burdened with significant financial challenges, juggling academics with work and outside activities, and dealing with anxiety associated with securing a post-graduate residency or employment. Some students also have numerous home and family issues for which they must deal with during their time on campus. For the longest time, I was not aware of many of the issues impacting many of our students. I assumed there were adequate student support resources on our campuses for students to access when needed. I also assumed students would naturally come forward to reveal their problems, anxiety, and/or depression. Lastly, I wrongly assumed all students had a faculty or staff member they knew well enough to reach out to in their time of need. After all, there were at least 10-20 students in each class I thought I knew well and would reach out to me if they needed help.
SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
January – April 2018
The Mental Health of our Students, cont’d These assumptions were rocked approximately 5 years ago when one of our students took his life during the academic year. Although I did not know the student well, the event impacted me physically and resulted an increased sensitivity about student wellness. Subsequent to that event, I modified content in our orientation program to stress the importance wellness and made an effort to inquire about wellness when I had one-on-one conversations with students. Our college took significant additional steps to make faculty, staff, and students aware of available academic and mental health services.
Less than two weeks ago, yet another student (less than 3 months from graduation) too his life. Again, I did not know this student well but I hoped there was at least one faculty or staff member that could say they knew this student really well. Sadly, I cannot say with confidence that was the case. As much as I was impacted by the most recent suicide, I cannot imagine how I would have felt if this tragic event had involved one of the students I knew well. My thoughts then switched to the APPE preceptors that interacted with the student during the past several months. The lingering question…Had this student formed a meaningful relationship with a faculty/staff member at the college or at his experiential sites such that he felt comfortable enough to reach out and ask for help during his struggles? Student wellness is a complex problem and one that will not be addressed by a simple solution. I trust the work of the Student Affairs Committee will supply us with potential strategies and initiatives that will help us deal with this important issue. Although we need the help and resources from our colleges and universities, my gut tells me that EVERY administrator, faculty member, staff member, preceptor, and student in our institutions must step forward to do her/his part to assure ALL of our students who are struggling feel they have someone to reach out to for help and support. I urge all of my pharmacy education colleagues to take the time to get to know at least a few students in each class and work with your colleagues to be sure ALL students in our programs have someone to whom they can reach out to for advice and support. Likewise, we must not be hesitant to proactively reach out to those students whom we sense may be struggling and are unlikely to "knock on a door" to ask for help. Lastly, we must be sure our preceptors have adequate resources available to them when they notice a student struggling during experiential education. Let's ALL do our part to support student and faculty wellness initiatives on our campuses during the remainder of this academic year! A quote by Leo Buscaglia comes to mind… Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around. Kindest regards, Steve Steven A. Scott, Pharm.D. President American Association of Colleges of Pharmacy Purdue University College of Pharmacy
SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
January – April 2018
SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
January – April 2018 There’s a lot in the literature about trends and improvements in experiential education. So we’ve created an easy way for you to keep up: The Journal Monitor. In each preceptor newsletter, we’ll provide you a brief look at some current articles. And we’ll provide the source information as well so you can take a look at the entire article yourself.
A Qualitative Study Identifying Key Components to Standardize Across Inpatient General Medicine Advanced Pharmacy Practice Experiences American Journal of Pharmaceutical Education Vol. 82, Iss. 2 (2018)
Teresa A. O’Sullivan, PharmD, Erin Sy, BS • OBJECTIVE: To identify key components of inpatient general medicine advanced pharmacy practice experiences (APPEs) across sites, determine which components were important to standardize, and distinguish a benchmark of each component that would indicate standardization. • BROAD THEME: HOW THE STUDENT WAS WELCOMED AND ORIENTED TO THE SITE • KEY COMPONENTS: Orientation and written materials for the student outlining the schedule and expectations • NOTABLE PRACTICE: Providing written performance criteria so that the student would be clear about the expected level of performance and all preceptors would use a standard measure for assessing the student’s performance. • BROAD THEME: HOW THE STUDENT WAS INTEGRATED INTO PRACTICE AT THE SITE • KEY COMPONENTS: Daily interactions between preceptor and student, and student participation in patient care activities. • NOTABLE PRACTICE : Preceptor incorporated the student into the practice enough so that capable students were taking on some of the preceptor’s workload by the end of the experience, freeing the preceptor to perform other duties. • BROAD THEME: THE EXTENT OF THE STUDENT’S INTERACTIONS WITH PROVIDERS AND WITH NONPHARMACIST HEALTH CARE PROVIDERS • KEY COMPONENTS: Meaningful daily interactions with both patients and other health care team members • NOTABLE PRACTICE: Student was made the primary pharmacy care provider for a service, after adequate orientation and role modeling.
Intentional IPE Experiences American Journal of Pharmaceutical Education 2018; 82 (3) Article 6502.
INTRODUCTION: The American Association of Colleges of Pharmacy (AACP) Experiential Education Section formed the Task Force on Intentional Interprofessional Education in Experiential Education and this commentary describes the work of the task force. While some is known about the quantity of Interprofessional Education (IPE) in IPPEs, little is known about their quality or intentionality and even less is known about APPEs. As a result, developing and delivering high quality interprofessional activities is viewed as a major challenge. FULLY DEFINING INTENTION INTERPROFESSIONAL EXPERIENTIAL EDUCATION: “The explicit effort by preceptors and practice sites to create/foster educational opportunities or activities designed specifically to achieve interprofessional educational competencies.” THE TASK FORCE’S RECOMMENDATIONS: Intentional IEE within IPPEs should introduce learners to foundational concepts and allow them to develop key skills necessary to succeed during their APPE year. Intentional IEE activities in APPEs should emphasize the core concepts taught in the pre-APPE years, providing additional exposure and opportunities to build upon their skills to improve patient outcomes.
FOR EXAMPLE: An APPE in a health system with a rounding medical team is not necessarily intentional IEE by itself. The intentionality comes with specifically targeting competencies in the design/developmental phases of the activity. This might include reflection and assessment to determine whether the competencies were achieved with the specific activities designed.
SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
January – April 2018
Experiential Program Review Committee The Experiential Program Review Committee (EPRC) is a school committee made up of faculty, students, experiential office members, and preceptors from diverse practice settings. Next year, the committee will be assisting in a review of all active preceptors, as well as other tasks assigned to the committee. If you are interested in participating as a preceptor reviewer, please contact Mary Douglass Smith (mdsmith@presby.edu) by May 31st.
Spring Awards Ceremony The Preceptor of the Year and the Faculty Preceptor of the Year were announced and recognized at the spring awards ceremony at the school of pharmacy. Each year, students submit nominations and vote for the deserving preceptors.
Preceptor of the Year Dr. Lee Dailey Laurens County Memorial Hospital Student statements from Dr. Dailey’s nomination: “This preceptor is outstanding! She made sure we were continuously learning things. She started topic discussions during "down time" so we could continue to learn even in those moments.” “Dr. Dailey goes above and beyond to ensure that I was having quality experiences as a student.”
Faculty Preceptor of the Year Dr. Erika Tillery G. Werber Bryan Psychiatric Hospital Student statements from Dr. Tillery’s nomination: “Very easy to talk to and approachable. She always has a very positive attitude and praise and suggestions with the proper mindset expected of a professional.” “Overall, she is simply a good preceptor who takes pride in her work and in ensuring a quality learning experience for her students.”
CONGRATS TO DR. DAILEY AND DR. TILLERY!
SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
January – April 2018
What we’ve been up to…. Site Visits Walmart #0641, Greenville, SC North Greenville Hospital, Travelers Rest, SC Walgreens #09230, Simpsonville, SC CVS at Target #16990, Simpsonville, SC Network Healthcare, Greenville, SC Bi-Lo #5267, Laurens, SC Laurens Drug, Laurens, SC Clear Skye Treatment Center, Laurens, SC New Horizon FHS, Greenville, SC Palmetto Health Parkridge, Columbia, SC
Student evaluations on the way! Student evaluations of preceptors (both APPE and IPPE) will be released in May. These will include evaluations that students completed from December 2017 – April 2018. As a new professional requirement, students are required to complete at least 90% of their evaluations, so we are expecting larger numbers of evaluations for our preceptors than we’ve had in the past. We hope you will continue to use this information to improve and refine your teaching.
Holiday Policy IPPE students follow the holiday schedule of the school, and typically, IPPEs will be set up around school holidays (such as Easter and Spring Break). APPE students do not follow the holiday schedule of the PCSP nor do they automatically get time off for holidays. Instead, they take the holidays allowed by the preceptor based on the schedule of the site and/or the preceptor.
Absence Policy This academic year included several days of severe weather as well as an historical influenza outbreak. This required several students (and even preceptors) to change rotation days and scheduling. Here is the absence policy from the PCSP Pharmacy Experiential Program Manual (available in full on E*Value):
Illness and emergencies In the event of illness, injury, or emergency, the student should contact the preceptor first with an information email to the OEE. The student will then coordinate the missed hours with the preceptor as soon as possible. These hours should be completed before the end of the rotation and the student should expect that these may occur on alternative days and possibly weekends.
Inclement Weather If inclement weather occurs when a student is to report to an IPPE and either the site or the school is closed, the student is excused from the rotation. The student should call the site to determine the site’s status and, in the case of a school closing, to inform his/her preceptor of the school’s status. An absence due to inclement weather is considered excused and the hours should be made up at the discretion of the preceptor. If the start of school is delayed due to the weather, this delay would also apply to the IPPE within reason, depending on travel time. Delays to the start of IPPE may be made up at an alternate time which is mutually agreed upon by the student and preceptor. Students should not plan or request absences from their experiential site due to vacation, outside work obligations, homework assignments, or any other responsibilities.
SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
January – April 2018
E*Value Tip: Law Quiz for Students If you have P1 students on rotation, you will see that the workbook recommends giving a law quiz, that can be found on E*Value. If you are having trouble finding this quiz, follow these steps:
Log in to E*Value Go to the E*Value home page and scroll down
Under the heading IPPE Courses and IPPE Workbooks & Other Activities
Law Quiz for P1 Students Both the quiz and answer key are provided for preceptors
Though this quiz is required for P1 students, it can be utilized for any level student on any rotation.
SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
January – April 2018
Preceptor Spotlight: Angela Godfrey, PharmD Pharmacist, Walgreens Pharmacy Greenville, South Carolina Dr. Godfrey grew up in Columbia, SC, and graduated from Northeast High School. She then graduated from the University of North Carolina at Chapel Hill with a BA in English. While at USC-Columbia conducting research in a mouse laboratory on cryopreservation of mouse sperm (she verifies that this is a real thing…), she completed her pre-pharmacy work. She then went on to the Medical University of South Carolina and graduated with a Doctorate of Pharmacy degree in 2004. She immediately started working with Walgreens and has been pharmacy manager there for 12 years. She assists in interviewing pharmacists for new positions, training Walgreen pharmacists, precepting pharmacy students and technician students, and presenting topics to the community. Dr. Godfrey precepts P1–P4 students in community pharmacy. Her main emphasis is over-the-counter medications and self-care because she feels that the community rotation is the best opportunity to refine these skills. Whether a 1st or 4th year student, she teaches students how to deal with drug interactions, patient cases, OTC counseling, herbal medications, data review, patient work-ups, and pharmacy management.
Dr. Godfrey married her high school crush! (He was the high school football player and in ROTC…and she was the band nerd!) After 14 years, he looked her up, they were married and now have 2 beautiful boys (ages 3 and 6). The family enjoys hiking and camping.
1. What are the most difficult aspects of being a preceptor? And how do you overcome these barriers? The most difficult aspect of being a preceptor is juggling your everyday duties with the time allotted, and still giving the students the experience and education they need. I try my hardest to overcome this by letting them help me catch up with the everyday duties that are educational (typing, adherence calls, new-to-therapy calls, patient counseling, doctor calls) in order to free up time to teach them on a daily basis. In addition, I also try to do on-the-spot training for the students. For example, if there is a question from a patient and it is a teaching moment, I stop to talk about that disease state briefly or allow the student to research it further for later discussion.
2. What do you value most about being a preceptor? I value the growth that I see in the students from when they start my rotation to when they finish. To see the students take the classroom knowledge and grow as clinicians makes us proud as preceptors. I relate it to a mother seeing her child walk for the first time! 3. How do you judge a student's success on your rotation? Every student is different and has had different experiences. I judge a student’s success if he/she has grown and learned while on the rotation. If he/she comes away from my rotation with learning (whether it is how to conduct research, how to counsel patients, getting along with staff, etc), then I feel as though they have succeeded. I look at the small successes as well, especially if it is the student’s first experience giving a vaccine outside of the classroom. This may seem small to us, but to see how proud they are after they have administered it is a HUGE success to the student.
“I like to gear my rotation to fit the student. If he/she is interested in research, we look at and interpret studies. If he/she is interested in retail, we do a lot of herbal and OTC learning. If he or she is more clinical, we look at the guidelines for the major disease states. All students get all of these areas, but there is special focus based on student’s interest,” Dr. Angela Godfrey, preceptor
SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
January – April 2018
Student Spotlight: Rodney Samuel Rodney Samuel, a P2 student originally from Columbia, SC, has had a winding and interesting path to pharmacy school. Following high school, Rodney enlisted in the US Navy and was trained as a hospital corpsman. When given the opportunity to choose a specialty, Rodney was immediately drawn to pharmacy, knowing that it would further benefit him in the civilian sector. While in the Navy, Rodney accomplished training and education while working in pharmacies of various naval medical centers. While still enlisted, Rodney attended University of Maryland University College and Vincennes University. After honorably serving, he pursued a pharmacist career path fulltime at Midlands Technical College. He started working with CVS Pharmacy and gained an appreciation of the civilian sector, retail pharmacy, and its place in the practice setting. Additionally, he worked at Moncrief Army Hospital Pharmacy and Dorn VA Medical Center Pharmacy before accepting the offer at Presbyterian College School of Pharmacy. Currently, Rodney works at Bi-Lo Pharmacy in Laurens, SC. His ideal pharmacist job is to be both in an inpatient and outpatient setting, allowing him to stay up to date with his skills, knowledge, and education. He states that the value of being fluent and flexible in both settings has been the most satisfying in his prior experiences.
1. What has been your most valuable rotation so far and why? My most valuable rotation so far has been at Spartanburg Regional Healthcare System. I have never experienced a more in-depth pharmacy rotation that not only challenges the student but encourages them to do more than just meet the requirements. It was very rewarding experience for me to learn from the numerous pharmacists, technicians, and support staff encountered in various areas. The eagerness and willingness to teach, even during times of high volume, speaks of their dedication to the pharmacy practice.
2. How do you balance the demands of your rotations with your school work? I balance the demands of my rotations and my school by setting goals and standards for myself. Making commitments to achievement, as well as being prepared for what is approaching (exams, presentations, projects) helps minimize my stress. I also utilize my time wisely while on rotations during downtime. I have learned to set boundaries and take time out to rest, relax and release. All these help balance being a full-time student and having rotations within the curriculum. Most importantly, simply being engaged and attentive while on rotations alleviates the pressure and allows me to truly enjoy the experience.
3. What is something you have learned about yourself on rotation? What I have learned about myself on rotation is that I really enjoy the pharmacy practice setting. I am always intrigued and constantly learning from each site. Whether it’s a new system, process, update, or protocol, I am always taking away something that will stay with me throughout my rotations and education experience. Now I always consider the possibilities, thinking outside the box where it concerns patient safety, outcomes, medication therapy, or the standard operating procedures; concepts and principles I learned and now utilize are becoming more prominent in my decision making. However, the most important thing I learned is that it takes an extraordinary amount of teamwork to allow pharmacy operations to run smoothly and each member of the pharmacy plays an integral role.
“I enjoyed the challenge of working at a pharmacy: checking prescriptions as a technician, looking up medications that could be harmful in pregnancy, recommending something over the counter, even calculating a parental dose antibiotic for an infant at 2:00am. And all while being designated a technician. These are just a few examples of what I encountered and excelled at with little to no supervision while serving in the US Navy,” Rodney Samuel, P2
SCHOOL OF PHARMACY
pharmacy.presby.edu | 864.938.3900
January – April 2018
Alumni Spotlight:
Taylor Greene, PharmD Pharmacist, Aiken Endocrinology Aiken, South Carolina
Dr. Green, a 2017 graduate of PCSP, currently lives and works in Aiken, SC. At Aiken Endocrinology, she works with patients who have diabetes, suffer from obesity, or often both. At the physician's office, she has several roles, including answering drug information questions; dosing medications; or solving communication barriers between patients, pharmacies, and/or insurance companies. Her position is unique because it is supported by an independent practice and most ambulatory care pharmacists have an affiliation with a school or hospital system. Because of this arrangement, she has a lot of freedom and room to grow but is also required to create strategies and programs from scratch. She states that it is stressful but incredibly rewarding. Currently, Dr. Greene is pursuing a BC-ADM and will sit for the exam in June. With that credential, she will be able to provide and bill for diabetes education services for her patients in the Aiken area.
1. What have been the most difficult parts of being a new practitioner? And what do you do to overcome these barriers? One of the most difficult things for me has been overcoming the limitations that pharmacists face in the healthcare system. I have had to learn a lot about billing just to understand the financial side and to maximize my role in the office. There are also several barriers with the perception of what a pharmacist is capable of and what I am actually capable of doing. I often hear "Oh, I didn't know Dr. Vaughters' office had a pharmacy," and I have to explain that my education goes far beyond the walls of a pharmacy and dispensing medication. It is exciting knowing that your role is expanding, but it certainly is frustrating at times.
2. What rotation experiences inspired your current career? The rotation that pushed me to pursue this role was my ambulatory care rotation at Laurens Family Medicine. Additionally, the concepts that I learned in transitions of care, drug information, and community rotations are definitely skills that I am constantly using. Some of the hospital rotations that addressed dosing, preparation, and interactions are also relevant in my current practice.
3. Describe one of your favorite moments in patient care. I have been fortunate enough to experience moments of happy tears, gratitude, and genuine appreciation that have made me feel very important in the care of these patients. Recently, I was told by a patient whom I have been helping with weight loss that I was the first person to hear out her story and that she would not be seeing results if it weren't for my persistence and help. Another encounter that stands out for me was with my group of patients for diabetes education who all have had previous diabetic education encounters, but because of my approach, were still willing to participate in the discussions and found benefit in the program.
“I have seen patients lose large amounts of weight, diabetics able to inject insulin less frequently, and grateful patients who all make my job more rewarding, “ Dr. Taylor Greene, PCSP Class of 2017