Author Archives: tchen6

Professionalism (Part 1)

This 3-part video series covers professionalism standards for pharmacy students.

Part 1: Confidentiality
Part 2: Accountability, Honesty and Integrity, Appropriate Attire and Appearance, and Punctuality
Part 3: Practice Scenario

Transcript:
Hello, my name is Dr. Tablet, but you can just call me Tab. In this 3-part video series, I’ll be giving you a crash course on professionalism.

When I was a student, I thought I knew everything I needed to know about being professional on practicum. Don’t use my phone, arrive on time, follow the dress code, and the list goes on and on. It all seemed like common sense. Then one day I did something that made my practice educator quite disappointed. And in that moment, I realized that anyone can experience a lapse in their judgement especially if the situation is not so black and white. This is my story:

It was a particularly busy day at the pharmacy, and I decided to post this on social media. “I can’t wait for this day to be over! The line at the pharmacy was so long and this old man with Parkinson’s took forever to get his prescription out of his bag. Maybe if he actually took his meds, the tremors wouldn’t be so bad.”
#RxProblems #ChronicallyTired

I didn’t name the patient or the pharmacy. The post was just going to my followers – most of them friends, family, or classmates – and the post was obviously just a joke about my bad day at work. I thought it was pretty harmless at first. That’s why I was surprised when the pharmacist pulled me aside the next day.
—–
Pharmacist: “My colleague saw your post yesterday and showed it to me. Do you think what you shared was appropriate?”

Dr. Tablet (student): “What do you mean?”

Pharmacist: “I can identify the patient from your post, and you can tell that it’s my pharmacy based on the background. If the patient sees this, it could be really upsetting for him and can compromise his trust in the pharmacy team. How do you think this patient would feel if they saw this post about themselves? You did not have permission to share this photo of the pharmacy or patient on social media and a complaint could be filed with the College of Pharmacists of BC. What you thought was a simple joke online has the potential to significantly impact my patients and pharmacy. I’m very disappointed.”
—–

I felt awful but I’m glad that the pharmacist pointed it out. I can’t take back what I did, but I learned from my mistake and maybe you can too. You should never share or post photos of your patients or practice site without consent. It’s important to note that the identity of your patient can be revealed even if you don’t include any names, especially in small towns. Be mindful of who may be listening or watching when you talk about patients and please think twice about sharing things on social media.

Exhibiting professional attitudes and behaviors at all times is a program expectation. The tenets of professionalism for pharmacy students are described in the faculty’s code of conduct. In this video, we will be focusing on five of these standards: confidentiality, accountability, honesty and integrity, appropriate attire and appearance, and punctuality.

My social media story illustrates a breach in confidentiality. Patients put their trust in you. They are willing to share sensitive information with you such as their sexual health, recreational drug use, and mental health concerns. This information may be essential to proving optimal pharmaceutical care. It is your responsibility to protect this information, otherwise the pharmacist-patient relationship could be compromised and thus their care may be negatively impacted.

Now, I’m going to give you another scenario and see how well you do.

Jane learns that her brother is in the hospital – the same one at which she is currently on practicum. She’s worried about him and wants to know how he’s doing. Is it acceptable for Jane to access her brother’s medical records? The answer is no.
If you are not in the patient’s circle of care, you are not permitted to access their information even if they’re your family member or friend. Although Jane is concerned about her brother, it is not appropriate for her to look at his information.

Some of you may be wondering if you’re allowed to access your own patient file. I mean, don’t you have a right to your own information?
You are not allowed to view your own medical records. Healthcare professionals, like any other people, must adhere to the proper channels for requesting their own records.

Let’s try another scenario.

Caleb was working on a care plan at the pharmacy but did not finish before closing time. Is it acceptable for him to take a picture of the patient’s information so that he can work on it at home? He will delete it afterwards.
No.
Patient information should never be removed from the practice site. If you must work on a care plan at home, ask for your practice educator’s permission and make sure to carefully remove all patient identifiers. Remember, you become responsible for ensuring that the information is safe with you at all times. Do not take photos because the risk for a data breach is too high as sometimes photos are saved automatically on cloud storage and digital devices can be hacked. If you are ever unsure, it is best to seek support and have a discussion with your practice educator.

Thanks for watching Part 1 of the professionalism video series. Please watch Part 2 where we’ll continue our discussion on professionalism. I’m Dr. Tablet and I hope you have a fanTABulous practicum!

Acknowledgements:  We would like to thank Alyssa Low (Undergraduate Student) for helping to create this video and Garrett Tang (Undergraduate Student) for designing original images (e.g. Dr. Tablet).

Tips for Practicum

This video follows a third year student on their first day of hospital practicum and outlines 7 tips to help you get the most out of your experiential education experience.

Video Timestamps:

o Introduce Yourself 0:55
o Seize Opportunities 1:32
o Set Expectations 2:19
o Set Goals 2:53
o Embrace All Activities 4:00
o Feedback 5:09
o Stages of Learning 5:47

Transcript:
Hello, my name is Dr. Tablet but you can just call me Tab. In this video, we’ll be following Wanda on her first few days of hospital practicum and I’ll be sharing seven helpful tips along the way. Let’s get started.Today is Wanda’s first day, she refers to the email from her practice educator to confirm her start time
and dress code. Before leaving, she checks that she has her notebook, pens and orientation documents in her bag.Wanda arrives at the designated meeting place 15 minutes early, wearing her lab coat and UBC nametag. She meets Justin, her practice educator, and introduces herself. Excited to begin, Wanda asks if now is a good time for Justin to go over the orientation documents with her. Justin suggests reviewing them later, since rounds are starting soon and he’d like her to participate and observe.To kick off team rounds, everyone is given the opportunity to introduce themselves to the rest of the team. This brings me to my first tip. Introduce yourself as a student pharmacist to the people around you. This may include health care professionals, medical staff, other team members or patients. Fostering a good rapport can help you
create a positive learning space. It can also help you get to know the roles of other workers at the site and help them understand yours. While Wanda had a chance to meet most of the health care team right at the start of her practicum, your experience may be different. It’s important that you introduce yourself with your name, program and year level whenever you meet someone new.During team rounds, Wanda takes initiative in her learning by being attentive, asking questions and taking notes to refer back to later. This brings me to my next tip. Be adaptable and seize learning opportunities. Practicums are a chance for students to immerse themselves in the practice setting and observe their practice educators and other team members. Asking questions and being open to new experiences can help you get the most out of your practicum. Wanda shadows her practice educator for most of the day as he provides care to his patients. Before each interaction, she introduces herself as a pharmacy student and follows the pharmacist’s lead as he speaks with the patient. She takes notes, asks questions, and debriefs with her practice educator between the interactions. After lunch, Justin gives Wanda an unofficial tour of the practice site and sits down with her to discuss the practicum schedule.Guided by the orientation documents, they discuss a tentative timeline for the practicum and review expectations. Setting expectations should be a discussion between you and your practice educator at the start of your practicum. Each practice educator may approach things a little bit differently in terms of their style of teaching or even
their feedback approach. It’s important to discuss expectations for patient care activities and how to integrate yourself into the site’s workflow. It’s also a good idea to determine how and when you’ll be touching base for feedback. Wanda returns home after a busy first day. Now that she’s had some time to observe the workflow, she has a better understanding of the learning opportunities available and can start to think about her personal goals. This brings me to my next tip. When identifying your goals and working on your learning contract, consider site-specific factors such as the patient population, available resources and unique needs.The next day, Wanda and Justin review the learning contract together. Wanda notices that her practice site offers many opportunities to practice medication reconciliation, also known as Med Rec. She asks Justin if that would be something she could focus on during her practicum. Justin asks her about her comfort level and previous experience with the process. Wanda has never completed one before with a real patient and admits
to feeling a bit nervous. Justin suggests that she shadow him first as he performs the tasks and work toward taking more of a lead role as she becomes more comfortable.Later that day, Justin models how to complete a Med Rec. Wanda was looking forward to having him observe and provide feedback as she completed the activity. But before she has a chance to do so, they find out that help is
needed in the dispensary. Wanda is reluctant to go as she feels she has plenty of experience dispensing medications and figures she has more to learn on the ward. Let’s pause for a moment and explore Wanda’s feelings.

Although Wanda is excited to spend time on the patient ward, it’s important that she learns about
all aspects of pharmacy practice. Pharmacists are responsible for both patient care and drug distribution tasks. Student pharmacists are expected to build a solid understanding of medication distribution processes in a variety of practice settings. Students can be expected to become more familiar with medications,
learning their shape, color and branding. Learn how to use various pharmacy distribution technologies. Learn how to identify, manage and prevent distribution errors, and understand the procedures and workflow of a pharmacy practice. My advice for students is to embrace all aspects of pharmacy workflow. Wanda considers the importance of learning the medication distribution process and its impact on patient care and safety. After reflecting on her feelings, she goes forward with a growth mindset and follows Justin to the dispensary.

Justin meets with Wanda at the end of the day to provide some feedback. In reflecting on her patient interaction earlier that day, Justin commends her for being thorough in her information gathering, but suggest she use fewer technical terms. Wanda is surprised she thought the interaction went really well. My advice to students is to be
open to receiving feedback. Feedback is an important step in the learning process and can help
you improve your knowledge and skills. We can’t improve if we don’t know what we need to work on. I would encourage you to be curious and ask for examples to understand your practice educator’s perspective. Practice educators take the time to provide feedback because they care and are invested in their students learning. Wanda thanks Justin for his feedback. Although she recognizes that she is still learning, she can’t help
but feel a bit frustrated. She feels like she’s always struggling and checking her notes while all her peers seem to be doing so well. It’s common for students to feel this way. My advice for you is to remember that learning is a process and it all starts with day one.

When working to develop a new skill, feelings of frustration and other emotional responses are normal. To understand Wanda’s situation, we need to recognize that learning is a process and there are four stages students must transition through when learning a new skill. In the unconscious incompetence stage. Students don’t know what they don’t know. They are inept, unaware of it, and may not recognize the value
of a new skill or the need to learn it. For example, before providing a Med Rec for a patient, Wanda didn’t
know what she needed to work on. When students become aware of what they
don’t know, what they can’t do or how much they need to learn, they have entered
the conscious, incompetent stage. During this stage, it’s normal for students to feel hesitant and uncomfortable. They may have low confidence or feel like they’re making a lot of errors. Students will transition in and out of this stage frequently throughout the course of their program. While it can be difficult to acknowledge
your learning gaps, this stage is key as this is where learning starts. With time and work, students will enter the conscious competence stage.

Here, students understand or know how to do something, but need to think
and work hard to do it. They still need to refer to their notes or checklists and go through each process step by step in order to complete the task. The skill doesn’t come naturally yet. The fourth and final stage
is unconscious competence. This is when the task can be done easily and is almost second nature. Wanda’s practice educator, Justin, is at this stage and is able to complete a Med Rec easily without having to consciously think about each individual step in the process. While on practicum, continue to observe, reflect, and ask questions. What you gain from your practicum depends on how much effort you put into it. In Wanda’s case, she embraced the spirit of experiential learning, was open-minded to new learning opportunities, and demonstrated adaptability to the dynamic practice environment. She made the most of the rest of her practicum by being actively engaged in her own learning. When her practicum finally came to an end, she left with invaluable
experience, new skills and knowledge and a better understanding of what it means to be a pharmacist.

I hope you found this video helpful. Thanks for watching. I’m Dr. Tablet and I hope you have a fanTABulous practicum.

Acknowledgements:
We would like to thank Alyssa Low (Undergraduate Student) for helping to create this video and Garrett Tang (Undergraduate Student) for designing original images (e.g. Dr. Tablet).

BounceBack BC

What you will find here: BounceBack® is a free skill-building program designed to help adults and youth 15+ manage low mood, mild to moderate depression, anxiety, stress or worry. Delivered online or over the phone with a coach, you will get access to tools that will support you on your path to mental wellness.

BounceBack BC

Here2Talk

What you will find here:  Here2Talk connects students with mental health support when they need it. Through this program, all students – domestic or international – currently registered in a B.C. post-secondary institution have access to free, confidential counselling and community referral services, conveniently available 24/7 via app, phone and web.

For your convenience, we provide counselling and support services in various languages upon request. We will try our best to match people to support in their preferred language. However, please note that language-specific counsellors, and third-party translation services are limited and therefore, subject to availability and/or a waiting time.

Here2Talk

Working with Displeased Patients

This video explains how to work with displeased patients using a complaint resolution method known as the BLAST technique.  

Video Timestamps:

o Believe 1:06
o Listen 1:43
o Apologize 2:28
o Satisfy 2:50 
o Thank 4:49

Transcript:
Hello my name is Dr. Tablet, but you can just call me Tab. Have you ever encountered a displeased patient while on practicum? It can be an uncomfortable situation especially when emotions are running high. In this video, I’ll be talking about how to work with displeased patients using the BLAST technique. The “BLAST” technique is a complaint-resolution method that is helpful for addressing patients’ concerns or complaints. Let’s begin.BLAST stands for Believe, Listen, Apologize, Satisfy, and Thank. To explain how to use the BLAST method, let’s work through a scenario together:Natasha was completing her practicum at a community pharmacy when Bruce stormed up to the counter and demanded to speak with her.“You didn’t tell me these antidepressants could cause weight gain!” he said. “If I had known, I never would have taken them. I’ve gained 5 pounds in the past month and it’s all your fault.”Natasha is taken aback by this accusation, but she knows that responding angrily or defensively could escalate the situation and create adversarial feelings and mistrust between herself and the patient. When emotions are running high, it’s helpful to have the BLAST technique in your tool box to help you work through difficult situations.The first step in the BLAST technique is B, believe the patient. This refers to acknowledging and validating the patient’s experience and emotions even if there are parts of their story you don’t agree with. Even though it isn’t Natasha’s fault that Bruce gained weight, arguing this point would be counterproductive and Natasha needs to respond in a way that acknowledges his experience and validates his feelings. For example, she could say something like, “I’m sorry this happened, and I understand you feel you were not properly informed about this medication.” Accepting the patient’s concern as legitimate shows empathy and tells the patient that you hear them, you understand their concern, and you want to work with them.The L in BLAST stands for Listen. Active listening is necessary to help you discern the patient’s unmet expectations and resolve the issue. In this case, the patient is upset because he trusted the pharmacy to explain all the side effects of his medication and he feels that they failed to explain the risk of weight gain. Natasha allows the patient to fully express himself and demonstrates active listening by facing the patient with an open posture, making eye contact, and being attentive and empathetic.After Bruce is finished speaking, Natasha should restate his concerns in simple, non-medical terms. She might say something like this: “It sounds like you have some concerns about your antidepressant causing weight gain and you feel that important information may have been missed when the pharmacist counselled you on your medication last time. Is that correct?Going back to the BLAST technique, the A stands for apologize. Apologizing helps you to de-escalate the situation while opening up an avenue to provide more of an explanation without appearing defensive. Natasha might say: “Bruce, I’m sorry that this happened to you and it sounds like we could have done better. I’m open to talk about how we can address your concerns.”

Natasha’s response leads us into the next step, S, which stands for Satisfy. While you may be able to resolve certain concerns for the patient, there may be times when you are not able to give the patient what they want. It is helpful to address these things first so that patients have a clear idea of what you can and cannot do about their situation. It helps to manage their expectations at the onset of the conversation to prevent further misunderstandings. You might consider asking the patient what they want as it gives them some control over their situation and offers you more information about what they expect from you. If the patient proposes a reasonable solution, the problem may be solved without further conflict. If the patient proposes something that cannot be done, you can explain why their proposed option is not possible and try to provide them with other options.

When Natasha asks what would make Bruce feel better about the situation, Bruce states that he does not want other patients to experience what he went through. He suggests that Natasha explain every possible side effect, no matter how rare, to every patient that picks up a new drug. How do you think Natasha should respond to this? Is his request reasonable?

Natasha responds by saying: “Yes, I appreciate your concern and want to assure you that we also want what’s best for our patients. It may be overwhelming for some patients to be counselled on every potential side effect. Some side effects are rare and may not be applicable to all patients, so counselling is often focused on the most common side effects likely to be experienced. In your case, I could have provided you with additional written information with a comprehensive list of all potential side effects. If you want, I could provide that to you now and I’d also be happy to discuss options for managing the weight gain.”

Notice how Natasha started her answer with “yes”. Starting your sentences with positive words like this can help to show the patient that you’re on their side rather than arguing with them. Natasha explains why she can’t accept Bruce’s solution as it is and redirects him to other options. If possible, it is best to provide the patient with 2 or 3 of options. To ensure that you have resolved the issue to the patient’s satisfaction, ask the patient if they are satisfied or if they have any other concerns to talk about.

That brings us to the final step in the blast technique, Thanking the patient. Remember to thank the patient for taking the time to share their feedback and concerns with you. All feedback is an opportunity to reflect and identify how we can better serve the patients under our care

As a student, you should always inform your practice educator immediately about any complaints or concerns that are shared with you. This gives them a chance to step in and help you address the patient’s complaint and follow up with the patient.

In some situations, students may experience rudeness and criticism directed at them. If you ever feel unsafe or if you are losing control of the situation, it is okay to remove yourself and ask for help from your practice educator or another member of the team.

In summary, the BLAST technique can help you navigate through challenging patient interactions step by step. Through practice and over time, you will become more comfortable with handling these situations. The key is to stay calm and work alongside the patient to address their concerns.

I hope you found this video helpful.

Thanks for watching. I’m Dr. Tablet and I hope you have a fanTABulous practicum

Acknowledgements:

We would like to thank Alyssa Low (Undergraduate Student) for helping to create this video and Garrett Tang (Undergraduate Student) for designing original images (e.g. Dr. Tablet).

Introduction to Experiential Education

This video introduces the concept of experiential education, the practicum courses offered by the E2P PharmD program, and the office of experiential education.

Video Timestamps:
o What is Experiential Education? 0:29
o Types of Experiential Education 0:54
o Practicum Courses 2:44
o The Office of Experiential Education (OEE) 5:38

Transcript:
Hello, my name is Dr. Tablet, but you can just call me Tab. In this video I’ll be providing a brief introduction to experiential education. There’s a lot to cover, so let’s begin.Back when I was a pharmacy student, I aspired to become a competent and caring pharmacist. I studied the classroom material diligently and worked at the local pharmacy on weekends. While watching the pharmacists work, it made me wonder: Will I be able to do all of that when I graduate? How do I develop and practice those skills?Experiential education is “a teaching philosophy in which educators engage with learners in direct experience and focused reflection in order to increase knowledge and skills, clarify values, and develop one’s capacity to contribute to their communities” (Association for Experiential Education). In the context of pharmacy school, think of it as the “bridge” that connects theoretical knowledge gained in the classroom to professional practice in the workplace. Let’s look at some examples.One type of experiential education is work-integrated learning, where learners tackle real tasks and solve real problems. Examples of this include outpatient and inpatient practicums. Unlike in a classroom environment, I was interacting with real patients. I got to apply my knowledge and skills and witness how my clinical decisions impacted my patients’ health and well-being. I also learned how to communicate and collaborate effectively with members of the team. Work-integrated learning helped me to become practice-ready.As some of you may already have pharmacy work experience, you might be wondering how practicum activities compare with pharmacy assistant duties? While there is overlap between the two, pharmacy assistants are involved in technical duties, such as ordering and filling prescriptions. They cannot provide medical advice or clinical services to patients. On the other hand, practicum activities are generally focused on learning about the pharmacist’s role and providing patient care which may include counselling patients, conducting medication reviews, and providing therapeutic recommendations. Activities are supervised by a practice educator or pharmacist and students engage in self-reflection and feedback.Another example of experiential education is community-engaged learning, which occurs when students partner with community organizations or community members to learn from their expertise. Often, these partner organizations run programs for historically, persistently, and systemically marginalized groups. My placement at a soup kitchen allowed me to see how people deal with barriers, and how difficult it is to overcome them. I saw and experienced their frustration, not at myself, but because they’re hungry and they feel helpless. It wasn’t until I talked to them that I began to understand their struggle. I was able to help them get through their toughest times.Now that we’ve discussed some types of experiential learning, let’s take a quick look at all the different practicum courses you’ll participate in!The Entry-to-Practice Doctor of Pharmacy program provides 42 weeks of hands-on experiential education to prepare students to fully take on their clinician role upon graduation.Starting with the Introductory Pharmacy Practice Experiences, which are also known as IPPEs – PHRM 171 will take place the summer of year one in an outpatient setting. Students are introduced to the pharmacy workflow and the role of the pharmacist. Over the course of 4 weeks, you’ll become familiar with the various distribution activities and provide direct patient care.In second year, you’ll be enrolled in 3 courses: PHRM 270, 271 and 272.

PHRM 270, community service learning is a course where students will learn about broader social issues, such as the social determinants of health in your community, and gain awareness of their civic responsibilities through serving others. It differs from volunteering and clinical placements in that it puts equal focus on service, as well as self-refection and learning. Throughout second year, you’ll be engaging in activities that benefit the community.

During the summer of second year, you’ll participate in two practicum courses.

PHRM 271 will be your second exposure to outpatient practice. During this 4 week-practicum, students will be expected to provide care to more complex patients and handle more tasks and increasingly difficult situations compared to first year.

PHRM 272 is a 2-week introduction to inpatient practice. Students will become familiar with various aspects of inpatient practice within the hospital setting and participate in both observation and direct patient care activities.

In the summer of 3rd year, you’ll once again practice in an outpatient pharmacy, your final IPPE. PHRM 371 is an 8-week course allowing students to consolidate their knowledge and skills from the past three years of their pharmacy education. The duration of this course is longer than previous years to allow students to have more opportunities to follow up with their patients. Students will be expected to provide care to a wide array of patients with increasing complexity.

The IPPEs from Years 1 to 3 expose students to direct patient care activities and provide them with a clear understanding of pharmacy practice. As you transition out of IPPEs and into your 4th year practicums, the Advanced Pharmacy Practice Experiences, there will be a shift in expectations. Students will be expected to apply, reinforce, and advance their knowledge and skills; and to provide competent care to patients with increasing complexity.

Throughout your 4th year, you will spend a total of 24 weeks in practice: 8 weeks at an outpatient setting for PHRM 471; 8 weeks at an inpatient setting for PHRM 472; and 8 weeks of selected experiences for PHRM 473. Examples of selected experiences may include outpatient settings such as travel medicine or compounding pharmacy; Inpatient settings such as critical care or antimicrobial stewardship; or Non-direct patient care settings such as academic teaching or drug and poison information. The practicum categories and opportunities available may vary from year to year.

So, who coordinates these experiences? The team at the Office of Experiential Education, also known as the OEE, are responsible for the academic and administrative leadership of experiential education. Their mission is to create meaningful learning opportunities for students to gain the knowledge, skills, and professional attributes needed to become exemplary pharmacists and leaders.

Let’s briefly go through the organization of this unit.

First up is the director who oversees the entire experiential education program and leads the team in determining and achieving various goals and initiatives within the four strategic imperatives, which are: (1) student experience, (2) practice educator experience, (3) experiential education sites and, (4) program advancement.

Next up is the administrative team, which includes the placement manager and senior program assistants. They coordinate practicum placements and schedules every year. They also liaise with various stakeholders such as UBC Health, UBC’s Safety & Risk Services, WorkSafeBC and our Health Authorities in setting up pre-practicum requirements that support your safety while on practicum. One example is your annual flu shot. The team can answer questions about scheduling and respond to general inquiries about experiential education.

Last but not least, we have the course who run the individual practicum courses. They are responsible for developing curricula, aligning with program and accreditation requirements, as well as ensuring that educational outcomes are achieved by the end of the program. In addition, they’re here to support your success and to discuss any aspect of your practicum. Whether it’s a question or concern or an experience you simply want to share, they are happy to connect with you.

Beyond the work of supporting students, the team as a whole is responsible for engaging with our external stakeholders. One example is onboarding, training, and providing continuing education to our practice educators. Formal processes are in place to ensure our sites and practice educators are prepared and well supported to host our learners. The team also facilitates the quality assurance of practice sites in order to meet accreditation and program requirements to ensure students have a robust and positive learning experience.

Through experiential learning, I was able to immediately apply knowledge from the didactic courses, receive timely feedback and coaching from practice educators and other team members, foster my lifelong learning attitude through regular practice of self-reflection, apply my knowledge and skills flexibly and creatively in different situations, and provide service to communities. As the scope of pharmacy practice is rapidly expanding, I want to encourage you to embrace the various opportunities that lie ahead of you. I’m grateful for experiential learning as it has informed my future practice and prepared me for my professional career.

Thanks for watching. I’m Dr. Tablet and I hope you have a fanTABulous practicum!

Acknowledgements:  We would like to thank Lucy Zhou and Alyssa Low (Undergraduate Students) for helping to create this video and Garrett Tang (Undergraduate Student) for designing original images (e.g. Dr. Tablet).