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Week 4: 11/05/12 - 11/9/12 by John Michael Segars

Reflective Essay: Week 4

11/05/12 – 11/9/12

To summarize my fourth week at AACP, I would say I primarily learned about intention. I was given the opportunity to witness an AACP Board Meeting, where verbal conversations and opinions criss-crossed throughout the room, but each dialogued syllable was rooted with an intention to better serve AACP and its members. The intention to respectfully discuss issues facing pharmacy or communicate opinions on organizational topics was, to me, unspokenly defined as leaders trying to make decisions that will leave pharmacy as a more enhanced, effective profession than when they started participating in AACP.
I entered the meeting in Alexandria, VA, unsure of what to expect. I sat in the back of the room, with the smell of coffee wafting into my nose from a nearby door, waiting for the meeting to begin. Friendly greetings punctuated the morning conversations as the board members and AACP staff arrived, simulating a friendly environment for the meeting to take place in. Dr. Lyle Bootman, current AACP President, conducted introductions and began the meeting proceedings. The day before the meeting, Dr. Jennifer Adams, my preceptor, educated me about the laws associated with a board of directors of an organization. She gave me in-depth information about fiduciary responsibility, loyalty responsibility, and the Sarbanes-Oxley Act, which makes a board accountable for controlling internal finances and conducting audits accordingly.  I was grateful that she took the time to teach me about these concepts, especially once the meeting had started and many of the topics we had talked about were being reviewed before my eyes. From this, I learned that a board of directors requires standard procedures to produce more efficient results. I learned more about the Sarbanes-Oxley Act from my own research, and I recognized that it provides standards to aid in the management of an organization, allows for whistleblowers, and focuses a board’s attention on finances with the intention of producing a functional, lucrative organization that is accountable for its own operational capacity. This legislation is enforced to ensure that unethical stock trading or false audit reports are prevented from occurring, which I think is important to improve the integrity of the organization. By eliminating the risk of fraudulent or unethical behavior, a board of directors is able to focus on the purpose or the intention of the organization’s actions and programs. Since I had never had exposure to any of these topics, I was excited to be educated about these concepts to enhance my own understanding of how AACP consistently sustains itself as an operating organization.
One interesting topic discussed during the AACP Board Meeting included the Institute of Medicine (IOM) accepting a pharmacist as a research fellow.  I went back to learn more about the IOM, and discovered it is a national organization, which acts to provide evidence-based information on various issues such as biomedical science, medicine, and healthcare.  The IOM mission is to supply information on these topics on a national level to promote health.  It is very exciting for the pharmacy profession to have a pharmacist receive the IOM fellowship because this award allows pharmacy to have a seat at the table during the discussions of healthcare topics at IOM. Pharmacy is an important aspect to healthcare, and it was exciting not only to learn about this fellowship, but also to hear the AACP Board Members demonstrate their elation and discuss ways to market and communicate this information so more AACP members and pharmacists will receive the news of this progressive step forward. As I analyzed what I was hearing during the meeting, I learned that by incorporating pharmacy, this recognizes the evolved role of pharmacy practice and the need to include a pharmacist’s opinions during discussions about various disease states. IOM will have more representative discussions about medication errors, community-based programs aiding in preventing illness, smoking cessation programs that reduce incidence of other disease states, and many other important projects carried out by IOM that have a pharmacy influence.  I felt proud that pharmacy has been integrated enough into healthcare that we have earned a voice during discussions about the current state of healthcare, and pharmacy will now be included during times when action must be taken to improve healthcare via preventative health programs for the national population.
As the meeting continued on, the topic of enrollment management or “admission traffic rules” during the student pharmacist application process was presented before the board. From the discussion, I learned that students will apply to numerous schools of pharmacy, get accepted at institution A and agree to attend this school, but then switch at the last minute to institution B where they are also accepted.  AACP had a productive discussion about traffic standardization in the application process.  It was fascinating to listen to the different opinions on this matter.  This discussion allowed me to better understand that not all board members always agree on every subject, but they were always respectful and consistently brought the discussion back to focus on the risk-benefit ratio of how this affects AACP members.  I noticed how they guided the discussion by continually communicating the end outcome if AACP established a stance on managing enrollment, asking questions, such as: “Is this enforceable?” and “Would members benefit more from published guidelines to alleviate negative outcomes associated with non-standardized enrollment management?”  This teaches me how to be a better decision maker. I realized that if an intention is pre-determined, such as aiding AACP members to enhance academic pharmacy, then it is easier to make decisions that will fulfill this purpose. Many times during the meeting as the board decided on an action, I watched them accept information from anecdotal admonitions, evidence-based information, and from data submitted by AACP members, thus utilizing multiple sources to improve knowledge on a given subject before making an intellectual decision.  During the enrollment management discussion, I think this is a primary example of how intention was present and how this will help me in the future during my own decision-making process as I embark on the journey of trying to decide which field of pharmacy emerges as the best fit for my life.
To summarize recently attended meetings, various AACP staff members presented information about the main points of interest that occurred at several recent meetings. The reports I found to be most interesting included the Center for the Advancement of Pharmaceutical Education (CAPE Outcomes) meeting report and the AACP Professional Affairs Standing Committee meeting summary.  In brief, I learned that the CAPE Outcomes revised document is still being prepared and is not yet finalized. As Dr. Cecilia Plaza spoke about the process of incorporating core competencies into the new document, I was able to learn more about the process of encompassing all of the pharmacy practice competencies into one document. After the board meeting, I went to Dr. Plaza’s office to learn more about the revised CAPE Outcomes and was able to learn more about the process of integrating affective domains of learning into the essential components of pharmacy practice. I will be working with Dr. Plaza more this week on a project to help the process of writing the CAPE Outcomes, and I plan to meet with her again to increase my understanding of the many domains of learning and how to illustrate this in one document for pharmacy education.
Dr. Lynette Bradley-Baker discussed the AACP Professional Affairs Standing Committee meeting and talked more about how this committee identified beneficial relationships between student organizations, state boards of pharmacy, and state pharmacy organizations via literature reviews. She explained about the need to identify functional relationships and determine how these three groups can work effectively in pharmacy practice settings, and she informed the board that scholarship of service or advocacy could be an effective mechanism to get these groups to work together. I learned from her discussion that the true issue is the need to emphasize that these three groups work toward engaging in advocacy with one another through various means, such as scholarship. I learned many things from Dr. Bradley-Baker’s report to the board, but mostly I left with a better understanding that the three groups being discussed are an integral part of advocating for the pharmacy profession. I learned that advocacy can also lead to financial benefits in grants or scholarship, and if students and state organizations work together with boards of pharmacy to create programs worthy of scholarship, then this connects state leaders and students in a way that can highlight advocacy and community outreach programs. After this discussion, I understood how scholarship is a mechanism to reward activities of students and organizations that are succeeding in advocacy or community service programs, and this could be a catalyst for motivating other states to try and seek such recognition by establishing their own programs. This motivated me to discuss the possibility of creating a program with students with my friends at the Mississippi Board of Pharmacy in hopes of promoting better student outreach in my own state. This discussion opened my eyes to the fact that more can be done to strengthen the relationship between the governing bodies of pharmacy and student pharmacists. Hopefully, we can think of ideas to promote advocacy, service, and scholarship.
Intention is a purpose. From this week’s experience, I was able to learn more clearly about the intent and purpose of AACP as an organization. Whether I was listening to summaries of meetings previously attended by board members or learning about AACP’s position on issues such as the meningitis outbreak or conscience clauses, the haze slowly lifted in my brain and a more refined impression of AACP’s purpose for performing certain actions arose in my mind. The board had respectful, positive dialogue that communicated a given position that would better serve AACP and pharmacy as a profession. Interpreting the discussion, I concluded that the projects and meetings they discussed came from various decision-making foundations (utilitarianism, beneficence, non-maleficence), but I understood their united desire to let members know they matter and make decisions to enhance pharmacy education.  AACP effectively utilizes time and resources to balance between recruitment, creating revenue, maintaining operations, and appointing committees to tackle issues needing improvement. By pushing standardization of the pharmacy practice model or including new domains into pharmacy practice core competencies, I recognized that AACP is reducing the layered, disproportional dynamic of pharmacy practice and academic education that existed before AACP intervention.  Past and future: the consciousness of knowing how to progress forward without forgetting the mistakes of the past.  I think AACP definitely considers the past but actively works with the intention of moving forward to improve healthcare and make rational decisions that will help AACP members to succeed in the future.
To expand upon what I learned in a more philosophical manner, I realized that making decisions with an end-goal or outcome in mind is something I need to work toward that will help me as a professional.  I often make decisions that are influenced by what will make me happy in the moment, or I’ll state that I need ____ in order to be successful, but after the board meeting I realized this is a very near-sighted way of thinking. I need to think about the goal of decisions and what outcome is to be achieved so that I can make better decisions for patients or employees in the future. I was very impressed with the board’s ability to do this, and it has definitely allowed me to realize how I can improve to be a better pharmacist in the future.
During my last week at AACP, I plan to finish my project on financial aid and help to create



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