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AACP APPE Student Blog: A Great New Way to Stay Connected to Academic Pharmacy

Have you ever been curious as to what a day in the life of an AACP APPE student is like? So have we!

The American Association of Colleges of Pharmacy is proud to announce that they are now accepting applications for APPE students who wish to complete a rotation and find out more about association work. Dr. Jennifer Adams, Senior Director of Strategic Academic Partnerships at AACP, is the primary preceptor for student pharmacists for the duration of their APPE rotation. Please email appe@aacp.org with any questions you may have about the AACP APPE or related topics.

*For rotations occurring in the fall 2016 and spring 2017 time frame, AACP will accept applications until Dec. 1, 2015. All applicants will be notified by Jan. 30, 2016 of their acceptance status.

This blog will serve as an innovative forum for students to post their weekly reflections about their experiences at AACP and provide unique insight into the great work that the association does for academic pharmacy. Feel free to post your comments/feedback/suggestions and we look forward to sharing our journey with you!

Week 3: A New City by E. Maggie Jones

Week 3: A New City by E. Maggie Jones
March 9, 2015 to March 13, 2015

This week was slow on engagements, but heavy on work. It was my first full week at the office, and I recognized that work-life balance is possible. I noticed an increase in the freedom of my thoughts, I began feeling energized, and I was making a conscious effort to be adventurous within my budget. Without being forced to make quick decisions due to lack of time and increased stress, I was able to create a few new habits that nourish the mind, body, and soul. Here are a few key points that I think are relevant in all of our lives:

·         Spend time with yourself every day

·         Make time for self-expression

·         Plan out your meals

 

Spend time with yourself every day:

For the first time in my life, I am utilizing public transportation on a daily basis. My morning commute is one hour long, and I have grown to enjoy it because I am able to utilize the time for myself. If each of us were able to spare a few minutes a day to let our minds wander, we would lose a few minutes a day of stressing about our commute, or feeling like we are wasting time doing something other than work. During the first three years of didactic pharmacy education, I definitely felt bad when I took an hour to exercise or two hours to grocery shop and cook for myself due to the fact that I had work and studying piling up underneath. How sad! Such is the nature of the beast of professional education though, I suppose. Thankfully, I have been able to slowly reclaim my life as this fourth year of experiential learning has gone on. Upon my arrival to the Washington, D.C. area, I was quite surprised at how quickly I figured out my public transportation route to get to the AACP office. Once I didn’t have to think about which train to get on or which stop to get off, I found myself perusing my psyche. Letting go of having control over how fast I was driving and paying attention to the traffic around me by using the metro to get to work allowed me to begin reflecting not only on my work strategies for the day, but also on new Washington, D.C. and Virginia scenery, personal goals, and life in general.

My challenge to you: Self-reflection can be a scary idea when it is unknown territory. Begin by simply being observant of your surroundings: what color coats people have on, how the buildings change based on the different areas of the city you are traveling through, the feeling of the sun on your face through the window. Once your surroundings become more familiar and your comfort level increases, you will be able to regress into your own mind with the freedom to think and feel in the moment. In my free time, I will choose to contemplate the day instead of immediately reaching for my phone.

Make time for self-expression:

Dance was a huge part of my life growing up, and lasted until pharmacy school. Dancing is my preferred way of expressing myself, and with this occurrence essentially gone for the last four years, I have definitely suffered. My self-worth is diminished, I have gained weight, and the confidence I once had in myself is gone. This week, I recognized that I could change all of this, and made a vow that I would make the change and do it for myself; it’s called Xtend Barre – a ballet-inspired Pilates/yoga/cardio workout class that makes me sweat, strengthens and lengthens my muscles, and serves as a small outlet of self-expression through movement. I happened across the Xtend Barre studio during a walk to Whole Foods in Old Town, Alexandria. I’ve made it to class after work four times now, and I feel great about it.

My challenge to you: Write, draw, sing, run, or dance, but don’t forget to express yourself the way that is fulfilling to you. One hour is only 4% of your day, so let me inspire you to make it happen! Because I have identified that I am best motivated in a group setting, I sign up for Xtend Barre classes at the beginning of each week to hold myself accountable, but also set realistic and manageable weekly goals. If I don’t show up, I am charged a fee, so that holds me responsible for showing up, as well!

Plan out your meals:

I figured out pretty quickly that you can spend quite a bit of money here in Alexandria without trying very hard. But don’t think that price has to deter you from being adventurous or curb your culinary pursuits. Unfortunately, money can also be spent easily when in a hurry on not-so-quality meals (e.g., Subway, Five Guys) that you happen to pass by while out. Who wants to spend money on low-quality, processed food? I recommend using the 80/20 rule, which can be applied to many different things, as a way to keep your meal spending in check. Spend 80% of your food budget on regular, healthy, grocery store items to feed yourself and help stretch your budget. Spend the remaining 20% on just a few higher-quality meals a week to keep yourself satisfied. Once I figured out which restaurants I wanted to try this week (i.e., Halsa and Brookland&pizza), I determined which days I would eat there, and how I would get there via the metro. This way of adventurous, yet spending-conscious dining gives me something to look forward to all week long, and keeps my budget in check. I utilize the Old Town Alexandria Whole Foods and AACP office fridge for most of my other meals (e.g., frozen waffles with almond butter and blueberries, turkey and avocado lettuce wraps, or the hot food buffet).

My challenge to you: Research restaurants at the beginning of every week (or on the weekend), and choose two to three that you can’t go another week without trying. That means that for two or three meals, you will be “splurging” on high-quality food, and using the 80/20 rule on your meal spending. To keep my costs down, I purchase and prepare food once or twice per week using a pre-made grocery list. Once I determine what my 20% “splurge” will consist of, I plan it into that week’s meals, which helps alleviate any stress I may have experienced regarding food that week.

Although the information in this blog post may seem inconsequential, part of living in a new city for a short period of time is listening to yourself, expressing yourself, and living adventurously, but within your means.

Image reference: http://arbourrealty.com/communities/alexandria-community-information/

Week 2: A Letter to the Editor by E. Maggie Jones

Week 2: A Letter to the Editor by E. Maggie Jones
March 2, 2015 to March 6, 2015

“You really want my opinion?”

“What experiences do I, as a student, have that warrant a respectable letter?”

These were the questions circulating in my mind as I began contemplating how to begin writing my first “Letter to the Editor” after being asked to provide a student perspective response to an opinion piece in Drug Topics. I immediately searched for online examples, asked for input from those at AACP, and read through the article that I would be responding to several times. Making an outline including the points that I wanted to address and specific examples from my pharmacy career thus far, including extracurricular and rotation experiences, seemed a logical place to begin writing. I found that I could relate to the author’s claim that pharmacy schools are flooding the market with pharmacists, but I believe that he missed the point that although the number of community and hospital-oriented pharmacist positions may be declining, there are an increasing number of alternative diverse avenues for pharmacists to choose from.

One piece of advice that I received from an AACP staff member was to think about “working at the top of your education,” as opposed to at the “top of your license,” and what that means during this transformation of the profession of pharmacy. Thinking back to views expressed from professors at my college of pharmacy, the majority felt that obtaining a clinical hospital position equates to working at the top of the Pharm.D. They stress factors such as:

·         Ability to make pharmaceutical recommendations

·         Drug outcome monitoring responsibility

·         Patient counseling

·         Being accepted as a necessary and respected member of the healthcare team

 

While I agree that pharmacists should be capable of participating in each of these areas with their Pharm.D., there is also a responsibility for pharmacists to provide support to student pharmacists so that we graduate competent, well-rounded, and innovation-minded professionals that challenge and push the profession into the future. Upon my realization that the bulk of pharmacy education prepares students to practice in an environment of the future, rather than solely focus on medication dispensing, I recognize that our education broadens the horizon of professional work beyond that of the pharmacist license.

The author of the article I was responding to stated that the traditional dispensing model of pharmacy is shrinking due to the increased number of graduating pharmacists, but misses the overwhelming evidence of pharmacy morphing into a new model. Because of this, I focused a large part of my letter content related to ways that I, as a student, sought out interprofessional and quality improvement-based experiences to supplement my clinical curriculum. What makes my experience unique is the innovative and creative approach taken which is outside the box of traditional straight-laced, factual, process-based pharmacy practice. In my opinion, this is proof that pharmacy education is beginning to include opportunities for students to develop distinct leadership and project management skills that can be applied to future creative endeavors.

I will also say that through my own search for positions, there are many diverse opportunities that did not exist ten years ago in areas of residency, fellowship, managed care, and research for new pharmacy graduates looking for post-graduate training. However, to those practicing in more traditional pharmacist roles with little knowledge of these developments, it may be hard to look past the increase in the number of graduates looking to gain positions in the static (and possibly declining) dispensing roles. For this reason, I understand where the author’s strong opinions stem from, given his background in community hospital pharmacy.

As I reflect on the process of writing this letter, I recognize that I am only one person with opinions, but I am choosing to base my opinions on my pharmacy school experience, which is not unique to me; there are 99 other people in my class alone. I will be honest and mention that I feel a competitive nature brewing among members in my class of student pharmacists due to the rising graduate and post-graduate educational expectations that are being demanded by current institutional pharmacy employers. Just as the Pharm.D. became the new expectation versus the Bachelor of Pharmacy degree, residency training is becoming the norm. At what point will a residency not be enough? I feel the weight of staying true to myself while seeking out increasing challenges that will (hopefully) set me apart from other applicants, and do not wish to pursue a residency just to say that I have completed this experience and align with the “status quo.”

I don’t believe that my views and one Letter to the Editor will effect change in our profession overnight. However, I can work to improve and expand the scope of pharmacy practice by working at the top of my education.  Through precepting students, I can be assured that future pharmacists will have seen the positive impact that our profession has on patients (in whatever practice or research setting I end up in), and will understand the broad range of opportunities available upon graduation that will push our profession toward increasing innovation.

Overall, I think that offering an opinion or perspective based on real-life experiences is valuable for the reader, as well as the writer. I can see a practice being implemented for current student pharmacists to write Letters to the Editor as part of their learning experience with the intention that it will create advocacy-minded individuals to further drive the profession as pharmacists. I have chosen three healthcare-oriented publications (i.e., Drug Topics, Pharmacy Today, U.S. Pharmacist) to utilize as an outlet for the student pharmacist (soon to be practicing pharmacist) voice through more Letters to the Editor and article responses. This is one small way to begin making a difference in our profession as a student, and I am excited to represent my generation of young pharmacy professionals.

Response to: Kiacz B. Schools, advocacy groups edging pharmacists toward life support. Drug Topics. February 25, 2015. http://drugtopics.modernmedicine.com/drug-topics/news/pharmacy-schools-advocacy-groups-edging-pharmacists-toward-life-support?page=0,0

Image reference: http://www.bizpacreview.com/2013/02/10/liberals-letter-to-the-editor-goes-viral-for-stupidity-19521

Week 1: Is Our Work Ever “Done”? by E. Maggie Jones

Week 1: Is Our Work Ever “Done”?
February 23, 2015 – February 27, 2015

Opening my LinkedIn account on the first day of my rotation at AACP, I scrolled through my news feed for interesting articles. Enter, “The One Word That Will Make You Rich” – of course I clicked on it. Who wouldn’t have? The author, Brian de Haaff, CEO of Aha! (a product roadmap software company), began by listing the ways this one word speaks to him: “denotes team progress,” “sense of accomplishment,” “achieving what you have dreamed.” He challenges the definition of wealth in monetary and tangible terms, and then provides survey data regarding a person’s definition of success. De Haaff states that using this one word, which he finally reveals as “Done,” does the following:

·         Builds confidence

·         Pleases others

·         Highlights your value

All of this made sense to me until I began thinking about why I joined the profession of pharmacy.

The very first task given to me by my AACP preceptor involved taking Tom Rath’s Strengths Finder 2.0 assessment. I will be honest and say that I am not surprised by my top five strength results, and that they paint an accurate picture of my most usable qualities, including Maximizer and Relator. But one stood out as a reminder of the promise I have made to my future patients: Learner. To me, this means one who continuously seeks new knowledge and ways to better themselves and their peers. For me, this means being an active participant in change. My work will never be “Done.”

I chose pharmacy because I saw the challenge of keeping up with new drug development and changing standards of practice. I knew there would always be another patient to educate and empower to be proactive in their own health. I knew there would always be room for me to improve my individual practice knowledge and skills. What I didn’t realize was the need for each of us to take responsibility for improving the care that our health system, as a whole, offers patients by being agents of change. I, as a student pharmacist, feel responsible for taking action to improve the practical skills and knowledge of my peers, which in turn will enable our future patients to receive a higher level of care. Our work will never be “Done.”

With the AACP Mission statement including, “advancing pharmacy education, research, scholarship, practice, and service to improve societal health,” and the AACP Vision statement including, “transform[ing] the future of healthcare to create a world of healthy people,” it is comforting knowing that our profession is being pushed to change. AACP offers many tools for their members to utilize in engaging others toward growth and facilitating change in the way we educate students and professionals, the way we communicate among disciplines, and the way we support and analyze research and development initiatives. AACP’s work will never be “Done.”

My definition might be different than your definition, but I don’t equate wealth and success with being “Done.” I dream of improving the quality of care that patients receive through our healthcare system, and that means changing the way our system operates. If we view wealth and success as fluid concepts, then we choose to recognize the infinite number of ways that we are capable of revolutionizing healthcare in our ever-changing world.

I recognize the value of checking an item off of one’s to-do list, and how that sense of accomplishment may make one inspired to take on the next challenge with full force. In this way, De Haaff’s article supports its position that writing “Done” makes you feel successful, wealthy, and ultimately rich. I can completely relate to this feeling. However, I see an absent sense of duty that I believe is innately part of humanity. As Winston Churchill eloquently puts it, “To improve is to change; to be perfect is to change often.” If what de Haaff’s “Rich” definition actually means is “Perfect” or “Complete” or “Finished,”  then he missed the important concept of continuous improvement leading change.

We have explored the many definitions that “Done” might hold, and I challenge you to discover your own definition. I am certain that our definitions will change as we grow individually, and as we change the world, but begin painting your picture of “Done” by digging down to your roots and examining your goals and aspirations. Here are three ways that ensure I will never be truly “Done”:

·         Empowering others

·         Respecting individuals

·         Challenging the system

In my opinion, motivating others through education and understanding while leaving the ultimate decision up to the individual makes for more well-informed decisions, and happier, healthier patients. As much as we, healthcare providers, command patients to take their medications a certain way or change their diets, informing patients and allowing them to make decisions will empower them to be in charge of their own health and care. I will work through the patient care that I provide in my career to empower my patients.

Giving this decision-making power to patients can be difficult for providers who have been trained to think and act a certain way. However, when we don’t include patients in the decision-making process, we are not being respectful of their wishes, which they have a right to be in control of. In other words, empowering patients is part of demonstrating our respect as healthcare providers. I will work to include my patients in the decision-making process to show them respect.

Lastly, instead of standing by idly when errors and inefficiencies show up in daily workflow, take action and change the system or process in some small way. This may include beginning with data capture, for instance emergency room wait times, and gaining an understanding of the bigger picture before something can change. That is perfectly reasonable, and necessary. Change is gradual, but as long as we are continuously challenging the system, we are improving the quality of care that our patients receive. I will work to continuously look for improvements to challenge the system so I can provide a higher quality of care.

 

Article Reference: De Haaff, B. The One Word That Will Make You Rich. LinkedIn. February 23, 2015. https://www.linkedin.com/pulse/one-word-make-you-rich-brian-de-haaff?trk=tod-home-art-list-large_0

Quote Reference: http://www.brainyquote.com/quotes/keywords/improve.html

Image Reference: http://www.algonquincollege.com/jazan/files/2013/07/Choice.jpg

Week 5: Communication: More than the Message by Sarah Barden
Week 5: Communication: More than the Message
February 9, 2015 – February 13, 2015
 
 
Before the official AACP Interim Meeting began in Austin, Texas, the AACP Board of Directors met, and I had the opportunity to be a fly on the wall in that room. I cannot divulge the content of that meeting, but to follow up on my blog from last week, I want to talk about a process that I saw in action during that meeting.
 
I am not sure if all directorial boards operate this way or if I witnessed something unusual that day. I know that the student organization executive teams I have been part of within pharmacy school have not reached this level of sophistication and foresight yet. I wish I could have bottled the wisdom of this interaction and taken it back to my fellow students as an example of effective communication around a sensitive topic.
 
So what happened? Well, there was a topic of particular interest being discussed at the meeting, and most, if not all, of the people in the room had very strong opinions about this topic. They had well formed and articulated reasons behind their opinions, but the discussion was also very emotionally charged. The topic needed to be discussed with a few key third parties. I was concerned about how they would respond to these emotionally charged opinions.
 
What I witnessed instead impressed me: the board created a specific, detailed communication plan. Rather than starting a conversation with heated queries, they determined a set of critical questions they wanted to ask and then assigned each question to an individual best suited to ask it. They crafted an introductory statement pointing out the positive elements of the topic. They critically thought about how their questions might be interpreted and carefully chose language that made their points while attempting to prevent a completely defensive reaction.
 
The conversation that ensued was truly that: a conversation. It wasn’t an emotional debate, it wasn’t a series of accusations followed by defensive posturing, and it wasn’t a fly-by-the-seat-of-your-pants point and counterpoint argument. It was a rational conversation. Was there some defensiveness? Sure. That is to be expected when people question a decision, but, despite still disagreeing with the position, when the board walked away from the discussion, I heard many comments about it being an overall positive interaction.
 
Watching the interplay of board members and third parties and how they approached a controversial conversation made me think about a situation that happened at my school a year or so ago. The Student Executive Council (SEC) wanted to change a long-standing policy about student group fundraising. I believe there was some discussion—I was not privy to the meeting—about a new method, but what happened afterward amounted to an edict from the SEC simply changing the rules to the new policy. The communication of the change lacked finesse, explanation, and rationale. One day it was one thing, and the next day it was something different. It made a lot of people angry. After watching an effective communication plan implemented to address a difficult topic, I think a different type of communication strategy could have averted much of the anger and backlash. I think the change might have actually been welcomed if students had understood the reasoning behind it and the deliberations that had occurred. This is obviously speculation, but it might have given the students an opportunity to provide a rational rather than emotional response.
 
I had an interesting conversation with a gentleman on the airplane ride back from Austin about this topic of emotional versus rational thought. (He suggested a book to read about it, but I haven’t had time yet so I’m going to paraphrase the conversation.) He explained the difference as this: emotional thought triggers a gut reaction and ties into the fight or flight response. It’s quick and does not include detailed analysis. Rational thought, on the other hand, requires time, more data input, asking clarifying questions, and weighing costs and benefits to come to a well-reasoned conclusion. Emotional thought is beneficial in some situations, but if we use it to address issues that require careful deliberation, we never reach a rational conclusion. (It was a pretty intense airplane conversation!)
 
My key takeaway from this boardroom experience and further reflection is that creating a communication plan and presenting the message in a strategic way is just as important as the message itself. To avoid triggering an emotional response that ultimately prevents a rational conversation about a topic, a purposefully crafted and clearly articulated message can bypass emotion and stimulate rational thinking enabling both parties to engage in a civilized discussion. My mom told me numerous times as a child that I needed to “think before I speak,” but I think it actually goes deeper. When I have a potentially controversial topic to discuss, I need to think strategically and then craft and deliver my message in a way that makes my point while avoiding the emotional triggers that derail a conversation. As I look to move into an administrative residency program that focuses on management, I think this is an important lesson to remember. I see this being useful particularly in dealing with human resource issues and when introducing changes to the organization. I am sure I will have ample opportunities to practice this in the future, and I hope I have the presence of mind to remember this lesson before my own emotional responses get in the way.
 
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