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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 1: Limits - Real or Imagined?
Week 1: Limits - Real or Imagined?
January 12, 2015 - January 16, 2015
 
“We care about what schools and deans care about—and they care about a lot of different things.” –Jennifer Adams, Senior Director of Academic Partnerships, AACP
 
What struck me as the most interesting part of my first week at AACP was not the two-hour delay due to icy roads on my first day or my trek through the snow to get to work on my third day (those were special experiences in their own right) but rather the breadth and diversity of activities falling under the purview of AACP’s normal operations. I thought I had a good understanding of the organization’s role within pharmacy. In fact, a lot can be intuited from just their name: American Association of Colleges of Pharmacy. Clearly they exist to work with the schools and colleges of pharmacy across the United States, but my mind built a nice little box of assumptions such as (1) they only deal with PharmD programs, (2) they only address curricular content within pharmacy schools, and (3) they only focus on professional development for “teaching” faculty.
 
I was wrong. Really wrong. The word only in those assumptions was a limiting construct of my mind. AACP does support PharmD programs, but they have an increasing role in graduate education relating to pharmaceutical sciences, everything from drug development to pharmacy administration. AACP does promote curricular development for PharmD programs, but they have a huge focus on interprofessional education and map competencies needed for pharmacists to those of other professional schools such as medicine and dentistry. They are a key player in the Interprofessional Education Coalition (IPEC) which is encouraging integrated educational opportunities for multiple health disciplines to the forefront of education. AACP does provide education and training to help teaching faculty succeed, but they also support administrators at dean levels as well as support staff such as members of experiential education offices who enable students to successfully navigate their IPPEs and APPEs.
 
My classification of faculty as “teaching” versus “non-teaching” was also incorrect. In fact, every faculty member has a commitment to teaching, research, and service. The percentage of time each person spends on each component may vary depending on their individual interests and may change dramatically throughout his or her career. These components can also come in different forms. Teaching, for example, can occur in the traditional classroom but can also be accomplished by precepting students during clinical experiences. Research can be NIH funded clinical trials, or it can be trying innovative teaching methods in the classroom and sharing the results via academic publications so that others may learn best practices. Faculty members can serve the profession by volunteering with associations—such as serving as an AACP Council of Faculties Chair—or by working directly in the community such as in collaborative practice with other providers to provide healthcare to underserved populations. AACP provides resources to support all of these functions.
 
The full scope of what AACP does covers a broad range of activities from their own internal governance and strategic planning to advocating for both education (pre- and post-licensure) and professional practice to building and leveraging relationships with broader stakeholders including national and international coalitions trying to improve global health. They even touch K-12 and early secondary education to help recruit young students to the sciences—and hopefully pharmacy. AACP finds resources and creates programs to support the issues that are critical to pharmacy schools’ success which are as diverse as the faculty and students themselves.
 
Realizing my limited perspective prior to beginning this rotation, I wonder how many other limits I have placed by using words like only or by putting people or organizations into boxes I made up in my mind. How many times have I put limits on a patient’s ability to make choices about their own health care because of what I thought about him or her? Did I inadvertently cause that person to actually be limited? When I talked to a female patient who was obese with diabetes and hypertension, did I assume she was unable to exercise because her weight caused her joints to hurt and therefore fail to address lifestyle changes such as diet and exercise as important parts of her treatment regimen? By not offering her this information, did I inadvertently prevent her from understanding how diet and exercise can help manager her diabetes and hypertension? Did I—not she—limit her ability to self-manage her conditions? I assumed that everyone knows the importance of diet and exercise, but what if no one ever talked to this individual patient about what might work for her to create a plan specifically designed for her situation? How might I have been able to help this person become healthier had I not made assumptions about her?
 
I like to think that I am a self-aware person. I like to learn new things. I like to challenge the way things are currently with visions for the way things could be (in fact, my leading strength according to Strengths Finder 2.0 is “Futuristic”). I try to take feedback from people and use it to guide self-improvement. Despite this, though, I still allow preconceptions and assumptions to creep into my thinking without realizing it. That lack of awareness of when I start operating based on subconscious ideas is most distressing for me. What I can do in the future is make a conscious decision to ask, “What am I assuming?” when I start on new ventures or interact with other people to ensure that I am asking the right questions and learning about reality rather than being stuck in my own head.
 
My lessons learned: Avoid creating boxes for people or organizations based on limited information. Ask thoughtful questions to understand the full scope of the situation rather than making assumptions because of what I think I know.
 
Week 5: Never Stop Learning
Week 5: Never Stop Learning
November 3 - November 7
 
Sitting on the metro train, headed to my last meeting in Washington, DC, I stared out the window, reflecting on my last week of the rotation. The train zoomed by the tall brick buildings in Alexandria and I couldn’t help but notice a quaint little street a couple blocks from the AACP building. I saw a small clothing shop and a little café with tables outside. I started thinking about how I sat on the metro at least a dozen times in the past month and not once did I notice this endearing little coffee shop. I walked around the area for lunch almost every day while I was in the office and I never ventured much further than King Street. Alexandria is a small town and I barely got a chance to see half of it before this rotation ended.
 
It’s amazing how fast time moves during rotations. It always seems that just as you begin to feel comfortable at one site, it’s time to move on to the next one. But with each rotation, you leave with significantly more knowledge than when it began. That just goes to show you the substantial amount of information and knowledge that you can gain from the profession. Much like being a tourist in a new town, we should constantly be exploring new areas of pharmacy. One of my last meetings here at AACP was with the Joint Commission of Pharmacy Practitioners (JCPP). AACP is only one of many different pharmacy organizations who attend these meetings with a primary purpose to improve patient care and to progress the profession. This working group succeeded in creating a standardized, patient-centered, team-based approach to patient care provided by pharmacists from all fields of pharmacy. They gather as a group multiple times a year to develop strategic plans to advocate for my profession and until this week, I had no knowledge of their existence. This was the same for the National Council on Patient Information and Education (NCPIE) and even the considerable amount of sections and special interest groups within AACP.
 
I have been a part of this profession for four years as a student and it often feels as if I have learned more than my brain can hold. Now I am beginning to understand that there will always be more to learn. If one day passes and I haven’t learned something new then I missed a valuable opportunity. No matter how much knowledge I have gained on the basics of the pathophysiology in oncology and the appropriate treatment regimens in intensive care, there will always be more. The profession of pharmacy is constantly changing and the knowledge required continues to grow. To be a beneficial component of the health care team, we all must continue to learn. This learning does not solely apply to clinical pharmacists’ but also to areas such as association management and pharmacy education. 
 
In my experience at AACP, I have also been introduced to the impact of advocacy for the profession. For the most part, pharmacy does not have a specific field of pharmacists who have a main purpose of conducting advocacy efforts. Instead, each pharmacist that I have encountered wears a variety of hats. They may be a clinical pharmacist and an educator during the day but they also spend a generous amount of time working with national pharmacy organizations and speaking to legislators in support of the profession. While they spend copious amounts of time updating their knowledge for their particular field, they also spend equal amounts of time understanding the policy and advocacy process. Encountering pharmacists that are able to balance both aspects of continuing education has inspired me to achieve the same level of competency.
 
There will always be an ocean of information and just a small cup to put it in; however, I will not allow this to overwhelm me. Even as a student, I plan to seek opportunities to learn each day. I hope to make my voice heard in advocacy efforts and I will be more aware of the policies and politics centered on improving my profession. I entered this profession so I would have a world of opportunities that would constantly challenge me throughout my career. Since the day that I took the Oath of a Pharmacist, the words have not been as impactful to me as they are now. The Oath said:
 
At this time, I vow to devote my professional life to the service of all humankind through the profession of pharmacy.
 
I will consider the welfare of humanity and relief of human suffering my primary concerns.
 
I will apply my knowledge, experience and skills to the best of my ability to assure optimal drug therapy outcomes for the patients I serve.
 
I will keep abreast of developments and maintain professional competency in my profession of pharmacy.
 
I will maintain the highest principles of moral, ethical and legal conduct.
 
I will embrace and advocate change in the profession of pharmacy that improves patient care.
 
I take these vows voluntarily with the full realization of the responsibility with which I am entrusted by the public.

This oath will be posted in my office of my future career. I will read it whenever I find myself solely focusing on my career as a pharmacist. I am not in this profession only to be the best pharmacist that I can be; I am in this profession to improve patient care and to advocate for change. While focusing on my own career I can improve the patients that I encounter, focusing on the profession will allow me to improve the lives of countless amounts of patients in the future. This can only be done through continual and persistent learning.
 
My final challenge to you: Never stop learning. No matter where you work or what you’re doing, there will always be something to learn. Do not allow yourself to get discouraged by the endless amount of knowledge available to you. Keep your mind set on improving the future and not only yourself.
Week 4: Face Your Fears
Week 4: Face Your Fears
October 27 - October 31
 
 
“If you’re not uncomfortable, you’re not growing.” Dr. Anne Lin, the Dean of my school, said this to my class on our first day of pharmacy school. At that time, the comment did not resonate with me in the way that it does now. I guess I was unable to realize how “uncomfortable” I would be throughout my years of pharmacy education. Not a day goes by where I feel fully confident in what I am doing; constantly studying topics that I’ve never heard of, networking with leaders in the field of pharmacy, giving presentations to an audience far more qualified than I am. In any of these situations, it would have been very easy to shy away from the opportunities that were presented to me. Thinking retrospectively, it is clear to me that if I denied any of these opportunities; I would not be where I am today.
 
This week I was given a great opportunity to attend the AACP Board of Directors meeting. After attending this meeting, it was brought to my attention that these so called “uncomfortable” situations will not end with pharmacy school. Before the meeting began, I peered around the room and observed my surroundings. The appearance of the board room wasn’t anything overly impressive. There were tables gathered together with some refreshments in the back of a simple hotel conference room. Although this board room was very simplistic and uninteresting in its design, the content and participation of the meeting was far from lifeless. Minutes after the beginning of the meeting, a variety of productive debates began regarding important areas of pharmacy education and the profession of pharmacy in general.
 
As the board members raised their hands to contribute to the conversation, I tried to understand each of their roles in their particular positions at AACP. Each board member and staff member had a name tag stating their position at AACP. Later I realized that their title at AACP was only one of many titles that each of them hold. Surrounded by board members who had additional roles as the Dean of eminent schools and colleges of pharmacy as well as other significant leaders in academia and the profession of pharmacy, I was able to gain an understanding of the amount of wisdom in the room. Every person in that room offered a significant amount of passion and experience for pharmacy that allowed for an extremely productive meeting. After speaking with a variety of board members I have come to realize that passion and experience do not develop overnight. It is often the result of overcoming strenuous, “uncomfortable” circumstances that are presented in life. This realization is evidenced by discussing the various accomplishments of each individual.
 
Throughout the duration of the board meeting, several topics were introduced, each associated with a different struggle. A significant amount of time was spent on deciding the appropriate communication plan for AACP to use to portray academic pharmacy to stakeholders. This particular message would be utilized not only to improve the outlook of pharmacy education, but also the outlook of the profession as a whole. Another critical discussion was focused on the current views of the profession of pharmacy. The media is currently ruminating on the saturation of pharmacy positions in combination with the excess of graduates. This negative perception impedes any attempts to expand the profession to improve clinical outcomes for patients, and is impacting interest in the profession of pharmacy. Whether it’s changing the message of AACP or creating a positive outlook for the field of pharmacy, the solution to these problems would not be an easy one.  Fortunately, this did not discourage the Board of Directors. These challenges fueled their motivation to overcome every struggle and to continue to advance the profession of pharmacy.
 
If this group of people can face major challenges to the progress of our profession, I should not be preoccupied with less significant issues. The current issue that I am facing is the completion of my final project for this APPE rotation. The more that I researched the concept of Knowledge Management, the more that I have realized I am in over my head. As the deadline for my project presentation is quickly approaching, I am beginning to be more discouraged. There have been many occasions where I considered asking for another project because I did not feel competent enough to handle this topic. In each moment, when discouragement overcame my thoughts, I remembered previous situations in which I encountered this same feeling. I think back to the meeting with the Board of Directors and I realize that they never conceded to any sign of discouragement.
 
In all of the time that I wasted trying to conjure another project idea, I could have been concentrating on my current research. When I finally focused on the problem at hand, I was able to expand my knowledge in a particular area and to offer assistance from the unique aspect of a student pharmacist. This concept will follow me for the rest of my life. There will always be circumstances where it is easier to admit defeat than it is to persevere. The solution to this problem is a constant vision of what you are trying to achieve. While working on my Knowledge Management research, my primary goal should not solely be to complete a presentation. My primary goal is to synthesize ideas that will impact the capabilities of AACP. In my future rotations and in my career, I hope to continue this thought process by accepting challenging projects in order to expand my knowledge. I will not shy away from something with the fear of failing because I know that even through failure, I will be making an impact in some way. This visionary frame of mind is what is needed in our profession. It may be easier to be preoccupied with things such as the possible shortage of pharmacist positions but we really should be motivated to advocate for the utility of a pharmacist in the health care system. To be a part of the profession of pharmacy, you must be persistent and encouraged knowing that you are working towards something greater than the current difficulties.
 
My challenge to you: Do not be afraid to accept challenges despite the fear of failure. Every difficulty that is presented to us in life is a chance to grow. Do not enter these challenges with a narrow frame of mind. Instead, envision the impact that you will make when you persevere.     
Week 3: Dream Big, Act Small
Week 3: Dream Big, Act Small
October 20 – October 24
 
 
 For the majority of my APPE rotations thus far, each day has consisted of waking up before the sun rises, working most of the day inside a building and then leaving after the sun sets.  I was hardly ever able to appreciate the beauty of my surroundings mainly because I never had a chance to see it. In my time here at AACP, not a day goes by where I have not recognized the character that this town has. I often walk outside for lunch to clear my mind and enjoy the fresh air. If you take one look down King Street you see cobblestone paths leading to quaint, antique-looking shops. Although the town lends itself a sense of peace, it is not rare to see people rushing around in business suits traveling to and from work. This sight always motivates me with the thought that one day I will be in their shoes, enjoying the peaceful surroundings as I start my day in my dream career, wherever that may be.

I knew this was the motivation that I needed when I started my search for a final project idea. I was told to create a final project that would be beneficial for AACP or the profession of pharmacy in general. How could one person create something that would shape pharmacy education on a national level? To reflect on this thought, I decided to sit at an outside dining table to finish my lunch. I simply observed the people around me in search of some great idea that would change the world. In the thirty minutes that I was sitting there, at least a dozen people walked by briskly to return to their daily routine after lunch. I tried to imagine where they were going and what they were going to do. Could it have been a pharmacist working for the National Community Pharmacists Association headed back to the office to develop a plan for achieving pharmacy provider status? Getting lost in the idea of possibly having an encounter with the one pharmacist who was going to change the future of healthcare, I realized how unrealistic the thought was.

With all great changes and movements in history, nothing was achieved by one person alone. With this being said, I experienced confusion at how I could make any impact on the specific topics for my final project. I will be participating in the development of the Pharmacists’ Patient Care Process and the implementation of Knowledge Management in pharmacy education. The Pharmacists’ Patient Care Process is a collaborative agreement on a standard model for patient care provided by pharmacists. This process was created by the Joint Commission of Pharmacy Practitioners in collaboration with several different pharmacy representatives in a variety of areas within the field of pharmacy. It is possible that implementation of this process may be the next step to achieving provider status for pharmacists. With this constantly changing health profession, AACP will continue to grow and develop. To assist in this process, AACP will begin integration of a process called “knowledge management”. Knowledge management is the complex process of maintaining and distributing information and knowledge within an organization to create a more productive and effective environment for staff and members. Each of these concepts has the potential to shape the future of pharmacy and I have been given the opportunity to be involved in the process.

From my childhood, I was always taught to dream big. Big dreams are the basis of a strong work ethic. As I grow older, I am beginning to understand that aspirations are important, however, proper planning is essential to achieve success. All too often, we try to change the world by skipping to the end of the process before we complete the first step. This is an example of a desire for instant gratification without putting in the necessary effort.

Although one person cannot achieve great things alone, it only takes one person to initiate the process. Just one thought, one idea, can open opportunities that never existed. This was an important lesson for me to learn. I constantly have limitless aspirations but no idea what to do with them. For things as simple as creating a final project idea for my APPE rotation or as extensive as changing the profession of pharmacy, I know that I can only achieve these things by starting small. With the hopes of one day increasing the utilization of clinical pharmacists in the health systems setting, I know that I will first have to establish relationships with other members of the healthcare team. Despite the simplicity of this task, the end product cannot be achieved without it. People cannot be expected to understand that pharmacists are significant assets to the healthcare team before we prove it to them. From this day forward, I will continue to seek the first step to achieving success. I will not be discouraged by simple tasks as they are the stepping stones to a greater good. 

My challenge to you:
Do not be afraid to dream big, for it is with these dreams that change is created. But do not forget that change only comes with perseverance and hard work, starting at the very first step of the process and continuing until the end.
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