White Coat Radio

White Coat Radio

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  • Episode 6 - Steps to better sleep for pharmacy students with Dr. Sarah Melton and Dr. Jeff Gray.

    On this episode of White Coat Radio, we learn the steps to better sleep for pharmacy students. Dr. Sarah Melton, a board certified psychiatric and ambulatory care pharmacist, and Dr. Jeff Gray, who specializes in the care of advanced age patients with acute and chronic conditions are both professors in the Department of Pharmacy Practice at East Tennessee State University Bill Gatton College of Pharmacy in Johnson City, Tennessee. They offer insights into the effects of poor sleep hygiene on learning and performance, as well as practical advice for sleeping well. 

    Note: This episode discusses medication and health conditions and is for informational purposes only. Proper diagnosis and treatment of health conditions depends on a number of factors. Your doctor or other licensed health care provider is the best person to address your individual health care needs.  

    Transcript:

    Dan Vanzant

    Welcome to White Coat Radio, a podcast from East Tennessee State University Gatton College of Pharmacy in Johnson City, Tennessee. Each episode, we cover a wide range of topics about the pharmacy school experience, from study tips to deep dives with faculty and student pharmacists. I'm one of your hosts, Dan VanZant.

    Michele Williams

    And I'm Michele Williams. In this episode, we'll be talking about sleeping well as a pharmacy student with Doctor Sarah Melton and Doctor Jeffrey Gray. Doctor Melton is a professor of pharmacy practice at Gatton. She's a board‑certified psychiatric and ambulatory care pharmacist. Doctor Jeffrey Gray is an associate professor, also in the Department of Pharmacy Practice here at Gatton, and an adjunct professor in the Department of Community and Behavioral Health at the ETSU College of Public Health.

    Michele Williams

    He specializes in care of advanced‑age patients with chronic and acute conditions. Doctor Melton and Doctor Gray, welcome to White Coat Radio.

    Sarah Melton

    Thanks for having us.

    Jeff Gray

    It's good to be here. Thank you.

    Michele Williams

    Doctor Melton, you're an expert in psychiatric and neurological conditions, and Doctor Gray, you have a wealth of knowledge in patient care and wellness. And both of you have many years of experience working with students. So what interests you about the topic of sleep, particularly with students?

    Sarah Melton

    Well, I’ve been in academia probably for 20 years now and worked with hundreds of students during that time who come to me with difficulty sleeping and asking for advice, or they’ve come with anxiety and depression and we link it back to not sleeping well. So it’s really been an interest of mine because I know with better sleep there’s better performance.

    Sarah Melton

    And I think it's our goal to provide information so that everybody does sleep the best so they can perform the best.

    Jeff Gray

    Yes. And for me, I teach a class during the P2 year, and I'm always amazed on an annual basis how many students—when I put them into a project where they investigate a topic they're not necessarily familiar with—choose sleep deprivation or insomnia or something related to the quality of their sleep, because they recognize it impacts potentially their performance and other things they desire to do.

    Jeff Gray

    And so I know there's a desire among students to learn more about this topic.

    Michele Williams

    Yeah. I talk with students a lot about sleep deprivation, especially with regard to studying for exams. So I'm really excited about this topic and looking forward to learning more from both of you. And it's tempting for students, I think, to forgo sleeping—especially the night before an exam—just so they can get those few more hours of studying in.

    Michele Williams

    And also because it's difficult to sleep when they're worried. What types of things can result from depriving yourself of sleep?

    Sarah Melton

    Well, we know that students aged 19 to 25 need at least 7 to 9 hours of sleep a night—so on average, eight hours. In the third year, I have our students do a two‑week sleep diary, which is very interesting. What I’ve noticed is that most of our students get much less than eight hours. And before exams, maybe they’re getting 2 to 3 hours, and sometimes some students don’t go to bed at all.

    Sarah Melton

    And when they're deprived, we see dramatic decreases in cognitive function. Some studies have shown it’s like you're drinking alcohol. And who wants to take an exam when you're under the influence, right? So that's one big thing we notice for sure.

    Jeff Gray

    Yes. I personally witnessed a student last week—this student had been involved in an engineering camp. They had minimal sleep during the week but probably enough to manage. But on Friday night, the last night of the camp, they decided to stay up all night socializing.

    The final camp day was Saturday, and I watched this individual all day long—knowing they’d had hardly any sleep. Their performance was way off, compared to earlier in the week. They were not as engaged. Had they had an exam that day, I’m certain they wouldn’t have performed well.

    Jeff Gray

    But your question also touches on chronic deprivation. Chronic lack of sleep increases risks of cardiovascular disease, hypertension, stroke—much higher risks than individuals with adequate sleep.

    And with athletes, inadequate sleep increases risk of accidents and injuries. Sometimes students find that motivating.

    Michele Williams

    Yeah, and what their needs are to strive for better sleep.

    Sarah Melton

    Well, another thing we frequently see with chronic sleep deprivation is increased anxiety and depression. And if you're anxious or depressed, you're not going to be productive or perform well.

    We also see a link with obesity and weight gain, which many people don’t realize.

    Michele Williams

    I notice when students come to me after an exam they didn’t do well on saying, “I don’t know what happened—I was so prepared, and then I just went blank,” I always ask, “How much did you sleep the night before?”

    Often the answer is none or just a couple hours. They don’t connect the dots that they would perform better if they slept more and studied less that last night.

    Sarah Melton

    I totally agree. It’s super important to ask.

    Jeff Gray

    Yes, there's often a disconnect. Students want consistent sleep but don’t realize how it affects exam performance, athletic events, or other activities.

    Michele Williams

    Pharmacy school can really cause students to feel they don’t have enough hours in the day. They feel like sleep is a luxury. So what are some realistic things busy pharmacy students can do to improve the quality of their sleep?

    Sarah Melton

    We call this sleep hygiene. Just like brushing your teeth every day, these are daily habits for better sleep.

    Number one: Go to bed and get up at the same time every day. The brain likes patterns. Students often sleep less during the week and try to catch up on weekends—our brains don't work that way.

    Number two: No caffeine after 3 or 4 PM. Students laugh at this, but caffeine disrupts sleep. Energy drinks are especially harmful.

    Jeff Gray

    I don’t think students realize how much caffeine they’re consuming—many drinks today have several days' worth of caffeine in one serving.

    Sarah Melton

    We once had a student drinking 28 Mountain Dews a day! They were referred for anxiety and insomnia—they didn’t need medication; they needed a caffeine taper.

    Sarah Melton

    Alcohol: binge drinking on weekends severely disrupts sleep. Some drink alcohol to help fall asleep, but chronically this harms sleep patterns.

    Jeff Gray

    Over‑the‑counter products can also interfere with sleep—pseudoephedrine, decongestants, antihistamines taken at the wrong time can be stimulating.

    Michele Williams

    So students should ask: What am I ingesting? How much caffeine? Any allergy meds? Alcohol? It’s not always just stress.

    Sarah Melton

    Exactly. Also, avoid exercising right before bed—it increases alertness. Avoid TV and screens before bed.

    If you can’t fall asleep, don’t stare at the clock—turn it away.

    Your room should be cool, dark, quiet—some like white noise.

    Jeff Gray

    Where we’re recording now would be a great sleep environment—dim lighting, quiet, gentle HVAC noise.

    Sarah Melton

    But naps? Not always a good idea. Napping late makes it harder to sleep at night. Consolidated nighttime sleep is best.

    Jeff Gray

    Yes—sleep hygiene is an all‑day process, not just what happens before bed.

    Dan Vanzant

    As a parent, I’ve seen more people recommending melatonin. Have you seen an uptick in students using melatonin or self‑medicating?

    Jeff Gray

    Students definitely self‑medicate. Hopefully they're informed.

    I work with older adults—many use melatonin. I rarely recommend it for anyone over 40 unless there’s a schedule disruption, like jet lag.

    Sarah Melton

    Evidence shows melatonin is only effective in a few populations: intellectual disabilities, developmental delays, blindness, jet lag. Otherwise, it’s not very effective—though some swear by it.

    Other OTC sleep aids like diphenhydramine or doxylamine cause next‑day hangover and cognitive impairment. Not ideal for exam days.

    Jeff Gray

    Best practice: Don’t try new medications the night before an exam.
    Follow the same routine you used while studying.

    Michele Williams

    That makes so much sense.

    Dan Vanzant

    Doctor Melton, you mentioned blue light. People say not to use devices before bed. Any thoughts?

    Sarah Melton

    We recommend no phone, computer, iPad, or TV for one hour before bed. Light is activating. Create a calming routine instead—bath, pajamas, brushing teeth, reading. Blue‑light‑filter glasses can help too.

    Jeff Gray

    Students still need electronics to study, but that 30–60 minute window helps.

    Dan Vanzant

    What about fitness trackers and tech that monitors sleep?

    Sarah Melton

    Fitness trackers are helpful—especially for seeing how long it takes to fall asleep (we want 15–20 min), number of awakenings, hours slept.

    Jeff Gray

    My mattress even tracks my sleep! It was eye‑opening to see how restless nights matched how I felt the next day. Tracking patterns can reveal how alcohol, cold medicine, or activities affect sleep.

    Sarah Melton

    There’s a great free app: CBT‑I Coach (Cognitive Behavioral Therapy for Insomnia). It guides sleep diaries and teaches cognitive strategies for sleep. No ads. I recommend it often.

    Dan Vanzant

    That’s great. We’ll link it in the notes.

    Michele Williams

    This has been fascinating.

    Dan Vanzant

    Doctor Gray and Doctor Melton, thank you so much. This has been great information for students about sleep and sleep hygiene.

    Sarah Melton

    Thanks for having us.

    Jeff Gray

    My pleasure.

     

     

     

     

    26 min
  • Episode 5 - Part 2 - Experiential Education deep dive with Dr. Katelyn Alexander

    In Part 2, Dr. Katelyn Alexander, Director of Experiential Education at ETSU Bill Gatton College of Pharmacy in Johnson City, Tennessee, goes deep into the context and purpose of experiential education and offers insights and perspective from the preceptor’s point of view.

    Transcript:

     

     

    Michele Williams

    Welcome to White Coat Radio, a podcast from East Tennessee State University, Bill Gatton College of Pharmacy in Johnson City, Tennessee. Each episode we cover a wide range of topics about the pharmacy school experience, from study tips to deep dives with faculty and student pharmacists. I'm your host, doctor Michelle Williams. In part two of this two part episode, we'll be talking about experiential education with Doctor Katelyn Alexander, associate professor of pharmacy practice and currently serving as Director of Experiential Education.

    Michele Williams

    If you missed our last episode, we covered the basics of experiential education and clinical rotations. So if you're new to pharmacy school, you really want to check that out. So welcome back to White Coat Radio.

    Katelyn Alexander

    Doctor Alexander, I'm excited for this one.

    Michele Williams

    Me too.

    Michele Williams

    So in this segment we're going to take a deeper dive into experiential education at Gatton. And I'm excited about this episode because there's so much to learn. And I recently found out in our last episode that, experiential education is responsible for one third of the pharmacy school curriculum, and that's amazing.

    Katelyn Alexander

    Yeah, there's been all sorts of cool things about experiential at that. I've learned since moving into this office and, and that the relationship between experiential education and students like career planning, between, the kind of career exploration, there's just a lot of things that relate. So, yeah, it's a it's, it's a complex and complex office with a lot going on.

    Michele Williams

    Yes, definitely. And, so, so I'm so glad that we're we're doing a deeper dive into experiential education with this episode. And, so, so I have some, some more specific questions. So. Yeah. So let's say I'm a student pharmacist and I'm getting ready for my first immersive rotation. That would be an eye eye PPE and introductory.

    Michele Williams

    Yep. Pharmacy practice experience. Yep. When we're where I'll be at the practice site all day for several days in a row, it's my understanding it's an immersive rotation.

    Katelyn Alexander

    Yeah. So most of the time students will spend between 8 and 12 hour per day. Usually, subsequent days over the course of about two weeks. So our blocks are two weeks. But, you know, sometimes the the length of time can vary minimum of 80 hours for those initial rotations.

    Michele Williams

    Okay. And so, so I know that this learning experience is going to be different from sitting in a classroom listening to a professor, you know, engaging in the classroom setting. So, so what can I do to shift into that experiential mindset? Because it's it's been my experience as someone who who works with students on developing, learning strategies and becoming more aware of their thinking processes and their learning processes, that that sometimes when there is that shift to an experiential setting, students take with them that classroom mindset of, you know, I'm used to being in the classroom.

    Michele Williams

    I'm really good at listening to lectures and or participating in small groups. So so what can students do to get into a more experiential mindset?

    Katelyn Alexander

    So I think that is true. It's a it's a much different type of, delivery of information. It's a much different type of assessment of what students know. So I think the first thing is, for the IPS, we specifically provide a workbook to help kind of guide students to give them a little bit of that academic structure.

    Katelyn Alexander

    Rotations in your fourth year or AP rotations do not have that same rotation or workbooks that goes with the rotation, but for IB is to kind of bridge them from the classroom to the practice environment. We provide this workbook to help kind of get them thinking and asking the right questions. So, you know, we usually tell students to kind of look that over to look over information about the rotation just so they sort of know what they may be participating in.

    Katelyn Alexander

    But the biggest thing I think that's different about experiential coursework versus didactic coursework is you also get to be somewhat in charge of your learning. So students have to be reflective about, okay, what am I comfortable doing or what have I had experience with? What am I maybe nervous about that I would like to learn more about?

    Katelyn Alexander

    Or what do I what haven't I seen? What don't I understand that I feel like I really need to gain confidence in. So you can approach rotations from lots of different ways. You can seek out opportunities to practice things that you are comfortable with, but want to gain more exposure to. You can use it to fill in gaps of things that you're not comfortable with.

    Katelyn Alexander

    Preceptors can can accommodate lots of different requests, but you have to tell them what it is that you're hoping to gain out of the experience. So it also takes a little bit of introspection to figure out, well, what do I want to get out of the experience and how will I go about doing that potentially.

    Michele Williams

    So you have to be a little bit more active in understanding what your goals and what your needs are, as opposed to in a classroom where the faculty, the professor, is going to have a sense of what your needs are as a learner, you're you're a little bit more behind the wheel in an experiential setting. It sounds like where you're you need to have thought about those things ahead of time and, and verbalize those to if there's something that that you're wanting from the experience.

    Katelyn Alexander

    Absolutely. Because people can adjust it versus the classroom. You know, I have to make it fit every learner in the room because everybody is receiving the same delivery of that lecture content, but with a rotation, most of these placements, you're 1 to 1 with your preceptor. Maybe there's two students to one preceptor. So the ratios are much smaller, which means even though the preceptor is still doing their full time job, being a pharmacist in whatever setting you're in, there can still create learning opportunities for you.

    Katelyn Alexander

    And it also helps them know, okay, where am I going to have to really provide a lot of guidance to a student on. Or where am I going to have to maybe identify some additional learning opportunities versus if they're comfortable and confident, I can maybe watch them a few times, can model, but then I can really give them autonomy very quickly because they're comfortable with that.

    Katelyn Alexander

    And then I can kind of let them go and fly, because I think an experiential where students learn the best is when they just get to do things autonomously, when they get to do it on their own. So having a having a preceptor be aware of what you think your strengths and weaknesses are, things you want to work on really helps them model that rotation.

    Katelyn Alexander

    And every site's going to be different. I mean, certain sites maybe have different opportunities available. So for example, if you recognize that maybe you're not that comfortable giving immunizations, some sites are going to be and depending on the time of year, some sites will have lots of vaccines that they give and some sites that may not be as much of a part of what they do or maybe just wouldn't be available.

    Katelyn Alexander

    So they can try to prioritize it based on what they know you want to work on to to an extent. And, and that's where we come into play. We usually will help coach students, as well with their rankings. If I know that you have this kind of goal, I can help you pre identify the sites where you're most likely to achieve that.

    Katelyn Alexander

    Oh, okay. So we even go about it before you even step out on to rotation. Our office, when we help students plan their schedule or rank their preferences, we provide some coaching about the types of sites that will accomplish the goals that they have.

    Michele Williams

    So students really need to be thinking about what they want and what what their needs are, even before the first day of rotation.

    Katelyn Alexander

    Yeah. So the earlier you can kind of start doing that all along, I think. I think that helps out a lot.

    Michele Williams

    Okay. So it sounds like, like being a very active and sort of engaged student when you're on rotation is is really beneficial. Yeah. What if I'm a little more, on the, on the introverted or reserved side of things? I'm not super comfortable, you know, being really chatty or. I feel a little intimidated. What what would you suggest that a student could do to to have a good experience, even though they're not, very, very extroverted.

    Katelyn Alexander

    Yeah. Or comfortable. So we probably get a lot of questions from students to that first rotation that they go out on. That might be the most time they've ever spent in a pharmacy. And so they're very nervous about I don't really know how things run. I don't want to I don't want to get in the way. Yeah. So the first thing is rotation.

    Katelyn Alexander

    Just because you have a preceptor or an instructor doesn't mean that's the only person you're going to work with. Okay. So look for lots of people who can help you, technicians who are, sort of support staff in the pharmacy. Other students, they may be, more able to assist. You are more, more approachable, but they may just have more flexibility with time, because of their responsibilities.

    Katelyn Alexander

    So don't always assume that just your preceptor can help you. I think there's lots of different people you can learn from on rotations. I think students sometimes feel like there's an expectation that they know how to use the computer system right away, or that they know very quickly how to jump into the workflow. And we just tell them we're we're not looking for perfection.

    Katelyn Alexander

    I just want you to try, and maybe do things that you are comfortable with. So you may not know how to put how to answer the call, but if the phone's ringing, listen a couple times to figure out how people answer the phone. You can answer in the next call and maybe talk to the tech ahead to figure out how you put them on hold after the fact.

    Katelyn Alexander

    But, you know, just kind of jumping in honestly will help you feel more comfortable because, because it gains confidence. And the thing that sometimes I think hold students back who are worried about messing up is that they never get the practice. They never dip their toe in enough to to feel confident about anything. So you have to be a little uncomfortable to grow.

    Katelyn Alexander

    And this is the perfect time because we're just looking for you to show progress.

    Michele Williams

    So take a little bit of a risk.

    Katelyn Alexander

    You take you take some little risks. And if and if you're not sure and want some guidance still about what risks to take. Find a friendly technician and maybe say, how can I help? And they will be happy to tell you a million ways, whether it's helping them pull, restock bottles, maybe it's helping them answer the phone, maybe it's helping with check out like they will find little ways to get you, incorporate into the workflow.

    Katelyn Alexander

    And they're happy to answer questions. There are no dumb questions when you're on rotation.

    Michele Williams

    That's good to know. And and I from from what you're saying, it's it's a good idea to, to take a risk because then once you realize you can do it, that confidence builds on itself and and you get better and better.

    Katelyn Alexander

    Yeah. And sometimes students, I think, worry about, well, what's what's my role as a student versus, oh, I shouldn't do that because that's a I don't want to step on someone else's toes. Or maybe that that role is not beneath me, but it's it's meant for a different type of staff member. And I would say like, everybody kind of jumps in and does everything and most pharmacy setting.

    Katelyn Alexander

    So it's okay. However you start to just just start. That's the biggest thing. Like we all have to be willing to take out the trash. So most pharmacists will tell you at the end of the day, you know, if, if, if the phone is ringing or something needs done, they have to know every aspect of what happens in their work setting.

    Katelyn Alexander

    So, so by a student jumping in, there's no wrong place to get started.

    Michele Williams

    Great. And, so, so it sounds like that, that kind of taking action and, and getting engaged and stepping outside of your comfort zone, those are things that are that are expected and and are good to do. And, and can you talk a little bit about some of the other expectations that, that are different from a classroom expectation?

    Michele Williams

    Sometimes it's difficult to, to bridge that gap. So when you're in a new environment, it can be difficult to know, what are they expecting of me? Like you said, am I in the way? I don't want to be in the way. I don't want to be an impediment to them getting their work done. So. So how do you, find out what those expectations are?

    Katelyn Alexander

    So on for a good rotation? All of that happens on day one or happens ahead of the start. So we'll coach students to reach out to their preceptors roughly two weeks before the start of the rotation via email, they usually ask a couple of questions. You know, where do I show up? What do I wear? What time do you want me there?

    Katelyn Alexander

    All those things? Do I pack a lunch? And then on the first day, most preceptors, unless something goes catastrophically wrong and they have to adjust, they'll do a quick orientation with the student of here's, here's maybe where we'll have you start different kind of get you oriented to the workflow, get you introduced to people. And that just kind of shows you, I think, where you might be involved, but rotations, IB rotations specifically their pass fail.

    Katelyn Alexander

    So the elements of the grade for the rotation are a guided by the workbook. So they're things that because of where you are in the curriculum, we know you can do and we can apply and this real world setting. And then the other part is just do you show up? Do you act like a professional. So I think as long as you're making an attempt to be involved, as long as you're, you know, putting your best foot forward and really trying to be engaged and and staying, participating in the elements of, what's going on around you?

    Katelyn Alexander

    That's that's really what we're looking for in a past. The things that sometimes students, I think, misinterpret. It's not a good it's you're not really doing what you're supposed to do if you're simply just hanging out, standing against the back wall, letting things fly by.

    Michele Williams

    You.

    Katelyn Alexander

    Okay, you're not just there to observe. You're there to participate because you're not going to learn as much as you can if you're simply watching. You really learn by doing so, you have.

    Michele Williams

    To build on it.

    Katelyn Alexander

    Yeah, okay. And you can do things that you feel comfortable with. So throughout the first year curriculum, we will prepare you through lab and through several courses. There will be skills that you learn that you can use communication skills with patients. You'll have a lot of the foundational things that you can start using when you go out.

    Katelyn Alexander

    So you have to be responsible for the knowledge that you have received, and you have to be willing to provide that. But as far as things that are unique to the site, maybe the computer system or specifics with the workflow, there's no way we can teach every every student, every individual pharmacy or health systems way of doing things.

    Katelyn Alexander

    Yeah. So there are some on the job that you'll have to kind of pick up on. And there's a learning curve there, but we're not expecting you to be an expert after two weeks, especially if this is your first time working in that setting a pharmacy.

    Michele Williams

    Okay.

    Katelyn Alexander

    But you have to be willing to just do it's not just observational, okay? And then you have to really, I think still be able to dig back within what you've learned in the curriculum and be able to apply it. So an example of that might be, let's say a patient comes up to the counter seeking a recommendation for an over-the-counter product.

    Katelyn Alexander

    Maybe they have seasonal allergies or cold or something. You've had that in the curriculum as a P1. So when the pharmacist says, hey, would you mind counseling them on this. And I histamine that they picked up or this allergy medicine that they picked up. Yeah. You know that you can do that. Yep. You're up and, and probably the first time I mean most preceptors, they'll kind of feel the student out to to figure out what you're comfortable with.

    Katelyn Alexander

    Like we talked about previously, you know, you have to also be aware of what you're good at and what you're not comfortable with. Right. But generally, you know, after maybe observing one, the preceptor watching you, for one, you know, then they'll sort of turn you loose when they feel like you're ready. So, you know, the expectation is that you do are responsible for what, you know, however, from there, it's really just are you kind of participating?

    Katelyn Alexander

    That's really the expectation.

    Michele Williams

    Okay. And, let's say that that I get the sense that, I don't have a good communication with the preceptor, because people are people, and human beings don't always have a great fit with each other. Yeah. What are some things that, if I'm a student pharmacist, that I can do to to work on that communication because you you're you may encounter that at the point where, where, you wish the communication were better with the preceptor.

    Katelyn Alexander

    Yeah. And that that can be for lots of different reasons. Like you said, it can be a mismatch between kind of people's personalities. Sometimes preceptors have personal things going on. Pharmacies are really busy places, and so it can be easy to get lost. The one thing that sometimes I notice where students can sometimes fall into a can, they can they can, I want to say it, they can create communication barriers for themselves is by picking the wrong time.

    Katelyn Alexander

    So you may have to kind of step back and think, okay, if I'm asked, do I have to ask my preceptor this question? Like, maybe it's a question about the computer function or, where do I find this thing? Do I have to ask my preceptor and then be, if it's a question about like, philosophical things, tell me about how did you get to this career?

    Katelyn Alexander

    What do you really like about this type of pharmacy is right now the best time to ask them that question. So sometimes students won't have the awareness of this is a super busy time and I'm peppering my pharmacist with questions. Maybe I need to wait until there's a little more of a lull, because preceptors love having those conversations with students, of course.

    Katelyn Alexander

    But sometimes communication breakdown happens just because the timing is off. And, and sometimes preceptors because they're, they're taking you on in addition to their, their full time job. You know, they may not be able to be the only person you go to with every question. So that's where getting comfortable with the rest of the staff is really important.

    Katelyn Alexander

    Because if you're on a rotation with me and you have a question about something related to the operations of our office, I may not be the best person to tell you. It's probably one of my staff members. So, so using the rest of the team essentially can can be helpful. But if those things aren't really what's at the crux of the problem?

    Katelyn Alexander

    I mean, openness is the best kind of communication. And sometimes you may have to pull your preceptor aside an opportune time and and sort of say, I feel like we're not on the same page. Can you clarify this? And you may have to kind of work through whatever that communication is. Just so you have some clarity, or if that really isn't working, either, you can always reach out to our office and we'd be happy to work with you.

    Katelyn Alexander

    But most of the time, I think it's just a matter of, you know, who are you asking? Are you asking the right person the right question? And then also, timing.

    Michele Williams

    So it's it's probably a good idea if you get a little bit of a short response from the pharmacist to think back on, when was I asking this question? And and maybe it wasn't the question or it wasn't me. It was that I should have picked a better time to ask the question. And and then was there someone else that I could have asked?

    Katelyn Alexander

    Yeah, a lot of.

    Michele Williams

    Pharmacists or people. Right. And they get busy and just like everybody else, if you if you ask the person when they're really busy and distracted by some important task that they're doing, you may not get.

    Katelyn Alexander

    You're not going to get their full attention and you might not get the type of response you want. And students, I think it is a big shift. If you're in a classroom and you have a question, you're the only person you turn to is the instructors, the faculty member. And since the preceptor is the faculty or instructor or equivalent of the rotation, a lot of students feel like, well, I should only be asking that person.

    Katelyn Alexander

    But we even tell students, you may not even exclusively be working with that person. They may work a schedule that's different to yours. So you might work with other pharmacists at the company. You'll definitely work with other staff members. And that's a good thing, because in the real world, you're going to be working with all those people to like, you need to kind of to, you know, get comfortable with lots of different folks.

    Michele Williams

    So, so the whole environment and all the people in that environment are part of that learning.

    Katelyn Alexander

    Yes.

    Michele Williams

    It's not just a 1 to 1 with that preceptor.

    Katelyn Alexander

    Yeah. You're not you're not like side by side with them across the entirety of the experience. You're not glued to their side. You you definitely kind of float around with everybody working in that, that team.

    Michele Williams

    And they can still, if a student is having, a challenge and they need a little bit of advice on isolating it, they can they can contact you. Yeah. They could contact me, actually, if they wanted to talk about just straight up communication skills, not the clinical piece.

    Katelyn Alexander

    But.

    Michele Williams

    The communications. One other thing that I would suggest if, if someone is having, if they're a little more on the reserve side, a little more introverted and, and you're, you're trying to break through a kind of communication barrier or something that I think can be helpful. It's also helpful if you have if you're more extroverted, too, but especially if you have a little more introversion is to write down what you're going to say.

    Katelyn Alexander

    So yep.

    Michele Williams

    If if things didn't go well to kind of process it, once you're out of the fray, once you're home and think about what how you'd like to articulate, you know, the express yourself and and make a connection with that preceptors, there's nothing wrong with writing it down and sort of thinking about what you're going to say first. Don't don't read it to the preceptor.

    Michele Williams

    But but that act of writing, it helps you to kind of articulate what it is you, the point you want to make and get the information across, especially if something a little, less than optimal happened in the communication. That can really be helpful.
    And and the other thing that I think is so important about experiential ed is that it's, it's in those, those tough situations or tougher situations that we learn the most.

    Michele Williams

    Oh yeah. Working with other people. Working through communication, misunderstandings and things like that. That's you don't learn how to deal with misunderstandings unless you have a misunderstanding.

    Katelyn Alexander

    Yeah. And and our office is happy to coach you. But a lot of times we do tell students, okay, take our advice. And now you have to go do it for exactly that reason. Because this is a perfect learning opportunity to to build a skill set that, that a lot of students don't have. And that's really important for your future job.

    Katelyn Alexander

    So, yeah, absolutely. And, both Jolina and I's Angelina, is the assistant director for experiential ed. Her background is in, career counseling, so she actually has a lot of good insight, too, about just how to how to talk with other people in the workplace, as well as kind of giving advice for placements as it relates to, like, ultimate career goals.

    Katelyn Alexander

    So, so.

    Michele Williams

    Lots of good resources.

    Katelyn Alexander

    For.

    Michele Williams

    Experience all at.

    Katelyn Alexander

    Yeah. And we're we're happy to help navigate that and we'll, we'll intervene with preceptors if we have to. But most of the time it's usually just, a timing issue or difference of expectations. I think sometimes too is like the real problem. But yeah, we're happy to help students navigate that.

    Michele Williams

    So you mentioned, sort of career readiness. Yeah. Some of these skills that you're learning are really not just the the clinical skills that you're learning, but also the communication skills, the interpersonal skills workplace skills, those are all things that are happening while you're on rotation. And they really start from the very first IPA. Yeah. So can you talk a little bit more about that?

    Michele Williams

    The the relationship of that, that, IPA and AP experience to the larger kind of career plan that.

    Katelyn Alexander

    Yeah. So IPA is because they're introductory, they're more just kind of exploration. But a lot of students, what we have found with IPA is, is it's a good opportunity to find, paid employment. So students will go, let's say, to maybe a retail chain, they're really impressed. And that preceptor has a network of folks above them. And they might say, well, we're we know a store close by is looking to hire an intern.

    Katelyn Alexander

    And it's amazing how quickly then that student usually is called up of, hey, I heard from your preceptor, or they're encouraged by the preceptor to apply because they're just did a really great job. So that's usually one kind of career route. A lot of students, find that their IP rotations will influence their AP rotations. So maybe they go to on their clinical IP after their second year.

    Katelyn Alexander

    Maybe they go with a at an ambulatory care site. So outpatient, outpatient clinic where a pharmacist is working alongside physicians and nurse practitioners. And I don't know how many times we hear, man, I definitely want that rotation. Maybe we even have that same preceptor. On my app is. And on the flip side, sometimes students will say, I know that's not the career for me.

    Katelyn Alexander

    And I, I'm going to change my rotation selections to kind of go in a different direction. So that I think definitely helps kind of guide APS in general. A lot of students will come in, well, both ways, since they're come in still not knowing exactly what they want to do post-graduation. Or sometimes students come in with a very clear idea of what they want to do, and we provide coaching to all students about selection, both on IPS and APS.

    Katelyn Alexander

    But, a lot of times we hear back from students, particularly in the fourth year and every I don't know how many students I've heard say, every month. Oh, this was my favorite. Oh, no, this one was my favorite. So it's really fun to see how the rotation experiences change their career path. And open their minds to different opportunities.

    Katelyn Alexander

    And, and ultimately result in job. So on the fourth year there you're there for four weeks and four weeks is an awfully long interview. So I don't know that students always appreciate that the rotations really can set them up for future job opportunities simply because, you know, if ever there's a position opening, a lot of times pharmacies will go back and hospitals will go back and say, well, who did we have on our rotation?

    Katelyn Alexander

    Oh yeah, I love that person. Let's see if I wonder if they're still around here. I wonder if they're available. They also, employers will reach out to our office, sometimes to inquire about students that they've had. Or just if we know anybody who is job searching. So it's said a lot. The field of pharmacy is really small, but it's really true.

    Katelyn Alexander

    If you have a good experience, whether it's an IPA, two week rotation or an AP four week rotation, that really can create a lot of opportunity for you. Just because people really value and recognize good work and a good fit with the rest of the team at a site. So, yeah, there's a lot of things that grow out of a lot of opportunities that grow out of rotations that students may not always think about.

    Michele Williams

    I was kind of wondering that to our students, where you use the word interview when you were talking about rotations. And so it sounds a bit like a rotation is like an extended interview in some cases, because your specialty, if you're interested in and working in that particular area.

    Katelyn Alexander

    Yeah. Because, because it, it if you're exposed as a preceptor, if I'm exposed to a student and I get to watch firsthand what they do, you know.

    Michele Williams

    Quality of their.

    Katelyn Alexander

    Work, the quality of their work, their, their behavior, their, yeah, their, you know, their attitudes, all of that, their knowledge. I can't help but apply that to a future interview. And, you know, interviews are pretty brief. So if you have that rapport with somebody because of that placement, yeah, it can definitely change the way you're perceived.

    Katelyn Alexander

    In an during an interview process, really.

    Michele Williams

    Gets your foot in the door. It sounds like.

    Katelyn Alexander

    Yeah, for both jobs and for residency. So we'll coach students, you know, if you're interested in, residency placements as well, consider doing a rotation. I don't know that I would do all my rotations at a single site, but consider maybe at least one month because you know that that will make an impression. And that will get back to, the, the director of the program at that site.

    Katelyn Alexander

    So it's a really great way of and it's a good way for the student to kind of feel out, both from a, in a residency seeking process and a job seeking process. Is this a good fit for me? Yeah. So I think it it definitely works. Both ways, but yeah, it's, it's an important element and similarly, a good work.

    Katelyn Alexander

    The news travels fast, but, you know, bad news travels fast as well. So sometimes what we'll hear from preceptors is, maybe the student is interested and has a clear direction for career goals. So again, on our our fourth year, there's four core rotations that every student has to take. They cover a lot of variety of practice settings.

    Katelyn Alexander

    So let's say you're going to you really want to work in a community pharmacy, but, you're on rotation in a hospital or more clinical environment up on the floor. And preceptor could really tell that you weren't that interested or you didn't give very good effort. Well, I don't know how many times we've heard that, you know, that preceptor and that employer, through various channels probably know each other or know someone else.

    Katelyn Alexander

    And so sometimes we're we've heard, well, a student maybe didn't get an opportunity because, you know, they kind of melded in on an experience. So their.

    Michele Williams

    Lack of enthusiasm.

    Katelyn Alexander

    Kind of showed. Yeah. So you can never take for granted that even rotations that maybe aren't what you really want to do, still can make a big impression because you're how you represent yourself is, is your identity. And that will travel with you whether you intend for it to or not. So yeah. So it's really we always coach students like you have to be interested.

    Katelyn Alexander

    You have to be dedicated and be enthusiastic whether it's what you want to do or not.

    Michele Williams

    That makes sense. And I think it's it's a really good thing to know ahead of time to realize, that that those skills that you're, that you're learning and that you're employing, they're being noticed, they're worthwhile to develop. You want the preceptor to see you developing those skills. And it sounds like the, the expectation is not that you've got everything all sorted out and, and that you do things perfectly, but that you're, that you're engaged and you're really working to, to do your best and, and to improve areas that you might be weekend.

    Katelyn Alexander

    Yeah. In particular in the AVP. So in your advanced pharmacy practice experience, the the ante is up a little bit. The stakes are a little higher because you've been through the whole curriculum. There is a little bit more, of an expectation that you can apply the knowledge and you may not get the, the preceptors question, or you may not get the answer to every patient scenario.

    Katelyn Alexander

    Right. Every time. But if you have a learning opportunity and rotation, the other expectation is that you learn from it and you can take that and apply it moving forward. So you're really responsible for building on that knowledge and you want to see a progression. So everybody's going to have different starting points. And your starting point is going to look very different when you first start on rotations.

    Katelyn Alexander

    In the summer of your P4 year versus the spring of your P4 year, when you're months away from getting licensed. So preceptors expectations kind of have to shift because of the amount of experiences that you've had. But I think as long as you're showing growth and as, as long as your, applying knowledge that are things that you've learned and kind of consistently then can apply them over time, that's going to make you successful.

    Katelyn Alexander

    We had a faculty member one time laugh that a student was upset that they didn't get an A for A rotation. Students. I showed up on time, I dress professionally, I communicated well, and the preceptor said, yeah, that's the expectation at baseline. That's the foundation. I need you to kind of continue moving. Because kind of like we talked in the past, sometimes you have to be a little uncomfortable in order to grow.

    Katelyn Alexander

    If if I'm just if I'm meeting where you where you are and you're constantly comfortable, then I didn't really do my job because I didn't get you to do something. I didn't push you. So preceptors are not going to. They're not going to have things that are completely un, unreasonable as far as expectations. Yeah, but they are going to try to get you to move forward so that you can grow.

    Katelyn Alexander

    Yeah. Because that's the whole point of that fourth year, and.

    Michele Williams

    It's all in service of, helping someone to become a really good pharmacist.

    Katelyn Alexander

    Right.

    Michele Williams

    Which which we all want to have happen.

    Katelyn Alexander

    Right. We want you to be successful in your career. We want you to be successfully licensed. We want you to take care of our patients, too. I mean, we're going to share patients across the the continuum. And so, yeah, it's all out of a place of I, just looking out for you. And that's sometimes tricky for students, too.

    Katelyn Alexander

    I think the feedback that you get on rotations is a little different than how it's delivered in the classroom. So sometimes students really struggle feeling like it's, either personal or feeling like they can't do anything. Right. And that's not that's not the goal of it at all. The goal is, again, kind of making you aware, if you aren't already, what you're good at and what you are and where to focus attention and, and how to kind of continue to grow and move forward.

    Katelyn Alexander

    So maybe that's where you have to study a little bit more. Maybe that's where you need to find out where you can get more practice. But, you're going to get a lot more feedback and it's all going to be verbal versus in the classroom. The ways we assess your knowledge is much different.

    Michele Williams

    Yeah, that's a good point. And it I think it's probably a little a little more challenging to get verbal feedback about your performance versus getting this sort of grade that pops up on your, on your computer that you can look at. But to have a interaction with somebody where they're telling you something, I think that's and that's actually much more like the real world.

    Katelyn Alexander

    Yeah, absolutely, absolutely.

    Michele Williams

    So yeah. All of this is, is, I think, so important for students to understand because, some of it is not, not necessarily written in a manual or workbook.

    Katelyn Alexander

    No, it's not there.

    Michele Williams

    But they're things that are really important to know about the, about experiential education, what the expectations are and how they're different from, from being in the classroom. Are there any other things that, that you can think of or sort of parting words about, experiential education that.

    Katelyn Alexander

    Yeah. So we, I mean, this isn't the only time students will hear about experiential ed. So we orient everybody, to the courses in the fall. We do lots of orientations when they get to provide their rankings. We're actually going to start meeting with every single student to kind of coach them through their ranking process. We do a very extensive onboarding.

    Katelyn Alexander

    So there's a lot of touch points that students will hear information.

    Michele Williams

    So the ranking process is where they prioritize their first choice, second choice, etcetera. For the rotations. That's what you mean right okay.

    Katelyn Alexander

    And they can also prioritize time when they don't want to be on rotation. So like if a student is going on a vacation that they know about, if they're getting married, they can also tell us and priority or through their other rankings, they can kind of avoid certain timing and we'll look at that. But yeah, students, and a lot of students don't really know, you know, what they, what they want to do or what the difference is.

    Katelyn Alexander

    And some of the placements are. So that's why we meet with them to really talk through. Okay, here's the read between the lines. Because similarly, just seeing a preceptor name who you don't know, a store that you're not aware of, the differences between the Walgreens on the corner of State of Franklin, that's just around the corner, and West Town Pharmacy, they couldn't be any different.

    Katelyn Alexander

    And they're a stone's throw away from each other. So, and that's really where our office can kind of help students decide. There's just so many cool opportunities. And I think, experiential ed is a really place where students can do some exploration. So we have rotations. I think I mentioned maybe in the past episode, we have different zones for rotations so students can complete rotations out of our area, or they can elect to do everything within kind of 90 miles of the college.

    Katelyn Alexander

    We do have some rotations that students can apply for. So we have rotations with the Tennessee Pharmacists Association. We partner with the FDA, the CDC, with multiple professional associations at the national level like Pharmacy Quality Alliance, the American Pharmacists Association, various other different associations that students can do rotations there.

    Michele Williams

    Katelyn Alexander

    We have rotations, across the country so students can request to do rotations with the Indian Health Service. And we have sites in partnership with the IHS, all the way from Juneau, Alaska to, sites in New Mexico and Arizona, and then close by here and Cherokee, North Carolina, just serving different tribes and different populations of, of Native Americans.

    Katelyn Alexander

    And that stuff that, you know, you may never those types of experiences are things that you might never get to do in your future career. We have rotations. Nuclear pharmacy is where you get to see, radioactive materials. You can do a rotation with the veterinary pharmacy to figure out, how they prepare meds for animals.

    Katelyn Alexander

    We have opportunities with research. I mentioned academia. I think the last, episode, you can do management at a hospital or, a retail pharmacy setting. In a pet pharmacy ownership, like, the possibilities are just endless. And that's what's so cool of helping students figure out there's a lot of different ways that they can prepare themselves for a future career.

    Katelyn Alexander

    And it's fun to be able to help. Help coach them, to figure out how to make that work. And, you know, there's always some, some quirky things. Our office motto is your schedule isn't final until you graduate. Because since we're we're working with all these external folks, you know, some things are always up in the air and a little bit out of our control, but we always guarantee that, you know, students, we will work as hard as we can to provide students with the best experience possible.

    Katelyn Alexander

    It just may be adjusted over time.

    Michele Williams

    For various.

    Katelyn Alexander

    Factors, but, yeah, we have over shoot over 300 preceptors that we work with. Wow. And countless sites. So yeah, lots of different opportunities and, just really exciting to be able to help students find that career that's perfect for them in pharmacy.

    Michele Williams

    That's amazing. And, and I think that, all this information is so incredibly important, experiential. That is such a huge part of pharmacy school. So I really thank you for, for sharing this information with us. And, Doctor Alexander and, Angelina Piano, who works in the Office of Experiential Education. Both great resources. If you have follow up questions.

    Katelyn Alexander

    Come up and see us. We'd be happy to help you. And Sandra Telford, our office coordinator, can you can also point in the right direction. So, we know it's it's sometimes can be a little complicated with, with all the different sites and terminology. So help us help you. Yeah. Don't be a stranger. Alright.

    Michele Williams

    Well, thank you so much, Doctor Alexander.

    Katelyn Alexander
    Thanks for having me. It was fun.

    Michele Williams

    Till next time, thanks for joining us on White Coat Radio.

     

     

    46 min
  • Episode 5 - Part 1 - An introduction to Experiential Education with Dr. Katelyn Alexander

    In this two-part episode, we hear from Dr. Katelyn Alexander, Associate Professor of Pharmacy Practice, who serves as Director of Experiential Education at the ETSU Bill Gatton College of Pharmacy in Johnson City, Tennessee.

    In Part 1, Dr. Alexander gives us a comprehensive introduction to Experiential Education and what students need to know to get the most out of all of their IPPE’s and APPE’s.

    Transcript:

    Michele Williams

    Welcome to White Coat Radio, a podcast from East Tennessee State University at Bill Gatton College of Pharmacy in Johnson City, Tennessee. Each episode, we cover a wide range of topics about the pharmacy school experience, from study tips to deep dives with faculty and student pharmacists. I'm your host, Doctor Michele Williams. In this two part episode, we'll be talking about experiential education with Doctor Katelyn Alexander, associate professor of pharmacy practice and currently serving as the Director of Experiential Education.

    Michele Williams

    Welcome to White Coat Radio, Doctor Alexander, thanks.

    Katelyn Alexander

    So much for having me.

    Michele Williams

    We're really happy to have you here. This is going to be part one of our two part episode on experiential Education. In this segment, we're going to talk about the basics of experiential ed at Gatton. Are you ready to get started?

    Katelyn Alexander

    Yeah, absolutely. Just go for it. Terrific.

    Michele Williams

    So I'm going to be very basic with my first question. What exactly is experiential education?

    Katelyn Alexander

    Yeah. So for students who have not been in a professional program before or in a health science major, it probably isn't something they're familiar with. So experiential education is experience driven. You may have heard of it as more along the lines of an internship, a clinical, sometimes called just place it. But it's basically things that happen outside of the classroom.

    Michele Williams

    Okay. Okay. So I sometimes hear of clinical rotations referred to as IPAs and APIs, or APIs and APIs. I've heard that.

    Katelyn Alexander

    Before. Yep. Depending depending on on who you're talking to. Those are the same. Yep.

    Michele Williams

    So, let's start with IPAs. What are those? Exactly.

    Katelyn Alexander

    So, just for some definition, IPA is introductory pharmacy practice experience. Okay. So these are more foundational. They're more skills driven. They're more to give students kind of an awareness of different areas in pharmacy practice. They're they're definitely more, I wouldn't say solely observational, but it's, I think the expectation are that you, you sort of show up and participate and become more aware of that type of pharmacy practice.

    Katelyn Alexander

    Environment. Okay. And then APIs or APIs are advanced pharmacy practice experiences. APIs occur throughout the entirety of the fourth year.

    Michele Williams

    So, okay, so you don't really start APIs until you're a fourth year pharmacy.

    Katelyn Alexander

    Yeah. So the IP is in the first through third year of the program. And once you clear the IP as you move on to APIs and those advanced practice, experiences, advanced pharmacy practice experiences, really run the entire fourth year. So students are out of the building. They're out in different pharmacy practice environments, for nine months out of that final fourth year of our program.

    Katelyn Alexander

    Okay. Yeah. So there's, there's a lot more variety when it comes to APIs. They differ in terms of expectations in terms of time. So there are some pretty big differences. They're both pharmacy practice driven. But they fall at different times in the program. And the links are much different.

    Michele Williams

    So they're truly more advanced.

    Katelyn Alexander

    Yeah, absolutely. Absolutely.

    Michele Williams

    When do student pharmacists, let's say I'm I'm a new student pharmacist. I'm just starting a program. When can I expect to start going on rotations?

    Katelyn Alexander

    So you'll participate in the introductory IPAs from the moment you walk into the door. Okay. So you'll have some things that occur during the calendar year. So during the semester, there are certain experiences that students have that fit in alongside their classwork. And that's true throughout the first three years. And those might be things like going to abundant Christian living community and working with a group of students to meet with a resident and talk about, their health history, maybe to talk about, some of their experiences.

    Michele Williams

    That a senior living.

    Katelyn Alexander

    It is. Yeah. So the patients are our older adults, and, students are given kind of guiding questions and the experiences crafted around a longitudinal, relationship with that person over the course of several years. So it's really fun. And and fulfilling for a lot of people, like adopting a grandparent. Really. Other things that students get to do during the actual, didactic year include, service hours.

    Katelyn Alexander

    So we have students self-select different, learning opportunities based on what's interest, of interest to them. And then, a lot of the other activities that fall within IPA are skills driven. And they all set up the summer rotations. So the first time you really get to go out on rotation for more of a, immersion rotation, that's what I would call it, where you're in the pharmacy setting for extended hours per day for several subsequent days or in the summers.

    Katelyn Alexander

    So after the first year, the way our curriculum is structured, students go out and spend time in a community pharmacy for two weeks and on rotation, and then in the week or in the year after the summer, after the, second year of the program, they spend two rotations, one in a hospital and one in a clinical setting, usually ambulatory care or an outpatient pharmacy setting.

    Katelyn Alexander

    And in a inpatient setting. More on rounds up in the in the floors at the hospital.

    Michele Williams

    Okay. And and you mentioned, a minute ago, the, the students get to select some of their learning experiences. So do students get to, to pick where they go on rotation or some rotations. And how does that work?

    Katelyn Alexander

    Yeah. So to a degree. So for the community rotation for example, obviously you have to do go to a community pharmacy. And we provide students with lots of different options as far as location, both local and in some of our kind of particular zoned areas where we know we have a lot of student interest and good preceptor sites, and you get to rank preferences, you rank preferences based on site, preceptor and time.

    Katelyn Alexander

    And usually we're able to accommodate most students requests.

    Michele Williams

    Oh, nice.

    Katelyn Alexander

    Yeah. So the only thing that usually we can't place students at is a place where they're employed, because we want students to have a diverse experience. So we wouldn't want someone who works, for example, at CVS to do a rotation there as well. We'd want them to see the way another community pharmacy would operate.

    Michele Williams

    Okay, that makes sense. And, you mentioned some of the places that students go on rotation and community pharmacies. What are some of the other rotation sites that students can go to?

    Katelyn Alexander

    Sure. So for IP is then after the second year, students got to health systems and spend a two week placement.

    Michele Williams

    Health systems are hospital.

    Katelyn Alexander

    Hospitals, right? So they'll be, in the central dispensing area or the main pharmacy of a of a hospital. And we primarily partner with Ballard Health Facilities here in the Tri-Cities. So we have rotations at the majority of Ballard facilities all the way from Greenville, Tennessee, up to Abingdon, Virginia, down to Elizabethton and Sycamore Shoals Hospital, which is they are.

    Katelyn Alexander

    And also here at JCM, which is right across the parking lot. Students sometimes also can go to hospitals in some of our main zoned areas. So we have pockets of rotations that are available in Southwest Virginia and Chattanooga and in, Knoxville area. And so we have health system partners in those places as well.

    Michele Williams

    Great.

    Katelyn Alexander

    So pretty regional. And then the clinical IBP, which also happens in the summer after the second year. That one's pretty diverse. We have pharmacists that are embedded in primary care clinics throughout the region. For more outpatient based care, we have, clinical specialists who round up in the floors in interdisciplinary teams in a hospital. And we have community pharmacies that offer advanced patient care services.

    Katelyn Alexander

    The the element of the clinical rotation, I think that's unique is it's all kind of a team based care, environment. So you're going to see not just what a pharmacist does, but how a pharmacist and the rest of the health care team, impact that patient's health outcomes. That's. Yeah.

    Michele Williams

    So sounds like an important part of it.

    Katelyn Alexander

    Yeah. And it's it's so nice to get to see that that regardless of what area of practice you're in, whether it's in the hospital or out of the hospital, those teams still exist in different ways. So that's a kind of a unique thing about the clinical IP.

    Michele Williams

    Okay.

    Katelyn Alexander

    The APIs though, they are even more diverse. So we talked about practice experiences. There are similar to the IPAs. There are some rotations that every student has to do.

    Michele Williams

    Okay. So they're required.

    Katelyn Alexander

    Yeah. And they're for four of them. Okay. That's dictated by the, body that oversees our, our the design of our curriculum, our accreditation standards. So every student will go on a rotation in their fourth year at a community pharmacy within the main pharmacy in the hospital. In an ambulatory care outpatient pharmacy. And then in some sort of acute care, or inpatient medicine setting.

    Katelyn Alexander

    So again, that kind of rounding on the floor, okay, of, of a hospital environment and then the remaining five rotations. Our elective. So students get to pick and they get to give input on those. So have to be involving patient care. So they might be things like disease state areas. Maybe it's pediatrics or oncology or cardiology or diabetes.

    Katelyn Alexander

    And that can be in the inpatient or the outpatient setting. Some of them are driven by settings. So maybe you're going to a specialty pharmacy to see patient care there or seeing advanced services that are in a community pharmacy. And then some are not patient care focused. So electives that are, focus maybe on research, on management, on academia.

    Katelyn Alexander

    They want to spend a month with me. And then we have all sorts of other unusual ones, which I think we probably get into in the next episode, some of those really unique experiences. But yeah, the fourth year is fun because students can really kind of personalize it. They have a ton of choice.

    Michele Williams

    So an academic AP, that's the I love those because I get to see the students again back on campus.

    Katelyn Alexander

    That's right.

    Michele Williams

    Who what what, is the interest there? So a student that goes on an academic AP, are they interested in teaching or, presenting or.

    Katelyn Alexander

    I think with a lot of the electives, it's just branching out and seeing areas of pharmacy that maybe you're not familiar with. So from an academia rotation, a student might pick it because I always tell students when they come with me, it's like seeing the magic behind Disney. Because you see what you see in the classroom.

    Katelyn Alexander

    But there's so much stuff that goes into why that experience that you have as a learner is the way it is.

    Michele Williams

    Yeah.

    Katelyn Alexander

    So they get to spend some time just figuring out how do we write, exam questions. How do we evaluate exam questions? What goes into researching a lecture? And that's only a fraction of my job. Right. So, service opportunities and research and and now administrative. So students get to see all of that and kind of how we spend our time.

    Katelyn Alexander

    And most students have a very different expectation what they think going in versus what they find out coming out of the rotation. So I think that's true of a lot of the electives in the fourth year. Students will sometimes pick them because, well, maybe it's the only time you're ever going to see that kind of pharmacy practice. Or maybe you're still undecided about a career and just want to kind of explore what your options are.

    Katelyn Alexander

    So, yeah, I think it can be for lots of different reasons that people rank rank different, rotation types.

    Michele Williams

    Okay. Well, that that sounds really interesting, actually. And I, there there are a lot of things that that when you hear experiential education, you don't realize how much goes into it. I, I was surprised when you told me we were talking about this. How much of the curriculum, what's the percentage of the curriculum of pharmacy school comes under?

    Michele Williams

    Experiential education.

    Katelyn Alexander

    It's roughly a third as well. So students spend time in the classroom. But yeah, roughly a third of their overall time spend is with an experiential. So if you think about it, you have these experiential rotations longitudinally throughout the semesters. You have the immersion rotations in the summers. And those all run about two weeks. And there are about 40, about 80 hours total.

    Michele Williams

    Okay.

    Katelyn Alexander

    So then that can differ. So we we schedule students in two week blocks, but the amount of time can vary that they're on site. So they do that over three different immersion rotations across two summers. And then the entire fourth year is really rotation driven where they spend month long blocks, across nine different rotations.

    Michele Williams

    Really tells you the importance of that practical experience and really being in a place and, having those having those educational opportunities.

    Katelyn Alexander

    Yeah. Because what a lot of students will say is I learned it in a classroom, but I, I didn't really understand what that meant or I didn't really I didn't have any practical experience to tie that dizzy state or that concept to. So the really awesome thing about rotations is that students get to go out and see real people and real clinicians problem solving and figuring out solutions to improve the outcomes of those people that they serve.

    Katelyn Alexander

    And also get to apply skills that you can do in a classroom. But it's so much different to do it in a real world environment. So it's sort of stepping you towards being a practitioner yourself, having that autonomy and being ready to make those decisions on your own. And having the skills and confidence to be able to do it.

    Michele Williams

    So, so students get lots of opportunities to practice skills. Yes. And improve and develop as they go through the curriculum.

    Katelyn Alexander

    Sounds like. Yeah. And that's I think why you have the division between the IPS and the AP. So the IP are very they are introductory, the expectations are lower. They are very much practice. We grade them as pass fail. So as long as students kind of show up, they act in a way that's representative of a professional and they do what they're supposed to do.

    Katelyn Alexander

    And they they kind of play along, you know, and they absorb as much as they can. That's really what we're looking for. We're just looking for progress, not perfection. And then the AP is, you know, there are a little more stakes because ideally you can do more because you've been through three years of the curriculum. So you know more, you have more skills.

    Katelyn Alexander

    And now to get you to that place of being an independent practitioner, the stakes are a little higher to ensure that you do have the competency to do it.

    Michele Williams

    That's great. Yeah. So this is all been really helpful and interesting. I hope our listeners find it, informative. And, and so the, the last part of, of this segment of the podcast, I'd like to, to ask you some questions that we're going to call, either fake frequently asked questions or MythBusters. Okay. Come up. So and you've kind of alluded to the answers to some.

    Michele Williams

    Okay. But, this is something that the, I think probably comes up a lot, which is that the terminology, there's a lot of terminology for experiential expectation. So what is the difference between a clinical rotation and an internship and a practicum?

    Katelyn Alexander

    I mean, they're they kind of all get to the same thing, which is a placement outside of, the primary institution where you sit for your classes, like it's something out that is a continuation of what you've learned within the program. I think it just depends on what type of degree you're earning. So maybe an internship is, and I don't, I don't know, I'm thinking, like, business, I think of internships.

    Katelyn Alexander

    But because this is all in clinical settings, we just call them call them rotations or clinical rotations. Other thing that you might think of differently is who the instructor is for the experience. Being a pharmacist, I've actually never gone through practicums or internships, but I'm not sure what their instructors would be called. Maybe they're just instructors, but the instructors for our clinical rotations, we call preceptors.

    Katelyn Alexander

    Okay. So they're the people who, oversee the experience. They might, they're the ones who provide the evaluation and ultimately grade the student at the end.

    Michele Williams

    And this is a pharmacist, right?

    Katelyn Alexander

    Most of them are pharmacists for AP irritations. We do have some non pharmacists that serve as preceptors, but the majority of them are not faculty. So they're not necessarily people that work at the college or that you'll see throughout the rest of the program. There are people who are employed by hospitals and pharmacies in the area and etc., etc., but they volunteer to take students because they want to give back.

    Katelyn Alexander

    As a way of helping the next generation. So, the preceptor is essentially your instructor for that rotation.

    Michele Williams

    Okay. And and you alluded to this, but if I already work in a pharmacy, you said I can't go on rotation in that pharmacy, and it makes sense because you need a new experience. This is time to learn. But the other question is, and is related to that, do can I get paid for being on rotation?

    Michele Williams

    I mean, I'm working right in some cases.

    Katelyn Alexander

    So there are two questions we usually get from students. Can I get paid and also can I test out? So I don't know if that was going to be on your list or not, but so as far as getting paid, the answer is unfortunately no, because it's a rotation. Also you get course credit for so because you're getting a grade it's part of the curriculum.

    Katelyn Alexander

    It would really be a conflict of interest if they were also going to compensate you. So so no, unfortunately because of the rules of our accreditation standards, you cannot be compensated. Because it is a learning environment. It's not it's it's not a hard position. However, we'll talk about, I think, in our next segment that a lot of these opportunities do turn into paid employment down the line.

    Katelyn Alexander

    So even though that two week rotation or four week rotation isn't paid, there's sometimes are opportunities that come out of it.

    Michele Williams

    And then you mentioned, can I, can I test out of a rotation? That was going to be my next question.

    Katelyn Alexander

    Yeah. And a lot of students will ask that because we have we probably have a split. Some probably 50% of our students come in with some form of experience and probably about.

    Michele Williams

    For pharmacy technician. Yeah. Like that.

    Katelyn Alexander

    And some of them it's shadowing, but some of them have been pharmacy technicians, either in a hospital or in community pharmacy for a long, long time. And they'll say, well, if I've worked in a hospital, do I really have to spend this introductory experience for two weeks? And again, the answer is unfortunately, yes, because it's a course within the program.

    Katelyn Alexander

    Our accreditation standards dictate that students have to, over the course of the entirety of the program, achieve so many hours in placement. And our curriculum is designed to give you that many hours for IEPs. It's a minimum of 300 hours. We provide a little bit of buffer, but if you test out of that, I have to find something else equivalent for you to do.

    Katelyn Alexander

    And everything kind of sequentially builds. So our thought is, no, we really need students to do the experiences. You can select, type of practice setting that maybe is different. So maybe you are in a community hospital where you work. Let's go. So maybe a level one trauma center, so much bigger hospital that's seeing much more acute patients.

    Katelyn Alexander

    Maybe you worked at a retail chain pharmacy in the community. Well, let's see what practice would look like in an independently owned pharmacy. So we try to find diversity within that experience so that even though you kind of know the role, you're still getting some new learning opportunities just because of the diversity, of, of pharmacy practice available, available sites.

    Michele Williams

    So it keeps it interesting. Yeah. Adds to a person's knowledge base. It sounds like.

    Katelyn Alexander

    Yeah. And sometimes just because you learn something one way through your work experience doesn't necessarily mean it's the right way or the best way to do something. So it also helps just to make sure that everybody kind of has the same foundational experience and then kind of progresses together.

    Michele Williams

    That makes so much sense. And then if I this is a tough question. If I transfer from another college of pharmacy, let's say I come to get in as P2. Okay. And I had my first year of pharmacy school at another pharmacy, another college pharmacy. Do my or P3 even do my clinical rotations from the other college transfer to Gatton.

    Katelyn Alexander

    So it is a tough question. And the answer is it depends. Okay. So unlike well, not even unlike the didactic curriculums depending on the College of Pharmacy, they go to, they are varied in terms of what's what's in them, what year in the program things happen, how the curriculum is delivered. An experiential is the same. So different schools have different rotations, at different times.

    Katelyn Alexander

    So essentially what we would do is kind of look at what, what experiential learning environment or learning opportunities have you had? Does it line up with our curriculum? Are we going to meet those required number of total hours? And also does the curriculum that you have in the experiences that you have set you up for success in our so our curriculum is designed so that certain things kind of build.

    Katelyn Alexander

    And so we might have you repeat some rotations or some, experiential learning opportunities just to make sure that you're prepared for kind of what comes next.

    Michele Williams

    So if they're not able to, to use those past experiences, it's really in their it's to their benefit.

    Katelyn Alexander

    Absolutely. Yeah. Because we wouldn't want you to go somewhere with expectations that you weren't ready to meet because you hadn't really seen, that type of practice setting or had some skill practice with wherever you're headed. So, yeah, it would it would be for the students benefit.

    Michele Williams

    Okay. Well, thank you so much, for for answering all these questions and for giving us some really basic information about experiential education. I'm, I appreciate it so much. And I'm looking forward to part two of of this particular topic where we do a deeper dive into experiential ad. So until then, thanks so much for joining me.

    Michele Williams

    And, we'll talk to you again soon.

    Katelyn Alexander

    Yeah. Thanks for having me.

     

    25 min
  • Episode 4 – Psychostimulant research and tips for success in Human Physiology with Dr. Brooks Pond

    On this “Pondcast,” Dan and Michele interview Dr. Brooks Pond, Professor of Pharmaceutical Sciences at ETSU Bill Gatton College of Pharmacy and recipient of ETSU’s Distinguished Faculty Award. Dr. Pond talks with us about her fascinating research into the effects of psychostimulant use on the brain, as well as tips for being successful in her Human Physiology course.

    Transcript:

    Dan Vanzant

    Welcome to White Coat Radio podcast from East Tennessee State University Bill Gatton College of Pharmacy in Johnson City, Tennessee. Each episode we cover a wide range of topics about the pharmacy school experience, from study tips and deep dives with faculty and student premises. We are your hosts, Dan Vanzant.

    Michele Williams

    And I'm Doctor Michele Williams, the Gatton academic success specialist. In this episode, we'll be talking with Doctor Brooks Pond, Professor of Pharmaceutical Sciences at the Bill Gatton College of Pharmacy. Doctor Pond teaches human physiology and conducts research into the consequences of psychostimulant use on the brain. She was also the recipient of ETSU’s Distinguished Faculty Award for Teaching in 2020.

    Michele Williams

    Welcome to White Coat Radio, Doctor Pond. Thank you. I guess we should call this episode the pondcast. And you think so?

    Michele Williams

    It works. You're very well known around Gatton as the professor who coordinates human physiology. But your PhD is in pharmacology, particularly neuropharmacology. Can you tell us a little bit about that? Sure.

    Brooks Pond

    So I always loved the biological sciences, and I was actually a biochemistry and molecular biology major in college. And while I was in college, I did undergraduate research with a professor, at my undergraduate institution, at Center in Danville, Kentucky. And it was neuro research. And so I loved neuroscience. Knew that I had an interest in teaching, ultimately.

    Brooks Pond

    And I applied to programs in cell and molecular biology, that would enable me to essentially rotate through multiple different labs. But give me a good broad base of, teaching expertise. And, I ended up at Duke University in that cell and molecular biology program, and I rotated through all neuro labs. But the lab that I chose to ultimately do my thesis work in was a neuropharmacology lab.

    Brooks Pond

    And so my primary, appointment was actually in pharmacology. And so I joined the Department of Pharmacology after my first year, and it was fortuitous because I loved physiology. And to me, pharmacology just really applied physiology. So using their physiological concepts to understand drug action. And so I really enjoyed that, kind of move that it was just serendipitous really.

    Michele Williams

    Yeah. And lucky for us too. So, human physiology that that we mentioned, you you coordinate at Gatton is really an essential and foundational course in the pharmacy school curriculum. If a student wants to be successful in your course, what kinds of things would you recommend that they do?

    Brooks Pond

    So the biggest thing is that we just cover a lot of content in one semester. And I think that the biggest challenge for students and so the biggest piece of advice I have for success is staying on top of your studies and literally adopting a daily study approach as opposed to studying for exams. And so if you go home every night and spend, you know, at least half the time that you're in class that evening and going over what we did in class, I think by the time it comes test time, it's largely going to be review.

    Brooks Pond

    So that's the biggest, piece of advice I have. The other thing is to utilize the worksheet that I provide, as well as the in-class activities that we do to self test. So, you know, you can do those, do the worksheets while we're going through class and enable you to take notes that also utilize those before a test and see if you can fill it in without looking at your notes.

    Brooks Pond

    And you can do the same thing with the in class activities that are designed to be group work, where we're looking at models and answering questions based on the model. But ideally, come test time, students should be able to answer the questions without looking at the model and without engaging with others.

    Michele Williams

    That that makes so much sense. And I, I love that you do that, that you give students a worksheet that actually helps them prioritize what's important during the lecture. So what they should really tune into, because I think especially students who are new to pharmacy school, it can feel like a lot of information is coming at them at the same time.

    Michele Williams

    And so to have that resource to focus your attention and help you to register, oh, she's talking about that thing that's on the worksheet. I think that's terrific. Yeah. So students will see you again later in the curriculum. And what other courses will you be teaching.

    Brooks Pond

    So in the second year I teach a little bit in the renal integrated series. And then I also teach a well, an elective course called Non medicinal Drug Use in the second year. So of course not every student would have that, but some may choose to sign up for that. It's a fun class, and I coordinate that and teach a majority of the content for that class.

    Brooks Pond

    And then I teach quite a bit in the third year, in particular in the third year fall. So I teach in the neuro psych and then also in the endocrine, men's and women's health. That's, recently two classes that merged.

    Michele Williams

    That's great. And and it helps it helps to sort of remind students that the things they're learning in their P1 year, they'll, they'll be hearing about again and they'll be seeing you again. And, there's that continuity throughout the curriculum. I think that's great.

    Brooks Pond

    Yes. In fact, a lot of times I'll use like the exact slides from physiology and my repeats and pharmacology, like remember this. And then we're going to talk about the drugs.

    Michele Williams

    Yeah. So that's terrific.

    Dan Vanzant

    Are there any apps or programs that you recommend students using or that you use in the class that that maybe they wouldn't experience in other classes or that they would find useful?

    Brooks Pond

    Yes. So our book, comes with McGraw Hill Connect, and that is an awesome resource. There's an e-book that you can walk through. There's also exercises with practice questions. There's interactive, figures that you can walk through, and it provides you immediate feedback. So if you mess something up, it'll tell you and explain why that's the wrong answer.

    Brooks Pond

    And you know why the correct answer is correct. And so that's a great resource. So I encourage students to utilize that. I've already assigned, a Gen Cam and Gen bio kind of review, to all students because some students struggled on certain concepts on the pre-assessment that we did on the second day of getting ready. And so hopefully students are already looking at that, some that they have it for all the chapters.

    Dan Vanzant

    So yeah. Okay. And is that the McGraw Hill content. Is that all available through tool or can they go directly to McGraw Hill.

    Brooks Pond

    And so you.

    Michele Williams

    Can.

    Brooks Pond

    You set up a connect and then just bookmark it. But there's a link to connect through our D2L site.

    Michele Williams

    So it's easy to get to. Yes. That's great.

    Dan Vanzant

    That's great. Yeah. So you've done research looking at the long term effects of psychostimulants like Ritalin. Can you tell us more about that?

    Brooks Pond

    Yes. I love talking about this. So, so yes, I have, been at Gatton for 15 years and have been working on a project involving Ritalin for a majority of my time here. So when I was a postdoc, I worked with a guy who was traditionally a Parkinson's researcher, and he became interested. And the link between that long term, spike of stimulant use and, neurodegenerative disease and particular Parkinson's disease.

    Brooks Pond

    And the reason that there may be a link at all is because with, psychostimulants, they all increase their levels of dopamine in the brain. And never mean does a lot of good things is a feel good chemical in the brain. But it can be oxidized to, quinone and actually lead to oxidative stress and neurotoxicity.

    Brooks Pond

    So caused brain cells to die. And, so the thought was that, okay, if we're providing a long term like stimulant that's consistently elevating our dopamine levels, we may be providing this kind of long term oxidative stress that may sensitize those brain cells, to becoming vulnerable, to other insults. And so in his lab, he used a MPC, TP model.

    Brooks Pond

    So MTB as a really super long chemical name one methyl for fennel, 1236 tetra Hydra pyridine. That thankfully we can.

    Dan Vanzant

    See it's at now.

    Michele Williams

    Brooks Pond

    So, but it has a really interesting, sad, but interesting history. It was discovered first actually in humans. So back in the early 80s, there were seven cases of, essentially people developing Parkinson's overnight when they injected themselves with what they thought was going to be like a parodying. So they were trying to, synthesize a synthetic opioid like my parodying, and they sped the reaction and ended up with like 95% in PTB, and they injected themselves with it and killed the same neurons that we see die in Parkinson's disease and had the same symptoms, like severe motor symptoms, like, you know, they were called the frozen addicts.

    Brooks Pond

    And so basically we've used that tragedy. Now we have an animal model that uses that same chemical. And, we use that as a Parkinson's model. And so he used that and essentially he found that there were several different strains of mice had different vulnerability to that toxin. So certain strains exhibited a significant loss of brain cells in the area of the brain that's affected by Parkinson's disease, which is called the substantia nigra.

    Brooks Pond

    And then certain mice strange did not show a loss. And so basically, what, when I worked with him, I found that you could take a psycho stimulant, provide the mouse with a psycho stimulant long term, and it would cause the not vulnerable mouse to become vulnerable. So where once they didn't have a cell loss, they would lose cells.

    Brooks Pond

    And so since then, we've collaborated with him some. But we've also done some independent work in terms of trying to figure out why. And is basically, I think what we thought, which is that you're elevating dopamine. We measured that. We saw increased dopamine quinones, with our psycho stimulant exposure. And, there's a natural and eye oxidant that we have in our bodies, and it's in our brain called glutathione.

    Brooks Pond

    And that can be kind of added to the quinone or conjugated to the quinone to try to protect cells from that, damaging molecule. But you can deplete it. And so we have found that the long term psycho stimulant use depletes glutathione. And so we basically increase this oxidative stress there. And we deplete the thing that's going to protect against it.

    Brooks Pond

    And so ultimately it causes this vulnerability. Well and so yeah, so we have done, done some work with that. So it's been cool stuff.

    Michele Williams

    And it seems like really important research given that Ritalin isn't very common.

    Brooks Pond

    Yes it is. You know, they they estimate like 8 to 10% of school age children, are treated with some kind of psycho stimulant for ADHD. And in fact, like in adolescence, methylphenidate is the number one prescribed drug in adolescents. Yeah.

    Michele Williams

    So it's a lot of food for thought. Yeah, yeah. So.

    Dan Vanzant

    So you also study this, pharmacokinetics of vape substances, like, nicotine. What have you found so far with that research?

    Brooks Pond

    So. Yes. So we've been collaborating with a researcher from the University of Wisconsin, and he has, little rodent vaping chambers. So essentially the mouse, gets put in this chamber and it's like the whole cage goes in there and it, causes, you know, nicotine vapor in the environment. And it's a very controlled manner. So it's a way of like delivering the drug in the way that humans would take the drug, in a very controlled manner.

    Brooks Pond

    And he really wanted to measure the nicotine content in the brain and plasma of these rodents exposed to nicotine vapor. Well, a lot of the methods by which you, measure nicotine are kind of more geared towards measuring nicotine in the vape itself, like, in the fluid. And so you have to have quite a bit higher concentration for those methods to detect the nicotine.

    Brooks Pond

    And so if we're going to detect it in a biological matrix like, plasma or our brain, and we need to get down to the nanogram per mil range, they're pretty low concentration. And so we developed methods that we could do that using our LC‑MS machine over in building 178. And we have developed that and we did we're able to detect our nicotine and, rodents exposed to the nicotine vapor, but we haven't actually conducted any studies yet.

    Michele Williams

    Which is interesting. What is LC‑MS? Dan. Sorry.

    Brooks Pond

    Liquid chromatography, mass spectrometry.

    Michele Williams

    Okay.

    Brooks Pond

    Yes. Yes.

    Michele Williams

    So, I.

    Brooks Pond

    I it's a little bit hard to say.

    Michele Williams

    Yeah. It's just they use that too in those crime shows like.

    Brooks Pond

    Yes. That's right, that's right.

    Dan Vanzant

    I understand that pharmacy students can assist with your very interesting research you've been telling us about. What can students expect from that experience?

    Brooks Pond

    Yes. So I love working with students in the lab. It's a lot of fun to kind of get to know them outside of the classroom. For one, and all of the students that have been through the lab have multiple opportunities to present their research, either locally at the Appalachian Student Research Forum that's held at ETSU each year, as well as national or even international meetings, depending on their interest.

    Brooks Pond

    So I've had a lot of students, present at pharmacy related meetings, like the mid-year meeting is a big one that a lot of students will present, particular when they're thinking residency and want to kind of, mingle, with preceptors in that environment. And then also, I've had students who actually accompany me on my meeting, which I'm a member of a pharmacology society.

    Brooks Pond

    And we, our annual meeting. Sometimes I've gone and presented at that meeting as well. And then I've had, you know, pretty much most people that go through the lab get a publication by the time they graduate, if they do their research concentration in the lab. And in fact, have had a couple students, had two publications by the time they've graduated.

    Michele Williams

    So that's awesome. Yeah. Yeah. Great opportunity.

    Brooks Pond

    Yeah. So.

    Michele Williams

    Well, Doctor Pond, thank you so much for for participating in our podcast today. And, and I look forward to, to learning more about your research and, and I'm sure students are, going to have a lot of great opportunities working with you. So thank you so much for talking to us today. Yeah. Sure thing.

    Dan Vanzant

    All right. Thank you.

     

    18 min
  • Episode 3 – What to expect in Medications and Terminology with Dr. Adam Welch

    Dan and Michele interview Dr. Adam Welch, Associate Professor of Pharmacy Practice at ETSU Bill Gatton College of Pharmacy and nationally-recognized vaccine expert. We learn more about his Medication and Terminology Course as well as his work providing COVID-19 vaccinations to thousands of East Tennesseans through multiple vaccine clinics in the region.

    Transcript:

    Michele Williams

    Welcome to White Coat Radio, a podcast from East Tennessee State University Bill Gatton College of Pharmacy, in Johnson City, Tennessee. Each episode, we cover a wide range of topics about the pharmacy school experience, from study tips to deep dives with faculty and student pharmacists. We are your hosts, Doctor Michele Williams.

    Dan Vanzant

    And I'm Dan Vanzant, instructional design and technology manager. In this episode, we'll be talking with Doctor Adam Welch, associate professor of pharmacy practice at the Bill Gatton College of Pharmacy. Welcome to White Coat Radio, Doctor Welch

    Adam Welch

    Yeah, pleasure to be here.

    Dan Vanzant

    So, students, know you as a professor who teaches the medication and terminology course as well as nonprescription drugs, but they may not know that you are a nationally recognized expert on vaccines and that you were instrumental in ETSU's Covid 19 vaccination clinic effort. Can you tell us a little more about how you came to be a pharmacist and, and a vaccination expert?

    Adam Welch

    So, so vaccines. I started by taking the same course. Pretty much every pharmacy student takes in this country is an American Pharmacists Association's pharmacy based immunization delivery certificate course. Been around for several years. 350,000 pharmacists are taking this course. So I took the same course and I was, you know, I went into residency and I had done some research on perceptions of vaccines and pharmacists giving vaccines.

    Adam Welch

    I was looking at some some physicians in the area and seeing how would they felt about pharmacists joining that, that, vaccination effort. And when I took my first job out of residency, I was working in Pennsylvania at a school of pharmacy. Pennsylvania at the time did not allow pharmacists to vaccinate. In fact, they were the 44th state in the country to allow pharmacists to vaccinate.

    Adam Welch

    So they were kind of late to the game. Relative to other states. Now, Tennessee, you know, they've been allowing pharmacies to vaccinate for much, much longer. I think Washington State may have been the first. In any case. You know, I was my job was to work with community pharmacies, and part of that was to help, as this law was coming out in Pennsylvania, was to allow community pharmacists and give them the skills they needed to be able to start vaccinating their patients.

    Adam Welch

    And I was thinking, working in academia, but wow, this is going to really get big. It's been big in 43 other states, 44th being Pennsylvania. We need to make sure all of our graduates are ready to give vaccines. So this training, this APhA training, we adopted it into our curriculum and mandated for everyone. And it was kind of a big deal.

    Adam Welch

    People weren't ready to, you know, they didn't go to pharmacy school to, to start poking people with needles. It wasn't, you know, it wasn't what they signed up for originally. But, but it became important. It became part of their job description when they when they graduated. And now, every state, Puerto Rico, Washington, D.C., allows pharmacists to vaccinate.

    Adam Welch

    So it really was the right move at the time. But what that did was it got me in with a started to meet the staff, started to understand what their needs are. When they had a project, they would call me, to it to work on it. And I made sure I said yes to those opportunities. I didn't want to pass it off.

    Adam Welch

    If I was busy, I probably still said yes and just worked a little longer during the nights to to get something done. But I established that rapport with some of the staff members at, at and that became important. So I said yes to that opportunity. I also got to know people in in the academia world, in the association world and pharmacy in general.

    Adam Welch

    And what that did was as more opportunities came up, they were thinking of me. I need someone who knows vaccines. Well, I had them up there in Pennsylvania, knows that. Let's, let's let's go call him. And moving forward, I became then a national speaker for the immunization training program. So I started training other companies. I went to probably a dozen different locations, drug companies, chain pharmacies, and taught their folks how to teach the training program for on behalf of APhA.

    Adam Welch

    Few years later, I was asked to serve on a, a workgroup for the Advisory Committee on Immunization Practices. So ACIP that's the group that makes all of the vaccine recommendations in our country. They are they're part of the CDC. And what.

    Michele Williams

    Does that stand for?

    Adam Welch

    The Advisory Committee on Immunization Practices? Yeah. So ACIP so they meet, several times a year and they make all the recommendations for how we use vaccines. Well, all the busy work gets done by a workgroup. So 1 or 2 members of the ACIP work with a series of other experts across the country, and they go through the studies, they go through the evidence, and they figure out how they're going to recommend, you know, what the evidence would suggest for recommendations for these vaccines.

    Adam Welch

    So for a number of years, I was the APhA liaison, meaning I was the only pharmacist on the zoster workgroup. So any shingles recommendation that ACIP put out, I was providing the pharmacist perspective on behalf of the entire profession on behalf of. So that really, I think, step my career forward because I was seeing the folks who are making the decisions about the way we use vaccines, all the way back from Zostavax.

    Adam Welch

    I was on that committee when that became that's no longer on the market now. Shingrix, which is the product we use now for shingles vaccine. So, so it's been a long journey, which got me here and maintaining those, that all of that expertise, you know, when Covid came around, it became, a huge opportunity to provide Covid vaccine to people, as you all know, the pandemic and, I began working with, a physician in the College of Medicine to, to establish those clinics here at ETSU.

    Michele Williams

    Wow. And that that's such a, a good story for students to hear. I think about, saying yes to things even when you're a bit busy. Right. So all these sorts of opportunities seem to come up when you do that. So, as Dan mentioned, you teach the medication and terminology course here at Gatton. And P1, P2 and P3 take that course.

    Michele Williams

    It's also of course, I, I've learned since I've been working here this called drug cards. So obviously knowledge about medications is really at the heart of what pharmacists do. But students can underestimate how difficult this course can be sometimes I think. So can you talk a little bit about the role of the meds in terms course in the curriculum?

    Michele Williams

    And what students can expect as they progress through the course.

    Adam Welch

    In medicine terms, is, is that course in our curriculum? It's it's self-paced. So it's kind of always been the background because because you're not in class, specifically every given Monday, Wednesday, whatever it may be. But it's such an important course because it's focusing on basic knowledge of the top 300 most commonly prescribed drugs in our country. And that list evolves a little bit year over year.

    Adam Welch

    But for the most part, the drugs are very similar on that list. And why that's important is because when you get out onto rotations for your final year of rotations, your P4 year, you need to have that baseline knowledge so that you can begin applying it to patient scenarios. This patient comes in, you have these options because you need to know a little bit about those drugs before you can start applying that.

    Adam Welch

    It's to the higher level, care that you would need. So so this course becomes a way to help you, maintain and polish that that foundational knowledge. We found that, about 30% of our first year class, doesn't have any work experience in a pharmacy formally just yet. They may have shadowed here and there, but formally, they don't have that experience.

    Adam Welch

    So a course like this helps them learn the drugs, and the names of the drugs. And it helps them, be able to associate what we're going to cover in class with something a little more tangible. They remember, and this list of drug, they've seen identifications of the tablet or the capsule, and they've seen some information about it.

    Adam Welch

    So it really ties in the other aspects of the curriculum. By having this medicine in terms course and we build upon it, we, we do it in first year. It's very basic information. We add a little bit more information, we add a few more drugs. So by the end of the third year, this cumulative three year meds in terms course will give you that foundational knowledge.

    Adam Welch

    You need to be successful during your P4 year.

    Michele Williams

    So I've seen the course materials for for the medicine terms course and the spreadsheet of drugs that students are required to learn. It seems quite daunting, I think, especially when someone is first starting the course. So what can students do if they're struggling to remember all that's required? For the drugs in medicine terms, and especially, as you mentioned, if they don't work in a pharmacy and they really haven't had that kind of experience.

    Adam Welch

    Oh, that list can be extremely overwhelming the first time you look at it. It's kind of like buying a loaf of salami. And you may not like salami, right? No, no. All right. So salami. Right. I can tolerate a slice of salami maybe once a day, maybe once every other day, maybe I don't. Maybe you don't like salami.

    Adam Welch

    Pick your whatever. But if I had a whole loaf of salami and I was asked to eat it right now, I couldn't do it. Nobody could do it. I mean, it's a loaf of salami.

    Dan Vanzant

    Gross.

    Adam Welch

    So the idea is that you slice, you take one slice and you eat it, and then you take another slice the next day and you eat it. And by spacing out your consumption of salami and in the educational world, as you know, spaced learning is what they call it. You're able to, you know, by the time you look back, over time, you're able to make it through an entire loaf of salami.

    Adam Welch

    You're able to make it through the entire list of the top 300 prescription drugs, by taking little bits and pieces over time so that repetition in that continuous approach to it, where you’re doing a little bit each time is really the best way to approach a course like this. Can’t eat a whole loaf of salami in one sitting.

    Adam Welch

    You can't study the entire top 300 drugs in one sitting, so you got to space it out.

    Michele Williams

    That makes a lot of sense.

    Adam Welch

    So students, when they approach quizzes and assignments, they really want to get the highest grade. It's just this desire to succeed. You know, certainly with a test you want to score the highest grade because that's a big indicator of your knowledge, skills and abilities. And that's what we use to pass you through the course. But but the quizzes are often worth a small percentage of the course grade.

    Adam Welch

    And in many students that becomes sort of the the easy A. If I just do the work, I can, I can get through that. And and that's important. But the way it's designed in medicine terms is a little bit different. The quizzes themselves are truly designed as a learning tool. So I would rather you take the quiz, score poorly on it, but understand where you scored poorly, which questions you got incorrect, go back and look through it and then take the quiz again.

    Adam Welch

    Maybe you score poorly or a little bit better and you take it again. You score a little bit better. So by that repetition you're able to learn through the process of taking quizzes. It really is a study tool, not an evaluation tool, an assessment tool, the way it's designed in this course. And I think a lot of courses don't always set it up that way.

    Adam Welch

    So, so in order to do well in our version of medicine terms, you need to complete several of these practice quizzes because you're seeing questions about the top 300 commonly prescribed drugs, and you're picking up little tidbits about these drugs through taking these questions on these quizzes. So all we're interested in is at some point you get a 90% and then you can move on to the next one.

    Adam Welch

    But your process to get up there, I don't want students to worry about their grades. I want them to worry about learning what they got incorrect and fixing it for the next time.

    Dan Vanzant

    Yeah, because it's about the exposure to these drugs or the repeated exposure to these drugs. And what they're what they're good for.

    Adam Welch

    Yeah, it's it's important. It's one slice of salami every day.

    Dan Vanzant

    Adam Welch

    Yeah.

    Michele Williams

    And I can't read the lunch and meat of your choice.

    Dan Vanzant

    Yeah.

    Adam Welch

    And I will say, you know, I want to give credit to a former colleague of mine, Doctor James Cohan, who, who used that salami reference one time, and I overheard it. So I'm kind of borrowing, so that's a great reference.

    Dan Vanzant

    It is. Yeah. This is a symmetrical question. Again, this is not on the list, but drug cards. Where does that where did that name come from? Like why why is it called drug cards.

    Adam Welch

    So in our textbook which is, it's online here at Gatton. And we use a system from McGraw Hill called Access Pharmacy. And in there are cards that have information about the top 300 most commonly prescribed medications in this country. So these they're on there printed on what looks like cards. And and I think that's where the term came from that they're drug information on cards but virtually.

    Adam Welch

    So drug cards.

    Dan Vanzant

    Gotcha. And so, so they've it's always been kind of a flash card almost. Yes. Yeah. Sure. Okay. Cool. Thanks. So as a student, you know, going through these 300, 300 slices of salami, or have you found that, there any apps or programs that students have, you know, used? You mentioned that we're not using physical cards anymore.

    Dan Vanzant

    We're using, you know, virtual cards. But what kind of apps? Students found.

    Adam Welch

    Yeah. So as I mentioned before, Quizlet is used a lot now, I think the benefit and something like a Quizlet and there are other apps out there similar to that, and people like the old index card, you know, I'm a little more traditional. I'd rather go buy a package of index cards, but, part of the learning process is the creation of those cards.

    Adam Welch

    So if you rely on somebody else's Quizlet, if you start taking it, yeah, you're going to pick up some information as you go through. But if you have to physically write or even type out the information onto a card, it adds one extra layer of of studying by just simply creating the content that you're going to be studying from.

    Adam Welch

    So with any of these apps, I think if you create it yourself, you're going to get a little bit more out of it than if you're borrowing somebody else's.

    Michele Williams

    It's interesting that you should say that, because often when I talk to students and they say, you know, so-and-so created some some drug cards in Quizlet and they really know their drug cards, and I'll say it's because they created the drug.

    Adam Welch

    Cards through a cards.

    Michele Williams

    So, you know, we've talked a little bit about about vaccines in your expertise and, and vaccinations. And the ETSU vaccine clinics, have provided Covid 19 vaccines to hundreds of people in the region, including me and Dan. That's right. So thanks. Yeah. Can you give us an update on these clinics? Yeah.

    Adam Welch

    Yeah. And we've actually vaccinated thousands of people. We've been really out there in the community, and our students have been involved with tens of thousands of vaccines. So we will go out to hospitals and help them. I remember early in the pandemic, I was volunteering at, the local hospital here and, just going in 530 in the morning and just preparing the doses to give to their staff.

    Adam Welch

    This is early in the pandemic. So we've been involved with a lot of the vaccination efforts. So what happened with ETSU early on? The state, the Tennessee Department of Health, they had some money from the Centers for Disease Control, and they, reached out to universities and said one of the ways we can help vaccinate people is to set up clinics in universities.

    Adam Welch

    They seem to be a community hub in many areas across the state. So, the physician that I was working with and I, developed this pod pod point of distribution for vaccines here at ETSU. Now, I'm not talking ETSU health clinics. This was East Tennessee State University. Let's find a room. And that was the first challenge. And we said, well, you know, at the time we needed free flowing air and space, social distancing and all of that.

    Adam Welch

    So we said, well, what if we did it outside and, you know, it was cold in December. We didn't want to do it then. So then we ended up centering in on, a ballroom that we used for conferences. We have a conference center here called the Millennium Center, and that became our hub, and we started providing vaccines out of it.

    Adam Welch

    And the first time we did it was with a test sample just to work out our kinks for about 50 people. And I think that's where you all may have gotten it. So, and then we moved and provided the vaccine to hundreds of more people in this mass clinic where we there's hundreds of people flowing into the ballroom.

    Adam Welch

    We had stations set up. We mapped out the entire process. We had all these policies in place. All of this took a lot of time. And we're able to vaccinate a large number of people in small amount of time, with lots of help from volunteers, from all of the health science colleges. So, you know, they were certainly instrumental in this process.

    Adam Welch

    And then, you know, as we got that first wave of people vaccinated, we started to notice that the demand for the vaccine started to drop off. And we needed to do more than just have a big mass clinic set up in the Millennium Center. So we started taking our vaccines on the road and we went to small employer groups.

    Adam Welch

    There's a there's a company in Johnson City here that makes hot tubs, and they have a staff of manufacturers that, many of them were not vaccinated. So they invited us down. We set up a table in their lunchroom, the breakroom, and started vaccinating people. We did that a couple times. We went to local churches. We went to, other areas.

    Adam Welch

    We even went to around our own campus, our student union building, where there was a lot of traffic going through, and we started vaccinating people. And even if it was 5 or 6 people a day, it was better than nothing. And it was vaccinating those 5 or 6 people, were important. We did find, we had an early voting site.

    Adam Welch

    We found we set up a booth next to an early voting site that we had. A lot of folks came in to vote inside to get their booster vaccine while they were here. So it was a nice complimentary business. So we did that for a while. That funding dissolved. It served its purpose. And our next project is to really reach out and provide Covid vaccines to people who may not have already gotten it.

    Adam Welch

    So, Tennessee, they're about 45th in the state for Covid vaccine rates. There's a large portion of the population in the state that have not received the vaccine at all yet. I think about 55, 60% of people have been vaccinated. So there's, you know, 40% plus that have not. And that's where the aim is of this next project is to go into socially vulnerable areas, particularly in northeast Tennessee.

    Adam Welch

    There's about nine counties that we're looking at and provide Covid vaccine to people who may not have otherwise gotten it, whether it be to certain barriers or just haven't made the time to go get vaccinated. And I think as flu season picks up and as we cycle through, you know, the time of the year when people have a lot of upper respiratory things happening, I think this will be a great service to the community.

    Adam Welch

    We're also going to partner with some of our College of Nursing clinics, in and around this region that will, provide vaccine were previously they hadn't had vaccine. And that's going to also target that socially vulnerable population. So we're excited about this new project and about being able to, kind of reach out and bring the vaccine to people who may not have otherwise had access to it.

    Michele Williams

    That just sounds great.

    Dan Vanzant

    Did so when you go into those areas where they're, you know, a large percentage of the population that have been vaccine vaccinated, are you doing any kind of media or creating anything in order to kind of make it get the word? Yeah, get the word out or increase people's willingness to come do it?

    Adam Welch

    Yeah, that's the idea. We're going to one. We're going to try to partner with some community leaders within that particular county, that particular area. So we'll have a reason to go. We'll have a liaison there as a partner. And then we're going to utilize ETSU’s marketing team to create messaging to help, help people, be informed when they when they make the decision to get the vaccine.

    Adam Welch

    So so that's the idea. It's going to be a multi-pronged approach to, to help improve the health of our region.

    Michele Williams

    Well, doctor, Welch, thank you so much for joining us today. It's just been a fascinating conversation and we really appreciate you taking the time.

    Adam Welch

    Yeah. Thanks. So much for having me.

    Dan Vanzant

    Yeah. Thanks so much.

     

     

     

    23 min
  • Episode 2 - Excelling at Pharmacy Calculations and Pharmaceutical Research with Dr. Ashana Puri

    Dr. Ashana Puri, Assistant Professor of Pharmaceutical Sciences at ETSU Bill Gatton College of Pharmacy, talks with Dan and Michele about her fascinating research into transdermal drug delivery systems and keys to success in her Pharmacy Calculations course.

    Transcript:


    Michele Williams

    Welcome to White Coat Radio, a podcast from East Tennessee State University Bill Gatton College of Pharmacy, in Johnson City, Tennessee. Each episode, we cover a wide range of topics about the pharmacy school experience, from study tips to deep dives with faculty and student pharmacists. We are your hosts, Doctor Michele Williams.

    Dan Vanzant

    And I’m Dan Vanzant. And in this episode, we'll be talking with Doctor Ashana Puri, assistant professor of pharmaceutical sciences at the Bill Gatton College of Pharmacy. Doctor Puri teaches pharmacy calculations and conducts research involving topical and transdermal drug delivery systems. Welcome to White Coat Radio, Doctor Puri.

    Ashana Puri

    Thank you. Michele, and Dan.

    Dan Vanzant

    To start us off, could you share a little of your background with us? How did you come to be interested in the pharmaceutical sciences?

    Ashana Puri

    Sure. So I am originally from India. I did my bachelor's and master's in pharmacy from India. I always wanted to stay connected to the healthcare field. I came to know about pharmacy, and I was pretty interested in that. And when I was doing my master's, I was working on a project where I had developed a product, a topical product, and I was testing the anti-cancer activity of that, drug.

    And when I saw that the product that I had developed was actually able to, prove the progression of skin cancer, I was like, wow, this is rewarding. And that made me fall in love with the research. And that's when I came to the US to do my PhD in pharmaceutical sciences. Particularly in topical and transdermal systems.

    That's where my educational background ended. And after that, I worked as an associate scientist for one year at Teva Pharmaceuticals. But I always wanted to end up in academics because I love teaching and research. And that's how I came to the Gatton College of Pharmacy.

    Michele Williams

    That's great. And it's very lucky for us, too.

    Ashana Puri

    Thank you.

    Michele Williams

    You're the course coordinator and instructor of pharmacy calculations, which is an incredibly important course in the pharmacy school curriculum. Why is having a strong mastery of pharmacy calculation so important?

    Ashana Puri

    Yes, Michele. That's absolutely right. Pharmacy calculations is a very important and integral part of the pharmacy profession. So, I would say no matter where the students end up, you know, working. Be it as, be it a compounding pharmacy where they are supposed to compound prescriptions, they would have to do calculations to, you know, make the recipe as per the prescription.

    Or if they end up, you know, working in the community pharmacy where they have to fill capsules and take care of the dose that needs to be dispensed, or the more critically, you know, important environment of a hospital where they're dealing with patients and they have to take into consideration, let's say, just the body weight of the patient or other pharmacokinetic parameters.

    It's it's really important for them to, you know, be able to do the right calculations and give the right dose. And as I, as you would imagine, with math, if, you know, one decimal goes here and there, what is going to happen? We all know that. So if it's going to be ten fold less, it's going to be under dosing.

    And you might not see the effect of the drug if it's ten times higher. It's overdosing. And as you can imagine it can be so fatal.

    Michele Williams

    Yeah.

    Ashana Puri

    So that's where we want all the pharmacists to understand their importance in calculations. Miscalculation can actually result in medication errors. And that can be very, very fatal. And so that's that's you know pretty much it like how calculations are so, so important. Just to add a little bit, let's say you're working in the kitchen. You have a recipe you're trying to make.

    And cook something. What happens if you miss something or you don't end up, you know, adding the salt as per what was required. It's just going to ruin your dinner or your taste buds are not going to like it. But what if you're preparing a formulation and you mess up the ingredients in a medicine that can be very, very fatal.

    So, we need to understand the importance of calculations there. And that's where we would emphasize on all these aspects. Teaching the students what they really need to do the calculations correctly. And, and that's that's pretty much it. Calculations is really, really important.

    Michele Williams

    Absolutely. It sounds like it's literally a matter of life and death. If you get the you need to get those calculations correct. Exactly. That's that's amazing. If a student wants to be successful in your course, and I'm assuming all students who start your course want to be successful in your course, what kinds of things do they need to do?

    Ashana Puri

    Sure. So since I'm talking about calculations, as you all know, math is all about practice. So of course I'm going to be there to give them instruction, but it really depends on the students to practice. So the first key to success is going to be practice. The course has been structured in a way where they will be given instruction.

    They will be, asked to participate actively in the class. They'll be given a lot of questions through quizzes, practice quizzes. They'll be allowed to like, work on questions in my presence and of course, outside class as well. So the second thing is to follow the structure as closely as possible. What I have set for them is it's possible for them to practice regularly, because that's the key to success if they solve questions every day.

    That is going to result in their success. Also, I know that students love to study in a group. You know, they love to be with people when they're practicing. But one thing that I've noticed is that students should develop the habit of being able to solve a question independently, all by themselves. Oh yeah. Even though the group helps you to kind of solve the question and understand the concept.

    My advice to students is always to develop the capability of solving the question independently when no one is around you, because that is going to determine your success in an assessment, in an exam. And if you can solve questions with an open book or with a friend at your side, just make sure you can solve questions with closed book and no friend at your side as well, because that is something that I've seen has impacted the success of students.

    So, practice, follow the structure and be able to solve questions independently. And don't be shy and never hesitate to reach out to me or the student tutors for help. That's you're going to be really successful if you do all these things.

    Michele Williams

    That's great. That sounds like great advice.

    Dan Vanzant

    And so you touched on this a little bit, but could you tell us more about, what students can expect regarding the expectations or structure of your course in the classroom, in the classroom, and outside of the classroom?

    Ashana Puri

    Sure. So, for this coming semester, what I'm planning is students will have an opportunity to review the material before class. So it's not going to be a lot. It's going to be like a 30 minute review where you just go through the concept that, you know, doctor is going to talk about this in the class. So I'll just take a look at it and come to class.

    In the class you will be given instruction by me. We're going to solve some questions together. And I'm going to use quizzes for gaming in the class. So I'm going to have questions through the quiz that they have to answer. And they will get a participation credit for that as well. So that's going to be the instruction mostly on Tuesdays.

    When I have a lecture or a two hour lecture. They'll go back home, they'll have a quiz to work on, which is going to be a graded quiz. So, they'll have three days to complete the quiz based on the questions that we have discussed in the class. When they come back to class on Friday, they're going to have a low stakes in-class quiz.

    In my presence, it's going to be open book. They can get help from friends. They can get help from me. All I want for them is to actively solve questions in my presence. Determine their weaknesses and know the areas where they have to work. They go back home. They have additional questions to practice, but they're not going to be graded.

    So like I said, the course has been structured in a way where you get a lot of practice in class and you go back home and you get a lot of practice as well. So my expectation from students is to actively participate in the class and also sincerely work on their homework each day, every day. And that's going to determine their success.

    Michele Williams

    That so there's there's doesn't sound like there's any magic to it. It's really a matter of completing the practice that you have built into the course. They don't have to find their own material to practice with. They can use what you've given them. And another thing I really like about what you just said is that it sort of disrupts what's called the forgetting curve.

    So, within hours after the first, you know, exposure to material, you already start forgetting that material. So if you have the opportunity right after class or as soon as you can after class to go over that material again, or to do it within a day's time, it's going to further encode that material into your long term memory.

    And, and I think what a lot of students miss is that opportunity to practice in that frequent exposure that they'll get if they engage in the materials in your course, it's going to make the time they spend studying for an exam, not as intensive, so they don't have to drop everything in their lives and only do calculations for hours at a time right before the exam, because they've been studying steadily all along.

    And, I think it's great that your course gives them that opportunity to do that. So, I hope students will take advantage of that, because it does sound like the really the key to success in calculations.

    Ashana Puri

    Yeah, I hope so too. And, I would just like to add that, you know, the assessment of the exams, they're all going to be cumulative because the material and calculations build upon what is taught each week. So, I want to challenge students to connect the dots and, you know, question me. How are the two chapters related?

    You know, how am I going to apply all this? So we start with the basics, and students will discover how they're going to actually apply those basics and all the clinical calculations that get along the way in the in the further chapters. So it's all cumulative. They will not have a chance to forget anything. And that's why the course has been structured in a way that they get practice in.

    Like you, you mentioned retention is so, so important. So that was actually my goal when I, you know, decided how to structure this course.

    Michele Williams

    Yeah, it sounds very intentional. And they're going to be thanking you later when they take the NAPLEX. And they remember all those calculations.

    Ashana Puri

    I hope so.

    Michele Williams

    So, if a student doesn't consider themselves a math person, can they still be successful in in your class? And what would you recommend those students do?

    Ashana Puri

    Absolutely. So, the good thing is that we are not doing any high level math here. Okay, so it's not calculus or anything that should scare students. So what the students themselves will discover in the way is pharmacy calculations is more about word problems.

    For them to be able to read the question properly. Most of the times the question is going to be like seven lines or eight lines or a paragraph, and you know, that should not scare them off.

    So the first thing is that the students should know how to read the question and interpret it correctly. So if you understand that situation, you're able to understand what the question is exactly asking you. Then it should not be a problem. So that's the first thing they should know how to do.

    The second thing is the kind of calculations that we do is very basic algebra. So if you know how to cross multiply, if you know how to set up a ratio and proportion, if you know how to do dimensional analysis. Trust me, those students are going to do well and they're going to love the course. You know, if they develop the habit of reading the question. Right, and just applying the basic, you know, those math concepts, like I said, it's not really calculus.

    However, if the student, you know, feels that they're weak in math and that is something that scares them off. I would say early on in the course, they should just work on the basics and kind of strengthen just just the ones like I mentioned. And once they do that, they should be fine all throughout. And of course they're going to be formulas and equations and those are not too bad.

    It's all about memorization and just applying the concept correctly. So and also, you know, like in the second, third year, they actually see these situations and they apply these calculations. So definitely it's going to just help them reinforce and they, they're going to be fine. And they can always reach out to me for help.

    Michele Williams

    That's good to know.

    Dan Vanzant

    Okay. Are there are there any apps or programs that you would recommend for those students who need extra help or want to practice outside of class? Apps that you know, you recommend for students in your class or that you're going to use in class on regular basis.

    Ashana Puri

    So I do not really have an additional app as such or program. Like I said, in the class, we're going to do, a quizzes kind of a game. Rest of it is just going to be the D2L platform for all the quizzes. So the additional practice that they would want to do, I would recommend to, you know, use the book that I'm going to refer to for additional practice.

    But other than that, I don't really have an app or a program that I would ask them to use for this course.

    Dan Vanzant

    So we've talked a little bit about, what students can expect in the classroom. Can you tell us more about your research? What do topical and transdermal delivery systems involve?

    Ashana Puri

    Sure. So, like I said, I do research. I have a research background with, topical and transdermal drug delivery systems. And I do have an independent lab now, working in the same area. Having one PhD student and then some pharmacy students working with me. So basically, I develop the products that can be applied on skin for a local effect of the drug on skin.

    Or it could be the drug actually going into the body transdermal. So also my research is all about skin, and I work with therapeutics and drugs, of course, but I do work on cosmetics as well. So, if there's a project that involves the use of natural products that have, let's say, anti-cancer activity on the skin or something, I would love to develop a product for those kind of, phytochemical, products as well.

    So, topicals and was, let's say formulation of gels or creams or ointments or some of those fancy nanoparticles, micro emulsions and those kind of systems. If someone is familiar about this field, they would have heard about these terms. Transdermal. I work on transdermal patches, as you would see in a pharmacy. And also I work on some fancy active technologies like micro needles or kind of devices, which is like using electric current to push the drug through the skin.

    Or using lasers for drug delivery. So, so like I said, transdermal, it's more of pushing the drug into the system, into the blood. To help, you know, cure any of the diseases in the body. So, so that is that is mostly what I do in the lab. And students get to actually develop these products and then test them on, skin.

    And just, you know, kind of work on those kind of projects.

    Michele Williams

    So when you say, a transdermal patch, for example, with micro needles on it to, to someone who doesn't have a background in, in pharmaceuticals, that sounds terrifying.

    So can you, can you tell us a little bit more about what that involves? A micro needle on a on a transdermal patch, and what kind of medication might be delivered in that in that form?

    Ashana Puri

    Sure. I totally understand how micro needles might sound to someone who doesn't know about it, but let me tell you that micro needles are actually available on Amazon as well. They are, they're more for cosmetic tools, so they're actually used for wrinkle rejuvenation.

    And so you so if you check like, you know, the services offered by a cosmetic clinic, you're going to see Microneedling there as well.

    So it's a cosmetic tool which is now being, heavily involved for drug delivery. And that's what we do. What I do in the lab. So, while there are needles, there are micron size needles. So they are, like, really tiny needles. And let's say there's a patch that has 100 micron sized needles on it. So it's very tiny.

    It's not going to not going to reach your nerve endings. That means you're not going to feel the pain, but they are actually going to help make pores on the skin. So, you know, the difficult drugs that cannot cross the skin will get a channel to cross the skin.

    So that's why we use micro needles mostly for like puncturing the skin deliberately to get our drugs across the skin.

    So that's, that's how I use it for drug delivery, but it depends on the length of the needle if you're going to experience pain or not. But usually we don't go with the long needles that can make someone experience pain. So, yeah. So because it's cosmetic and people use it at home as well. So trust me, it's not painful.

    Michele Williams

    So, when, when pharmacy students work with you on your research, what can they expect from that experience?

    Ashana Puri

    Sure. So, like I mentioned, all the delivery systems that I work on be topical or transdermal. The students would get an experience formulating and developing those products by themselves, so they would get an understanding of how to make the product what is in the product, how would they select the ingredients and that specific composition. So understanding the development of those products will actually help them, you know, when it comes to the pharmacy in their dispensing a product that gives them a better understanding of the ingredients, their role, and you know how they can better counsel the patients?

    So let's say if they're making the transdermal patch and, you know, they ask the patient to not cut the patch, but when they actually make the patch, they would understand how cutting a patch can actually result in overdosing and could be harmful for a patient.

    So, you know, just getting more details about how the product is formulated is going to give them a better idea of how it works. And then, they can be better at patient counseling. So that's one part of product development.

    Like I said, we would test these products on skin to see how the drug will move. So they will have an opportunity to actually work with pig ears because pig ears are ears.

    Michele Williams

    Yeah. Interesting.

    Ashana Puri

    Yeah, they are, very close stimulator of human skin. So the skin barrier that we have resembles, the pigs’ as well. So in the lab, we have these special cells that we work with. So we mount the pig skin on it, and we can test, the permeation of our drugs across the skin, and we can make predictions about how it's going to actually behave in humans as well.

    So they get experience working with pig ears, testing their formulation for drug permeation. Pretty much I do more of like, in‑vitro stuff. So they don't actually test it in animals or humans. They would start from like those basic cells and skin studies. And, they will get an idea of how their formulation is going to behave in the body.

    Other than the students who have worked in my lab so far, they have all, received an opportunity to be co‑authors on a publication. They have presented several posters. So be it regional conferences or national. I try my best to send them out so that they can present as well. And, you know, they can add a lot of value to their CV, and get some good experience from my lab.

    Michele Williams

    So you have a student who will be presenting at AACP, in the coming week?

    Ashana Puri

    Yes, yes. Yeah. So Dakshita Ban, she's, before now, she has worked with me ever since, I think, the one year, really, where she volunteered for research with me and, she's been part of a very important project in my lab where I am developing microneedle for naloxone delivery. For opioid overdose treatment. Well, we've had some interesting data that she's going to go out and present at the AACP.

    And she did at the regional conference. And she won a prize as well. So I'm I'm really, really proud of her.

    Michele Williams

    Yeah, I bet you are. That's terrific.

    Ashana Puri

    Yes.

    Michele Williams

    And it sounds like really fascinating research and a great opportunity for a student to learn more about a particular topic. And I'm, I'm guessing also, looks great on on someone's CV when they're going out, once they're ready to, to look for jobs. That's terrific. That's so interesting. Well, Doctor Puri, thank you so much for for joining us today.

    Michele Williams

    We really appreciate it. And for talking about calculations and about your research.

    Ashana Puri

    You're. Oh, my pleasure. Thank you. Michele, and Dan.

     

     

    24 min
  • Episode 1 - Preparing for Your First Year with Michele Graybeal and Regan Bell

    Our inaugural episode of “White Coat Radio” welcomes the Class of 2026 to ETSU Bill Gatton College of Pharmacy with advice, encouragement, and inside info.

     

    Transcript:


    Michele Williams

    Welcome to White Coat Radio.

    Michele Williams

    Your resource for all things related to the pharmacy school experience. Where your. Michelle Williams, academic success specialist for the College of Pharmacy at East Tennessee State University.

    Dan Vanzant

    And I'm Dan Vance, instructional design and technology manager.

    Michele Williams

    So this is our first episode of White Coat Radio. And we thought it would be great to begin again with the show for our incoming P1s, also known as the class of 2026. So with us today, we have Michelle Gray Graybeal, the student life coordinator here again, and Reagan Bell, a student in the class of 2023 and former president of the student Wellbeing Committee.

    Michele Williams

    So Reagan and Michelle, welcome.

    Michele Graybeal

    Thank you. Thanks for having us.

    Michele Williams

    Well, thanks for being here. So we'll start with you, Michelle Graybill. There's so many things that students need to know before they start pharmacy school. If there were one thing that you could tell them, what would that be?

    Michele Graybeal

    I actually have two things.

    Michele Williams

    Okay.

    Michele Graybeal

    So the first one is, just we are here for you. So at any point, if you feel like you don't know what you're doing or supposed to do, please reach out, because we truly are here for you and we will help you through the process. No matter where you are in pharmacy school. And the second thing would be something that my, one of my professors at Etsu said when I was in college, he would always tell us, be responsible for what you're responsible for, which is pretty simple if you think about it.

    So, that would break down to read your emails, follow instructions. Keep us updated if any changes, and if something isn't clear, please reach out to us. Because while we try to make everything clear, sometimes it doesn't come through that way to a student. So, please don't be shy about reaching out and asking a question.

    Michele Williams

    Great. Thank you so much for that. Raegan, it's been a while since you were an incoming P1. It probably feels like a very long time ago at this point. But what do you wish someone had told you before you started pharmacy school?

    Reagan Bell

    I got a lot of really great advice coming in to pharmacy school. I had the fortunate opportunity, to get to speak to some students before I came. But the two pieces of advice that I gave students coming in whenever I get the chance to talk to them is one. Get involved. I've probably been way over involved in my time here.

    But then my other piece of advice would be, just give yourself some grace. This is a big learning adjustment for everyone. It's an adjustment for our faculty and staff to get to know you. And as adjustment for you just learning how to be a graduate student. There's going to be more material. There's going to be more obstacles and give yourself some grace.

    If you get that one bad test grade or something just doesn't work the way you think, that it should. So that has to be my two pieces of advice.

    Michele Williams

    When? When you started pharmacy school. Outside of. Of course, the academic coursework is rigorous. It's it's not not easy. But what what did you find most challenging about the transition between being an undergrad and being a pharmacy student?

    Reagan Bell

    I think for me, the most challenging thing was just the material that we were learning. And I always tell people this too it's not necessarily any harder than what I was learning in undergrad. It's just a lot more material in a shorter amount of time. And so for me, up until I got to pharmacy school, I truly don't think I've ever had to study a lot.

    Which sounds crazy, but it's true. I just I would study the day before, and I would be fine. And so when I got here, I had to really adjust the way that I learned and the way that I studied. And so I had a few bad exam scores. And honestly, that's why I say, like, it's important to give yourself some grace because I was so stressed out about it, so nervous about it.

    I think I met with you about it. But my professors were reaching out to make sure that I was okay if something was out of the ordinary. And I think that helped a lot to, just kind of ace that stress. To allow me to take the time to study is because I knew that my professors knew what I was struggling with and, like, wanted to give me time to fix it.

    So yeah, I think that was my biggest adjustment.

    Michele Williams

    That that's so important I think to, to talk about with students because you don't get into pharmacy school by being a bad undergraduate student. Right. By being a poor student. And so you have this image of yourself, as always, doing well. And then you get to pharmacy school and I think one of the reasons we reach out so frequently is because it happens so frequently, because the courses are, you know, the level of material and the courses are challenging.

    And so, can you talk a little bit about how you sort of regain that sense of yourself as a student, and what did you do to to sort of feel like I'm okay? I, you know, I had this problem. You said something about giving yourself a bit of grace, but what does that look like?

    Reagan Bell

    For me, I've always been somewhat of a perfectionist. And so when I say giving myself grace, I mean truly anything less than a it was a struggle for me. So the first time I truly did poorly on an exam, was like, I'm never going to make it. I don't know what I'm going to do. And so I have gotten my fair share of poor grades over my time here.

    But for me, Grace just looks like, you know, stepping back and saying. What happened in the time that I studied. Was there something else going on during that time? Did I just not study like I should? And so one year I sat down and studied, differently for the first few exams just to see which one stuck better for me.

    I figured out that if I wrote steps down several times, that was important that I knew I needed to remember. That helped. I started studying with a group after I would study about myself. And it took a little bit of time before I truly started to see my grades reflecting what, what I would envision for myself to be acceptable.

    And even though that might not be a true reality. But yeah, for me, Grace is just giving myself time to figure out what happened when something doesn't go the way that I wanted it to. And the same has gone for organizations that I've been in leadership roles in. When something doesn't work out, just stepping back and figuring out what happened and asking for help if you need it.

    I think that's one of the things that as a pharmacy student, you know, up until this point, you've never really had to ask for help as often as you probably should now. And so I encourage everyone, like if you need help, there's someone who can help you. So just like reach out and they'll connect you with whoever it is, that you need help with or that can help you with the thing that you need help with.

    Michele Williams

    So that's great. And and there that that sounds like great advice. And, considering the fact that that you are just a year away from being finished with pharmacy school, I would say that's a pretty good formula for kind of getting back on track when you need to. That's great. Thank you so much for sharing that.

    And Michelle, what advice do you have for students when they, when they get here in terms of, getting connected and getting involved and, managing all the different things that you want to do along with responsibilities and school.

    Michele Graybeal

    Well, I would say to definitely take advantage of a lot of the, organization meetings that will be happening during the first month of, classes. The student organizations here are amazing. They do wonderful things, and they connect you, to your profession in a way that, I don't think you fully get without them. They're obviously not required participation, but we've heard from students throughout the years that the more involved you get, the more you actually see what is going to interest you in the profession.

    The more connected you you get with professionals and other student pharmacists around the country. And, it actually helps kind of codify what you're doing in the classroom, what you're learning in the classroom with the reality of what pharmacy is. So I highly encourage students to get involved in at least one organization. And you can kind of get your feet wet with one, you know, when you first get here and if that's not the one for you, it's okay.

    You can always switch to a different one or you can add one the next year. Our student organization leaders are really good about, reaching out on a regular basis and giving those opportunities for involvement. Plus, you get to go out into the community and, do some good things in the community.

    Michele Williams

    Yeah, I'm always hearing about the terrific things student hearts do. It makes me really proud to to work again when I read about this. It does.

    Michele Graybeal

    And a lot of times they will feed you. So just got some meetings and I end up with some free food.

    Michele Williams

    So there's an event that's going to be happening during getting ready. That's kind of an interesting way to learn more about the student organizations. Can you tell us a little bit about that what that's going to be like?

    Michele Graybeal

    So we call it the Student Organizations Fair, where we invite, representatives from each of our pharmacy student organizations to come and meet with you.

    So, we're going to split up the P1 class into small groups, and you get to travel around the building and actually visit with those leaders, kind of more of a one on one situation where you really get the to know what each organization is about and what might interest you.

    You're not making any kind of commitment at that point. It's really just, kind of speed dating for student organizations. And it's nice because the upperclassmen who are here get to know some of the new students, too, and I think they enjoy doing that as well.

    Michele Williams

    That's terrific. Sounds like a good way to sort of get get to know people who are not in your particular class and get some advice from upperclassmen and, maybe even find a friend or study buddy or something like that.

    Michele Graybeal

    Yeah, I think it's key to have some connections with some of the upperclassmen as well. That's great.

    Michele Williams

    The incoming students web page that we have is really, really useful, but there are a lot of items on there and it can be a little bit overwhelming. What what is your suggestion for how students might prioritize the items on that page?

    Michele Graybeal

    Yes. I think the overwhelming part is mostly when you see all the deadlines on there. And as we're recording this, the June 5th deadline for most of those requirements has passed. But I don't want anybody to panic. If there's some reason that you weren't able to submit something, then we will work with you on a timeline.

    As long as you're making reasonable progress on those things. So I don't want you to give up on that. Or we will work with you. But beyond the immunizations, basically, you just need to read through the instructions. And if you have trouble again, like we keep saying, reach out. If you go beyond that, it just talk about getting ready and your white coat ceremony, which is kind of your welcome to the profession of pharmacy, the official welcome.

    And getting ready is considered the start of the semester. So you will actually be starting courses as well as some kind of more traditional orientation type activities. So that's August 1st. Your semester starts on August 1st, and then, at the end of that first two weeks is your white coat ceremony, which is very exciting. You get to invite your loved ones to that.

    There's no limit to how many you invite. Although I would say if you're planning to invite 50, maybe give us a heads up. But the venue, the Martin Center for the Arts, it's a really beautiful new venue at Etsu and, its capacity is quite large, so I don't think we'll have any issues with that. And then, beyond that, there's some opportunities to connect with your classmates, either through social media.

    And then, there is some financial aid information on there. So I would say make sure that you have your budget kind of set for the year. There are resources on the financial aid page that's linked there. And just kind of make sure that you've gone through the six steps that Angel, our financial aid director, has laid out for you there.

    It's pretty easy if you just follow her six steps. Make sure you have somewhere to live, that fits within your budget. And if you haven't done that yet, I would suggest you get on it today. And if you have trouble with that, just reach out. But we we do have resources on the web page that will help you figure out some good places to live with recommendations, even from current and former pharmacy students.

    Great. And that's nice. We do add academic information to that page as it's available. So like your academic calendar for the year is out there. And later on we'll send you your, fall exam schedule so that you'll know when your exams will be scheduled. Terrific. Yeah. So also on that page are your computer and technology requirements so that you'll know what to look for as you're purchasing those.

    Michele Williams

    So it sounds like a great resource.

    Michele Graybeal

    Yes. We want it to be helpful and not totally overwhelming.

    Michele Williams

    All right. So as we wrap this up, are there are there any things that, sort of parting words that you, you think our incoming P1s should know or that you'd like to say to our incoming P1s? You're going to get lots of opportunities to talk to them during getting ready as well.

    Michele Graybeal

    All right. So we like to talk about ourselves as a family or a family.

    Michele Williams

    I guess some people call it

    Michele Graybeal

    And it's not just, recruitment tactics. It is real. I've worked here for 14 years and I've seen it throughout my tenure here. We support each other, faculty, staff and students. And so, whether you're struggling or not, just know that we're here for you. And, we truly want you to come and and and seek us out.

    If you're having any issues or have a question that you think is a dumb question that nobody else has, most likely everybody else is thinking the same thing. But we we just want you to know that you're we we're glad that you're here.

    Michele Williams

    Yeah. Great. What about you, Reagan?

    Reagan Bell

    I would just say, first of all, congratulations. You've made it. I think I told you that if I saw you at Farmer Connect day. But I would kind of echo what Michelle said. You know, without the family atmosphere, the last three years would have been so hard, to make it through, to be successful, and to truly, like, come to school, excited to be here.

    I know I asked Michelle all kinds of those dumb questions that she was talking about. But truly, without building those connections with the other students in my class. Or with the faculty and staff here. My experience wouldn't have been the same. So I would encourage you just to really reach out and find someone that you connect with right off the bat.

    To make you feel at home here again. But congratulations.

    Michele Williams

    Well, thank you both so much for for participating in our first podcast or inaugural podcast. And, we'll hopefully have many more after this. And, Dan, do you have any parting words for us?

    Dan Vanzant

    I do not, but thank you for the opportunity.

    Michele Williams

    So with that, until next time.

     

     

    18 min

About White Coat Radio

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“White Coat Radio” provides listeners with helpful advice, stories, and insights from the faculty, staff, and student pharmacists at East Tennessee State University Bill Gatton College of Pharmacy…