Michigan PharmD Students Making an Impact on Their Community, at Home and Abroad
A
sk Associate Dean Lynda S. Welage, BSPharm'81,
PharmD, to define the foundation of a Michigan PharmD
education, and "community engagement" is bound to
appear on the short list.
"At our College, community engagement is built into nearly everything
we say, do, and teach," Welage says."It is implicit
in the ethics of the pharmacy profession, and is the standard
of conduct we aspire to as University of Michigan pharmacists
and as trusted healthcare professionals. We expect our PharmD
students to be personally committed to making their community
a better place, whether they define community as the place they
work, the specific
town in which they live, or the world at large. We nurture this
through teaching, learning, scholarship, and direct experiences
involving faculty, students, and community in mutually beneficial
and respectful partnerships."
Welage reels off example after example.
Community engagement is ...
- evident in new curriculum refinements, such as the longitudinal
early practice experience (LEPE), matching P-1 students to elderly
residents of Ann Arbor nursing homes and assisted-living centers;
- what motivated Phi Delta Chi members to raise money in support
of cancer research;
- why the College's American Pharmacists' Association-Academy
of Student Pharmacists (APhA-ASP) chapter members visited
kindergarten and first-grade classrooms to talk about the health
dangers of smoking and poison prevention; to teach adults about
the risks of undiagnosed symptomatic heartburn; and to meet
with legislators at the State capitol to teach them what pharmacists
are doing to make their communities better, healthier places;
- what inspired 2007 Dean's Professionalism Award-winner P-4
Carrie Mulvahill to volunteer countless hours at Hope Free Medical
Clinic in Ypsilanti, and to recruit a dozen Michigan PharmD students
to join her
- what sparked 2006 Dee and Fred Lyons Leadership
Scholarship winner Nicole Anderson's decision to join a multidisciplinary
health mission to Guatemala last fall;
-what prompted P-2 Mary Liu to spend last summer in Taiwan,
developing educational programs to steer adolescents and teens
from the path of drug abuse and addiction.
"The examples of community engagement are abundant and
diverse," affirms Nancy Mason, BSPharm'76, PharmD'81,
director of
the office of experiential training and community engagement. "We're constantly
refining the opportunities we have, and adding
new ones every year. In some cases, the initiative begins with
us."
In other cases, we are partnering with other agencies and U-M academic units to meet community needs. Ultimately, every activity, whether part of the curriculum or part of an external collaboration, is directed toward a common goal: to prepare our PharmD graduates to be contributing members of society, to set and achieve the highest standards of clinical excellence, and to be leaders no matter what practice path they choose." What follows is a representative sampling of community engagement> activities in which Michigan PharmD students were involved during the 2006-2007 academic year.
COMMUNITY ENGAGEMENT
Longitudinal Early Practice Experience
In fall term 2006, the College added a new dimension to its
stepped-up program of PharmD student-patient interaction: the
P-1
longitudinal early practice experience (LEPE). With the P-1 LEPE,
two students are paired with a resident of an assisted-living
or independent-
living community. Over the next two years, these students
will meet with their assigned patient a total of eight times.
The P-1
LEPE encounters are designed to help students develop communications
skills, sensitivity, and empathy. Because P-2 students already
do a medication history project with a resident of an assisted-living
community, advancing practice experience to the P-1 year will
help
students derive even more from all subsequent patient interaction
experiences, Mason says.
Performing a concert for residents of Lurie Terrace on Jan. 20, 2007 were
first-year PharmD students, left to right: Arturo Dominguez, Mike
Lu, Philip Williams, Melinda Tran, Theresa
Bomer, Jake
Holler, Jong-Eun Park, and Yi Yu Liu.
"We had previously matched P-1 students with P-4 students via our shadow project, and had P-1 students interview practicing pharmacists as part of their pharmacy practice environment project," explains Mason. "The P-1 LEPE enhances learning by integrating more patient contact, earlier."
P-1s Philip Williams and Michael Lu like the new LEPE. Both are paired with Virginia Newell, a resident at Lurie Terrace, a senior independent-living apartment complex on Ann Arbor's west side.
"I think the longitudinal practice experience is a good idea," says Williams, who works weekends and summers in the central pharmacy at Foote Hospital in Jackson, Mich. "I rarely interact with patients in my current job, and my past work experiences as a U.S. Air Force outpatient clinic medic consisted mainly of contact with pilots and their families: a much younger, comparatively healthy population. As a result, I never had much contact with elderly people, other than my grandparents. Getting to know Ms. Newell has taught me a lot about the way health issues and medication therapies affect the lives of older people."
Lu nods.
"I had no community pharmacy experience before starting at U-M," states Lu, a former employee of both Abbott Laboratories and University research facilities. "My grandfather is one of my favorite people, so it was fairly easy for me to relate to an older person. But there's a different dynamic with a non-family member. Seeing the world through Ms. Newell's eyes gave me a different perspective about aging and complex therapeutic regimens.
"Ms. Newell is also a very bright, lady," Lu adds. "When we met her the first time to interview her, she interviewed us right back," he laughs. "She found out that Phil plays guitar and that a couple of other P-1s also are musicians. Ms. Newell suggested we put on a concert."
So on Jan. 20, a group of P-1s did just that.
"We loved the concert," Newell says. "That put a whole different stamp on things, made the relationship much more personal from the start. I have very positive impressions of these young people and that's the same feedback I'm hearing from the other Lurie Terrace residents who are involved in the [LEPE] program. The Michigan Pharmacy students have been very well mannered, very businesslike, and prompt in contacting us and following up. The students have been well trained to answer questions within their sphere of knowledge and they listen well. I give Michigan a lot of credit for this program."
COMMUNITY ENGAGEMENT
Heartburn Education
Each year, the national chapter of the American Pharmacists' Association-Academy
of Student Pharmacists (APhA-ASP) encourages its local chapters to get
involved in community education projects ranging from asthma, hypertension,
cholesterol, and diabetes awareness to immunization programs; poison prevention
to heartburn awareness; National Pharmacy Week legislative and public
information events to OTC/herbal counseling. Along with APhAASP's
clarion call comes a pre-packaged library of PowerPoint presentations,
brochures, and other collateral materials.
Invariably, the College's APhA-ASP chapter answers the call. In
2006, the College's APhA-ASP chapter responded with hypertension
and diabetes screening events at local pharmacies, heartburn awareness
events, antibiotic resistance awareness and poison prevention
awareness events, and anti-smoking outreach to adults and children.
But Michigan Pharmacy students are not given carte blanche. Rule
No. 1 is that no U-M College of Pharmacy student group is permitted
to make a public presentation with potential clinical consequence
unless the presentation is reviewed by a faculty member, first.
"Our view is that you can't give P-1 and P-2 students a collection
of slides to look at and then declare them experts," explains Professor
of Pharmacy Rosemary Berardi, PharmD'68. "The possibilities
for misinformation are too great. It's not in the best interest of
the
patient, and that's not the way we do things here."
When Berardi, an international authority on gastrointestinal
disease and therapeutics, learned, through Welage and APhA-ASP
faculty sponsor, Clinical Assistant Professor Kristin
Klein, PharmD,
that the College’s APhA-ASP members wanted to make presentations
about heartburn, Berardi volunteered to review the materials.
Berardi and Welage subsequently decided that students could make
the presentations, but only after they had completed the Therapeutics
432 sequence on gastrointestinal disease and therapeutics,
taught by Berardi, winter term, P-2 year. As many APhA-ASP members
are in their P-1 year, Berardi invited them to sit in on the GI
sequence, and many did.
In the meantime, Berardi reviewed the APhA-ASP slides with the
students, helped them pick out those most relevant, and then critiqued
the students' presentation as they rehearsed it.
"We fine-tuned it for content, duration, the questions students
might be asked, and how they should respond to those questions,"
Berardi remarks.
In January and February 2007, the College's APhA-ASP students
made their presentations at an independent-living site and at an
assisted-living site.
"I sat in the back of the room just in case the students needed my
help," Berardi says. "I was taken aback at the number of people
who
showed up for these presentations. And I'll tell you something: our
students were really good. There was an incredible sense of wanting
to participate; wanting to be of help. They took great pride in being
able to use information they had learned to help others. After the
presentation, our students talked one-to-one with members of the
audience, handled out literature, really connected with people. I
thought that was awesome. It made me feel proud, but I think it
made them feel proud, too."
P-2s Josh Bayer and Ruby Leong, who provided the student leadership
on this project and who both work in community retail practice,
were proud.
"One of the biggest lessons I learned, and others have expressed
a similar observation, is how this experience has allowed us to use,
in a practical setting, the therapeutic knowledge we've been taught,"
Bayer explains. "So often when you are in class, you are taught material,
you memorize it, and then you take exams to see how well
you've memorized it. It's sometimes difficult to see how all
these individual pieces add up to professional competence. In the case
of our heartburn presentation, we discussed the topic, but then we
were asked a ton of questions. Even as P-2s, we had acquired enough
knowledge, thanks to Dr. Berardi, to answer nearly every patient
question. I was amazed at how much we knew."
Leong came away with that message--and something else, too.
"This experience reinforced the idea that because pharmacists
are the most accessible healthcare professional in most communities,
they have an ethical obligation to learn as much as possible so
patients can trust their counsel," Leong adds. "You also realize
how important it is to be a good listener: to understand not only what
the patient is asking, but also what information they actually want,
so that you can explain it in a way that is clear, precise, and understandable.
"I'd never done any community outreach programs like this,"
Leong smiles. "Having to stand in front of a group of patients and
present was a little scary at first. So was being the 'expert.' But
once I realized I knew the material and that we had Dr. Berardi there,
I was comfortable."
COMMUNITY ENGAGEMENT
Saying No to Smoking
Vicki Ellingrod, PharmD, is an associate professor of pharmacy
at the College and at the U-M School of Medicine, and an internationally
renowned expert in the use of pharmacological treatments
for mental illness. But it was as the mother of a kindergartner
at
Mitchell Elementary School in Ann Arbor that she reached out
to the
College's APhA-ASP group.
"I could smell tobacco smoke on the clothing of my daughter's
classmates when they came to visit, and I wondered if any of
our st u-dent groups were involved in smoking education in elementary
schools," Ellingrod explains. "I was involved with the Kappa
Psi
pharmacy fraternity at Iowa where PharmD students visited middle
schools and upper elementary schools to give a smoking education
presentation. They discovered that even by this age, students had
already made up their minds. I thought that presenting the message
to early elementary students might have greater impact."
APhA-ASP members made multiple visits to impart an anti-smoking message to kindergarten and first-grade students at Mitchell Elementary School during winter term 2007. Taking part in one such kindergarten visit were PharmD students, left to right: P-2 Jennifer Poon (event co-chair), P-2 Amy Beaulac, P-2 Emily Chang, P-1 Theresa Bomer, P-3 Sapana Patel, P-2 Lesli Fisher, P-2 Karalea Rothenberg, P-2 Heidi Cole, P-2 Lisa Treumuth, and P-2 Mary Liu (event co-chair). Not shown: P-2 Beth McCarty. Photo courtesy: Vicki Ellingrod.
"I explained a few basic concepts about working with this age group, and the ASP students took the idea and ran with it," states Ellingrod. "They developed a complete, 40-minute presentation using some materials from the American Cancer Society and other sources, and created a lot of their own educational materials. They were wonderfully creative."
On four occasions between January and early March 2007, U-M students visited Mitchell. (The first two visits with kindergartners were such a hit that the school principal and teachers asked students to repeat their performance for first graders.)
The ASP students created five different education stations, each with a different activity. One station was a role-playing skit where one U-M student would try to convince a second to start smoking, with children offering advice on how to answer. At another station, children were given straws, told to jump around, and then asked to breathe only through the straw to experience how smoking affects the lungs. Other stations included coloring, fill-in-the-blank and mix-and-match activities; a spin-the-wheel and answer-the-question game; and illustrations showing how air gets from the lungs to the rest of the body, and the effect of smoking on circulation.
"I stood back with the teachers and let our students do what they were best at," Ellingrod says. "Both first-grade teachers told me: 'We have people coming in to make presentations fairly often, but this is one of the best we've ever seen.' I haven't been at U-M long enough to know the curriculum as well as veteran faculty," confides Ellingrod, who joined the College last summer,"but I can tell you these students were great, so we must be doing something right."
P-2s Jennifer Poon and Mary Liu, co-chairs for ASP's smoking cessation committee, who both have community pharmacy experience, say this was their first professional exposure to youngsters. (Liu, however, did work at the National Bureau of Controlled Drugs in Taipei, Taiwan, last summer where she co-developed drug abuse prevention strategies focused on that nation's adolescent and teen populations. See the sidebar on page 12 in this issue of Interactions.)
"I was pleased and a little surprised at how well the kids listened and how eager they were to learn," Poon notes. "Many of the students we met with had parents or grandparents or other family members who smoke. The kids knew that smoking was bad and were trying to get family members to stop. We can't tell them they should do that, but we can reinforce the idea that you should not start. The idea of this outreach was to try to head them off from a harmful habit as soon as possible."
For Liu, who also helped organize a "smoke-free day" program on campus in March, the topic has a personal as well as professional dimension.
"I have a brother who smokes and have seen how difficult it is to stop once you've got the habit," she says. "I want to help steer these kids away from the habit while they are still impressionable. Being involved in public activities such as this also allows you to change people's perspectives about what pharmacy is and what pharmacists can do."
Did the Michigan Pharmacy students leave a lasting impression on the Mitchell Elementary School children?
Just ask Vicki Ellingrod.
"I interact with my daughters classmates every week, and I still hear them talking about 'those people you work with' and the things they taught about smoking," Ellingrod says.
COMMUNITY ENGAGEMENT
Teaching the Lawmakers
As 2006-2007 president of the College's APhA-ASP chapter, P-3
Seema Ganatra was involved, directly or indirectly, in every
one of
the chapter's outreach activities.
Yet her Pharmacy Day visit to the State capitol on Sept. 19,
2006
as part of the State's three-pharmacy school delegation, was a signal
event for her.
The Michigan Pharmacists Association had pitched a tent on the
capitol lawn. Inside that tent were tables managed by pharmacists
and student pharmacists. Tables featured inhaler demonstrations,
bone density and blood glucose screening, blood pressure
screening, and other important, non-dispensing, pharmaceutical
care activities.
Some of the U-M PharmDs who traveled to Lansing on Pharmacy Day, September 2006 to meet with State legislators. Left to right: P-3 Mohammad Hamdan, P-3 Lili Zhao, P-3 Nancy Zou, P-1 Kendra Hsi Min Yum, P-3 Maie Seif, P-3 Seema Ganatra.
Approximately 100 State legislators did visit the exhibits: some in direct response to Ganatra's urging.
"I spoke with four legislators myself and one said, 'I have a family member who is a pharmacist and I didn't realize he had the background training to do these things,'" Ganatra recalls. "It was an important learning experience for the legislators, but also for me. When you are in a situation like that, you realize you are representing not just yourself, but everyone back home."
That experience, and many others as APhA-ASP chapter president,
drove home another message for Ganatra: the absolute importance
of teamwork.
"You are limited by what you can do, yourself," she remarks. "To
accomplish bigger, more complex tasks and projects, you need
the
energy and intelligence of others. I may have the title of president,
but APhA-ASP also has an executive board: president-elect, vice
president, secretary, treasurer, and a treasurer-elect. We have
committee
co-chairs for every project, and lots of faculty support, starting
with our chapter sponsor, Dr. Klein.
"Working with them as a group has clarified my strengths and
weaknesses in terms of leadership position and managing activities,"
Ganatra reflects. "As hard as I've worked, my teammates have
worked just as hard. We picked each other up when needed, and
worked and accomplished well as a group."
Ganatra notes that the College's comparatively small size offers
many opportunities for leadership, and for meeting others of
similar
stripe.
"Even though there are 26,000 students in APhA-ASP, you keep
encountering the same student leaders at national and regional
meetings," explains Ganatra, who completed an internship in the
clinical research/medical affairs department at Novartis in New
Jersey
last summer. "State, regional and national meetings also provide
opportunities to connect with U-M alumni. At the College's March
17
alumni and friends reception in Atlanta, Ga., I met Dr. Ilisa
Bernstein [PharmD'87, JD, senior advisor for regulatory policy, FDA] with
whom I'll be doing a P-4 clinical rotation at the FDA. It was great
to
meet my preceptor ahead of time and to get to know each other
as
U-M pharmacists.
"I definitely intend to stay involved in APhA when I'm in
practice.
I've learned so much already, and I'm just beginning."
