Innovative class project allows pharmacy students to serve real patients
Published: February 13, 2012
NDSU’s pharmacy program has developed a novel class project that allows third-year students to work with real patients before stepping into a professional setting. Through the Thrifty White Concept Pharmacy (a licensed pharmacy located in the College of Pharmacy, Nursing, and Allied Sciences), faculty and staff can volunteer to receive free health and wellness services, while students get to apply their knowledge reviewing medications, and perform blood pressure, cholesterol and blood glucose screenings.
“Throughout our whole pharmacy career we work with simulated patients, but then to actually to have a real patient, it just takes it to a whole new level,” said Natasha Petry, a fourth-year pharmacy student, who participated in the medication therapy management project last spring. “You can do simulation, you can do practice, but nothing is as good as the real thing.”
The students, grouped in pairs, begin preparing for the patient encounter a week ahead of time. They are given a medication list and demographic information for an unidentified volunteer. They do a complete analysis of the medication profile, checking for undesirable interactions – if the medications are being taken correctly, if costly medications could be exchanged for less expensive alternatives or if the number of medications can be reduced.
During the encounter, students talk to patients about concerns and explain medication therapy management. “We just make sure everything is going well for them and see if we can change anything to help them,” Petry said. Throughout the one-hour appointment, a registered pharmacist faculty member is present to answer questions and make sure correct information is given.
Since the project was introduced in spring 2010, many students have identified areas where patients can improve their treatment. For example, some patients were taking medication at the wrong time of day. Some were spending more money than necessary on name-brand prescriptions and others discovered they had dangerously high blood pressure or cholesterol. “It was really neat seeing that the things we learn, when they are applied to a patient, can really make a big difference,” said Nate Leedahl, who graduated from pharmacy in May 2011 and participated in the project in spring 2010.
The students are graded on all aspects of the encounter, including verbal and nonverbal communication. They have to be aware of arm and leg crossing, proper eye contact and filler words. “We watch for how they respond to the patient,” said Heidi Eukel, assistant professor of pharmacy practice, who was instrumental in initiating the medication therapy management project. “Are they really listening or are they just simply giving a response based on what they think they should say.”
Students also practice redirection techniques when the conversation gets sidetracked. A valuable tool, when the one-hour time limit goes faster than most students expected.
Many of the students also contact a physician to make a recommendation for the first time, something they also practice in class. “We felt prepared, but it’s definitely putting our first foot in the water,” Leedahl said. “This is the first time we really practice outside the classroom a real interdisciplinary approach to pharmacy practice.”
Eukel said the skills that they gain during the project transfer to all areas of pharmacy practice. “The skills they’re learning – communicating with patients, evaluating medical profiles, communicating recommendations with prescribers – that’s valuable no matter where you’re practicing.”
Leedahl, who is now a pharmacy resident at Sanford, said medication therapy management is becoming increasingly important. “This was a defining experience in the entire college curriculum for me and it’s something that is really crucial,” he said. “MTM is the future of pharmacy. Residencies around the country are emphasizing this outpatient MTM structure. Tons of people have dedicated their livelihoods to figure out how to implement and fund it in a greater way. Programs that are going to move forward and equip students to practice pharmacy in the future are going to have to have this become an even more crucial aspect of their curriculum.”
NDSU’s medication therapy management project is a model for other schools of pharmacy around the nation Eukel said. Organizers published an article in a national journal shortly after it was introduced in 2010. “At the time it was a very novel approach to introduce MTM because we did have real patients. Some schools are linked with medical schools so they can recruit patients, but this was a novel way of recruiting real patients without paying them or training them as actors. And with trained actors, there’s still that, ‘what did the professor put in here as a mistake or error?’ It’s not really a true experience,” she said.
The class project has had a lasting impact on Petry and Leedahl. “I have to go into multiple patient rooms a day and put a patient and their family at ease with therapy. All those ‘ums’ and ‘ahs’ and arm crossings become very significant when you’re dealing with someone who’s dying,” Leedahl said.
For Petry, who is completing a rotation at the Veterans Affairs Medical Center in Fargo, the project spurred an interest in ambulatory care, which refers to health care services provided on an outpatient basis and is strongly related to medication management therapy. “That lab really brought that out in me,” she said.
Volunteers have been very receptive to the project too. “The patients were so appreciative and so receptive to any knowledge or advice we could give them,” Petry said. “They had lots of questions and it was definitely an environment where our clinical practice could grow and not feel too intimidated.”
This year, faculty and staff can volunteer for the appointments scheduled March 26-30 in the Thrifty White Concept Pharmacy, Sudro Hall room 108. The deadline to sign up is Feb. 23. Faculty and staff from Concordia College, Rasmussen College and Minnesota State Community and Technical College also are invited to participate. Roughly 60 volunteers are needed. Individuals must be on at least three prescription or over-the-counter medications to be eligible.
For more information, call 701-231-7602.