NDSU pharmacy students learn how to communicate effectively with patients during healthcare challenges

“I just can’t believe they are sending my mother home on Hospice. I’m not ready to say goodbye,” said one family member. “Plus, my house is full of people and I have to figure out all these medications for her.”

Healthcare professionals in many different settings sometimes face challenging encounters with patients who need care. To gain skills to communicate effectively, NDSU third-year professional pharmacy students receive hands-on training with acting patients to simulate difficult conversations.

Pharmacy students engage with people acting as patients to learn professional and empathetic communication during simulations in the NDSU Aldevron Tower. The NDPhA Pharmacy Instructional Lab and a 10-room exam-room wing serve as the setting for the simulation. The facilities are similar to those that students will find in healthcare facilities when they graduate.

The actors portray patients in scripted clinical scenarios that coincide with a specific medical challenge to help students build their skills. Patients may be hurried, upset about prescription drug costs, embarrassed about a personal symptom, or disagree with the plan of care.

During the training, nine simulation scenarios represent difficult patient encounters in a variety of settings. These include community pharmacy, ambulatory care, emergency department, telehealth, institutional pharmacy, and transition between care locations.

Third-year pharmacy student Brennen Kuntz found the simulation helpful and realistic.

“The biggest thing I learned is how to be caring and show empathy. For those patients who are angry or bothered, showing you care about their needs and that you are trying to help can go a long way. As the pharmacist, you may not have been the one to anger the patient, but you do have the power to change how they feel by providing quality care,” said Kuntz.

The trained and scripted actors role-play as patients or caregivers. Some are unwilling to take prescription medications. Others are overwhelmed, confused, or doubtful. One scenario includes a provider who is demeaning and unhelpful regarding a medication cost concern.

The simulation was designed by Dr. Heidi Eukel, associate professor in pharmacy practice at NDSU.

“This simulation encourages students to think on their feet, respond to each individual patient, and allows them to practice with these difficult encounters in a safe environment and reflect on their performance,” said Eukel.

Students complete self-assessments of their ability to communicate with patients both before and after the simulations.

“I was surprised with how capable I was helping certain types of difficult patients and how much I need to work on my skills with others,” said third-year pharmacy student Brendon Wehri. “I feel like I was adequately prepared helping emotional patients, but I definitely need more work on OTC recommendations.”

Gabrielle Coudron, another third-year pharmacy student who participated in the simulation, said it shows many different skills are needed as a professional pharmacist.

“I was most surprised by how just simply knowing pharmacy knowledge is not enough in situations like this,” said Coudron. “Being able to apply this knowledge but remember those ‘soft skills’ is what is important, because without those skills, you don't have an effective way to communicate with the patient. The information you are trying to provide will be lost if you can't show empathy, understanding and care with these conversations.”

Actors in each scenario portray attributes that require students to respond using communication techniques to call upon pharmacotherapy skills. One scenario includes the need for a language translator and addresses cultural competencies. In another scenario, a family member is scared and confused about her mother’s end of life care plan.

In each scenario, an actor, a student facilitator, and a student pharmacist participate. The actors are trained to provide honest feedback to students following each encounter.

“I gained valuable feedback from the actors after each encounter and learned new tips for success from my partner, as she approached each situation slightly different than I may have, which was great to get a new perspective!” said Emily Lothspeich, third-year pharmacy student.

“Students often discuss the need to think on their feet as they attempt to listen to the patient, recall prior knowledge, think critically, use resources, and incorporate soft skills to carry out patient-centered plans with positive outcomes,” said Eukel. 

The simulation requires limited resources, transfers easily to other schools, and has the potential to meet accreditation expectations of pharmacy schools across the country, according to Eukel.

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