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.