White Coat Radio

Episode 10 - Meet our Student Pharmacists from Puerto Rico

Bienvenidos al White Coat Radio! a podcast from East Tennessee State University Bill Gatton College of Pharmacy, in Johnson City, Tennessee. In this episode, Dan and Michele talk with Gatton student pharmacists from the beautiful island of Puerto Rico to learn more about why they chose Gatton. 
Transcript:
Dan VanzantBienvenidos al 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 to deep dives with faculty and student pharmacists. I'm one of your hosts, Dan Vanzant.
Michele WilliamsAnd I'm Doctor Michele Williams. And today we'll be talking with Gatton student pharmacists Gilary Cortes Oliveras, Yareliz Pellot Soto, and Janer Torres Ramirez, and all of them come from sunny and beautiful Puerto Rico. So welcome, everybody.
HillaryThank you.
YarelizThank you.
JanerThank you for having us.
Dan VanzantAll right. So let's get started by each of you just telling us a little something about yourself.
JanerWell, as was said, my name is Luis Janer, pharmacy student, as you know. But I come from a rural area in Puerto Rico, in the mountains—private farm, privately owned farm. And so even though I feel like I'm pretty extroverted, I was raised in an introverted environment, I guess. But I like to do other stuff. I like drawing, I like to work on cars, and to play the guitar—a lot of instruments. I used to be in a musical group when I was back in my college in Puerto Rico, at the University of Puerto Rico Río Piedras campus. And that taught me a lot, not only in the area of music but in discipline. And so, yeah—that's part of why I'm here too. But that's a long story.
Michele WilliamsWell, thank you.
YarelizWell, that's hard to follow.
Dan Vanzantlaughs
YarelizSo I'm Yareliz. I'm from the west coast of Puerto Rico. I love the beach. I am shy, but I love—I'm a people person. I really enjoy talking to everyone.
JanerYou're also with all the organizations, right?
YarelizYeah. I love to be in all the organizations—well, most of them. I'm in a fraternity, part of the leadership committee. I belong to SNAPhA, to CPFI—that’s the Christian organization—the fraternity PDC, and I'm part of the directive committee.
Michele WilliamsNice.
YarelizIt's me.
Dan VanzantAnd if you wouldn't mind—what year is each of you in the program? Are you all in the same year?
JanerWell, I'm P1.
YarelizI'm in my second year.
GilaryHi. My name is Gilary. I'm the last one. I'm P2. I'm also from Puerto Rico. Of course. I was born and raised in Manatí. I have almost all my family there, so that's kind of hard for me. Normally I am introverted, but I always put myself out there even if it's uncomfortable for me. And I love to talk with people, so probably you'll see me normally quiet, but when you know me, I cannot stop talking. I'm also, like, the realest—I’m in most of the organizations. And I'm part of Phi Delta Chi too. I love to spend time with my family, friends, and read. I love to read as many books as I can, but I don't have a lot of time now.
Michele WilliamsI was gonna ask—if you've been doing a lot of reading for pleasure lately.
GilaryLike, yeah—now we read papers.
Dan VanzantAnd we do.
YarelizAnd we love traveling.
GilaryOh yeah, that is probably the most important thing. I love to travel. I met Yari one year ago—one year and a half—and I have traveled with her more than I’ve traveled with any other person, so I'm happy with that.
Michele WilliamsThat's nice. Well, thanks so much for those introductions. And let's talk a little bit about pharmacy school and what has been your favorite course so far in pharmacy school. And Gilary, we'll start with you—tell us what you enjoy about it.
GilaryOkay. So when I was thinking about this—because this is like a normal question that people ask and I'm always struggling, like, what will it be? But I say like the first one… and the one that made me choose Gatton probably. Or one of the reasons that I chose Gatton was for the interprofessional careers that we have here. I really enjoy meeting people from other—disciplines.
Michele WilliamsDisciplines.
GilaryDisciplines—like med school, nursing, or even I have, personally, my small group that is speech therapy. So it's very good for me to learn about these other disciplines and now know how to work with them. So I really liked that. And I will say that is my favorite.
Michele WilliamsHow about you, Yareliz?
YarelizWell, this is hard for me because I found so many classes so interesting. I loved all the interprofessional classes we have. But like—one of the reasons I chose pharmacy school was because you're an accessible health care provider. So one of the classes that I enjoyed the most was the OTC class. I was able to learn—for example, everyone takes Tylenol, everyone takes Advil, but you never read the instructions because it's something everyone takes. But then you can instruct people: “Oh, you shouldn’t take more than this,” or “If you have this, you should not take it.” I thought it was very interesting in applying and helping others.
Michele WilliamsSo it sounds like you learn a lot about everyday products that people take for granted, but there's a lot more to it. Exactly right. We might need to talk later.
Dan VanzantYeah, yeah.
Michele WilliamsHow about you, Janer?
JanerWell, in my limited experience here in Gatton—only being in one semester and half of the spring semester—I can safely say that my favorite class by far has been anatomy. I just love understanding how the body works and all the systems, how they work together to form this working body.
To me, that's very interesting, very amazing. Before coming here, I knew I loved anatomy. And I've been told by some doctors I know that I should have gone to be a physician. Yes.So I really like anatomy. But I also kind of like the physical pharmacy class, or what they call DDS. But that was probably mainly because it was Dr. Digavalli doing the class, and I found it absolutely wonderful—the way he taught, the tutoring he did. It was just wonderful.
And I really enjoyed that class as well. And obviously, like I said, I like anatomy—but then Dr. Pond… you combine anatomy with Dr. Pond and she’s going to make a great class. And I really enjoyed that one. That’s my favorite.
Michele WilliamsYeah, it does sound great. Makes me want to sit in on those classes more.
Dan VanzantYeah, yeah. See what Dr. Digavalli is doing in the class.
Michele WilliamsYeah.
Dan VanzantSo you all have mentioned inside the class what your favorite classes are. What's been a good experience you've had outside of the classroom?
YarelizFor me, I haven't been able to do a lot because we don't have a lot of free time. But all the hiking trails nearby—I’ve been able to do, I think, three. A professor recommended a whole list of trails and things I should know about Johnson City or nearby.
So it's definitely not the same as Puerto Rico, but Johnson City has its own thing. And it's been nice—at least the trails.
GilaryI will say the same, because we are like a package. When I see Yari, I'm behind.
YarelizSo yesterday, a professor told us, “Oh, it's funny because when I see one, I see the other.”
Dan VanzantReally? laughs
GilarySo I will say the same. But also—I love to cook. So every time we have an exam or something, I go to Yari’s house and I cook for them. That is something good to do outside the classroom without any stress—or at least having a break from the stress.
I just like to be here. I find Johnson City very close to my home in Puerto Rico. I live in a place called Monte Bello, which translates to “beautiful mountains,” and in Johnson City we have a lot. So I feel like home on that side.
JanerEspecially in the summer. Summer looks a lot like Puerto Rico.
GilaryOh yeah.
JanerWell, in my case, I've done so many things, I can't even start to list them here. But just to name a few—we actually went outdoor laser tagging with the girls and the fraternity. We did mini golf. I've gone to the trampoline park. I've done axe throwing. I went to Gatlinburg and saw WonderWorks, and went through… what was that?
GilaryAnakeesta?
JanerAnakeesta! I went to Anakeesta—I love it.
YarelizYou didn't see bears.
JanerI didn't see bears, but I wish I had. It's just very fun to go there.
And the area around Johnson City—the reason I picked Johnson City intentionally before coming here is because of the access to all the things it has. It's big enough to have everything you want, but small enough for people to be kind and for there not to be high crime rates or anything. I really, really like the city. And who knows—maybe I’ll end up staying here after I finish the degree. So yeah—I actually really like it here.
Michele WilliamsNice. So as all of you know, Gatton has the PEER‑E2 program funded by the Tennessee Board of Regents. PEER‑E2 stands for Promoting Engagement, Excellence and Retention for students whose first or best language is not English.
Funds from the program have allowed us to travel to Puerto Rico to recruit students. And Gilary and Yareliz have been members of the recruitment team, and Janer is one of the students we had the good fortune to recruit.
So let's start with the students who have traveled to Puerto Rico as part of the recruitment team. Tell us what that has been like.
GilaryFor me, it has been a very beautiful and excellent experience. I've been to Puerto Rico with the recruitment trip twice, and every time is a different experience. The first time we went with Rochelly—she’s a P4—and we had an amazing experience. We had the opportunity to visit not only schools but also specialty pharmacies in Puerto Rico. And that was a very cool experience.
Before going on that first trip, I didn’t know we had so many specialty pharmacies close to San Juan. That changed me—I’m now looking at that pathway, maybe when I finish my PharmD.
The second time was amazing too. We visited more schools. You have a unique opportunity to talk about your experiences to other students who maybe only think about Puerto Rico and don’t think about the other opportunities we have in the States. It’s very cool to talk with them and see the interest in their eyes.
YarelizFor me, it was my first time going this year, and the experience was awesome. Going back to my alma mater and talking with undergrads—and remembering when I was there too. Even though I hate the spotlight and it’s way out of my comfort zone, it felt so good talking about the school and my experience.
Michele WilliamsAnd remind us again—what is your alma mater?
YarelizInter American University of Puerto Rico.
Michele WilliamsOkay.
YarelizTigers!
Dan VanzantYeah!
YarelizThe students were so engaged. They asked so many questions. They wanted to know much more. Because in Puerto Rico we only have two options for pharmacy school, and they’re both in the capital area. So you don’t really consider going outside of Puerto Rico. We're very family‑oriented, and being far from family is scary. We don’t consider outside, mostly.
But they wanted to know more—“How have you been doing?”“What did you do to get here?”Because usually you think graduate school is so hard it’s impossible. Then they realize it’s not impossible. And they can relate to us.
JanerShe said a lot of things I wanted to say. Even though I've never been on a recruitment trip, I’ve had experience recruiting. I have two friends—one still applying, one recently accepted and already doing the paperwork to get here next year.
Gatton made it easier because the things this college offers are so different from my experience—so different from other colleges I applied to—it’s easy to convince people to come here. Not just because of the college, but the area and the staff. Everyone here is so wonderful and welcoming.
In Puerto Rico, we think entering pharmacy school is extremely hard because there are only two schools, and both are in the top ten hardest to enter in the U.S. So we think that’s what pharmacy school is everywhere. And since we're family‑oriented, we don’t want to leave.
But once I tell them how possible it is—and how accepting the staff is—they’re blown away. They try it for themselves and end up liking it. I hope one day I can make the trip too. That would be awesome.
Michele WilliamsYeah, that would be awesome. So tell us a little bit about what your P1 year has been like. It's coming to an end before you know it.
JanerWell… the P1 year has been—and I don't want anyone to misinterpret this—way easier than I expected. And the reason is that when I was at the University of Puerto Rico Río Piedras campus—the biggest campus—I actually had a harder time getting through my bachelor’s. Not because the classes were hard, but because of everything going on.
Puerto Rico was going through riots, earthquakes, hurricanes Irma and Maria… the governor was thrown out. There was always something happening. And I still had to study on top of that.
One thing I wanted when picking schools was a place that would limit distractions. And that alone made it so much easier to focus on what I needed to focus on—studying. That’s why it’s been easier in my P1 year.
Michele WilliamsThat makes so much sense. A lot of students don’t realize that studying and class rigor is just the beginning—life is still happening. You still have things to manage while you're in pharmacy school. So that’s a very interesting perspective. Thank you for sharing that.
JanerThat's why I feel like most Puerto Ricans are probably prepared to deal with the things they have to deal with here. We've already gone through so much, and we still had to study on top of it—and keep up with homework and grades. A lot of them—if they've done a science degree—they're probably prepared to deal with a pharmacy degree.
Michele WilliamsAre there any other things you'd like to share about your experience at Gatton? So I talked a little bit with Kwaku before this—he’s our graduate assistant—and he gave me some good advice about questions to ask.
He said to ask you all:What information do you need to know coming to pharmacy school, and what information is just good to know?
GilaryI will probably say one of the most important things—at least for me, and I’m still working on that—is finding the best way to study. That made me struggle. I'm still learning what the best way to study is, because not all classes are going to be the same way. And you have to adjust that for each class. So probably if you find the best way to study the first year, the first semester, that will be great.
Michele WilliamsGreat. Thank you. I can help with that too.
YarelizYeah. So absolutely—I'm still struggling on how to study because every professor is different. In one class, we can have multiple professors, and one study way is not going to be the same for another class or professor. So you need to get comfortable with change, I guess.
Michele WilliamsThat’s a good point.
JanerWell, in my case—again, I only went through one semester, so I don't have too much experience. But I can say the earlier you get used to the methods the professor uses to teach, the better it will be in the long run. Don't wait too long to get used to how the professor teaches and how you're supposed to study for the class.
Be quick about getting there. And when you do get there, it will feel much more consistent.
GilaryProbably—don’t be nervous or shy about asking for help. Here, I learned a lot of things, and one of the things I’m very grateful for is the faculty. They have given me a lot of things to get better. Even when I was in Puerto Rico, I never had a person who was like, “Hey, are you doing good?” or “Do you need help?”
So for me it was very difficult to say, “Hey, I need help. This is happening, and I don't know how to deal.” So probably—if you come here with an open mind, saying, “Okay, this is not going well, I need to ask for help”—please do it. Because they have the tools to help you. And they will help you.
Michele WilliamsGreat. That’s all really good advice.
Dan VanzantCould you give examples of the different teaching styles—how you've had to pivot from one class or professor to another?
GilaryI would say for us—now that we are in P2—cardio has a lot of professors. So sometimes the way they ask the questions is kind of hard. Also in renal, we have like three different professors. And sometimes when we do something like, “Okay, this is not that good,” we go to the professor to ask what's happening. And they say, “You did good in these questions from this professor, but this professor is the one where you’re not doing well.” So my biggest thing is—some professors are more superficial, some are more specific. So you have to know which specifics you need to deal with.
Dan VanzantOkay.
YarelizFor me—for example—we try everything. Teach someone else, or have someone else teach the class. Take notes, don’t take notes. Do a study guide, do flashcards. Everyone learns differently.
In cardio, with some professors, it’s me and Gilary—we study our material apart, then we come together and say, “Did you understand this?” If I understand it, I explain it to her. If she understands, she explains it to me. In undergrad, I studied by myself because I didn’t have classes with the same people and I was shy. But at the beginning of P1, that didn’t work. Then we started studying together—and that helps the most.
Also, for renal—I bought a whiteboard bigger than I expected for my home. Writing things down and doing diagrams helped me a lot. For other classes, I do a study guide in Word so I can make things prettier.
So it all depends on each individual and each professor.
Michele WilliamsThank you.
JanerYeah. Like they said—we have professors that like to teach in a broad spectrum, and others who like very narrow, specific teaching. You have to be fast at recognizing what type of professor you're dealing with and what type of questions they will give.
One thing I like about Gatton is—they give out a lot of quizzes. They’re meant for practice. Yes, they’re graded, but they help you understand the professor’s question format. When the test comes, you already know what to expect.
The hardest classes are the ones that don’t do quizzes—only lectures. When the test comes, you don’t know what to expect. So if a class doesn’t have quizzes, be careful. Those tend to be perceived as harder.
Dan VanzantInteresting. Thanks.
Michele WilliamsWell, this has been great. Thank you so much for sharing your experiences and advice for future students. And thank you so much for coming today.
JanerThank you for having us.
YarelizThank you for having us today. And now that you mentioned advice, I just thought of something. Sorry! So like, in general—not in regard to classes—I would advise everyone thinking about pharmacy school to not let fear dictate your decisions. I’m not saying don’t be scared… the best decisions of my life, I've made them dead scared. Even if it's scary—if it's what you want—at least try it.
Michele WilliamsYeah. That’s really good advice.
JanerI think we should say adios then. Like, together.
Dan VanzantYeah.
Michele WilliamsDo you have something you'd like to say in Spanish?
JanerOh, yeah.
Dan VanzantMaybe Michele can translate it later. laughs
Michele WilliamsThat's right.
JanerSigue tus sueños.Follow your dreams.
GilaryYeah… I don’t know. I will say, like—
Michele WilliamsSay it to your friends and family.
GilaryMuchas veces se nos hace difícil tomar decisiones por el miedo, como dijo Yareliz, pero si empiezas y tomas el primer paso, después de que estás aquí, todo se hace un poco más sencillo, y en el camino encuentras personas que van a hacer que tu camino sea mucho mejor, así que no tengas miedo.(ENG: A lot of times we find it difficult to make decisions because of fear, like Yareliz said, but if you start and take the first step, then after you are here, everything becomes simpler, and on the way you will find people who will make your path much better, so don’t be afraid.)
Dan VanzantJust beautiful. Yeah.
Michele WilliamsAwesome.
YarelizThe only thing that comes to mind…Donde Dios guía, Él provee.Where God guides, He provides.
JanerSo it sounds like it even rhymes in English.
Dan VanzantThat's good.
Dan VanzantThat’s awesome.
Michele WilliamsWell done, y’all.
Dan VanzantYeah.
JanerAdios, on three.
All¡Adios!
 

Episode 9 - Managing stress and anxiety while in pharmacy school with Dr. Lori Mills

This episode features Dr. Lori Mills, a clinical psychologist who is an expert on mood and anxiety disorders, as well as positive psychology. In addition, she provides counseling services to our student pharmacists at ETSU Bill Gatton College of Pharmacy. Dr. Mills shares valuable advice on how to manage stress and anxiety in order to thrive in pharmacy school.
Transcript:
Michele WilliamsWelcome 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 Michele Williams. In this episode, we'll be talking with Doctor Lori Mills, a licensed clinical psychologist in the state of Tennessee.
Michele WilliamsShe's an expert on mood and anxiety disorders, positive psychology, and counseling. She's a professor at Milligan University. And fortunately for us, Doctor Mills provides counseling services to our student pharmacists here at Gatton. Doctor Mills, welcome to White Coat Radio.
Lori MillsThank you very much. I'm glad to be here.
Michele WilliamsWell, I'm really glad we have this chance to talk to you today because you are an amazing resource for our students. But you and I rarely have a chance to chat this way, and so there are a lot of things I've always wanted to ask you. So before we begin talking about students, can you tell us a little bit about your background and what led you to a career as a psychologist?
Lori MillsSure. I am probably one of those rare people who decided in high school that I wanted to be a psychologist. And I'm from a very small town in Illinois, very small high school. So I never had a psychology class in high school, but I went to Milligan University—actually was where I did my undergrad—and I was a psychology major from day one. Never changed my major, never veered off of that. And then as I prepared to go to graduate school, I didn't know whether I wanted to be a licensed clinical social worker, like a professional counselor, marriage and family therapist, whatever. But one of my professors just kind of steered me towards clinical psychology, and that's where it went. And I think sometimes I say I had a friend who had a very traumatic accident the summer before my senior year, and that kind of solidified my senior year in high school. That kind of solidified that I can be around people going through really difficult things and enjoy—maybe the wrong word—but giving support in that kind of situation. So that sort of solidified, I think, my interest in psychology and doing therapy in particular.
Michele WilliamsSo you had that sense that you had that skill, that ability in you to support people in that way. Well that's awesome. I'm really glad that you do. How long have you worked with pharmacy students again?
Lori MillsSo it has been about six years. I was thinking about this. It's been since the spring of 2016.
Michele WilliamsOkay. And what has that been like?
Lori MillsIt's been very fulfilling. I have really enjoyed it. I'm like a lot of other people who go into clinical psychology. I thought, oh, I'm going to have my own private practice. That's what everyone thinks they're going to do. And then you realize how tough that is to build your own client base and all that kind of thing. So anyway, I fell in love with teaching undergraduate psychology, and that really has been the bulk of my career. But later in my life, I really think I've gotten better at doing therapy. I had to kind of get comfortable in my own skin and I think more confident and self‑assured. And I think I'm a better therapist than when I was a younger person.
Michele WilliamsYou never think about that with therapists. I don't think that they have a learning trajectory too. And they have to get comfortable as well. So being accepted into pharmacy school is a huge achievement, obviously, but it comes with stressors and responsibilities and demands that are not always easy to cope with. If I'm a student pharmacist who's starting to feel pressure in pharmacy school, how do I know it's time to reach out to you?
Lori MillsWell, I think the first thing I would want to say is any time is a good time to reach out to me. I'm always happy to meet with any students. But more to the point of your question, I guess this question made me think of a common theme that runs through mental health and mental illness: when something becomes a problem is when it causes impairment or distress. And so how I would say that is impairment is if this thing that you're dealing with is interfering with your life or interfering with your academic performance, interfering with your relationships, interfering with getting out of bed in the morning. So that would be the impairment piece. And then the distress piece is just, you know, like, I'm feeling really sad. I'm feeling really anxious. I'm feeling irritable all the time. I'm having trouble controlling my anger. Those kinds of things would be the distress. So when either of those—you feel like, yeah, this isn't just something that's been going on for a couple of days, this is lingering and it's causing me problems—that would be a time that I think you say, okay, now's the time to reach out.
Michele WilliamsThat makes so much sense. So to just sort of use that as a kind of measure of, you know, how long has it been going on, and is it interfering?
Lori MillsYeah. And I think, for example—and I know we'll get into things like test anxiety probably later—but maybe a typical situation would be that someone might feel like, wow, I get anxious at test time. Well, most people do, okay? I mean, there's some degree. Yeah. So you are going to feel anxious around tests. But if it's: I can't sleep at all the night before I have a test, I vomit every morning when I have a test, and I have isolated myself from all my social contacts… okay, those are things that are saying this is not sustainable. This is taking away from the quality of your life. Like those kinds of things would be indicators that yes, this has gone beyond what you want to keep happening and something that you might want help with.
Michele WilliamsSo beyond just wanting to do really well, and I'm nervous.
Lori MillsRight. Because I think the vast majority of people have some of that.
Michele WilliamsYeah. And what can a student expect when they make that first appointment with you? What is that going to be like?
Lori MillsOkay. So generally they would have contacted me—and you go straight to me. You generally call me and let me know that you'd like to meet. And I work with you to make an appointment that works for you and for me. And then ETSU owns a house that is probably maybe a mile from the pharmacy school, and it's just in a neighborhood. And so I give you the address of that house, and you come there and meet me. And we meet for 45 or 50 minutes, something like that. That first appointment I generally ask more questions than I would at any other time, just trying to get to know students, asking them what brings you in, tell me a little bit about your family. I ask specific symptom questions to know sort of what they're dealing with. And by the end of the session I get around to, okay, let's try to narrow this down: what are your goals, what do you hope to get out of meeting with me? And then we talk about, okay, yes, that's definitely something we can work on. Because it's one thing to sort of go and pour out a lot of information, but then it's like, well, okay, we have to get some kind of focus to what we're doing and see how we can proceed from there.
Michele WilliamsAnd so the goal setting, that's where you sort of figure out what the plan is—what you're going to do.
Lori MillsYeah.
Michele WilliamsSo one area of expertise—and you alluded to this just a minute ago—is anxiety. And just in the most general sense, what is anxiety? I mean, you hear people say I have anxiety, or test anxiety, or just, you know, I feel anxious. But actually, from your point of view, from an expert point of view, what is anxiety?
Lori MillsI think the closest maybe synonym or word that we use interchangeably with anxiety would be worry. And I would call this anxiety excessive worry. It's funny because we use the word anxiety, or we say anxious, but then there's diagnosable anxiety that rises to the level of disorder. So anxiety—I think a certain amount of it is okay and actually preferable. If you had zero anxiety about starting pharmacy school or zero anxiety about starting your rotations or zero anxiety about a test, you're not going to prepare, you're not going to study, you're not going to perform at the level you need to. But that's not what most of us are dealing with. Most of us are dealing with: my anxiety has gone too far. It's too much. So that's when we sort of say, okay, what can we do to take the edge off of this? We're not trying to remove anxiety. Therapy is just not that magical to do that anyway. But that's not even what we're trying to get to. We're trying to bring it down to a manageable level—a level that's appropriate to the situation. So excessive worry about maybe a specific situation that then takes on these different physical symptoms—shortness of breath, muscle tension, fatigue—and then also cognitive and emotional symptoms like difficulty concentrating, irritability. When it starts to gather in those other kinds of symptoms, I think that's when it becomes more anxiety that's problematic, not just “I feel a little worried about my test.”
Michele WilliamsRight. That makes sense. And just based on your experiences working with pharmacy students, what role do you see anxiety playing in the lives of pharmacy students?
Lori MillsSo I think for some people who maybe again, it's not super problematic, it plays the role of pushing them to work hard. So that's when anxiety is manageable and in check.
Michele WilliamsIt seems almost to me like conscientiousness. You know, if someone is conscientious, they worry what the professor thinks of them or how they're going to perform on an exam, and it seems to just come with the territory of someone who's a conscientious student.
Lori MillsWell, even to put this in another context—if you think about, for example, a school teacher. A lot of people would say a school teacher should have anxiety their first day of school every year. And if they don’t, maybe it’s time to retire or something. If it’s the first day of school and you don't even worry—you just say, oh, I'll just take out my lecture from last year—you might not be invested. So I think yes, that level of anxiety: most people don’t need to worry about having enough. But you’re right, it’s more conscientiousness.
But anxiety also unfortunately plays a very different role for some students. It causes difficulty studying, causes them to be preoccupied with negative thoughts, causes them to underperform, to second‑guess themselves on tests. Even more broadly, thoughts like: should I even be doing this, am I smart enough, do I belong here? So unfortunately I think it plays that role for some students.
Michele WilliamsAnd it’s interesting you say that. Because when I talk with students and they're having difficulty performing on an exam or on a clinical rotation, I often hear them say, “I just drew a blank,” or, “I froze,” or, “I knew the answer but I couldn't say it.” And then after the exam they remember it. I sometimes suspect that might be anxiety.
Lori MillsI think so too. For sure.
Michele WilliamsOkay. And why do you think it's so common? Working with many different types of students over the years, I feel like anxiety is a pretty large part of some pharmacy students' lives.
Lori MillsYes. Let me say something about pharmacy students in particular, and then something broader.
Pharmacy school involves high‑stakes testing. Other types of educational programs may spread grades across papers, presentations, projects—but pharmacy school is very heavily weighted toward tests. And you know you have to get a certain score to pass. Even licensing exams add to that pressure. Financial pressure also lingers in the background.
Then on a broader level, I think our culture feeds anxiety. We live in an “age of anxiety.” We hear about every bad thing happening in the world and feel powerless. The 24‑hour news cycle has been widely discussed as harmful for mental health.
And culturally, we're told we should be happy—and if we’re not, something’s wrong. If we just bought the right product, used the right planner, ate the right diet, decluttered the right things—we’d be happy. This pressure to be perfect contributes to anxiety.
Michele WilliamsYes, you're right. We feel pressure for everything to be going great, and life doesn't always work like that.
Lori MillsI think we have—this is going off‑script—a cultural narrative that says we should work ourselves to exhaustion so that “one day” we can finally enjoy life.
Like the story of the Mexican fisherman. He already had the life he wanted—simple, meaningful—but the Harvard MBA tried to convince him to build an empire so that someday he could retire and do exactly what he was already doing. That’s so much like American thinking. And it's unfortunate.
Michele WilliamsIt is. And it's easy to fall into that pattern, especially in pharmacy school.
Lori MillsYes.
Michele WilliamsSo we talked about anxiety in general—but what is test anxiety? And what tips do you have for helping with it?
Lori MillsTest anxiety is extreme distress in testing situations that interferes with performance.
There is a very high correlation between procrastination and test anxiety. It becomes a chicken‑and‑egg situation. If you procrastinate, you will feel unprepared, which leads to anxiety, which makes you feel overwhelmed, which leads to more procrastination.
Sometimes underperformance gets labeled as test anxiety when lack of preparation is the real issue.
I like to think of it like pain medication: doctors say “we have to get ahead of the pain.” You need to get ahead of the anxiety by preparing early.
Michele WilliamsThat is a great analogy. And you had some tips?
Lori MillsYes. The first is preparing a sufficient amount and studying over time rather than cramming. Spreading out studying reduces anxiety.
Studying effectively is also important—Michelle helps students with that. Not just studying more hours, but studying in ways that actually work.
Self‑care is crucial—sleep, nutrition, exercise, relationships, doing enjoyable things. This is a marathon, not a sprint. You can't deny yourself all self‑care for four years.
Something I found recently that I like is a calming worksheet. On one sheet, you list meaningful quotes, reminders like “breathe deeply,” your goals, your supporters’ names—things that ground you.
Deep breathing helps. Even taking one minute before a test to breathe in through your nose and out through your mouth slows you down.
And refuting negative thoughts. When you’re really anxious, you're probably telling yourself extreme things like “I'm going to fail” or “I can’t do this.” These thoughts are not helpful. You need to have prepared statements like “I can do this,” “I’m prepared,” “I know this material.”
You’re not trying to wipe out all negative thoughts or pretend everything is perfect—just nudging yourself away from the negative extremes.
Michele WilliamsI love that. Being ready to respond to those thoughts makes so much sense.
Lori MillsRight. I come from a cognitive‑behavioral perspective. A lot of people get anxious about having negative thoughts, which makes it worse. Sometimes you can just say, “I'll think about that later. Right now I need to look at this question.”
Or, “That thought isn’t true because I’ve passed every other test.”
Or, “Another way of seeing this is I won’t know every question, but I will know a lot of them.”
Michele WilliamsThat makes so much sense. So what advice would you give pharmacy students with regard to taking care of their psychological well‑being?
Lori MillsOne thing is: not everything should be about pharmacy school or the career of pharmacy. You need interests outside of that. You need friends outside of that. If your whole life is pharmacy school, everything will feel catastrophic when something goes wrong.
Another thing is stepping back and taking a long‑range perspective. Yes, this is hard. It’s supposed to be hard. But you can get through it.
Another important thing is seeking other people's feedback. Students get locked into their own narrative. They’re often afraid to talk to professors because they think the professor will judge them. But professors genuinely care. They want to help. So does Michelle, and so do many others.
Don’t lose connections to people outside pharmacy school. Those relationships remind you who you are beyond grades.
Michele WilliamsYes. I think students don't always realize how many of us are willing listeners. If they see an open door, they can come talk to us. Ninety‑nine percent of the time, we'd be happy to talk.
Lori MillsStudents are more than their grades and test scores. One of my own students once implied that professors only liked the top performers best, and I thought, that's simply not true.
Reaching out—even when it's scary—is important.
Michele WilliamsDoctor Mills, thank you so much for the conversation today. It's been terrific—really helpful. A lot of things I don't think students realize about the resources they have here. Are there any other things you'd like to add?
Lori MillsI would just add—doing things outside of school, like volunteering, is incredibly healthy. One of the most consistent findings in psychology is that helping others makes us feel better.
Getting outside, participating in something bigger than yourself, doing life‑giving things… whatever those look like for you. Identify the activities that energize you and make sure you keep doing them throughout pharmacy school.
Michele WilliamsI think that's great advice. And thank you so much for talking to us today and giving us great tips on maintaining good mental health, and what to do when the pressure is on and we may need a little extra help. Thank you so much for chatting with us.
Lori MillsAppreciate you asking.
 
 

Episode 8 - An introduction to Academic Affairs with Dr. David Stewart

Michele and Dan continue the conversation with Dr. David Stewart, Interim Associate Dean of Academic Affairs and Institutional Excellence and Professor of Pharmacy, about his role as the head of Academic Affairs at ETSU Bill Gatton College of Pharmacy. In this episode, we discuss services the department provides including insights into academic progression and student course evaluations. 
Transcript:
Michele WilliamsWelcome 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 one of your hosts, Doctor Michele Williams.
Dan VanzantAnd I'm Dan Vanzant. Today we'll be talking with Doctor David Stewart, interim associate dean of assessment and academic affairs and professor of pharmacy practice at Gatton. He specializes in cardiovascular pharmacotherapy. In this episode, we'll talk about Doctor Stewart's role as associate dean and learn more about how academic affairs serves the college and most importantly, our students. In particular, we're going to learn more about those course evaluations that students are asked to complete at the midterm and at the end of the semester—where they go and how they are used.
Dan VanzantDoctor Stewart, welcome to White Coat Radio.
David StewartThank you, Dan. It's good to be here.
Michele WilliamsSo, Doctor Stewart, all three of us work in the Office of Academic Affairs—you as dean, Dan as our instructional design and technology manager, and I'm the academic specialist—but I'm not sure our listeners really know all that Academic Affairs does within Gatton College of Pharmacy. Can you tell us a little bit about that?
David StewartYeah. So, you mentioned that I'm the interim associate dean, and I've been doing this role for about a year now. I have to admit, a year ago I don't think I knew all that Academic Affairs had within the College of Pharmacy. I was really fortunate to have some great folks in the office, and as you mentioned, everyone on the podcast here today is part of that office. We also have a director of assessment and institutional excellence, and an office coordinator. So it's a five‑person team.
I would say the two biggest buckets based on the title would be:Academic Affairs covers things like curriculum, and then we have the assessment component. Assessment is really important for our accreditation efforts and also guides a lot of what we do here at the college—curricular design and improvements, etc.
Other things we do include student success, academic progression, instructional design issues for the college, and housing office duties. So those are probably the big buckets.
Dan VanzantGreat. So as I mentioned in the introduction, Academic Affairs is responsible for distributing the midterm and end‑of‑semester course evaluations—formative and summative evaluations. We always encourage students to complete those. But what happens with those evaluations behind the scenes? How are they created? And then what happens when students fill them out?
David StewartYeah, that’s a great question. And I get the same questions from students about how these things are used. Oftentimes it's not even a question—it may be more of a comment: “Why would I fill these out? Nobody ever reads them. I don't think they ever use them. I never see anything change.”
So I think from a student’s perspective, I can see why they would feel that way. What I really try to encourage students to understand—and what I tell them upfront—is how they are used, because I don't think we do a very good job of telling students what we do with the data they provide.
When a student receives a course evaluation—the technical name is a student assessment of instruction (SAI)—we’re asking them about two things: the course and the faculty. There are specific questions for each faculty member and for the course as a whole.
So who gets them?I get a copy in Academic Affairs. The faculty member gets a copy. And the department chair for the faculty member also gets a copy. Our faculty are in one of two departments: the Department of Pharmaceutical Sciences or the Department of Pharmacy Practice. Each department has a chair, and the chair is responsible for reviewing evaluations with faculty each year during annual evaluations.
So these evaluations are used not only by faculty for feedback but also as part of their performance evaluation regarding teaching effectiveness.
As a faculty member myself in Pharmacy Practice, our chair asks us to identify things we plan to change and to provide a written plan for improvements based on student feedback.
I find this very helpful because students often point things out I may not appreciate or didn’t realize were happening.
Students are often hesitant to complete evaluations because we ask for them before finals are due, but they are completely de‑identified and anonymous unless a student includes identifying info. The system anonymizes them immediately—we only get the responses.
Dan VanzantOkay. And did you mention this? Do any of those get added to accreditation documents?
David StewartYes. Accreditation is one of those things—like in healthcare, where the Joint Commission accredits hospitals. If a hospital isn’t accredited, they can’t bill Medicare, and they’ll fail financially.
Likewise, if a College of Pharmacy is not accredited, students cannot sit for the national board exams. So accreditation is essential.
Our accreditors ask us to report on quality improvement and how we use assessment data. We have latitude in how we use our data, but we must always have ongoing quality assurance processes. Evaluations help us show how we collect and use assessment data, including examples of where students suggested things and we implemented changes—or where we developed alternative solutions aimed at curricular effectiveness.
Students often feel like nothing changes because they typically won’t see the changes themselves. It's usually at least a full year before those changes happen—long after they’ve moved on and forgotten about the course.
And sometimes changes are iterative; we might refine something over two or three years. Students may think “They’re still doing that!” when in fact we’re improving it each cycle.
Michele WilliamsAnd they just haven't seen that evolution as it took place.
David StewartRight. By the time the final version comes out, they’ve graduated and are working.
Dan VanzantDo you think that’s true of formative evaluations too? That faculty often don’t make changes mid‑semester, even though the intent is to?
David StewartGreat question—and yes, that may contribute to student frustration. Formative assessments—open‑ended feedback about what’s going well or not going well—are meant to allow short‑term changes.
We usually try to do these around six weeks into the semester. Block courses complicate timing because they’re so short. If we don’t have good systems in place, we might miss the window.
This year we asked faculty for the optimal timing for formative evals so feedback would be meaningful. That worked well.
Best practice is for faculty to close the loop: tell students, “Here’s what I heard, here’s what I can change now, here’s what I may change in the future, and here’s what I can’t change and why.” Students need to feel heard, even if everything can’t change immediately.
Summative evaluations are easier to analyze—Likert scales, trends, comments. We can identify consistent areas for improvement more clearly. But again, students themselves rarely see the results of their feedback because changes occur in the next offering or several offerings later.
Dan VanzantFeels like putting a message in a bottle and throwing it into the sea.
Michele WilliamsBut there is somebody who finds that bottle.
Dan VanzantThat's right—future classmates behind you.
Michele WilliamsYes. Students may not see the benefit of their feedback, but they benefit from the feedback of those who came before them.
David StewartAbsolutely. They are reaping the benefits of previous students’ suggestions, and future classes will benefit from theirs.
Michele WilliamsAnd some students give great feedback, it must be said.
Dan VanzantAs a faculty member, what types of feedback do you find most helpful?
David StewartGeneralizations are helpful, but specific examples are even more helpful. If a student says, “Dr. Stewart could present information more clearly,” I don’t know what that means. But if they say, “For example, when he explains things with a picture on a slide it’s helpful, but when it’s just words, I struggle,” that’s actionable.
If a student says expectations are unreasonable, that’s vague. But if they say, “There was too much pre‑reading—it took me this long—and the assignments took this long,” now I understand.
Michele WilliamsSo when students give open‑ended feedback, it helps if they include rich detail and an example.
David StewartExactly.
Michele WilliamsYou also mentioned Academic Affairs oversees academic progression. Could you talk about that?
David StewartAcademic progression can sound intimidating. But all students are monitored throughout their entire pharmacy education. Each semester, a committee reviews student grades and votes on progression.
If a student earns a non‑passing grade, the committee evaluates what’s needed.
You can’t be a pharmacist if you don’t master the content, so we must ensure competency.
For some students, if they earn a D in one course, they may complete expedited remediation over the summer. Others may need to repeat the course. Students doing very poorly may be dismissed.
The committee advises the dean. Academic Affairs oversees the administrative side—tracking, documentation, ensuring students are treated fairly and consistently.
Our goal is to help students progress. Student success is part of our office. Your role, Dr. Williams, involves supporting students through tutoring, success plans, mentoring, and resources. Students are often hesitant to seek help, but once they do, they often say, “Why didn’t I do that sooner?”
Michele WilliamsYes. Many students don’t realize how much support exists and how invested we are in their success. Pharmacy school is very different from undergrad—but Gatton especially is a supportive environment.
Dan VanzantTheir success is a measure of our success.
David StewartExactly. And if a large number of students consistently struggle, that reflects on us too. Education is always changing. Students today are different from students 20 years ago. Society has changed, K–12 changes, undergraduate differences… we must constantly adapt how we teach. It’s a never‑ending refinement process.
Michele WilliamsYes. That’s part of what makes higher education interesting—it never stays the same.
David StewartThe one thing that stays the same is that it’s always changing.
Michele WilliamsDefinitely. Do you have any other questions, Dan?
Dan VanzantNo, I’m good.
Michele WilliamsWell, Doctor Stewart, thank you so much for talking to us today about the role of Academic Affairs and all the different things our department does at Gatton. We appreciate it very much.
David StewartIt was a pleasure being your guest. Thank you.
Dan VanzantDoctor Williams.
 
 

Episode 7 - Tips for success in Cardiology with Dr. David Stewart.

In this episode, Dr. David Stewart, Interim Associate Dean of Academic Affairs and Institutional Excellence and Professor of Pharmacy Practice, talks with Michele and Dan about the Integrated Series at ETSU Bill Gatton College of Pharmacy and offers important context and advice for success in his cardio course. 
Transcript:
Dan VanZantWelcome to White Coat Radio, a podcast from East Tennessee State University Bill Gatton College of Pharmacy in Johnson City. 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 WilliamsAnd I'm Doctor Michele Williams. Today we'll be talking with Doctor David Stewart, interim associate dean of assessment and academic affairs and professor of pharmacy practice at Gatton. He specializes in cardiovascular pharmacotherapy and is the course coordinator for the Cardio course in the Integrated Series at Gatton, which students take in the spring of their P2 year. In this episode, we'll talk with Doctor Stewart about this very important and challenging course and get some advice on how to get the most out of it.
Michele WilliamsDoctor Stewart, welcome to White Coat Radio.
David StewartThank you. It’s good to be here.
Dan VanZantSo I think many students are a bit intimidated by your cardiovascular course—or “cardio,” as it's known. What do you think makes the course challenging? And should students be nervous about cardio?
David StewartWell, Dan, thanks for the question. I was kind of surprised when you said students are intimidated. Makes me sound like I'm a whole lot meaner than I think I am! Anyway, it is a transitional period for our students. As I talk with students going from P1 to P2 year, they’re beginning to transition from the foundational pharmacy science classes into more of the clinical courses.
Their first experience with that will be the Integrated Series in the fall with the Pulmonary course and the Infectious Disease course—that’s about 4 to 5 credit hours of material from an Integrated Series or clinical pharmacy standpoint. Contrast that with the spring semester: when they return after winter break, they’ll have a five‑credit‑hour course in cardiovascular pharmacotherapy, a two‑credit‑hour renal course, and a two‑credit‑hour GI course.
So for the semester, they’ll be focusing nine credit hours on clinical pharmacy practice and the pharmacology and medicinal chemistry associated with those disease states. That’s about 50% of their time in the classroom. Meaning at any given time, they are in two courses: cardio plus either renal or GI, depending on the half of the semester. That’s nine hours of material per week.
Students sometimes think, “Oh, I have two classes to study for,” but they must think: “This is half of my curriculum.” They need to spend about half of their study time devoted to these courses.
Michele WilliamsThat makes so much sense. I've never thought about it that way before, but that's a really important note for time management—to think of it as, “I should devote at least half of my study time to these courses.”
David StewartWell, and Doctor Williams, I’m not surprised you say that, because when I ask students on day one—while we're going over the content of the course—and I ask about credit hours, I realize students often don’t appreciate what a credit hour means. There’s a criterion behind it. So I explain on day one: allocate time based on credit hours. One credit hour doesn’t deserve as much time as a five‑credit‑hour course.
And also—they cannot get behind in a five‑credit‑hour course. If you think about compounding interest, time compounds like interest. If you put it off until the first exam at the end of month one, you're going to be so far behind, you’ll be in a very deep hole.
Michele WilliamsThat's really good advice—to be proactive and think about it that way. So at this moment, we're at the end of the fall semester. If I’m a student listening before cardio begins—or maybe I’m a P1 thinking about my P2 year—what’s the best way to prepare? What can students do to be ready for cardio?
David StewartOne of the biggest challenges students face is the mindset of making a grade, achieving a bar, then compartmentalizing and moving on. It's understandable—they’ve been doing that for years. But in pharmacy school, you must apply foundational sciences. You build on them continuously.
If a student asked me in December how to get ready for a course that begins in January, I’d say: understand the cardiovascular system. How does the heart work? How does the vascular system work? Blood flow, basic anatomy, heart physiology, contractility, action potentials.
Knowing those fundamentals makes it easier to understand arrhythmias and antiarrhythmic drugs.
Number one thing:Blood flow through the heart, coronary arteries, vascular system.
We’ll talk about stroke, VTE disease, venous and arterial vasculature.
Coagulation is also important—we discuss anticoagulants like warfarin and the DOACs (apixaban, rivaroxaban) versus antiplatelets like aspirin.
Students need to understand mechanistically how these drugs work.
Michele WilliamsThat’s interesting.
Dan VanZantYeah. I never really thought about that before.
Michele WilliamsSo would you say it would be a good idea for a student who struggled with the cardio aspects in physiology to go back through that chapter and review it?
David StewartAbsolutely. Physiology of the cardiac system would be very worth your time.
Second—review the Top 300 cardiovascular medications. There are roughly 75 drugs from the top 300 that we discuss. Knowing the class, generic/brand names—that gives students a leg up when we begin discussing pharmacology, mechanisms, etc.
Dan VanZantMakes sense with the drug cards.
Are there any apps you recommend for review?
David StewartGreat question. I remember getting a PalmPilot in 2001 and thinking it was incredible. Today, we have smartphones—everything is apps. But somewhere around the 2nd or 3rd generation iPhone, I realized technology was moving faster than I was. I used to love it, but now I only use what I need to do my job.
And honestly, I use less technology today than 10–12 years ago because it can distract students. So instead of apps, I recommend learning how to learn.
Read books on academic success, or how to teach yourself material. On day one, I tell students: here is my responsibility as faculty, here is your responsibility as a student.
My job: facilitate learning.Your job: apply yourself and learn the material—not memorize and regurgitate slides. Students who survive on memorizing slides haven't truly learned foundational skills.
If students recognize they are not using good study skills, cardio is a great opportunity to fix that.
If I could get away with it, I’d throw PowerPoint away and go back to handwritten notes. When I hand‑wrote notes, I learned better. PowerPoint often becomes someone else’s way of thinking—not your own.
Michele WilliamsI agree. And handwriting notes is supported by cognitive science. Writing things down starts the encoding process. It's why you remember your grocery list even when you leave it at home.
And it’s more efficient to shop when you create a list.
David StewartExactly.
Michele WilliamsI also have a question about case‑based questions. Cardio requires students to apply what they know. By cardio, they’ve already had some courses with these questions, but students still struggle with them—even P3s. And NAPLEX uses these sorts of questions. How can students become more adept?
David StewartGreat question. And I’ll be blunt: our society wants cheap, fast, easy. But learning clinical material requires time and deep engagement.
Students say:“I struggle with Integrated Series because of the case questions.”
So I ask:Do you understand the material?Or do you only think you understand it?
I often pull up exam reports with Bloom’s taxonomy tagging. Students will say they know the basics but struggle with application. But when we look at basic recall questions—classifications, mechanisms—they miss those too. So they think they know it, but they don’t.
It’s like sports. You don’t learn piano by reading about it. You don’t practice only on the weekend and expect to perform well.
Students often misuse practice tools. They click through quizzes fast, eliminating answers. They get the correct answer the third time and say, “See? I knew it!”—but they didn’t learn.
Correct method:
Take the quiz slowly—as if it’s an exam.
Justify why each option is wrong or right.
If you get it wrong, go back to notes or textbook.
Retake it only after reviewing the content.
Another tool is the Pharmacotherapy Casebook. Students hate it because there’s no answer key. But that’s the point. Like a clinician, you must think through it.
Michele WilliamsYes—flashcards and Quizlet can cause illusions of competence. When the answer is close to the question, you don’t struggle—and struggle is how learning happens.
David StewartExactly.
And another disconnect: students don’t understand the federal definition of a credit hour. For every 1 hour in class, you must spend 2 hours out of class. Minimum. Most students don’t.
They need to budget their time like money. Pencil study blocks into a calendar.
Students try to read slides seven times in 20 minutes instead of spending two hours in deep work. They avoid cases because they “take too long.” But deep learning requires that time.
And distractions make it even harder. Social media apps are engineered to steal attention with dopamine hits. Research shows:When you get distracted, it takes 25 minutes to fully refocus.
Turn phone to silent. Mute laptop notifications. Focus for an hour, then reward yourself with a 5‑minute break.
When I was in school, the library had no phones, no distractions. Students today are at a disadvantage—they have to create their own quiet.
Michele WilliamsI agree completely.
Dan VanZantSo in summary: unplug, get some books, study deeply.
David StewartExactly. I’m a huge proponent of classical learning: reading, writing, thinking.
Dan VanZantDo you remember the viral “Death by PowerPoint” video? I showed it yesterday—talks about distractibility and keeping slides clean and clear.
Michele WilliamsYes. And I do love that tablets let students keep everything in one place. But technology is a tool, not a replacement for thinking. Use it; don’t let it use you.
David StewartI also think students have been conditioned by bad teaching. They come to expect passive PowerPoints instead of real learning.
Michele WilliamsI agree—it goes both ways.
Dan VanZantDefinitely.
Michele WilliamsWell, this has been so interesting, Doctor Stewart. Thank you so much for your time. And I believe we’ll talk with you again about Academic Affairs and some insights regarding that. Thank you so much for your time today.
David StewartThank you. It’s a pleasure to be here.
David StewartAnd—
 
 

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 VanzantWelcome 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 WilliamsAnd 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 WilliamsHe specializes in care of advanced‑age patients with chronic and acute conditions. Doctor Melton and Doctor Gray, welcome to White Coat Radio.
Sarah MeltonThanks for having us.
Jeff GrayIt's good to be here. Thank you.
Michele WilliamsDoctor 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 MeltonWell, 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 MeltonAnd I think it's our goal to provide information so that everybody does sleep the best so they can perform the best.
Jeff GrayYes. 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 GrayAnd so I know there's a desire among students to learn more about this topic.
Michele WilliamsYeah. 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 WilliamsAnd also because it's difficult to sleep when they're worried. What types of things can result from depriving yourself of sleep?
Sarah MeltonWell, 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 MeltonAnd 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 GrayYes. 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 GrayBut 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 WilliamsYeah, and what their needs are to strive for better sleep.
Sarah MeltonWell, 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 WilliamsI 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 MeltonI totally agree. It’s super important to ask.
Jeff GrayYes, there's often a disconnect. Students want consistent sleep but don’t realize how it affects exam performance, athletic events, or other activities.
Michele WilliamsPharmacy 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 MeltonWe 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 GrayI don’t think students realize how much caffeine they’re consuming—many drinks today have several days' worth of caffeine in one serving.
Sarah MeltonWe 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 MeltonAlcohol: binge drinking on weekends severely disrupts sleep. Some drink alcohol to help fall asleep, but chronically this harms sleep patterns.
Jeff GrayOver‑the‑counter products can also interfere with sleep—pseudoephedrine, decongestants, antihistamines taken at the wrong time can be stimulating.
Michele WilliamsSo students should ask: What am I ingesting? How much caffeine? Any allergy meds? Alcohol? It’s not always just stress.
Sarah MeltonExactly. 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 GrayWhere we’re recording now would be a great sleep environment—dim lighting, quiet, gentle HVAC noise.
Sarah MeltonBut naps? Not always a good idea. Napping late makes it harder to sleep at night. Consolidated nighttime sleep is best.
Jeff GrayYes—sleep hygiene is an all‑day process, not just what happens before bed.
Dan VanzantAs a parent, I’ve seen more people recommending melatonin. Have you seen an uptick in students using melatonin or self‑medicating?
Jeff GrayStudents 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 MeltonEvidence 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 GrayBest practice: Don’t try new medications the night before an exam.Follow the same routine you used while studying.
Michele WilliamsThat makes so much sense.
Dan VanzantDoctor Melton, you mentioned blue light. People say not to use devices before bed. Any thoughts?
Sarah MeltonWe 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 GrayStudents still need electronics to study, but that 30–60 minute window helps.
Dan VanzantWhat about fitness trackers and tech that monitors sleep?
Sarah MeltonFitness trackers are helpful—especially for seeing how long it takes to fall asleep (we want 15–20 min), number of awakenings, hours slept.
Jeff GrayMy 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 MeltonThere’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 VanzantThat’s great. We’ll link it in the notes.
Michele WilliamsThis has been fascinating.
Dan VanzantDoctor Gray and Doctor Melton, thank you so much. This has been great information for students about sleep and sleep hygiene.
Sarah MeltonThanks for having us.
Jeff GrayMy pleasure.
 
 
 
 

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 WilliamsWelcome 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 WilliamsIf 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 AlexanderDoctor Alexander, I'm excited for this one.
Michele WilliamsMe too.
Michele WilliamsSo 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 AlexanderYeah, 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 WilliamsYes, 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 WilliamsYep. 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 AlexanderYeah. 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 WilliamsOkay. 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 WilliamsI'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 AlexanderSo 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 AlexanderRotations 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 AlexanderBut 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 AlexanderOr 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 AlexanderPreceptors 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 WilliamsSo 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 AlexanderAbsolutely. 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 AlexanderAnd 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 AlexanderAnd 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 AlexanderAnd 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 AlexanderSo 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 AlexanderOh, 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 WilliamsSo students really need to be thinking about what they want and what what their needs are, even before the first day of rotation.
Katelyn AlexanderYeah. So the earlier you can kind of start doing that all along, I think. I think that helps out a lot.
Michele WilliamsOkay. 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 AlexanderYeah. 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 AlexanderJust 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 AlexanderSo 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 AlexanderI 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 AlexanderBut, 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 AlexanderAnd this is the perfect time because we're just looking for you to show progress.
Michele WilliamsSo take a little bit of a risk.
Katelyn AlexanderYou 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 AlexanderAnd they're happy to answer questions. There are no dumb questions when you're on rotation.
Michele WilliamsThat'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 AlexanderYeah. 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 AlexanderSo 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 AlexanderSo, so by a student jumping in, there's no wrong place to get started.
Michele WilliamsGreat. 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 WilliamsSometimes 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 AlexanderSo 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 AlexanderAll 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 AlexanderSo 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 AlexanderThat'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 WilliamsYou.
Katelyn AlexanderOkay, 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 WilliamsTo build on it.
Katelyn AlexanderYeah, 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 AlexanderSo 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 AlexanderYeah. 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 WilliamsOkay.
Katelyn AlexanderBut 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 AlexanderMaybe 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 AlexanderLike 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 AlexanderThat's really the expectation.
Michele WilliamsOkay. 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 AlexanderYeah. 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 AlexanderSo 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 AlexanderWhat 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 AlexanderBut 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 AlexanderBecause 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 AlexanderI 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 AlexanderBut 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 WilliamsSo 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 AlexanderYeah, a lot of.
Michele WilliamsPharmacists 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 AlexanderYou'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 AlexanderBut 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 WilliamsSo, so the whole environment and all the people in that environment are part of that learning.
Katelyn AlexanderYes.
Michele WilliamsIt's not just a 1 to 1 with that preceptor.
Katelyn AlexanderYeah. 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 WilliamsAnd 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 AlexanderBut.
Michele WilliamsThe 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 AlexanderSo yep.
Michele WilliamsIf 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 WilliamsBut 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 WilliamsOh 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 AlexanderYeah. 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 AlexanderSo, 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 AlexanderSo, so.
Michele WilliamsLots of good resources.
Katelyn AlexanderFor.
Michele WilliamsExperience all at.
Katelyn AlexanderYeah. 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 WilliamsSo 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 WilliamsThe the relationship of that, that, IPA and AP experience to the larger kind of career plan that.
Katelyn AlexanderYeah. 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 AlexanderAnd 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 AlexanderMaybe 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 AlexanderAnd 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 AlexanderBut, 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 AlexanderAnd, 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 AlexanderOh 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 AlexanderIf 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 WilliamsI 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 AlexanderYeah. 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 WilliamsQuality of their.
Katelyn AlexanderWork, 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 AlexanderIn an during an interview process, really.
Michele WilliamsGets your foot in the door. It sounds like.
Katelyn AlexanderYeah, 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 AlexanderSo 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 AlexanderThe 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 AlexanderSo 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 AlexanderAnd 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 WilliamsLack of enthusiasm.
Katelyn AlexanderKind 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 AlexanderYou have to be dedicated and be enthusiastic whether it's what you want to do or not.
Michele WilliamsThat 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 AlexanderYeah. 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 AlexanderRight. 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 AlexanderIn 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 AlexanderWe 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 AlexanderIf 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 AlexanderYeah. Because that's the whole point of that fourth year, and.
Michele WilliamsIt's all in service of, helping someone to become a really good pharmacist.
Katelyn AlexanderRight.
Michele WilliamsWhich which we all want to have happen.
Katelyn AlexanderRight. 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 AlexanderI 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 AlexanderSo 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 WilliamsYeah, 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 AlexanderYeah, absolutely, absolutely.
Michele WilliamsSo 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 AlexanderNo, it's not there.
Michele WilliamsBut 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 AlexanderYeah. 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 AlexanderSo there's a lot of touch points that students will hear information.
Michele WilliamsSo the ranking process is where they prioritize their first choice, second choice, etcetera. For the rotations. That's what you mean right okay.
Katelyn AlexanderAnd 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 AlexanderAnd 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 AlexanderAnd 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 AlexanderWe 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 AlexanderWe 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 AlexanderAnd 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 AlexanderWe 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 AlexanderAnd 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 AlexanderIt just may be adjusted over time.
Michele WilliamsFor various.
Katelyn AlexanderFactors, 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 WilliamsThat'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 AlexanderCome 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 WilliamsWell, thank you so much, Doctor Alexander.Katelyn AlexanderThanks for having me. It was fun.
Michele WilliamsTill next time, thanks for joining us on White Coat Radio.
 
 

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 WilliamsWelcome 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 WilliamsWelcome to White Coat Radio, Doctor Alexander, thanks.
Katelyn AlexanderSo much for having me.
Michele WilliamsWe'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 AlexanderYeah, absolutely. Just go for it. Terrific.
Michele WilliamsSo I'm going to be very basic with my first question. What exactly is experiential education?
Katelyn AlexanderYeah. 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 WilliamsOkay. Okay. So I sometimes hear of clinical rotations referred to as IPAs and APIs, or APIs and APIs. I've heard that.
Katelyn AlexanderBefore. Yep. Depending depending on on who you're talking to. Those are the same. Yep.
Michele WilliamsSo, let's start with IPAs. What are those? Exactly.
Katelyn AlexanderSo, 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 AlexanderEnvironment. Okay. And then APIs or APIs are advanced pharmacy practice experiences. APIs occur throughout the entirety of the fourth year.
Michele WilliamsSo, okay, so you don't really start APIs until you're a fourth year pharmacy.
Katelyn AlexanderYeah. 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 AlexanderOkay. 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 WilliamsSo they're truly more advanced.
Katelyn AlexanderYeah, absolutely. Absolutely.
Michele WilliamsWhen 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 AlexanderSo 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 WilliamsThat a senior living.
Katelyn AlexanderIt 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 AlexanderSo 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 AlexanderSo 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 AlexanderAnd in a inpatient setting. More on rounds up in the in the floors at the hospital.
Michele WilliamsOkay. 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 AlexanderYeah. 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 AlexanderAnd usually we're able to accommodate most students requests.
Michele WilliamsOh, nice.
Katelyn AlexanderYeah. 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 WilliamsOkay, 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 AlexanderSure. So for IP is then after the second year, students got to health systems and spend a two week placement.
Michele WilliamsHealth systems are hospital.
Katelyn AlexanderHospitals, 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 AlexanderAnd 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 WilliamsGreat.
Katelyn AlexanderSo 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 AlexanderThe 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 WilliamsSo sounds like an important part of it.
Katelyn AlexanderYeah. 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 WilliamsOkay.
Katelyn AlexanderThe 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 WilliamsOkay. So they're required.
Katelyn AlexanderYeah. 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 AlexanderSo 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 AlexanderAnd 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 AlexanderThey 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 WilliamsSo an academic AP, that's the I love those because I get to see the students again back on campus.
Katelyn AlexanderThat's right.
Michele WilliamsWho what what, is the interest there? So a student that goes on an academic AP, are they interested in teaching or, presenting or.
Katelyn AlexanderI 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 AlexanderBut there's so much stuff that goes into why that experience that you have as a learner is the way it is.
Michele WilliamsYeah.
Katelyn AlexanderSo 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 AlexanderAnd 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 AlexanderSo, yeah, I think it can be for lots of different reasons that people rank rank different, rotation types.
Michele WilliamsOkay. 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 WilliamsExperiential education.
Katelyn AlexanderIt'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 WilliamsOkay.
Katelyn AlexanderSo 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 WilliamsReally tells you the importance of that practical experience and really being in a place and, having those having those educational opportunities.
Katelyn AlexanderYeah. 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 AlexanderAnd 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 WilliamsSo, so students get lots of opportunities to practice skills. Yes. And improve and develop as they go through the curriculum.
Katelyn AlexanderSounds 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 AlexanderAnd 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 AlexanderAnd 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 WilliamsThat'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 WilliamsOkay. 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 AlexanderI 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 AlexanderBut 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 AlexanderOkay. 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 WilliamsAnd this is a pharmacist, right?
Katelyn AlexanderMost 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 AlexanderAs a way of helping the next generation. So, the preceptor is essentially your instructor for that rotation.
Michele WilliamsOkay. 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 WilliamsI mean, I'm working right in some cases.
Katelyn AlexanderSo 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 AlexanderIt 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 AlexanderSo even though that two week rotation or four week rotation isn't paid, there's sometimes are opportunities that come out of it.
Michele WilliamsAnd then you mentioned, can I, can I test out of a rotation? That was going to be my next question.
Katelyn AlexanderYeah. 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 WilliamsFor pharmacy technician. Yeah. Like that.
Katelyn AlexanderAnd 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 AlexanderOur 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 AlexanderAnd 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 AlexanderMaybe 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 WilliamsSo it keeps it interesting. Yeah. Adds to a person's knowledge base. It sounds like.
Katelyn AlexanderYeah. 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 WilliamsThat 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 AlexanderSo 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 AlexanderSo 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 AlexanderAnd 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 WilliamsSo if they're not able to, to use those past experiences, it's really in their it's to their benefit.
Katelyn AlexanderAbsolutely. 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 WilliamsOkay. 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 WilliamsAnd, we'll talk to you again soon.
Katelyn AlexanderYeah. Thanks for having me.
 

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 VanzantWelcome 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 WilliamsAnd 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 WilliamsWelcome to White Coat Radio, Doctor Pond. Thank you. I guess we should call this episode the pondcast. And you think so?
Michele WilliamsIt 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 PondSo 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 PondAnd 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 PondAnd 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 WilliamsYeah. 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 PondSo 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 PondSo 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 PondAnd 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 WilliamsThat 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 WilliamsAnd 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 PondSo 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 PondAnd 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 WilliamsThat'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 PondYes. 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 WilliamsYeah. So that's terrific.
Dan VanzantAre 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 PondYes. 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 PondAnd 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 VanzantSo yeah. Okay. And is that the McGraw Hill content. Is that all available through tool or can they go directly to McGraw Hill.
Brooks PondAnd so you.
Michele WilliamsCan.
Brooks PondYou set up a connect and then just bookmark it. But there's a link to connect through our D2L site.
Michele WilliamsSo it's easy to get to. Yes. That's great.
Dan VanzantThat'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 PondYes. 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 PondAnd 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 PondSo 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 PondSo MTB as a really super long chemical name one methyl for fennel, 1236 tetra Hydra pyridine. That thankfully we can.
Dan VanzantSee it's at now.
Michele Williams
Brooks PondSo, 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 PondAnd 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 PondAnd 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 PondAnd 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 PondAnd 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 PondAnd 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 WilliamsAnd it seems like really important research given that Ritalin isn't very common.
Brooks PondYes 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 WilliamsSo it's a lot of food for thought. Yeah, yeah. So.
Dan VanzantSo you also study this, pharmacokinetics of vape substances, like, nicotine. What have you found so far with that research?
Brooks PondSo. 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 PondAnd 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 PondAnd 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 WilliamsWhich is interesting. What is LC‑MS? Dan. Sorry.
Brooks PondLiquid chromatography, mass spectrometry.
Michele WilliamsOkay.
Brooks PondYes. Yes.
Michele WilliamsSo, I.
Brooks PondI it's a little bit hard to say.
Michele WilliamsYeah. It's just they use that too in those crime shows like.
Brooks PondYes. That's right, that's right.
Dan VanzantI 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 PondYes. 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 PondSo 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 PondAnd 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 WilliamsSo that's awesome. Yeah. Yeah. Great opportunity.
Brooks PondYeah. So.
Michele WilliamsWell, 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 VanzantAll right. Thank you.
 

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 WilliamsWelcome 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 VanzantAnd 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 WelchYeah, pleasure to be here.
Dan VanzantSo, 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 WelchSo, 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 WelchI 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 WelchSo 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 WelchAnd 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 WelchPeople 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 WelchSo 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 WelchIf 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 WelchAnd 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 WelchFew 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 WilliamsDoes that stand for?
Adam WelchThe 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 WelchSo 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 WelchI 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 WilliamsWow. 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 WilliamsIt'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 WilliamsAnd what students can expect as they progress through the course.
Adam WelchIn 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 WelchBut 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 WelchIt'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 WelchSo 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 WelchSo 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 WelchYou need to be successful during your P4 year.
Michele WilliamsSo 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 WelchOh, 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 WelchPick 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 VanzantGross.
Adam WelchSo 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 WelchYou'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 WelchYou can't study the entire top 300 drugs in one sitting, so you got to space it out.
Michele WilliamsThat makes a lot of sense.
Adam WelchSo 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 WelchAnd 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 WelchMaybe 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 WelchSo, 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 WelchBut 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 VanzantYeah, 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 WelchYeah, it's it's important. It's one slice of salami every day.
Dan Vanzant
Adam WelchYeah.
Michele WilliamsAnd I can't read the lunch and meat of your choice.
Dan VanzantYeah.
Adam WelchAnd 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 VanzantIt 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 WelchSo 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 WelchSo drug cards.
Dan VanzantGotcha. 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 VanzantWe're using, you know, virtual cards. But what kind of apps? Students found.
Adam WelchYeah. 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 WelchSo 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 WelchSo 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 WilliamsIt'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 WelchCards through a cards.
Michele WilliamsSo, 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 WelchYeah. 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 WelchThis 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 WelchThey 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 WelchSo 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 WelchAnd 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 WelchWe 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 WelchAnd 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 WelchThere'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 WelchWe 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 WelchWe 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 WelchSo, 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 WelchThere'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 WelchWe'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 WilliamsThat just sounds great.
Dan VanzantDid 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 WelchYeah, 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 WelchSo so that's the idea. It's going to be a multi-pronged approach to, to help improve the health of our region.
Michele WilliamsWell, 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 WelchYeah. Thanks. So much for having me.
Dan VanzantYeah. Thanks so much.
 
 
 

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 WilliamsWelcome 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 VanzantAnd 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 PuriThank you. Michele, and Dan.
Dan VanzantTo 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 PuriSure. 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 WilliamsThat's great. And it's very lucky for us, too.
Ashana PuriThank you.
Michele WilliamsYou'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 PuriYes, 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 WilliamsYeah.
Ashana PuriSo 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 WilliamsAbsolutely. 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 PuriSure. 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 WilliamsThat's great. That sounds like great advice.
Dan VanzantAnd 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 PuriSure. 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 WilliamsThat 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 PuriYeah, 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 WilliamsYeah, 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 PuriI hope so.
Michele WilliamsSo, 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 PuriAbsolutely. 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 WilliamsThat's good to know.
Dan VanzantOkay. 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 PuriSo 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 VanzantSo 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 PuriSure. 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 WilliamsSo 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 PuriSure. 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 WilliamsSo, when, when pharmacy students work with you on your research, what can they expect from that experience?
Ashana PuriSure. 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 WilliamsYeah. Interesting.
Ashana PuriYeah, 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 WilliamsSo you have a student who will be presenting at AACP, in the coming week?
Ashana PuriYes, 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 WilliamsYeah, I bet you are. That's terrific.
Ashana PuriYes.
Michele WilliamsAnd 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 WilliamsWe really appreciate it. And for talking about calculations and about your research.
Ashana PuriYou're. Oh, my pleasure. Thank you. Michele, and Dan.