Advanced Pharmacy Practice Experiences: Helping Students Adjust to Learning Outside the Classroom

By Kaitlyn Grunder, 2019 PharmD Candidate

Students often find excitement when didactic coursework ends and Advanced Pharmacy Practice Experiences (APPEs) begin. However, transitioning from the classroom to APPEs can be more difficult than one would think. Throughout my my first APPE I discovered some strategies that my preceptors used to help me succeed and get the most out of my experiences. These strategies can be used by both students and preceptors to smooth this transition.

MAKING THE TRANSITION TO APPEs FROM DIDACTIC COURSEWORK: WHAT CAN STUDENTS DO?

Try! Don’t be afraid to be wrong.
My preceptors reminded me that the time to make mistakes is now, while you are a student with preceptors here to help and teach you. These are experiences to learn from and better ourselves. Contrary to popular belief, research shows that when students make mistakes or fail to receive the right answer the first time, they are more likely to learn.1

For example, I reported to a preceptor that we should hold a vancomycin dose on a septic patient with declining renal function. She asked if the patient was in acute kidney injury (AKI), but I didn’t actually know. After reviewing the patient’s chart further, I realized the patient was not in AKI, and we should not hold the dose. I was frustrated that I forgot this information. However, the preceptor reminded me that this was a learning opportunity. I have not forgotten to check if subsequent patients are in AKI since!

Utilize the guidelines.
As a student in the classroom, I formed a bad habit of popping open my lecture notes to get an answer instead of looking at the clinical guidelines. Sometimes guidelines can be long and difficult to navigate and it can be tempting to just use your notes to find an answer quickly. However, class notes are soon out of date whereas guidelines update. Finding guidelines is a means of active learning, which promotes recall and deeper understanding because of engaging with the content rather than simply listening to it.2 My first preceptor always reminded me that part of being a great pharmacist is knowing where to find the information (such as through the guidelines.) Similarly, although I expected myself to know everything off the top of my head, this preceptor emphasized that it’s okay to forget something, as long as you know where to find the correct answer.

Become a lifelong learner.
One of the most difficult transitions for me was getting used to seeing “complicated” patient cases and knowing when clinical judgement came into play. One of my preceptors noticed I did not explain my reasoning while leading topic discussions or working on patient cases. This preceptor did a great job of reminding me to explain “Why?” by finding support or demonstrating my rationale. I needed the “why” in terms of a recommendation from clinical trials or mechanisms of actions in order to form my own opinions on the information.

I recently read a blog article about lifelong learning in pharmacy where the author stated healthcare is evolving at an unprecedented pace.3 The author discussed pharmacists’ responsibility to keep track of new drugs, updated regulations, and quality measures. He also challenged readers with a statement “So, whether you are about to graduate, or you’ve been out of school for years, please make it a point to never stop learning. Don’t just do the minimum of amount of continuing education to renew your license.”3

MAKING THE TRANSITION TO APPEs FROM DIDACTIC COURSEWORK: HOW CAN PRECEPTORS HELP WITH THIS TRANSITION?

Be understanding.
Preceptors should be understanding when a student makes a mistake and use this as a learning opportunity. I have had teachers who made me feel “bad” for making an error. Most of what I remember from these encounters is how terrible I felt afterwards. However, the preceptors who used these mistakes as an opportunity for growth helped me remember the mistakes and learn how to prevent them in the future .

Encourage independent learning.
Always encourage students to utilize the guidelines. When teachers just told me the right answer, I almost always forgot this information again. When encouraged to find the information on my own, I was more likely to remember it in the future.

Promote lifelong learning.
Encourage students to become lifelong learners. This is what will help students the most in the future by helping them understand the reasoning behind treatments and how to start making their own clinical judgements.

Understanding, use of guidelines, and lifelong learning helped me with my APPE transition and may also help other students who struggle as well. Both students and preceptors can promote these strategies to encourage student success in transitions from coursework to APPEs. What strategies have you used to help APPE students adjust to learning outside of the classroom setting?

Acknowledgements
Dr. Yuan Zhao for introducing me to Pulses and her encouragement and help on this article. Dr. Dana Winters and Dr. Stacy Miller for being such exceptional preceptors and helping me with my own transition.

References

  1. Roediger HL, Finn B. Getting It Wrong: Surprising Tips on How to Learn. Scientific American website. https://www.scientificamerican.com/article/getting-it-wrong/.Published 2009 Oct 20; accessed 2018 Sep 9.
  2. DiPiro JT. Why do we still lecture? Am J Pharm Educ. 2009; 73(8): Article 137.
  3. Mayfield B. What Being a “Lifelong Learner” Really Means For Pharmacists. Medium. April 22, 2018. https://medium.com/rxradio/what-being-a-lifelong-learner-really-means-for-pharmacists-a36311add047.

Kaitlyn Grunder is a student at Sullivan University College of Pharmacy. Educational scholarship interests include professional development and patient and professional advocacy. In her free time, Kaitlyn enjoys spending time with family and friends, playing with her three dogs, and curling up with a good book.


Pulses is a scholarly blog supported by Currents in Pharmacy Teaching and Learning

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s