My student wants more work and I'm over it.

[DpharmD41]

Preceptor here in specialty pharmacy. Currently working from home so the rotation is also from home for the student. So I have adjusted. Usually they would tour the facility, listen in on patient calls, and eventually make a few calls out to patients to counsel. My workplace won't allow them to be involved with any calls right now due to work from home issues and they have no access to patient profiles from home.

My rotation is an elective and Non direct care.

As a preceptor I really care about setting my students up for success in their careers by having them create budgets based on real take home pay of a pharmacist, discussing burnout and how to manage it, reviewing their resumes and making suggestions, working out a job search plan, and mock job interviews, etc. ***Even when on site this was the bulk of the rotation***

I have to be honest and say I don't care about teaching clinical gems that I know at least at my workplace we can learn on the job.

I do spend maybe 10% of my time reviewing specialty meds and counseling points.

I tell all my kids UPFRONT they have an A because I don't care about grades and I don't want them stressing about grades. I just want them to try to take in some life lessons and just relax. They will have their whole careers to be worked like dogs if they choose....why not just take my rotation as a time to reflect on what you really want in the future?

I always am very upfront and transparent in the beginning about what to expect from my rotation and how much I hate busy work for myself or my students.

So now that you may understand my sort of chill preceptor vibe let's get to my student.

My student has brought up that they want more work and feel like they are not learning. They want complex medication profiles to review and make clinical suggestions on.... They want homework. Their words not mine. Also the student is being DEAD ASS SERIOUS!!!!

huh? am I crazy? I don't want to change my rotation because I know there is so much value in what I'm teaching. But I don't want to do a disservice to my student.

Suggestions? Thoughts?

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[ValeRx]

Sounds like an overachiever.

 

[axelz165]

Honestly... just send there all of the work you do on a daily basis? Take out any relevant patient info but ask how they would have handled this situation.


I will say it's noble of you to do real world work... but the stuff you listed honestly would take 2-3 days max. What else are they doing for theother 27 days of the rotation??

 

[johnpharm01]

Give them what they want. How does this cause harm? Part of being a preceptor is tailoring the rotation to the student.

By the way, I have precepted and none of my students have been children so you probably want to drop that.

 

[owlegrad]

This is part of why I declined to do remote rotations. Not interested in assigning or following up on busy work.

That said, do you have pharmacists letter? If so go to preceptor letter and use some of those resources like journal club. Easy peasy.

 

[JustFillIt]

Preceptor here in specialty pharmacy. Currently working from home so the rotation is also from home for the student. So I have adjusted. Usually they would tour the facility, listen in on patient calls, and eventually make a few calls out to patients to counsel. My workplace won't allow them to be involved with any calls right now due to work from home issues and they have no access to patient profiles from home.

My rotation is an elective and Non direct care.

As a preceptor I really care about setting my students up for success in their careers by having them create budgets based on real take home pay of a pharmacist, discussing burnout and how to manage it, reviewing their resumes and making suggestions, working out a job search plan, and mock job interviews, etc. ***Even when on site this was the bulk of the rotation***

I have to be honest and say I don't care about teaching clinical gems that I know at least at my workplace we can learn on the job.

I do spend maybe 10% of my time reviewing specialty meds and counseling points.

I tell all my kids UPFRONT they have an A because I don't care about grades and I don't want them stressing about grades. I just want them to try to take in some life lessons and just relax. They will have their whole careers to be worked like dogs if they choose....why not just take my rotation as a time to reflect on what you really want in the future?

I always am very upfront and transparent in the beginning about what to expect from my rotation and how much I hate busy work for myself or my students.

So now that you may understand my sort of chill preceptor vibe let's get to my student.

My student has brought up that they want more work and feel like they are not learning. They want complex medication profiles to review and make clinical suggestions on.... They want homework. Their words not mine. Also the student is being DEAD ASS SERIOUS!!!!

huh? am I crazy? I don't want to change my rotation because I know there is so much value in what I'm teaching. But I don't want to do a disservice to my student.

Suggestions? Thoughts?

I took a “remote student” on the last rotation during COVID. I just gave them a whole bunch of home research to do.

I found about 5 of my most complex patients and I printed off their med list and H/P and deidentified everything and had them take hours to dissect it.

I told the student like it or lump it no one will hire you anyway so...... haha jk...

 

[Rockinacoustic]

Maybe the student wants more than 10% of a specialty pharmacy rotation to be spent learning specialty drugs?

 

[C Smith]

This is just busy work. Have you student or students watch one to all three movies and write a report(s) with a few conditions like length, Hippa, ethics, burnout work in some of the things you usually cover.

Love and Other Drugs (2010) - About Pharmaceutical sales and a love story

Better Living Through Chemistry (2014) - Pharmacist has an affair, abuses prescription drugs and plots a murder.

In Old California (1942) John Wayne as a Pharmacist in Sacramento, CA. in the 1800's

 

[spacecowgirl]

Have some pity on this kid. This horrible job market, rotations during a pandemic, loads of student debt and this is what they get for an elective? Have them research the latest literature on COVID treatment and present. What are the implications of all these job losses and insurance on specialty pharmacies? What should a pharmacist outside of specialty know about your workflow, care transitions, challenges?

 

[Old Timer]

You know there are two kinds of coaches. The first is the Tom Landry style. Everyone is treated the same. Not even the same, identically. Then there is the Vince Lombardi style. Give each player what they need. Some need a pat on the back and some need a kick in the ass. If you are not there to help them learn, why are you a preceptor?

 

[Deja]

This is just busy work. Have you student or students watch one to all three movies and write a report(s) with a few conditions like length, Hippa, ethics, burnout work in some of the things you usually cover.

Love and Other Drugs (2010) - About Pharmaceutical sales and a love story

Better Living Through Chemistry (2014) - Pharmacist has an affair, abuses prescription drugs and plots a murder.

In Old California (1942) John Wayne as a Pharmacist in Sacramento, CA. in the 1800's

what the... hope you are joking

 

[Sine Cura]

The student can also be a self-directed learner. You don't get paid so why care that much.

 

[deleted562805]

Does the student in your rotation have to present a journal club or patient presentation? If the student has not completed those listed activities, that’s busy work in and of itself

 

[Rockinacoustic]

The student can also be a self-directed learner. You don't get paid so why care that much.

Then don't take students.

 

[Sine Cura]

Then don't take students.

I did refuse all APPEs ever since CNSU decided to assign me "elective" APPE students because they can't get enough rotation sites

None of these students even knew how to do a proper journal club or even just look up information and present information or original thought. Literal cut and paste bull****

 

[PharmDBro2017]

Why sign up to be a preceptor if you don't put in any effort?

I would've happily taken the A and been quiet if I was in this kids shoes, though.

 

[Sine Cura]

Why sign up to be a preceptor if you don't put in any effort?

I would've happily taken the A and been quiet if I was in this kids shoes, though.

Effort is a two-way street. I don't want my rotations to be fill bitch labor but students need to try actually especially after being corrected on what they are doing wrong. So no more rotations.

What is this, Yelp?

What exactly is the accountability for the worst preceptors? Congraulations, we don't have to precept ****ty students from a ****ty pharmacy school? Oh the emotional pain/embarrassment.

 

[rxkrafted]

My student has brought up that they want more work and feel like they are not learning. They want complex medication profiles to review and make clinical suggestions on.... They want homework. Their words not mine. Also the student is being DEAD ASS SERIOUS!!!!

Ask the student what they want to learn exactly. Not all rotations can give complex med profiles to review and make clinical suggestions on... If that's just not what you normally do, tell that student to wait until they go to another rotation. What did the student reply when you asked him/her what they wanted to do in the future?

 

[earlydaffodil]

This is just busy work. Have you student or students watch one to all three movies and write a report(s) with a few conditions like length, Hippa, ethics, burnout work in some of the things you usually cover.

Love and Other Drugs (2010) - About Pharmaceutical sales and a love story

Better Living Through Chemistry (2014) - Pharmacist has an affair, abuses prescription drugs and plots a murder.

In Old California (1942) John Wayne as a Pharmacist in Sacramento, CA. in the 1800's

Wild...but I kinda like the idea

 

[KARM12]

Here are some ideas...not sure what specialty area you work in, but these can be universal. Even if you don't need these things done, there is still learning involved.
-Formal drug information consult paper - including referenced articles
-Drug class review - pick a drug class and make them write formal review comparing drugs - what would they suggest, differeneces between drugs in a class
-Compile a list of counseling points for the specialty meds - have them practice counseling over the phone
-Drug monograph
-Anything with medication safety or FDA alerts

 

[CynicalIntern]

I don't know how much you do for the doctor in your specialty pharmacy. But giving a student homework should be the easiest thing in the world.

"This prior authorization was denied. Here is the relevant clinical information that was presented. Do you agree with the insurance company or not. If not, write an appeal letter. Cite your sources"

Nobody has to read the appeal letter but you. You don't even have to do anything. But that's how I learned every single drug in my specialty is by going "well why would the doctor not be okay with prescribing this other drug" or "why is the doctor writing this drug for this indication"

 

[DpharmD41]

You know there are two kinds of coaches. The first is the Tom Landry style. Everyone is treated the same. Not even the same, identically. Then there is the Vince Lombardi style. Give each player what they need. Some need a pat on the back and some need a kick in the ass. If you are not there to help them learn, why are you a preceptor?

I hear that. To build on your analogy I feel like I am the advisor that realizes a lot of these players will leave professional sports with broken relationships, bodies, and having run through all their money (certainly not all but if I can help one player have a better life after this game runs through them then I will have succeeded in my eyes)

So when they come to me THAT is what I want to specifically focus on because we already know they can do the physical part and every other coach/advisor they run into is going to run drills, make them watch tapes of themselves playing, do physical practice, make them workout in the gym, time how fast they run, etc.

So when my player comes to me we are not doing any of that. We will focus on the part I know they aren't thinking about and I'm going to spend 90% of our time on that.

But now my player says.... "hey you don't make me watch game tape so you aren't teaching me anything can you please help me run faster because THAT is what is going to take my game to the next level?" In my heart I'm like no we aren't doing ANY pushups and I'm not going to sit here and time your runs. No I'm not printing out a workout to send you home with just because you can't see the bigger picture I'm painting right now. We will stay the course buddy.

Again I said I'm the advisor not the offense coach or defense coach or even special teams coach. I'm just the elective advisor who is currently playing on a team and is given some latitude on what my players experience in their time with me. Is running fast important? yes, but you made it after all these years of self discipline and coaching to be a professional athlete, I know you got the chops physically even if you still need some development there.

So will the majority of coaches think I'm a bit lazy, hippy trash and question my intentions or feel bad for my players for missing out on a physical aspect that they usually focus on.. yea. Will some players think time spent with me is 100% wasted, you bet.

I am thankful to all that replied and respect the opinions, thoughts, and suggestions even if we have to just agree to disagree because we are all rational adults and we can have sensible discourse even if we don't see things the same way

I initially posted because I was still working this out in my head and wanted some colleagues opinions and I'm thankful you all offered your insight

 

[Sabril]

I tell all my kids UPFRONT they have an A

Appreciate your vision but I'm not sure this is a good way to start out a rotation learning about "real life."

 

[PikminOC]

Appreciate your vision but I'm not sure this is a good way to start out a rotation learning about "real life."

They are the trophy for everyone generation..

 

[Seriously Serious]

None of these students even knew how to do a proper journal club or even just look up information and present information or original thought. Literal cut and paste bull****

Then teach them........ lol

 

[Sine Cura]

Then teach them........ lol

Isn't that what they do P1-P3 also?

 

[Seriously Serious]

Isn't that what they do P1-P3 also?

Is that really your excuse?

 

[Sine Cura]

Is that really your excuse?

Yes

 

[Seriously Serious]

Yes

Sad

 

[Sine Cura]

Sad

Relax. I know virtue signaling so hard is de rigueur but I don't take students anymore

 

[deleted562805]

Also, if student does not have anything to do in the rotation. He or she should be studying for the NAPLEX and build his resume if this student is serious for a job or residency. Not really demand for more work from you. There is always something to do for a P4 student.

 

[Deja]

Relax. I know virtue signaling so hard is de rigueur but I don't take students anymore

glad you weren't my preceptor if "de rigueur" is in your daily vocabulary lol

on a side note how many of you actually done a journal club after graduating lol

 

[TheBlaah]

on a side note how many of you actually done a journal club after graduating lol

Doesn't residencies force you to do a journal club, or something similar?

 

[Deja]

Doesn't residencies force you to do a journal club, or something similar?

well residency is still in training technically, that question is obviously meant for people whos already done with aeverything

 

[TateThePharmacist]

on a side note how many of you actually done a journal club after graduating lol

Took me till about half way through 4th year to realize the only way to get a good grade on journal club was to tear the article apart, and treat it as if it's not even worthy to wipe your own @$$ with. Really frustrated me that if I enjoyed an article and thought it had good points, it just got $%!# on by all the pharmacists (and this happened at every facility I went to, not just one).
But to answer your question, not once have a done a journal club since graduating. I'm at a small facility though, so I know at larger facilities you have the opportunity to read the article and participate if you want and I may do that once I have the opportunity.

 

[owlegrad]

Took me till about half way through 4th year to realize the only way to get a good grade on journal club was to tear the article apart, and treat it as if it's not even worthy to wipe your own @$$ with. Really frustrated me that if I enjoyed an article and thought it had good points, it just got $%!# on by all the pharmacists (and this happened at every facility I went to, not just one).
But to answer your question, not once have a done a journal club since graduating. I'm at a small facility though, so I know at larger facilities you have the opportunity to read the article and participate if you want and I may do that once I have the opportunity.

I only do journal clubs with students, never as part of my actual job.

What’s funny to me about your statement is I hate when students only talk about the strength of an article and never mention any flaws. It definitely makes me think the student doesn’t know how to critically evaluate an article. It’s much more enjoyable to me to find all the flaws or at least acknowledge the limitations. So I think you are right.

 

[TateThePharmacist]

I only do journal clubs with students, never as part of my actual job.

What’s funny to me about your statement is I hate when students only talk about the strength of an article and never mention any flaws. It definitely makes me think the student doesn’t know how to critically evaluate an article. It’s much more enjoyable to me to find all the flaws or at least acknowledge the limitations. So I think you are right.

Really there's nothing wrong with that, I just didn't understand the real purpose of journal club. You're looking through these articles to see if you need to change the way you practice medicine, or at least if there's a better way. Which I think that's great! But as I assume you'll agree, 99.9% of articles aren't ground breaking and have tons of flaws. The other 0.1% are typically the ones guidelines are based on. I just wish that it was explained to me that bluntly so I better understood what my purpose with journal club was: to sift through the garbage to find the gold nuggets, and to treat the garbage as garbage.

 

[Deja]

yeah here lies the problem... majority of the people doesn't even do journal clubs as part of their job and yet so much emphasis are put on it and people think its super important

 

[Seriously Serious]

Relax. I know virtue signaling so hard is de rigueur but I don't take students anymore

yeah here lies the problem... majority of the people doesn't even do journal clubs as part of their job and yet so much emphasis are put on it and people think its super important

I view doing journal clubs as a training exercise for sifting through literature and grading it at an acceptable level. Like teaching a kid to read, you need them to read aloud so you can correct their pronunciations. Yeah I doubt any graduate does journal clubs regularly without students around, but I bet most of you read through this COVID literature and have a decent BS meter.

It's interesting to see pharmacists be lazy teachers only to turn around and **** on new grads for not knowing anything.

 

[Sine Cura]

I view doing journal clubs as a training exercise for sifting through literature and grading it at an acceptable level. Like teaching a kid to read, you need them to read aloud so you can correct their pronunciations. Yeah I doubt any graduate does journal clubs regularly without students around, but I bet most of you read through this COVID literature and have a decent BS meter.

It's interesting to see pharmacists be lazy teachers only to turn around and **** on new grads for not knowing anything.

Even my diploma mill weed-out program had students do at least 4 graded journal clubs (DI + pharmacotherapy seminars) prior to rotation so what are other crappy programs' excuse? Journal club was one of my faves because 99% of pharmacy students and pharmacists don't know jack **** about statistics and probability so it's easy to "gotcha" everyone on even the most basic assertions (yep one of those people in class)

This derp CNSU program assigned me "am care" rotations for freakin retail so it was a challenge to hit all the syllabus checkpoints. But if students don't give a **** why take students. Like with journal cub if you literally cut and paste the abstract and claim that is your journal club WTF? Maybe that guy just wanted to be a fill bitch and wanted to blow off a free rotation block.


In any case I have no obligation to "pay it forward" as a preceptor or some other feel-good B.S. especially b/c TBH students are a net negative if they are not familiar with the system and workflow, worse than a mediocre tech. I don't see any benefit of having "free labor" TBH aside from screening ******* OTC questions

 

[owlegrad]

yeah here lies the problem... majority of the people doesn't even do journal clubs as part of their job and yet so much emphasis are put on it and people think its super important

I hear what you are saying but I do think there is value in learning how to critically evaluate studies. For one thing it is good for critical thinking skills which I think doesn't get nearly enough attention.

 

[Seriously Serious]

Even my diploma mill weed-out program had students do at least 4 graded journal clubs (DI + pharmacotherapy seminars) prior to rotation so what are other crappy programs' excuse? Journal club was one of my faves because 99% of pharmacy students and pharmacists don't know jack **** about statistics and probability so it's easy to "gotcha" everyone on even the most basic assertions (yep one of those people in class)

This derp CNSU program assigned me "am care" rotations for freakin retail so it was a challenge to hit all the syllabus checkpoints. But if students don't give a **** why take students. Like with journal cub if you literally cut and paste the abstract and claim that is your journal club WTF? Maybe that guy just wanted to be a fill bitch and wanted to blow off a free rotation block.


In any case I have no obligation to "pay it forward" as a preceptor or some other feel-good B.S. especially b/c TBH students are a net negative if they are not familiar with the system and workflow, worse than a mediocre tech. I don't see any benefit of having "free labor" TBH aside from screening ******* OTC questions

I mean I get your viewpoint, I bet most share your same thoughts and attitude. I am speaking from a recent grad perspective where I learned more from my preceptors who cared enough to whoop my ass into shape, than a classroom setting where I was N=1/120.

I'll never forgot those who cared, and I'd hire them in a heartbeat if I was in a position to do so. Sure, you have no obligation to pay it forward - but with the trend of new grads being hired as managers out of school, it doesn't hurt to leave a good impression.

 

[deleted562805]

Even my diploma mill weed-out program had students do at least 4 graded journal clubs (DI + pharmacotherapy seminars) prior to rotation so what are other crappy programs' excuse? Journal club was one of my faves because 99% of pharmacy students and pharmacists don't know jack **** about statistics and probability so it's easy to "gotcha" everyone on even the most basic assertions (yep one of those people in class)

This derp CNSU program assigned me "am care" rotations for freakin retail so it was a challenge to hit all the syllabus checkpoints. But if students don't give a **** why take students. Like with journal cub if you literally cut and paste the abstract and claim that is your journal club WTF? Maybe that guy just wanted to be a fill bitch and wanted to blow off a free rotation block.


In any case I have no obligation to "pay it forward" as a preceptor or some other feel-good B.S. especially b/c TBH students are a net negative if they are not familiar with the system and workflow, worse than a mediocre tech. I don't see any benefit of having "free labor" TBH aside from screening ******* OTC questions

What about patient presentations? Inservice presentations? Those are useful

 

[spacecowgirl]

yeah here lies the problem... majority of the people doesn't even do journal clubs as part of their job and yet so much emphasis are put on it and people think its super important

Every day all day but I know I'm in the small minority. That said, it's evident that critical thinking about information that is presented to us is sorely lacking so it's still a valuable skill.

Have them check out iforumrx or some FOAMed forums and podcasts and recommend some. I get a lot of insight following medical thought leaders on Twitter. Have them update on new ways of info dissemination and exchange. My old ass could use some guidance.

 

[Sine Cura]

What about patient presentations? Inservice presentations? Those are useful

Yes presentations and DI were part of the rotation but as anyone can surmise these activities do not integrate into chain retail workflow at all. Not to worry as I do not pretend to be a preceptor anymore

 

[deleted562805]

Yes presentations and DI were part of the rotation but as anyone can surmise these activities do not integrate into chain retail workflow at all. Not to worry as I do not pretend to be a preceptor anymore

Correct, those activities are more related to clinical pharmacy than retail.