Preceptors.... have you ever failed a student?

[ReReRetail]

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Please note, I created a temporary username to protect the identity of the student and his school.

Preceptors out there tell me about your failing students!

I'm currently in a retail/clinic setting and co-precepting students for the past 1.5 years. I love it, it's a fast paced pharmacy, low-pressure rotation, and we always have lots of fun... Enter "student F." He is graduating in May 2011. He is neither disrespectful nor is he violating any unspoken rules of etiquette... but he don't know nuthin! I'm puzzled. Never heard of coal tar. Or psoriasis. Never made an ointment. Hydrocodone is a steroid and you should take it on an empty stomach.... failed to tell me that glipizide causes hypoglycemia and what can happen when you exceed metformin's max dose. Who has never even heard of magic mouthwash? We give a cute little "top 200 brand generic quiz" and he scored 17%. Strangely enough he impresses us with his pathyphysiology of arrythmias, but fails to discuss the drugs in any detail.

Ok this aint rocket science, nor is it the ICU. This is retail.

I am really upset. Student F is supposed to be a Pharm.D. (DOCTOR!) in 5 months. Does he really think he's up for the title of pharmacist, let alone DOCTOR? Because who else is going to make that coal tar ointment? Who else is going to tell Suzy to take that codeine with food? I'm so frustrated and angry right now. I'm angry at the school for allowing this to happen, for cheapening our profession.

(As far as Student F goes, we have a plan. We will address this at midpoint review, and start intensive topic discussions straight out of the pharmacotherapy book. I admit I have very little experience with "problem students" and will do much soul searching to figure this out)

Thanks for listening to my rant! So colleagues, tell me all your student stories!

 

[Sparda29]

Please note, I created a temporary username to protect the identity of the student and his school.

Preceptors out there tell me about your failing students!

I'm currently in a retail/clinic setting and co-precepting students for the past 1.5 years. I love it, it's a fast paced pharmacy, low-pressure rotation, and we always have lots of fun... Enter "student F." He is graduating in May 2011. He is neither disrespectful nor is he violating any unspoken rules of etiquette... but he don't know nuthin! I'm puzzled. Never heard of coal tar. Or psoriasis. Never made an ointment. Hydrocodone is a steroid and you should take it on an empty stomach.... failed to tell me that glipizide causes hypoglycemia and what can happen when you exceed metformin's max dose. Who has never even heard of magic mouthwash? We give a cute little "top 200 brand generic quiz" and he scored 17%. Strangely enough he impresses us with his pathyphysiology of arrythmias, but fails to discuss the drugs in any detail.

Ok this aint rocket science, nor is it the ICU. This is retail.

I am really upset. Student F is supposed to be a Pharm.D. (DOCTOR!) in 5 months. Does he really think he's up for the title of pharmacist, let alone DOCTOR? Because who else is going to make that coal tar ointment? Who else is going to tell Suzy to take that codeine with food? I'm so frustrated and angry right now. I'm angry at the school for allowing this to happen, for cheapening our profession.

(As far as Student F goes, we have a plan. We will address this at midpoint review, and start intensive topic discussions straight out of the pharmacotherapy book. I admit I have very little experience with "problem students" and will do much soul searching to figure this out)

Thanks for listening to my rant! So colleagues, tell me all your student stories!

That's what happens when you study to pass exams instead of trying to understand the drugs.

I have a question for you and other preceptors? Let's say the student knows what he's doing and knows his drugs but is chronically late by like 5-15 minutes (stays 5-15 minutes longer to make up the time), is that grounds for failure?

 

[KARM12]

That's what happens when you study to pass exams instead of trying to understand the drugs.

I have a question for you and other preceptors? Let's say the student knows what he's doing and knows his drugs but is chronically late by like 5-15 minutes (stays 5-15 minutes longer to make up the time), is that grounds for failure?

Yes it is grounds for failure. Part of being a pharmacist is being responsible to make it to work on time.

 

[WVUPharm2007]

If the student offended you, you'd fail them. Without regard to what they actually know, naturally.

But if they are nice and an idiot, you have reservations.

Just one of the many things wrong with pharmacy education...preceptors care more about if the student pretends to love them than attempting to actually gauge how good they will actually be at protecting patients...

 

[WVUPharm2007]

Yes it is grounds for failure. Part of being a pharmacist is being responsible to make it to work on time.

I'm not going to fine someone (indirectly via having graduation delayed 3 months or so) about $30,000 for being a few minutes late to my rotation if they know what they are doing. I'm not paying them to be there.

(Full disclosure: I got booted/failed from a rotation for complaining rather bluntly that I was getting nothing out of the rotation and I didn't like being used for 1.5 weeks as a glorified tech that stuffed pills in boxes for 12 hours straight. I'm going to burn an Omnicare to the ground some day.)

 

[PharmD RPh]

Please note, I created a temporary username to protect the identity of the student and his school.

Preceptors out there tell me about your failing students!

I'm currently in a retail/clinic setting and co-precepting students for the past 1.5 years. I love it, it's a fast paced pharmacy, low-pressure rotation, and we always have lots of fun... Enter "student F." He is graduating in May 2011. He is neither disrespectful nor is he violating any unspoken rules of etiquette... but he don't know nuthin! I'm puzzled. Never heard of coal tar. Or psoriasis. Never made an ointment. Hydrocodone is a steroid and you should take it on an empty stomach.... failed to tell me that glipizide causes hypoglycemia and what can happen when you exceed metformin's max dose. Who has never even heard of magic mouthwash? We give a cute little "top 200 brand generic quiz" and he scored 17%. Strangely enough he impresses us with his pathyphysiology of arrythmias, but fails to discuss the drugs in any detail.

Ok this aint rocket science, nor is it the ICU. This is retail.

I am really upset. Student F is supposed to be a Pharm.D. (DOCTOR!) in 5 months. Does he really think he's up for the title of pharmacist, let alone DOCTOR? Because who else is going to make that coal tar ointment? Who else is going to tell Suzy to take that codeine with food? I'm so frustrated and angry right now. I'm angry at the school for allowing this to happen, for cheapening our profession.

(As far as Student F goes, we have a plan. We will address this at midpoint review, and start intensive topic discussions straight out of the pharmacotherapy book. I admit I have very little experience with "problem students" and will do much soul searching to figure this out)

Thanks for listening to my rant! So colleagues, tell me all your student stories!

Good question. I've precepted students but never had such a student with an extreme lack of knowledge as you suggest. I would do a few things...

1. Def give the student feedback at midterm. It's only fair so that they aren't blind sided.
2. Call the schools appe coordinator to discuss student and specific situation.
3. You have to do the right thing as a pharmacist and that might be failing the student. I'm surprised the student was able to make it this far.

Is this your first student from this school?

 

[GreyFox2002]

Please note, I created a temporary username to protect the identity of the student and his school.

Preceptors out there tell me about your failing students!

I'm currently in a retail/clinic setting and co-precepting students for the past 1.5 years. I love it, it's a fast paced pharmacy, low-pressure rotation, and we always have lots of fun... Enter "student F." He is graduating in May 2011. He is neither disrespectful nor is he violating any unspoken rules of etiquette... but he don't know nuthin! I'm puzzled. Never heard of coal tar. Or psoriasis. Never made an ointment. Hydrocodone is a steroid and you should take it on an empty stomach.... failed to tell me that glipizide causes hypoglycemia and what can happen when you exceed metformin's max dose. Who has never even heard of magic mouthwash? We give a cute little "top 200 brand generic quiz" and he scored 17%. Strangely enough he impresses us with his pathyphysiology of arrythmias, but fails to discuss the drugs in any detail.

Ok this aint rocket science, nor is it the ICU. This is retail.

I am really upset. Student F is supposed to be a Pharm.D. (DOCTOR!) in 5 months. Does he really think he's up for the title of pharmacist, let alone DOCTOR? Because who else is going to make that coal tar ointment? Who else is going to tell Suzy to take that codeine with food? I'm so frustrated and angry right now. I'm angry at the school for allowing this to happen, for cheapening our profession.

(As far as Student F goes, we have a plan. We will address this at midpoint review, and start intensive topic discussions straight out of the pharmacotherapy book. I admit I have very little experience with "problem students" and will do much soul searching to figure this out)

Thanks for listening to my rant! So colleagues, tell me all your student stories!

Ok this guy is definitely not with it.....he is clueless. I would recommend contacting the coordinatory of the community rotations/experiential rotations in general and address your concerns before you take drastic measures.

That being said, I attend a pharmacy school that is highly 'clinically' oriented, and all of my rotations (except my one community which is last) are at a level 1 trauma center in Detroit. So hopefully if you wind up as my preceptor, you won't think about failing me when I tell you that I have no clue how to compound coal tar ointment, or much less any ointment for that matter 🙂 I can, however, compound based off a formulated protocol. School's simply do not emphasize compounding anymore. I also have interned at a community site for 2.5 years and the only thing I've ever had the opportunity to compound was Tamiflu suspension. I'll rock that Top 200 drugs quiz though 🙂

 

[KARM12]

I'm not going to fine someone (indirectly via having graduation delayed 3 months or so) about $30,000 for being a few minutes late to my rotation if they know what they are doing. I'm not paying them to be there.

(Full disclosure: I got booted/failed from a rotation for complaining rather bluntly that I was getting nothing out of the rotation and I didn't like being used for 1.5 weeks as a glorified tech that stuffed pills in boxes for 12 hours straight. I'm going to burn an Omnicare to the ground some day.)

Disagree.

If they are late a few times, fine. We all miss the alarm or get stuck in traffic. If I've talked to them about it and they make no effort to show up on time and have no good reason why they can't make it there. Chronic tardiness is a problem.

 

[torchbearer]

Deciding whether to pass or fail this student certainly sounds like a tough decision.

Don't forget that he'll have to pass the NAPLEX, too. The NAPLEX isn't especially difficult, but if he wants to get a license, he'll have to learn at least the basics between now and this summer. So as you make your decision, don't feel pressured as if though you're the absolute last barrier between him and his future patients.

Funny side story: One of my pharmacy classmates told me that on one rotation, her preceptor was outraged because she didn't know all the steps of the Krebs cycle. Ha! I couldn't even tell you one step of the Krebs cycle if my life depended on it.

 

[owlegrad]

Preceptors out there tell me about your failing students!

...Never heard of coal tar. Or psoriasis. Never made an ointment. Hydrocodone is a steroid and you should take it on an empty stomach.... failed to tell me that glipizide causes hypoglycemia and what can happen when you exceed metformin's max dose. Who has never even heard of magic mouthwash? We give a cute little "top 200 brand generic quiz" and he scored 17%. Strangely enough he impresses us with his pathyphysiology of arrythmias, but fails to discuss the drugs in any detail.

Hope you don't mind me jumping in! If you do please just ignore me. I do not consider myself anything great, but just to let you know I am a P2 who has retail and hospital experience and I try to retain what I learn about drugs.

I am not familiar with coal tar. I have never made an ointment (I have compounded creams but not in class). The bolded statement scares me. I hope he was thinking of hydrocortisone? I can see how someone without a working back round could mix them up, although even hydrocortisone should be given with meals so he is wrong about that part either way. Not sure what else he could be thinking of? The glipizide is also odd, the only diabetes med that doesn't (usually) cause hypoglycemia that I am familiar with is metformin (if there are others I would be happy to learn them). I don't know metformins overdose toxicities off the top of my head (well I think I do now - your post scares me). Without working I would never have heard of magic mouthwash. My school doesn't cover brand/generic at all, so without work experience I wouldn't be able to score better than chance on your quiz.

I don't know, many of those issues don't really sound like it's his fault, sounds like things his school may not address (hydrocodone, glipizide, and metformin aside). He just sounds like he doesn't have any experience and maybe doesn't think well on his feat. Of course it's up to you whether or not he has the knowledge/skills to pass your rotation, I am not trying to comment on that at all, it's not my place. I am curious if this student is from the same college as your other appe students?

 

[owlegrad]

Deciding whether to pass or fail this student certainly sounds like a tough decision.

Don't forget that he'll have to pass the NAPLEX, too. The NAPLEX isn't especially difficult, but if he wants to get a license, he'll have to learn at least the basics between now and this summer. So as you make your decision, don't feel pressured as if though you're the absolute last barrier between him and his future patients.

Funny side story: One of my pharmacy classmates told me that on one rotation, her preceptor was outraged because she didn't know all the steps of the Krebs cycle. Ha! I couldn't even tell you one step of the Krebs cycle if my life depended on it.

HAHAHAHHAHAHAHA - Empathy 101. I love it!

I like the rest of the post as well.

 

[IndustryPharmD]

Regardless of whether it was chronic tardiness, texting on her phone when there were actually people in the pharmacy who needed to be helped, or not knowing even the very basic things, I would give the intern in question a full explanation of what they are doing wrong. And I would be willing to work with them on a 12 (or whatever) step program to fix whatever this wrong is. However, I do not believe in giving second chances until they become second millionth chances. I give you a warning - we agree on a plan - if you do not do you part, I will kick your sorry ass and won't feel bad. Coddling is supposed to stop in well before middle school, there is no need to drag it into professional school. Real world won't be forgiving even if preceptors would be. 😉

 

[PharmD RPh]

Regardless of whether it was chronic tardiness, texting on her phone when there were actually people in the pharmacy who needed to be helped, or not knowing even the very basic things, I would give the intern in question a full explanation of what they are doing wrong. And I would be willing to work with them on a 12 (or whatever) step program to fix whatever this wrong is. However, I do not believe in giving second chances until they become second millionth chances. I give you a warning - we agree on a plan - if you do not do you part, I will kick your sorry ass and won't feel bad. Coddling is supposed to stop in well before middle school, there is no need to drag it into professional school. Real world won't be forgiving even if preceptors would be. 😉

Very well stated!👍

 

[BMBiology]

Thanks for listening to my rant! So colleagues, tell me all your student stories!

I think you should also take into consideration to what he knows on day 1 vs. day 21. I would give him a serious warning first and if he doesnt improve, then that is ground for a bad grade.

 

[CUninja]

Regardless of whether it was chronic tardiness, texting on her phone when there were actually people in the pharmacy who needed to be helped, or not knowing even the very basic things, I would give the intern in question a full explanation of what they are doing wrong. And I would be willing to work with them on a 12 (or whatever) step program to fix whatever this wrong is. However, I do not believe in giving second chances until they become second millionth chances. I give you a warning - we agree on a plan - if you do not do you part, I will kick your sorry ass and won't feel bad. Coddling is supposed to stop in well before middle school, there is no need to drag it into professional school. Real world won't be forgiving even if preceptors would be. 😉

+1. Well said.

One of the things we have been specifically told not to do at a rotation is texting. That specific act is grounds for failure of a rotation.

Also - I can see being late once or in limited situations, twice, during a rotation. Any more than that and you are showing the preceptor you don't care at all. Many years from now when I become a preceptor, there will be grading or time consequences for being late. Because - if you show you don't care about my time - don't expect me to care about your time.

 

[IndustryPharmD]

I have a question for you and other preceptors? Let's say the student knows what he's doing and knows his drugs but is chronically late by like 5-15 minutes (stays 5-15 minutes longer to make up the time), is that grounds for failure?

There is absolutely no good reason to be chronically late by the same few minutes. There could be only two reasons:
- You can't be bothered to make in on time. I can't be bothered to take you staying late "to compensate" into account, then. If for some really good reason you can't be there at 8am (i.e. childcare where your kids go doesn't open until 7:45) - work it out so your rotation starts at 8:30. But then BE there at 8:30, not 8:37.
- You try, but you can't manage your time. If you are so dense as to be unable to figure out that you need to be on time, such as get up earlier/leave house earlier/stop going online "just to check the weather" and then play some stupid game - why should I assume your brain capacity to be greater in other aspects, such as drug therapy?

One of my rotations started at godawful early 6 am. To get ready and to be there on time, I had to get up at 4:30 am every single day. For someone who doesn't normally go to bed until 1 am - you think it was easy? Yet somehow, I have never once been late to that, or any other rotation. Yes, I would come home from that rotation around 4-ish and fall asleep and then wake up at 7pm and then fall asleep again around midnight, and it was the most miserable month of my life - but being late by 10 minutes would have made me no less miserable (I would have needed to be at least four hours late to recognize any benefit ) but it would be insulting to everyone else who did come on time.

 

[Sparda29]

There is absolutely no good reason to be chronically late by the same few minutes. There could be only two reasons:
- You can't be bothered to make in on time. I can't be bothered to take you staying late "to compensate" into account, then. If for some really good reason you can't be there at 8am (i.e. childcare where your kids go doesn't open until 7:45) - work it out so your rotation starts at 8:30. But then BE there at 8:30, not 8:37.
- You try, but you can't manage your time. If you are so dense as to be unable to figure out that you need to be on time, such as get up earlier/leave house earlier/stop going online "just to check the weather" and then play some stupid game - why should I assume your brain capacity to be greater in other aspects, such as drug therapy?

One of my rotations started at godawful early 6 am. To get ready and to be there on time, I had to get up at 4:30 am every single day. For someone who doesn't normally go to bed until 1 am - you think it was easy? Yet somehow, I have never once been late to that, or any other rotation. Yes, I would come home from that rotation around 4-ish and fall asleep and then wake up at 7pm and then fall asleep again around midnight, and it was the most miserable month of my life - but being late by 10 minutes would have made me no less miserable (I would have needed to be at least four hours late to recognize any benefit ) but it would be insulting to everyone else who did come on time.

Basically for me it was because I left the house as late as possible based on estimated travel time and never left myself any room for additional traffic build ups or accidents. (I gotta be there at 8AM, Google Maps/Traffic tells me it will take 25 minutes, I would leave at 7:35AM, hey look at that an accident, slows me down by 10 minutes, I don't end up there until 8:10AM.)

But yeah, now if the rotation site gives me a start time that would put me in rush hour traffic, I'll just leave 2-3 hours early, get there, sleep for a while in my car or in the cafeteria and get dressed in the locker rooms there.

 

[naseuy]

]Basically for me it was because I left the house as late as possible based on estimated travel time and never left myself any room for additional traffic build ups or accidents.[/B].

There's your problem. Leave earlier.

 

[bacillus1]

I'm a P3 about to enter my 2nd semester.
I don't know what coal tar is for. I have never seen coal tar dispensed in the pharmacy where I work.
I just compounded an ointment the other day at work. I did not remember how I did it in ceutics lab 1.5 years ago.
I do not remember to take hydrocodone on an empty stomach, but on a positive note I remember that it's metabolized by 2D6!

I am a rho chi student, so one can't say that I don't know this because I slacked off in class.

People forget many of the things they learned in school, since the practical knowledge gets mixed with so much impractical knowledge that it becomes too much to retain, so the rotation should be a learning experience. You should not fail the student for not knowing these things, but you can fail him if he fails to learn these things during the rotation.

 

[PharmDstudent]

It sounds like a lack of working experience.
And not knowing how to make coal tar ointment doesn't indicate anything. The last time that I learned anything about that was in Pharmaceutics P1 or P2 year.

And this isn't about you... It's about the student and how you can effectively educate him.
YOU'RE upset and angry. What a joke!

 

[IndustryPharmD]

Basically for me it was because I left the house as late as possible based on estimated travel time and never left myself any room for additional traffic build ups or accidents. (I gotta be there at 8AM, Google Maps/Traffic tells me it will take 25 minutes, I would leave at 7:35AM, hey look at that an accident, slows me down by 10 minutes, I don't end up there until 8:10AM.)

You've gotta be kidding me. You are what, 8 years old? I would have to go with the "dense" assumption, then, as that shows utter lack of ability to plan, to think ahead, and (since this keeps recurring) to put two and two together and learn from one's mistakes. That last one is an F for a rotation and for life. 😀

 

[spacecowgirl]

It sounds like a lack of working experience.
And not knowing how to make coal tar ointment doesn't indicate anything. The last time that I learned anything about that was in Pharmaceutics P1 or P2 year.

And this isn't about you... It's about the student and how you can effectively educate him.
YOU'RE upset and angry. What a joke!

Do you precept students?

 

[rxlea]

I think students underestimate the importance of work experience before and during school- even if it is working one shift a week. I knew what all that stuff was and how to compound it before I even started school (although we don't dispense coal tar here at the hospital at least not that I've seen). It is my personal opinion that students should try to get work experience prior to matriculating and then during summer and winter breaks, if not during a few weekends here and there during the semester. At work, you can apply your knowledge and subsequently perform well on rotations (so I have been told by upperclassman on rotations).

As for the chronic tardiness and overall lack of professionalism- I believe that should be grounds for failure. The pharmacists here precepted students from a number of schools and the best students maybe didn't remember what miracle mouthwash was (although they knew after being here), but they showed up willing to learn, were dedicated, got their work done, and were professional. Having a good work ethic paired with a desire to learn > knowing every little receptor a drug binds to.

 

[Caverject]

Personally, I evaluate the student within the first day or so to see where they are at on their education and use that as a baseline. If they need improvement and they do in fact improve, they pass in my book. I know some students are not geared for retail and have trouble speaking to patients or knowledge base issues. I don't hold that against them and I'm glad my hospital preceptors didn't hold it against me when I was a student.

 

[ttopping]

I'm currently in a retail/clinic setting and co-precepting students for the past 1.5 years. I love it, it's a fast paced pharmacy, low-pressure rotation, and we always have lots of fun... Enter "student F." He is graduating in May 2011. He is neither disrespectful nor is he violating any unspoken rules of etiquette... but he don't know nuthin! I'm puzzled. Never heard of coal tar. Or psoriasis. Never made an ointment. Hydrocodone is a steroid and you should take it on an empty stomach.... failed to tell me that glipizide causes hypoglycemia and what can happen when you exceed metformin's max dose. Who has never even heard of magic mouthwash? We give a cute little "top 200 brand generic quiz" and he scored 17%. Strangely enough he impresses us with his pathyphysiology of arrythmias, but fails to discuss the drugs in any detail.

Ok this aint rocket science, nor is it the ICU. This is retail.

I am really upset. Student F is supposed to be a Pharm.D. (DOCTOR!) in 5 months. Does he really think he's up for the title of pharmacist, let alone DOCTOR? Because who else is going to make that coal tar ointment? Who else is going to tell Suzy to take that codeine with food? I'm so frustrated and angry right now. I'm angry at the school for allowing this to happen, for cheapening our profession.

(As far as Student F goes, we have a plan. We will address this at midpoint review, and start intensive topic discussions straight out of the pharmacotherapy book. I admit I have very little experience with "problem students" and will do much soul searching to figure this out)

Thanks for listening to my rant! So colleagues, tell me all your student stories!

I honestly think it's a lack of exposure and work experience.

If it weren't for our compounding lab in school (and at UB they stress it because of the whole part 3 exam) I don't think I ever would have seen coal tar. Even then I saw it only once. If this students school doesn't have compounding and he doesn't work retail I wouldn't expect them to have made an ointment. Much like I wouldn't expect student working in retail to be proficient in making an IV.

On the same level, someone who doesn't work retail probably doesn't know what magic mouthwash is and I don't blame them. Top 200 is different in hospitals and you see way different drugs so that could be the issue as well. My school didn't stress memorizing top 200 brand generic.

I'm assuming they mistook hydrocodone for hydrocortisone as someone mentioned. Can't really defend that one...but so what if he doesn't tell them to take it with food, the patient might get a little nauseous, oh well. Again, hard to defend the diabetes drugs thing but maybe they haven't had a ton of exposure to that too. I've had preceptors in retail who didn't know why daptomycin couldn't be used for pneumonia. I've had preceptors in infectious disease who couldn't remember the generic for Crestor. They don't get exposure to that kind of thing. It happens

So yea, there are some things they don't know that they probably should. Most can be explained with lack of exposure. If that isn't the case...hopefully they aren't going into retail

On a different note, it's good you're taking the time to go over topic reviews. That's obviously what they need. I don't think it's grounds for failure though...

 

[Requiem]

If the student offended you, you'd fail them. Without regard to what they actually know, naturally.

But if they are nice and an idiot, you have reservations.

Just one of the many things wrong with pharmacy education...preceptors care more about if the student pretends to love them than attempting to actually gauge how good they will actually be at protecting patients...

This was the most insightful comment in the thread. People here got caught up in a "tardiness tangent" but this is the issue.

I can't speak for other professions directly, but pharmacists have a huge problem with standing up and taking action/responsibility.

If you have a student who seems to be on a P2 level, what is the relevance if they say hello? Being polite and professional is a given in this circumstance. But it doesn't matter if you say "take these glyburide on an empty stomach!!" with a smile, it's still a gross lack of fundamental knowledge that will endanger others. If you're ok with that, and being another step along the way that hasn't done anything about it, then tell yourself at least he was nice and pass him.

But hey, at least he didn't make a snide remark to a technician🙄

 

[Requiem]

Personally, I evaluate the student within the first day or so to see where they are at on their education and use that as a baseline. If they need improvement and they do in fact improve, they pass in my book. I know some students are not geared for retail and have trouble speaking to patients or knowledge base issues. I don't hold that against them and I'm glad my hospital preceptors didn't hold it against me when I was a student.

Fair approach. I'd expect nothing less 😉

 

[IndustryPharmD]

But if they are nice and an idiot, you have reservations.

I wouldn't. Idiots irritate me when I am the pharmacist stuck having to constantly listen to what they tell patients, instead of being able to fully focus on my work. And if I don't strain to listen, some poor sod will go home with completely wrong information about their drug, and should they get in trouble, guess who is stuck dealing with the Board? You guessed it, the preceptor, not the intern. So if someone shows that they don't know a thing, I will keep them away from patient interaction, for the patients' and my own sake. And will hand them the OTC handbook, make them read a chapter every day or two, and ask questions on that chapter. It's not my job to teach them pharmacotherapy in retail, but at least they will have learned something when they leave.

I have never been the primary preceptor, so I have never failed a rotation student, but when I taught, I have given failing grades on exams. I don't support grade inflation to protect the fragile self-esteem of the speshul ones. 😀

 

[PharmDstudent]

Do you precept students?

Not unless they want to rotate on nights! 😎

We train pharmacy tech school interns at my store, though. It takes a lot of patience...

 

[Jabberwocky12]

Not unless they want to rotate on nights! 😎

We train pharmacy tech school interns at my store, though. It takes a lot of patience...

Yeah we have had pharmacy tech interns before as well and... it's special. I'm going to mention that in an interview somewhere that I at least know how to enter a prescription (aka typing without misspelling) and not be a douchebag to other techs because I'm 50-100k in debt.

It's like most other jobs. If you a have a degree you are "qualified" but the training has almost no relevance to the degree until you reach the top.

Maybe I took it wrong when the intern called us oompa loompas and he was Willy Wonka?

 

[PharmDstudent]

Oh, and I work at a "compounding" chain pharmacy, and we've never compounded coal tar ointment. The recipe is in the computer, which is the only thing that really matters.

 

[Jabberwocky12]

Oh, and I work at a "compounding" chain pharmacy, and we've never compounded coal tar ointment. The recipe is in the computer, which is the only thing that really matters.

Luckily you weren't being tested on it then at school.

 

[Caverject]

Fair approach. I'd expect nothing less 😉

Some say I'm too nice but I like the fair approach...I think balls are busted enough during the didactic part that if you make it thru to rotations, you should get the benefit of the doubt. However, there are always that special case. I had one guy that I graduated with that should never have made it out of rotations. Scares the hell out of me that he is license now. It took him five tries to pass the NAPLEX. About 95% of my class passed on the first shot!

 

[Athelas]

We give a cute little "top 200 brand generic quiz" and he scored 17%. Strangely enough he impresses us with his pathyphysiology of arrythmias, but fails to discuss the drugs in any detail ... I'm angry at the school for allowing this to happen, for cheapening our profession.

Thanks for listening to my rant! So colleagues, tell me all your student stories!

It sounds like this chap is in the wrong profession but it's probably too late if they have all that student loan debt.

I would notify the school only if I thought the student was capable
of gross negligence in a psychopathic/apathetic manner towards patient care...

You sound angry so let me ask you this - What do preceptors really accomplish by failing students?... If they have knowledge deficit, it possibly could reflect when they take their boards and later becomes the apparent to the employer at some point.

If this method seems lax - well, it's because I have seen too many preceptors get self righteous power trips and unfairly treat students who put in a great deal of genuine effort and energy into rotations. It's sort of similar to the concept where the guilty man goes free over the innocent man put in jail.

 

[type b pharmD]

yeah some of these things are pretty bad, not knowing hydrocodone is a pain pill and not knowing how glipizide or metformin works .. thats a pretty big red flag that this guy might not have his **** together ... but as far as ointment and magic mouthwash goes? I learned that stuff last year and i already forgot it. When i get to rotations i hope they take pity on me and help me learn how retail works because i will have had zero retail experience probably (only spent time in hospital and nuclear as a tech and intern) ..

I would hope that a preceptor in this kind of case would help the student fill in his knowledge gaps and point him to good resources, not bemoan the students lack of education. Some of my professors say there isnt much knowledge you need to really know to be a good pharmacist, its more of the "process" or "skills" you need to know. I generally view this as some kind of academic silliness but there is definitely something to be said for someone who is able and motivated to learn and has the skills to find and absorb drug information.

Basically i second the opinion of most people who have already replied to this thread. Do a little bit more thorough digging to find out if the guy really doesnt know anything (i mean not knowing hydrocodone is not a steroid???? that seems pretty messed up), or if maybe he's just overwhelmed with a new environment and needs some careful benefit of the doubt and close tutoring about retail specifically. A lot of pharmacy students i know may be real good in the classroom or a more academic or clinical environment but maybe are the type of people to get flustered or overwhelmed by the fast pace and sudden rush of new things at a retail setting. Personally when i hit retail rotations, im probably gonna be a bit overwhelmed by all the stuff i dont know (retail specific), but I would at least have already read up on some stuff like magic mouthwash and the top 10 drugs by sales before i showed up. It's another red flag that the guy didnt even do that.

 

[Dalteparin]

I have never been the primary preceptor, so I have never failed a rotation student, but when I taught, I have given failing grades on exams. I don't support grade inflation to protect the fragile self-esteem of the speshul ones. 😀

Agreed. Giving a passing grade to a student who doesn't deserve one is a disservice to the student, the profession, and any patient who has to interact with the student. 17% on the Top 200?? Good grief, that's not even acceptable for a P2!

OP, I suggest you document every meeting you have with this student, and try not to meet with him alone if you can. If you give him an F, he may try to sue you, and you want proof that you failed him because he deserved to fail and not because you just don't like him.

What do preceptors really accomplish by failing students?... If they have knowledge deficit, it possibly could reflect when they take their boards and later becomes the apparent to the employer at some point.

By failing a student, we prevent incompetent people from being put in a position where they can harm patients. Yes, if a student like this graduates he might not pass the NAPLEX, and if he does his employer will find out that he's incompetent and fire him. The trouble is, a mistake big enough for an employer to fire a person is one where a patient suffered or died. If you know your student should not practice and you give him a passing grade anyway, and then he goes out and harms a patient, part of the blame is on you because you did not speak up about his deficiencies.

 

[PharmDstudent]

Since this thread has basically died, I'm ready to say this: my fellow classmate made mistakes just like this. In fact, he mixed up hydrocortisone and hydrocodone, too. It was *identical*.
Did my old boss fail him? No. He taught my classmate what he could and moved on to the next student.
Academia does not attempt to produce pharmacists that are any better than people who can pass exams. IPPE rotations and drug quizes can help, but they are not substitutes for real world experience.

 

[Dalteparin]

Academia does not attempt to produce pharmacists that are any better than people who can pass exams. IPPE rotations and drug quizes can help, but they are not substitutes for real world experience.

That's a very good point. I think academics often underestimate the value of working while in school. At the same time, if my student is a P4 and performing at the level of a P2, is it really fair to let him pass, graduate, and try to practice? Yes, I'm going to teach him all I can, but I can't make up for four years of neglect (either by him or the school) in one month.

 

[Sparda29]

Something I noticed about me when counseling, I get super nervous and forget things when I have someone breathing down my back watching me counsel or if I'm being recorded with a camera while I counsel. (I have no idea why it is necessary for the school to use a camera on us while we're counseling in the pharmacy simulator unless they plan on using that video footage of us P3s to show the P1s and P2s the correct way and the wrong way of counseling.)

 

[homeslice]

Something I noticed about me when counseling, I get super nervous and forget things when I have someone breathing down my back watching me counsel or if I'm being recorded with a camera while I counsel. (I have no idea why it is necessary for the school to use a camera on us while we're counseling in the pharmacy simulator unless they plan on using that video footage of us P3s to show the P1s and P2s the correct way and the wrong way of counseling.)

For us, you get recorded and have to go back and critique yourself later. Ugh.

 

[KARM12]

Even if the student lacks knowledge, but they have a good attitude, are teachable, and professional, they will pass. Not everyone wants to be a pharmacy specialist, I get that. But if you do your projects, show up on time, and have a good attitude, you will not fail. Preceptors do not want to fail students. I feel if the student is heading toward that path it is important to let them and someone from their school know this so that they are aware. This way, they have a chance to improve. If they show an effort, they will pass.

 

[ronkoshy]

...

 

[ucrx]

By failing a student, we prevent incompetent people from being put in a position where they can harm patients. Yes, if a student like this graduates he might not pass the NAPLEX, and if he does his employer will find out that he's incompetent and fire him. The trouble is, a mistake big enough for an employer to fire a person is one where a patient suffered or died. If you know your student should not practice and you give him a passing grade anyway, and then he goes out and harms a patient, part of the blame is on you because you did not speak up about his deficiencies.

This is what scares me. If a student is incompetent, they should be failed. Maybe they need to work harder, need help figuring out the best way for them to learn, or something else. Sometimes a failing grade gives them the motivation they need to figure out how to improve. Sometimes it prevents someone from becoming a pharmacist who would end up harming a patient. Anyone can make a mistake, but there are people out there who (from lack of knowledge, not caring, or anything else) are more likely to.

There was a student in my class who many of us felt should not have graduated. Students on the same rotations as him would come home and say how little he knew, how he didn't improve, and how much it scared them that he might become a pharmacist. It didn't matter how nice he was or how much effort he put in. They could just picture all the mistakes he would make and the incorrect information he would provide. He did pass his rotations, graduate, and pass the NAPLEX. I'm not sure what his job status is, but it does make me nervous that he is a licensed pharmacist.

I don't think the examples given by the OP should necessarily be grounds for a failing grade. Make a plan, work with the student, and if they improve give them a grade they deserve. It sounds like this is what the OP is doing, so hopefully the rest of the rotation goes very differently.

 

[297point1]

This is what scares me. If a student is incompetent, they should be failed. Maybe they need to work harder, need help figuring out the best way for them to learn, or something else. Sometimes a failing grade gives them the motivation they need to figure out how to improve. Sometimes it prevents someone from becoming a pharmacist who would end up harming a patient. Anyone can make a mistake, but there are people out there who (from lack of knowledge, not caring, or anything else) are more likely to.

Well stated ucrx

 

[Sparda29]

For us, you get recorded and have to go back and critique yourself later. Ugh.

The patient that we had to counsel was a professor, not some P1 or someone off the street that you can BS with. So what ended up happening was, a lot of us put so much information into the counseling sheet that we take into the counseling simulation, that we either went way past the time limit or we did it so fast that the person didn't understand much.

I am the suck when it comes to the "teach back" method.

Earlier this year, I was helping out the professor with the P2s who have to do the counseling simulation. I felt bad for one of my friends who had to do the counseling simulation. The entire student body knows that she has a crush on a certain professor (he's a young dude, not some old fart). As I was going down the list of who had to counsel which professor, I noticed that she had to counsel the professor who was her crush. I wanted to tell her beforehand who she had to counsel, but we were given specific instructions not to say a word to help out the P2s in any way.

 

[297point1]

Earlier this year, I was helping out the professor with the P2s who have to do the counseling simulation. I felt bad for one of my friends who had to do the counseling simulation. The entire student body knows that she has a crush on a certain professor (he's a young dude, not some old fart). As I was going down the list of who had to counsel which professor, I noticed that she had to counsel the professor who was her crush. I wanted to tell her beforehand who she had to counsel, but we were given specific instructions not to say a word to help out the P2s in any way.

And you followed the rules?
Who are you, and what did you do with Sparda?

 

[MountainPharmD]

Please note, I created a temporary username to protect the identity of the student and his school.

Preceptors out there tell me about your failing students!

I'm currently in a retail/clinic setting and co-precepting students for the past 1.5 years. I love it, it's a fast paced pharmacy, low-pressure rotation, and we always have lots of fun... Enter "student F." He is graduating in May 2011. He is neither disrespectful nor is he violating any unspoken rules of etiquette... but he don't know nuthin! I'm puzzled. Never heard of coal tar. Or psoriasis. Never made an ointment. Hydrocodone is a steroid and you should take it on an empty stomach.... failed to tell me that glipizide causes hypoglycemia and what can happen when you exceed metformin's max dose. Who has never even heard of magic mouthwash? We give a cute little "top 200 brand generic quiz" and he scored 17%. Strangely enough he impresses us with his pathyphysiology of arrythmias, but fails to discuss the drugs in any detail.

Ok this aint rocket science, nor is it the ICU. This is retail.

I am really upset. Student F is supposed to be a Pharm.D. (DOCTOR!) in 5 months. Does he really think he's up for the title of pharmacist, let alone DOCTOR? Because who else is going to make that coal tar ointment? Who else is going to tell Suzy to take that codeine with food? I'm so frustrated and angry right now. I'm angry at the school for allowing this to happen, for cheapening our profession.

(As far as Student F goes, we have a plan. We will address this at midpoint review, and start intensive topic discussions straight out of the pharmacotherapy book. I admit I have very little experience with "problem students" and will do much soul searching to figure this out)

Thanks for listening to my rant! So colleagues, tell me all your student stories!

In my graduating class there was a foriegn born student who failed her retail rotaion and was subsequently dismissed from school. Things went very similar for her as you describe. Iw as told her preceptor told her to counsel someone on Amoxacillin and she said she cound't because she did not know what it was.

I think you own it to the profession to fail someone who is not meeting the standard.

 

[MountainPharmD]

Personally, I evaluate the student within the first day or so to see where they are at on their education and use that as a baseline. If they need improvement and they do in fact improve, they pass in my book. I know some students are not geared for retail and have trouble speaking to patients or knowledge base issues. I don't hold that against them and I'm glad my hospital preceptors didn't hold it against me when I was a student.

This is a great point. The rotation is part of the student’s education. They are not supposed to be and you should not expect them to be as knowledgeable as a practicing Pharmacist. The whole point of the rotation is for them to learn something. Your goal as a preceptor is to educate them. As Caver said if the knowledge deficit on the first day is still there on the last then there is a problem. I say the onus is on you as a preceptor to get them to the level they need to be by the end of the rotation. If you have given your best effort and they do not satisfactorily improve then do what you have to do.

 

[MountainPharmD]

Oh I forgot to add who the hell compounds coal tar ointment anymore? Sheet the last time I did that was 8 years ago in my integrated laboratory. If that was one of the criteria to passing your rotation I guess I would fail.

 

[Praziquantel86]

Oh I forgot to add who the hell compounds coal tar ointment anymore? Sheet the last time I did that was 8 years ago in my integrated laboratory. If that was one of the criteria to passing your rotation I guess I would fail.

We had pre-made coal tar. And icthammol...that stuff is disgusting. Ruined one of my favorite shirts.

I don't think the deficits mentioned are necessarily worth failing a student over. IF the student was unwilling to learn, that's another issue. Clearly that student has the ability to gain that knowledge (based on the antiarrhythmics), so give him a chance.

A lot of schools leave teaching actual drug knowledge to the fourth year rotations, which is incredibly depressing. I can't count the number of times I heard "Don't worry about the dose, you'll learn that in rotations" or "You can get the counseling points out of Clinical Pharmacology".