Professor To Student: Dr.White, Pharmacy School and Stories

Dur­ing This episode we talk about phar­ma­cy school and “The Big Gulp” with Phar­ma­cy Pro­fes­sor and Researcher Dr. White.

Speak­er 2(Alex) (00:01)
Hel­lo and wel­come to Pro­fes­sor to Stu­dent. I’m Alex. I’m here with Dr. White, phar­ma­cy pro­fes­sor and researcher.

Speak­er 1(Dr.White) (00:14)
Hey, how are you?

Speak­er 2 (00:15)
So the first main top­ic I want to talk about is phar­ma­cy school back when you were in col­lege. What was it like com­par­a­tive to now?

Speak­er 1 (00:29)
Yeah, so mean, gen­er­al­ly it is, it’s very sim­i­lar, right? So when I went to school, we had five years in order to be able to get your bach­e­lor’s of sci­ence in phar­ma­cy, right? So it was a five year pro­gram. And then if you want­ed to get your doc­tor of phar­ma­cy pro­gram, that there was two addi­tion­al years that you need­ed to go to school for. And so at that time, since the bach­e­lor’s of sci­ence in phar­ma­cy degree was the one that you need­ed in order to be able to get licensed and prac­tice pharmacy,

not a lot of peo­ple end­ed up going on to get their doc­tor of phar­ma­cy degree. But as the pro­fes­sion of phar­ma­cy was chang­ing and there was an increased focus on more advanced patient care as part of the pro­fes­sion, they end­ed up chang­ing it so that instead of sev­en years to get your doc­tor of phar­ma­cy degree, that you could do it with­in six cal­en­dar years with some of the effi­cien­cies of not hav­ing to take some of the in some of those cours­es twice. So now the degree is a Phar­mD degree in order to be able to prac­tice pharmacy.

So at UConn, at the end of the fourth year, the stu­dents are get­ting their Bach­e­lors of Sci­ence in Phar­ma­cy Stud­ies, but they can’t get licensed in prac­tice with that degree. They need to spend their last two years in the School of Phar­ma­cy in order to get their Doc­tor of Phar­ma­cy degree. So that tran­si­tion end­ed up hap­pen­ing start­ing in Cal­i­for­nia, was slow­ly mov­ing its way through the coun­try, and end­ed up com­ing to New Eng­land, which is what we’re doing at the Uni­ver­si­ty of Con­necti­cut now.

Speak­er 2 (02:12)
And like with some of the advance­ments, because obvi­ous­ly some drugs did­n’t exist, how is it like, how have you adapt­ed when, you know, maybe in New York Phar­ma­cy School, you did­n’t know of said drugs, but now that they’re here and peo­ple take them and they’re need­ed to be taught, how do you, like how did you orig­i­nal­ly like teach and fig­ure out how to teach those drugs when you they weren’t like you were nev­er taught ful­ly so how did you go through the process of like teach­ing those drugs that were like a thing back

Speak­er 1 (02:51)
Yeah, so a cou­ple dif­fer­ent things. One is in addi­tion to teach­ing stu­dents the impor­tant facts that they need to know, we’re also try­ing to teach stu­dents how to be able to teach them­selves because there is a decay in terms of med­ical evi­dence and drug evi­dence over the course of time.

So nation­al guide­lines change, some new drugs come out, there’s new find­ings about old­er drugs, either how they can be applied to new dis­ease states or some of the weak­ness­es, some of the adverse events that maybe did­n’t come to light when the drugs were first com­ing out. Some drugs get removed from the mar­ket, they get new black box warn­ings. So you always need to be in a posi­tion that you’re keep­ing your knowl­edge base upright. In one of the cours­es that we teach, drug infor­ma­tion two, that course along with drug infor­ma­tion one that I don’t teach in, helps stu­dents be able to find evi­dence and then helps them be able to read the evi­dence in a way that they’ll know whether or not it’s some­thing that should be incor­po­rat­ed into their knowl­edge base and then how to take that knowl­edge and put it into a knowl­edge base so that you are cur­rent with your understanding.

You know, one of the things in our pro­fes­sion­al oath that we take as phar­ma­cists, it is to be doing con­tin­u­al learn­ing so that we’re able to pro­vide the most cur­rent and com­pre­hen­sive knowl­edge in order to be able to treat patients’ ill­ness­es. So, know…

One of the aspects is just the over­all change with­in the field and then keep­ing up with some of those changes. When you’re try­ing to teach the infor­ma­tion, some­times you’re fac­ing a dilem­ma. And the dilem­ma that you have is you were orig­i­nal­ly giv­en two hours in order to be able to teach this top­ic, right? And now there’s sev­en addi­tion­al drugs that was­n’t there before. And then you need to… make a deci­sion about what it is that you’re going to include and what you’re not going to include. And some­times it hurts your heart to have to go back in and be able to take some of the drugs that aren’t being com­mon­ly used any­more, but might be real­ly inter­est­ing from a phar­ma­col­o­gy stand­point, you know, from a clin­i­cal standpoint.

And there are all these nuances and things that you had to learn about these real­ly inter­est­ing drugs inside some of these class­es. But the real­i­ty is, if you only have two hours, you have to include the most impor­tant things for the peo­ple that are going to be prac­tic­ing now. So some things get a cur­so­ry glance rather than going in depth and real­ly talk­ing about that infor­ma­tion because you just don’t have that kind of time.

The oth­er thing is, you know, how do you teach peo­ple things? And, you know, there are a lot of things that I end­ed up learn­ing along the way that I think is very help­ful. Not only, you know, what con­tent should you be pre­sent­ing and then mak­ing sure that they’re clear­ly pre­sent­ed on a slide to what is the best way to be able to pro­vide information.

to stu­dents who don’t have a lot of expe­ri­ence with these dis­ease states and with these drugs so that they can take home some of the impor­tant points that they may need to have and real­ly be able to focus on the infor­ma­tion that’s going to be most crit­i­cal for them when all is said and done. So I think, you know, going through your career, it’s not just about keep­ing up with the newest infor­ma­tion and then mak­ing deci­sions about what to include, but how do you do the pre­sen­ta­tion for the stu­dents in a way that’s going to be most impact­ful for their abil­i­ty to be able to learn the mate­r­i­al, but then also be able to apply it when those sit­u­a­tions come to light.

Speak­er 2 (07:00)
I don’t know if this was in col­lege or if this was in, as you’ve been a teacher, but Lila, your daugh­ter, told me to ask of the big gulp. What is that?

Speak­er 1 (07:13)
Yeah, so when I was in col­lege, we had a course that’s very sim­i­lar to what the stu­dents need to take called patient com­mu­ni­ca­tions. of course, patient com­mu­ni­ca­tion is real­ly impor­tant, being able to take infor­ma­tion when you’re giv­ing them a new drug and be able to explain it in a way that, you know, patients of all dif­fer­ent back­grounds, old, young, dif­fer­ent races, eth­nic­i­ties, gen­ders, would be able to under­stand, be able to do it in a com­pas­sion­ate manner. 

When I was in col­lege I was also a… a part-time stand-up com­ic around the area. And so some­times those two worlds end­ed up col­lid­ing in ways that… were less than ful­ly pro­duc­tive. what she’s ask­ing about is this one class where I had to go up in front of the class and then I had to go through the patient coun­sel­ing for Fleet Prep Kit 5. And Fleet Prep Kit 5 is some­thing for peo­ple that are going to be hav­ing a med­ical pro­ce­dure. Right? 

And so you may know that you know now that you don’t give peo­ple this giant jug of water that they need to drink and has a lot of elec­trolytes in it and is sup­posed to clean you out so that when you have some­thing like a colonoscopy and they’re going in with the cam­era every­thing is clean they can see what they need so that you don’t have colon can­cer or if you do that they find it and if you have polyps that they see clear­ly enough they can remove the polyps you know as they’re doing that test but back in the old days they did­n’t have that

Right, what they did have was Fleet Prep Kit 5, which had a giant ene­ma bag. Right, so this giant ene­ma bag is here and inside it had, you know, some… soap that was inside and then when you put warm water in it, it cre­at­ed this soapy water kind of mix­ture that then you had to insert the tip into your rec­tum, infuse the con­tents of the bag, hold onto it for a peri­od of time, and then of course you have tremen­dous explo­sive diar­rhea after that.

My job was to do the patient coun­sel­ing for that. you know, they said, okay, you know, they called a num­ber ran­dom­ly and you had to go up in front of the class and then you had to do patient coun­sel­ing. So here I was in front of the class and the pro­fes­sor whips out Fleet Prep Kit 5 and, you know, so I have three min­utes in order to be able to read the instruc­tions and then I have to start doing my coun­sel­ing. So I go through the pack­age insert and then based on what I known about it before and then what I refreshed my knowl­edge about by read­ing the the offi­cial pack­age insert lan­guage about the use of the drug

I end­ed up say­ing, well I see that you have this pre­scrip­tion for Fleet Prep Kit 5, or what I like to call the Big Gulp. So you need to fill this with one liter of warm water. It’s going to cre­ate a soapy mix­ture. So you need to hang it from a hook about… you know, one to two feet above your head. But, you know, for added enjoy­ment, put it five or six feet above your head. That’ll real­ly give you a big rush. So then you lay on the ground and, you know, not wear­ing pants, not wear­ing under­wear, and then, you you take the tip and when you put it on your rec­tum, you point it towards your umbil­i­cal… you know, your bel­ly but­ton and then you insert it two to three inch­es on top of that and then you release the escape valve and then it’ll infuse the flu­id into your gut where you’ll try to retain it for three to four min­utes and then you’ll put the valve back on, you you’ll take it out and then of course you need to get up and sit on the toi­let right away because you’ll be hav­ing diarrhea.

I said, so, you know, if you do hang at five to six feet above your head, in addi­tion to hav­ing a bad rush, you could have some extra adverse events, you know, like a bad taste in your mouth, right? So the whole time that I’m going through and I’m doing this and it’s, you know, con­tin­u­ing on, the whole class is, you know, just uproar­i­ous­ly laughing. 

One of the stu­dents need to take out her inhaler, you know, for the asth­ma that she had the fac­ul­ty per­son that was in charge who was sup­posed to be the mock patient was not find­ing it fun­ny at all there was no humor that was there. So long sto­ry short I end­ed up hav­ing to do anoth­er coun­sel­ing ses­sion lat­er on with just he and I in the office doing a coun­sel­ing ses­sion. he told me at that time, he did think that what I said was actu­al­ly hilar­i­ous, in a real patient care sce­nario that I would­n’t want to do that. And I said, well, I would­n’t do that in a real sce­nario, but it just kind of came in my mind. And I had poor impulse con­trol. So that’s what I did.

It gives a cer­tain lev­el of under­stand­ing when you have stu­dents that are in your class now and you had some of those expe­ri­ences to be able to share also that helps stu­dents real­ize that you’re not just a fac­ul­ty per­son, but you’re also a per­son. And I think that’s good way to be able to break the ice with stu­dents. You don’t to have chaos in your class, right? But you also don’t want to have a class where stu­dents come in and they sit there and then for two hours you just suck their life force out of their bod­ies and then they leave as a shriv­eled husk of what they walked in at. So if there’s a way to be able to help to keep them engaged, there’s a way to com­pete against the temp­ta­tions that’s on their com­put­er of shoe shop­ping or… you know, at videos and oth­er things, you know, or the temp­ta­tions on their phone, you know, those kinds of things are good for edu­ca­tion, right? And they’re also enter­tain­ing for the stu­dents so that when they leave, you know, they have the infor­ma­tion that you real­ly want­ed them to have when you go. in a for­mat that was more inter­est­ing and engag­ing for them. you know, I like to call that edu­tain­ment. And if you could build some of that into the time that you have in class, I think that it does pay a lot of div­i­dends downstream.

Speak­er 2 (14:52)
I actu­al­ly agree with that. I think mak­ing class more fun while still being edu­ca­tion­al is the best way to go.

Speak­er 1 (14:58)
Yeah, and you know, not every­one can pull that off, right? So if humor is not your shtick and then you go in and you try to make it, you’re prob­a­bly going to end up at human resources, right? Because you’re going to say some­thing that’s going to be offen­sive to some­body else and you’re going to be in a lot of trou­ble. But if that’s, you know, authen­ti­cal­ly some­thing that you do, that you have the abil­i­ty to weave into your class­es, it can be effec­tive for oth­er peo­ple, you know, telling heart­felt sto­ries of, know, where peo­ple use this infor­ma­tion or they did­n’t use this infor­ma­tion and peo­ple were either helped or peo­ple were harmed because they did­n’t do it can also get across some of the same infor­ma­tion. when I was in school, when I was in col­lege, there was this pro­fes­sor that actu­al­ly had the abil­i­ty to write on the board back when we just had chalk­boards and he would have chalk in his left hand and in his right hand and he would write on the chalk­board two dif­fer­ent com­plete sen­tences with a dif­fer­ent hand on the board and every­one was like real­ly enthralled and infat­u­at­ed with what he was you know writ­ing and how he could pos­si­bly do that but that was some­thing that he had that gen­er­at­ed a lot of inter­est among the stu­dents and kept their attention

I don’t have the abil­i­ty to write with two hands, so I had to use the skill set that I did have in order to be as effec­tive of an instruc­tor as I am. And one of the things that I’ve real­ized over the course of time, and now that I’m depart­ment head and I’m bring­ing in new edu­ca­tors into the school, or there are… res­i­dents that may end up in teach­ing posi­tions in the future, is that when you’re pre­sent­ing on a top­ic, one of the most impor­tant things is that you know what your objec­tives are before you start. So then when you’re going through, you also know how much time you have before you start putting togeth­er the slides. So that what­ev­er time you have, you should have two-thirds of the time where you’re going to be pre­sent­ing con­tent but then one third of your time you’re doing dif­fer­ent forms of enrich­ment. And enrich­ment could be like a sil­ly sto­ry that helps to explain the point in a way that stu­dents will remem­ber it. Or it could be a very poignant thing that helps to real­ly dri­ve home that point. I think that for me it’s most effec­tive when you have a smat­ter­ing of those dif­fer­ent things.

So now I’m about to tell peo­ple a sto­ry. It’s time for the enrich­ment por­tion of the lec­ture. The stu­dents don’t know whether it’s going to be some­thing that is zany and ridicu­lous or whether it’s some­thing that’s heart­felt. But they’re, I think, more recep­tive because they don’t know which of the two ways that it is going to go. And then they get what­ev­er it is that they get when they’re doing the presentation.

Speak­er 2 (18:12)
Thank you for com­ing on. I real­ly appre­ci­ate it. Espe­cial­ly on short notice too. no prob­lem. I real­ly appre­ci­ate it. I’m Alex. That was Dr. White. And this is Teacher to Student.