Introducing Stacy Prelewicz, Pharm.D: A Wilkes Alumni Returning to Uganda

Stacy with the Savannah dry lands of Murchison Falls National Park, Uganda in the background.

Stacy with the Savannah dry lands of Murchison Falls National Park, Uganda in the background.

2 Days to Go:  Hello! My name is Stacy Prelewicz and I am currently a PGY-1 (post-graduate year 1) Pharmacy Practice Resident at Penn State Milton S. Hershey Medical Center in Pennsylvania. I graduated with my PharmD from Wilkes University last year. Throughout school I interned at both CVS, a large community pharmacy, and Geisinger Wyoming Valley Medical Center. I was also involved in Phi Lambda Sigma – The Pharmacy Leadership Society, Pharmacy Senate, and student government. I grew up in a small town right outside of Wilkes Barre. Next year I will be participating in a PGY-2 Pharmacy Residency in Hematology/Oncology at Huntsman Cancer Institute in Salt Lake City, Utah. My primary related interests include hematology, supportive care, and ambulatory care so I hope to eventually work in one of these areas.

Stacy participating in a Blood Pressure screening event in Masindi, Uganda fall 2013

Stacy participating in a Blood Pressure screening event in Masindi, Uganda fall 2013

I also have a passion for global health and advancing pharmaceutical care. This will be my second trip to Uganda! I gained so much knowledge and experience from the trip in Fall 2013 and I was ecstatic when I found out I could go back this year for a mini rotation. One of my favorite things to do is travel! I love going site seeing, trying new foods (although I am not too adventurous), and anything outdoors. I also enjoy playing tennis and watching ice hockey. I am really excited to go back to Uganda this year to work with Benjamin Mwesige, Pharmacist, at the Uganda Cancer Institute and see all of the students and pharmacists I met during my first visit!

Stacy in standing next to Benjamin, the UCI Head Pharmacist in the middle, with Nikko, now a Wilkes Pharmacy Alumni to his right and Vivian, an Ugandan Pharmacist and Jeff, now a Pharmacy Alumni from D'Youville School of Pharmacy to the left.

Stacy in standing next to Benjamin, the UCI Head Pharmacist in the middle, with Nikko, now a Wilkes Pharmacy Alumni to his right and Vivian, an Ugandan Pharmacist and Jeff, now a Pharmacy Alumni from D’Youville School of Pharmacy to the left. (Fall 2013)

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Introducing Wilkes Pharmacy Student Participant: Lizzie Cook

Lizzie

Lizzie

4 Days to Go:  Hello, my name is Lizzie Cook. I am currently in my final year of pharmacy school at Wilkes University in Pennsylvania and I also serve as a pharmacy intern at UHS Wilson Medical Center. During my college career I was extensively involved in community outreach programs serving the indigent population, as well programs targeted towards enhancing the education of the local youth. I grew up as a military dependent and lived in Germany for almost ten years, where I was afforded the opportunity to travel to multiple European countries. This lifestyle, combined with the training I have received at Wilkes, has spurred my enthusiasm for potentiating patient-centered care on a global scale.

Lizzie and Friends at the Relay for Life (A fundraising event to support Cancer Research)

Lizzie and Friends at the Relay for Life (A fundraising event to support Cancer Research)

In my free time I enjoy hiking, skiing and spending time with my family. Following graduation, I will be pursuing a pharmacy practice residency that allows me to explore the fields of Drug Information, Geriatrics and Internal Medicine. My ultimate goal is to become involved in academia where I can augment the education of future pharmacy students, so I am especially excited to collaborate with individuals at the Makerere University School of Pharmacy.

Lizzie and Friends

Lizzie and Friends

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Introducing Wilkes Pharmacy Student Participant: Kristen Konosky

Kristen

Kristen

5 Days to Go:  Hello everyone! My name is Kristen Konosky and I am in my final year at Wilkes University. I will be graduating as a dual major in Pharmacy and Spanish. I work as a pharmacy intern at a small independent pharmacy in Clifford, PA and prior to that I was a waitress for several years. Throughout my college career, I was involved in pharmacy organizations like American Pharmacists Association, American Society of Health-System Pharmacists, and National Community Pharmacists Association. I have also participated in two Alternative Spring Break (ASB) trips to the Dominican Republic and Costa Rica, as well as two summer study abroad programs in Madrid, Spain. Both ASB trips involved various community service opportunities, but my main responsibility in the Dominican Republic was teaching English to children in schools. In Costa Rica, the focus was on coffee farming and learning about the economic and cultural considerations of the global coffee trade.

Kristen in the Dominican Republic

Kristen in the Dominican Republic

These experiences have truly shaped me as a person, expanded my interest in global health and other cultures, as well as furthered my pursuit of lending help to others. I really enjoy traveling and have also been to Italy, France, England, Ireland, Wales, and Australia. It has been wonderful to meet people from other countries and learn about our differences and similarities. In my free time, I enjoy going to the gym, being outdoors hiking, running, or skiing/snowboarding, and eating different cuisine. My professional goals are to have a career in Public Health Service and pursue additional training to practice in a specialized area.  I can’t wait for our trip to Uganda and I am so excited to learn and experience everything I can!

Kristen in Australia

Kristen in Australia

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Introducing Wilkes Pharmacy Student Participant: Amanda Fenstermacher

Amanda (on the left) and her Mom (on the right)

Amanda (on the left) and her Mom (on the right)

6 Days to Go:  Hello everyone! My name is Amanda Fenstermacher, and I am currently in my last year of pharmacy school at Wilkes University. I have been a pharmacy intern at a CVS, a widely known community pharmacy, in my hometown for 6 years now. Throughout my college career I became more and more involved with organizations like the American Pharmacists Association and the Pennsylvania Pharmacists Association, and I became highly involved with tutoring the local children of all ages at the YMCA, which is an organization with a cause to strengthen the community. My professional goals are to continuously strive to improve the quality of care for patients, and I remain open-minded to different career opportunities. As far as hobbies go, I enjoy scuba diving, playing the piano/singing, running, skiing, and doing any kind of outdoor activities. I grew up with an older sister who is a physician’s assistant working in oncology/hematology, and I also have a stepsister who works in human resources.

With regard to my personal life, I recently got engaged to a friend I have known and traveled with since I was 11!

Amanda and her fiance, Andrew

Amanda and her fiance, Andrew

Ever since I was young, I have done a lot of international traveling, mostly to the Caribbean for scuba diving, and I have also traveled to a couple places in Europe (France and Finland). Africa is what attracted me to this experience (because I have always wanted to go to Africa), and I thought this would be an absolutely unforgettable once-in-a-lifetime experience! I look forward to seeing what pharmacy practice is like in Uganda/Africa, and most of all, the impact that this experience will have on me!

Amanda and her sister, Amy

Amanda and her sister, Amy

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Countdown to Another Experiential Learning Trip to Uganda with Pharmacy Students

Dr. KarenBeth Bohan, Pharm.D., BCPS, Associate Professor, Pharmacy Practice, Wilkes University

Dr. KarenBeth Bohan, Pharm.D., BCPS, Associate Professor, Pharmacy Practice, Wilkes University

7 Days to Go: Greetings from Wilkes University in Northeast Pennsylvania! I have some good news. First of all, I’m excited to be soon embarking on my 7th trip to Uganda, and my 4th with Pharmacy Students as a Global Health Advanced Pharmacy Practice Experience (APPE). I’ve been keeping this blog since March 2011 so that the Wilkes community, both on campus and at large, could learn about the healthcare challenges that affect Sub-Saharan Africa and experience the life and culture of the people of Uganda through the reports of activities and photos posted by my students and me. During 2014, I was able to come to Uganda for 3 separate trips of 4 weeks each through the Fulbright Specialist Program for the purpose of helping the faculty of Makerere University Department of Pharmacy develop new curriculum to teach Pharmacy students Pharmaceutical Care (PC) Skills. We developed a Skills Lab where Ugandan students used role-play to learn how to use drug information resources to solve drug therapy problems and how to communicate recommendations to patients and healthcare providers. We then brought the students to Mulago National Referral Hospital to use their new skills in the experiential setting. The whole program was immensely successful and well accepted by all, students, faculty, patients, and physicians. I was really fortunate to have 2 HVO Pharmacists (Healthcare Volunteers Overseas) also visit Uganda last fall and help me teach the PC Skills Lab.

When I left Uganda at the end of November 2014, we had all agreed that the Pharmaceutical Care course should be continued next September-November, 2015, but I had no idea how I would finance at trip back to Uganda to help out. Also, when I left, I found out on my layover in Amsterdam that my sister, who had been battling recurrent metastatic breast cancer, had been admitted to the Intensive Care Unit for a bad infection and had taken a turn for the worse. I was only home 4 nights before I left for Nebraska to go see my sister. Unfortunately, she lost her valiant battle just hours after I arrived. I was devastated as was the family she left behind. At only 48 years old, she left a husband and two children, a boy 7 years old and a daughter, 14 years old. I learned first-hand how relentless the monster, Cancer, can be and unfortunately, I had joined the ranks of the families of more than 8.2 million people who die each year of cancer. (Stats from WHO-2012) I stayed on in Nebraska to help my brother-in-law with the funeral planning and was surprised when he told me that he thought my sister, Ruth, would want donations in her memory to go to support my work in Uganda to advance pharmacy practice and improve safe medication use. This is a great honor and the best news of all is that donations have raised more than $4000, which is enough for me to go back to Uganda in Fall 2015 to help teach the PC course. Not only will this financial support help, but more than ever, I have been empowered through my sister’s faith in me to continue working with my Uganda collaborators to improve patient healthcare.

I have decided to add a Donations Link to this blog, just in case any of my readers would like to support the continuation of this project. Thanks in advance.

Over the next week I will be introducing you to the 3 Pharmacy Students and 2 Pharmacy Residents who will be accompanying me to Uganda on this upcoming trip. Stay tuned…

Ruth Ellen Heikkinen, my beloved Sister

Ruth Ellen Heikkinen, my beloved Sister

This Blog Post is dedicated to my beloved sister, Ruth Ellen Heikkinen, whose life exemplified a quest for justice and love for all people. Her unending faith in me motivates me everyday. Although she never got to accompany me to Uganda in person, she will be with me in spirit.

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Successful OSCE’s & Time To Say Goodbye

This in not an official U.S. Department of State (DOS) blog and the views and information presented are my own and do not represent the Fulbright Program or the DOS.

Linda, a Ugandan 4th Year Pharmacy Student, and me at a farewell dinner.

Linda, a Ugandan 4th Year Pharmacy Student, and me at a farewell dinner.

The OSCE Assessment event (Objective Standardized Clinical Examination) on Thursday and Friday for the 3rd and 4th year Makerere University Pharmacy Students went really well. Of course there were a few little issues, the biggest one for me being that we ran behind both days by about an hour. And, since the event was to go all day, running an hour behind meant we didn’t finish until after 6pm on Thursday and 5:30pm on Friday. I understand the reason for Thursday’s event because we started late, but on Friday, we got off to a start that was only about 15min late. The stations were timed to no more than 7 minutes for each student and I planned 1 minute in between stations, but that wasn’t timed. We ended up being short on faculty to assess the stations so I had to participate and therefore there was only one helper to coordinate sending students from station to station. I think in the future, we need 2 helpers to make sure people aren’t taking more than 1 minute between stations. Oh, I think I just figured out the issue. Before every station, the students are handed a “student stem” which explains what they will be walking into when they open the station door. That way they know if it is a community pharmacy situation or if it is a hospital situation. I just realized that we didn’t time this part and at my station, I just told the students to read the stem and come in when ready. I’m sure that is where we picked up the extra time.

Professor Richard Odoi and me at the farewell dinner

Professor Richard Odoi and me at the farewell dinner

So another one of the problems that I had anticipated is that we would not be able to get enough faculty to participate to run all of the stations. Unfortunately, last week on the OSCE days, there were 2 other events that took the pharmacy faculty away from campus. These things had been planned in advance and the OSCE days couldn’t really be changed due to the time constraints of my trip here, so we dealt with it. We decided to run only 4 stations, rather than the planned 5. The students did pretty well on 3 of them, but the 4th one, the hospital case, stumped many of them. I think this was because they really didn’t get to practice using the drug information references that were provided for the OSCEs in class as much as I would have liked. The 2 references that are required books for the Pharmacy School are the BNF (British National Formulary) and the UCG (Uganda Clinical Guidelines). The BNF is a reference with details about drug products including dosing, indications, general drug interactions, etc. The UCG hasn’t been updated since 2012 but included the basic guidelines for the treatment of all disease conditions in Uganda. For example, if you look up Malaria you will find guidelines on the diagnosis of Malaria, the classification, types, initial treatment strategies, including doses, and monitoring parameters. I had thought these would be very familiar to the students since they were the required texts, but it turns out the Ugandan students are no different from the American students and they see “required” as “optional”. Many of the Ugandan students now have smart phones and in class, they used their phone apps. But not every student has a smart phone and to allow the use of medical apps for the OSCEs wouldn’t be fair. So, I wrote the cases specifically using the BNF and UCG, and these were provided at each station, only to find out that many students appeared to have limited knowledge on how to use these sources. Planning more PCSL sessions around using and interpreting drug information resources will definitely be required for the future. But the issue of using appropriate resources is still to be addressed. I suppose the Pharmacy School could somehow hold the students accountable for purchasing the BNF and UCG, but I’m not certain this is the best move. First of all, the UCG is very out-of-date. The BNF is a British source and doesn’t include all of the Ugandan drugs. Using other Western sources would create the same problem. Fortunately, there is a group of medical personnel, including a lot of the pharmacy faculty, who are creating a Ugandan National Formulary and I’ve heard the UCG is undergoing a revision. So, hopefully those will be done by next year.

Cathy, one of the faculty at Makerere Pharmacy School, and me at the farewell dinner

Cathy, one of the faculty at Makerere Pharmacy School, and me at the farewell dinner

I want to sincerely thank all of the Faculty and Staff who helped out with the OSCEs, both during the development process as well as during the actual event. This could not have been pulled off without the team approach. In addition, because a few were intimately involved in the process, they now have the experience to lead the development of more OSCE’s in the future, if it is felt that this was an appropriate way to assess the students Pharmaceutical Care Skills. The faculty and the students are taking surveys to help determine this.

I have come to my last day in Uganda for this Fulbright Project. I was here the months of March, September, and November and I thoroughly enjoyed having the time to focus on the needs of Pharmacy Education at Makerere University. I got a chance to get to know more faculty than ever before and I worked closely with both the 3rd and 4th year students, loving every minute of it. It really seems that both faculty and students have embraced the new curriculum and the changes I’m seeing are exciting. Besides helping to teach new skills to the Pharmacy Students, I have tried to instill in them and in the Pharmacy Interns at Mulago a vision of “what could be” if Pharmacists took a more active role in the direct care of patients. I believe that the hospital would manage their limited drug supply much more efficiently so that more drugs are available for all patients, patients would better understand how to take their medications so they can get the most benefits, a closer eye would be kept by pharmacists to make sure the patients are getting the appropriate drugs and doses for their illnesses, and I truly believe patient care will be improved. So as I leave them now to fend for themselves, I challenge Students, Faculty, and Interns to continue the road forward. Don’t be complacent. Don’t let the new skills go to waste. Use them, hone them, and make a difference for Ugandan patients. Continue to interact with other healthcare professionals in a team approach to improve patient care. I’m coming back in April 2015 with my Wilkes Pharmacy Students and I’m really eager to see the progress that will be made. If any of them ever need some advice, they all have my email address and I’m only a computer click away. In the meantime, from Stateside, I will be doing my best to outline a project proposal to fund the next phase of the project to Advance Pharmacy Practice in Uganda.

A Mushroom and Cheese Pizza- Yummy (called a Fungi Pizza here)

A Mushroom and Cheese Pizza- Yummy (called a Fungi Pizza here)

One final thanks to all of the people who have sought me out over the past few days to tell me how much they value my work in Uganda with Makerere University and Mulago Hospital. It’s really nice to be appreciated and to know that the success of the program I’ve felt myself is mutual. And I’ve really gained just as much as the Ugandans from my involvement here. I am continually amazed that I have had the fortune to be here in Uganda for the 6th time doing work that is challenging and rewarding. Before 2008, I never even conceived of any involvement in Africa, but fast forward 6 years and here I am. God willing, this is still just the start of a long and fruitful collaboration. So, my friends, farewell for now, but I’ll be back in April and really excited to see your progress!

Having a goodbye lunch with Pamela, a Pharmaceutics Faculty.

Having a goodbye lunch with Pamela, a Pharmaceutics Faculty.

 

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Ready, Set, Go- OSCE’s Today & Tomorrow!

This in not an official U.S. Department of State (DOS) blog and the views and information presented are my own and do not represent the Fulbright Program or the DOS.

Hard at work writing the OSCE scenarios in my office in the Pharmacy School Building.

Hard at work writing the OSCE scenarios in my office in the Pharmacy School Building.

My time in Uganda is quickly coming to an end. Today and tomorrow are the big OCSE Assessment Days I have been planning since the beginning of this visit to Makerere University School of Pharmacy. OSCE stands for Objective Standardized Clinical Examination and it is a practical exam where the students will interact with a pretend patient and use their pharmaceutical care skills to address the issues presented. It could be a patient who needs a prescription filled and some patient education or one who is asking a question and needs advice about how to treat an illness.

A rainy view from my office window, overlooking the parking lot.  This has been a common scene the past 2 days.

A rainy view from my office window, overlooking the parking lot. This has been a common scene the past 2 days.

For these scenarios, the rooms will have a table with some drug products and other props so it is a little more real than the usual classroom role-play during the Pharmaceutical Care Skills Lab (PCSL) course I’ve been teaching this semester. There could also be hospital scenarios where the student might be presented with the medical chart of a patient, which they will review to find and solve any drug therapy problems. Then the students will have to interact with a pretend Physician to communicate their recommendations. The students will have only 7 minutes to complete the tasks at each of the 5 OSCE Stations they will go through tomorrow.

This is an interior view of the Pharmacy School. It is a really interesting building. You can see the adobe shingled roof of the Canteen where I eat everyday for lunch.

This is an interior view of the Pharmacy School. It is a really interesting building. You can see the adobe shingled roof of the Canteen where I eat everyday for lunch.

I knew that developing an OSCE Assessment for the PSCL would be a big undertaking but I really thought that it would be the best way to gauge both the success of the course and the abilities of the Ugandan Pharmacy Students. Although I have worked primarily on developing the scenarios, the faculty have reviewed them and made comments and suggestions for improvement. They also have helped with the standard setting, which means they helped me decide how to score each OSCE station. Finally, they have helped me gather together the many people needed to help with this event. We are running the OSCEs two days in a row. We will have all 42 4th Year students go through it today, which will take from 9:30am – 4:30pm and then on Friday, 32 3rd Year students will have a go at it. To accomplish this, we needed 5 faculty to agree to spend their entire day(s) assessing all those students in each of 5 stations. We also require 10 first year pharmacy students to role-play the patients- 5 for each day. I will be the coordinator for both days, unless I need to be pulled to be an assessor if one of the faculty doesn’t show up. Finally we need an additional helper to coordinate student movement between stations and to proctor the sequestration room where all of the students will need to stay until it is their turn. This is to secure the integrity of the exam. So, I’m excited to see how it all works out. Hopefully everyone will show up, both helpers and students, but one of the other faculty and I came up with some contingency plans, in case something doesn’t work out quite as we had hoped. If I’ve learned nothing else from all of my trips to Uganda, it has been to “be flexible” and expect the unexpected. Actually I’ve learned a whole lot of other things but to integrate successfully into this culture, and I’m not saying I’m there yet, you do need to be able to “go with the flow”. I’m really confident things will work out somehow- but I’m just not sure what surprises will pop up. I’ll let you know on Friday or Saturday how it all went…

This is another interior view of the Pharmacy School, looking the opposite way of the Canteen

This is another interior view of the Pharmacy School, looking the opposite way of the Canteen

 

 

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