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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A Sunday Party and A New Dress

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.

Although I kept busy this weekend working on the OCSE scenarios for the final assessment for the Pharmaceutical Care Skills Lab that will take place this week on Thursday and Friday, there was also time for fun. My friend, Vicky, who is a Pharmacist at China-Uganda Friendship Hospital- Naguru, took me grocery shopping and out to lunch. It was so nice to catch up with her. In the late afternoon, Professor Odoi’s daughter came to take me to the tailor to pick up the dress I had made from fabric I bought in Jinja during my last visit here.

This is the dress I had made by the tailor, David. The fabric was from my trip to Jinja, Uganda back in September.

This is the dress I had made by the tailor, David. The fabric was from my trip to Jinja, Uganda back in September.

On Sunday morning, my housemate, Monty, and I headed down to a big field on campus at 9:30am to attend a special Family Day outdoor worship service for the Church of Uganda. They had put up tents with many chairs- maybe a thousand. When we got there a little early, there were plenty of seats left but it did eventually fill up and even require more seating to be set out. We ended up staying an hour for the opening music and dancing but then when the introductions started and were taking quite long and the program said the service wouldn’t be over until 1pm, we decided to bail and go to St. Augustine, the Catholic church.

Russ shows me the deck at their new apartment

Russ shows me the deck at their new apartment

After a quick lunch at a local Ugandan foods canteen, we headed back to Edgehouse where I spent part of the afternoon preparing a beef stew with noodles dish for a potluck supper with the Fulbrighters in Kampala. Russ and Kiran, are anthropologists who were supposed to be doing work this year as Fulbright Scholars in Sierra Leone but due to the Ebola Outbreak, they were reassigned to Kampala where they are very welcome and are working with the Advocates Coalition for Development and Environment (ACODE). Initially they were staying in a guesthouse but recently they found an apartment to rent and invited the Fulbrighters of Uganda to come over for a party.

A gathering of new friends on the deck at Russ and Kiran's new apartment

A gathering of new friends on the deck at Russ and Kiran’s new apartment

I believe there were 8 of us total, including, Dorothy, the Ugandan woman who manages the Fulbright Programs from the US Embassy in Kampala. It was a lovely evening and you can see from the pictures that Russ and Kiran found a really great spot. We spent the evening on the deck and if I lived here, I bet that is where I would spend most of my time, too.

Dorothy manages the Fulbright Program at the US Embassy in Kampala

Dorothy manages the Fulbright Program at the US Embassy in Kampala

Monty and Kiran heat up the grasshoppers for nice and crispy munching

Monty and Kiran heat up the grasshoppers for nice and crispy munching

 

Lots of delicious food!

Lots of delicious food!

This is the view of the other apartments from the deck of Russ and Kiran's place- a nice oasis from the hustle and bustle of Kampala

This is the view of the other apartments from the deck of Russ and Kiran’s place- a nice oasis from the hustle and bustle of Kampala

 

 

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The Grasshoppers are Here and Guess What I did?

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.

Yes, I actually ate one and I have survived!

Grasshoppers: fried and salted they are crispy little critters- just pop them in your mouth but try not to look at the eyes!

Grasshoppers: fried and salted they are crispy little critters- just pop them in your mouth but try not to look at the eyes!

OK, let me tell you the story.  Since I’ve been coming to Uganda in Summer 2011, I’ve heard about the local delicacy of grasshoppers.  I’m not sure how it originally came up because it wasn’t grasshopper season, but it did during a local feast held at the end of our first successful trip to Uganda.  While we were munching away on other, more normal foods, someone started talking about grasshoppers.  All of the Ugandans raved about them. It is funny because as soon as you ask almost any Ugandan about whether they like grasshoppers, they get this cute smile on their faces and say something like “oh yeah!”  In fact, today is the first time ever that I’ve found a Ugandan who actually doesn’t like them. And his face looked exactly like mine probably did when I first learned about them- all squished up and a little nauseated. Anyway, that first summer, one of the Americans at the party who had lived in Uganda for a year or more quickly spoke up and said he really liked them too, and that they tasted a little like shrimp.  I was told that the “season” usually occurs in late November or December. In the villages, when someone notices the grasshoppers swarming, they run throughout the town calling “Nsenene, Nsenene”!! (pronounced sin-nee-nee) Then all the people stop working and run to where they are and start trying to capture them. One of the most common ways, and I guess this must be done in the evening, is to get a piece of metal and hold it above a large container of water. Then you shine a light at the metal which causes a reflection to draw the attention of the grasshoppers. They fly straight into the metal and get knocked out and fall into the water. They are scooped up, their wings are pulled off, and then they are dumped into a frying pan.  You apparently don’t need any oil because there is a lot of fat that dissolves out of the grasshoppers as they cook.  I’ve been told people usually like them either fried really crispy or some like them soft and mushy in the middle but crispy on the outside.  You can also throw in diced green pepper and onions for an extra tasty treat.

The one I ate yesterday was fried nice and crispy with the perfect amount of salt (see the picture). My housemate, Monty, tried them first, before I came home from the Pharmacy School.  When he told me they weren’t bad, and in fact, they were pretty good, I decided that I needed to have the guts to try them too. So, I built up my courage and then got out the container. Wow- I wasn’t expecting the eyes to be still on them. That took me by surprise and I almost lost my courage. But, not to be out done by Monty, I just had to do it. So, I got 2 bottles of water, just in case it was horrible, and opened them and sat them next to the container on the counter. Then, I quickly picked up a grasshopper and tossed it in my mouth. I started crunching it up very quickly and I wish I would have given Monty the camera to take my picture because I’m sure it was a site to see. Although I was squeamish about the act of chewing up the grasshopper, it actually didn’t taste bad at all- just different. It wasn’t a displeasing taste.  The outside was crunchy and reminded me of the hulls on pumpkin seeds that we eat after roasting them in the oven.  The inside was a little soft but not at all mushy- thank goodness! And, I agree that it tasted a little like shrimp.  So, I survived and will probably eat some more in the future but I’m not sure that I am anywhere near saying that this is a delicacy for me. But, who knows… Maybe they will grow on me….

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Planning the Next Steps for Advancing Pharmacy Practicein Uganda: Part 1

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.

This is the newly built Pharmacy House and Drug Research Center of the Pharmaceutical Society of Uganda- It is quite beautiful!

This is the newly built Pharmacy House and Drug Research Center of the Pharmaceutical Society of Uganda- It is quite beautiful!

I spent yesterday working on planning the next steps in the process to Advance Pharmacy Practice in Uganda.  The Professor and I have had numerous talks during this trip and in prior ones, but now the time has come to put it down on paper and start seeking approvals from the appropriate stakeholders.  I’m so happy to say that the first conversations have started off well.  The biggest part of the plan that needs both approval and funding is the need to develop the skills of practicing Ugandan Pharmacists who can then begin to work in the healthcare setting to develop a clinical practice site.  A Clinical Practice Site is a facility or even just a ward of a hospital where a Pharmacist’s job description provides for working directly with the patients, physicians, and other healthcare providers for the purpose of improving patient care outcomes.  These duties do not include administrative work such as managing staff or the drug supply chain management, and often don’t include basic dispensing.  The latter can be done by trained support staff and the former is best accomplished by Pharmacy Administrators who have been trained in Management.  Preferably this practice site will be Mulago National Referral and Teaching Hospital for a number of reasons.  First, it is the largest teaching hospital in the country. It is also the primary training facility for all healthcare providers; it is in Kampala, and perhaps most of all, I believe small and easy changes that Pharmacists can implement will make a huge difference in the care of patients and will also reduce drug expenditures.  The things I’m referring to include activities like talking with and reviewing the patient’s medical charts to be sure their drugs are given in doses that are appropriate to treat infections or other conditions without putting the patient at risk for toxic effects.  Pharmacists can evaluate patients and determine their risk of developing other problems in the hospital like blood clots (DVTs), stress ulcers, and new infections and can recommend therapy to help avoid these.  Acquired additional problems while in the hospital are one of the main reasons patients can have prolonged length of stay, which puts a drain on the healthcare system and is also not pleasant for them.  Pharmacists can help manage the blood sugar of diabetic patients so that high blood sugar doesn’t impair healing or a quick recovery.  One of the most important things that I have a special interest in is the appropriate use of antibiotics, called Antimicrobial Stewardship. If Pharmacists were allowed the time to help Physicians both make decisions about initial antibiotic therapy and also changing therapy based on the culture results and the patient’s response, not only do patients heal faster and go home but the hospital can also save money and drugs for the patients that need it.  It is quite common for Mulago to run out of certain antibiotics or other drugs and have gaps of days to weeks, at times, before the drugs are restocked.  If drugs were used more appropriately in the first place the supply shortages would be diminished.

I want to be clear that I am not saying the Physicians or other healthcare providers are making wrong decisions or don’t have the abilities to do these things but that as we’ve clearly learned in the USA, the best healthcare is provided when there is a team approach with many healthcare providers looking out for the patients in the special ways we are trained.  Doctors have traditionally been the lead manager of the patient’s illnesses and this is still basically true, but as any CEO or Executive Director relies on the expertise of his well-chosen staff around him to help advise him on important decisions, so can the adjunct healthcare professionals such as Pharmacists, Nurses, Therapists, Social Workers, etc. play a very important supportive role.  In the USA, we have many cases where Pharmacists even take a larger responsibility for the management of certain healthcare problems for patients who require regular medications for chronic diseases such as Diabetes, Hypertension, Heart Disease, etc.  Again, our role is in no way to supersede the Physician or diagnose such conditions. We act in a supportive role to provide more time for the Physicians who have to see large numbers of patients a day in their practices or at the hospital.  Instead of the Physician having to take time educating the patient about medications or helping to figure out how the patient can manage to pay for drugs the government isn’t able to provide, the Pharmacist can do this.  And when patients simply can’t afford drugs, the Pharmacist can help identify alternatives for the Physician.  All healthcare providers have different areas of expertise and only when this is leveraged using a team approach (commonly called Inter-Professional Practice), will patient health outcomes be improved.

This is the dedication plaque on the side of the new house of PSU opened just recently.

This is the dedication plaque on the side of the new house of PSU opened just recently.

So to start working towards developing the skills of already practicing Pharmacists, you may remember, if you’ve been following my story for awhile, I along with a partner faculty member at D’Youville School of Pharmacy in NY, hosted 2 Ugandan Pharmacists in the USA for 8 weeks in the fall of 2013.  They participated in an advanced Pharmaceutical Care Experiential Program where they worked with us at our hospitals to learn the role of a Clinical Pharmacist and the skills to do this back here in Uganda.  Both Pharmacists, Vicky and Patrick, found the program quite worthwhile and highly recommended it be repeated in the future.  (See blog entries from March 2014 for more information.)  Because the FSP Grant brought me to Uganda for 3 trips this year, the program hasn’t been repeated yet. Last night, though, Professor Odoi and I had a very successful meeting with Sam Opio, the Secretary of the Pharmaceutical Society of Uganda (PSU).  This meeting officially launched the planning stages, pending final approval from my Administration at Wilkes University and the Council of the PSU.  The plan is to again bring 2 Ugandan Pharmacists who have some knowledge and skills in Pharmaceutical Care AND a passion for working with Patients and other Healthcare professionals to the USA for 8 weeks to work with me at my hospital practice site in Wilkes-Barre, Pennsylvania.  This would take place in June and July 2015.  In addition, we are hoping to find an opportunity for them to put the new skills to work right away upon return to Uganda in a dedicated Clinical or Ward Pharmacist positions. This is still preliminary but I’m hopeful for approval by all parties so we can start to seek candidates soon.  Keep your fingers crossed for us. :)

This is the scenic view of Kampala from the second floor windows of the Pharmacy House.

This is the scenic view of Kampala from the second floor windows of the Pharmacy House.

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My First OSCE In Uganda Was a Success!

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.

It is hard to believe I’m already into my 3rd week here in Kampala on the last of my official Fulbright Specialist Program (FSP) Visits.  Although the grant was small, it has really helped me to really move forward my collaboration with my Ugandan partners to help them Advance Pharmacy Practice in Uganda. The FSP itself has only supported me for 6 weeks of the total of 12 weeks that I will have spent in Uganda, by the time I head home on November 23.  It is the support of Professor Odoi and Makerere University who have engaged in this vision with me that has provided the extra weeks of lodging and in-country transportation.  I am truly thankful for this opportunity!  Unfortunately, the FSP can’t be renewed and in order to take the project to the next level and maintain growth, I will have to find alternative funding.  At some point in the future I will discuss some options in another blog post.

In the Practice OSCE, I am portraying, Jane, a woman of my age who has a sinus infection and headache. This wasn't too far fetched since I had just suffered a migraine over the weekend.

In the Practice OSCE, I am portraying, Jane, a woman of my age who has a sinus infection and headache. This wasn’t too far fetched since I had just suffered a migraine over the weekend.

Today I want to tell you about the Practice OSCE that another faculty member and I ran on Monday. OSCE stands for Objective Structured Clinical Exam and this is a practical exam where students are assessed on the skills and knowledge they have been learning this term through the Pharmaceutical Care Skills Lab (PCSL) I have been teaching.  Every Monday in class they are presented with different patient case scenarios and they get in groups to role-play and practice being the pharmacist who interacts with the pretend patient and or healthcare provider.  Then the pharmacy students go to the Mulago Hospital during the week and work with real patients to hone these skills and get more practical experience.  Much of the time there have been preceptors at the hospital to help with this. Either Pharmacy Interns or Pharmacists, or the faculty or the American Guest Pharmacists have worked with the students. I think that most students have had a chance to work with one of these people. But, because there are only 5 Pharmacists and about 30 Pharmacy Interns in training at the hospital (although it is a 2000 bed hospital that is always overcrowded), the students have not always been able to receive guidance as I had hoped.  Still, though, I think they are learning a lot and most of the students are committed to improving their patient care skills and the level of care pharmacists can provide.

Another student portrays a pharmacist counseling the patient about the medications he just filled for her.

Another student portrays a pharmacist counseling the patient about the medications he just filled for her.

The OSCE is a way to formally assess these new skills.  Zubin Austin, from University of Toronto, who developed the method of OSCE’s, came to Wilkes University back in August to train the faculty of the Pharmacy School so we could implement this program to assess our students’ pharmaceutical care skills.  Fortunately, I was able to attend this 2 day session and have now used this method to develop an OSCE assessment for the PCSL in Uganda.  We decided to run a pilot yesterday for 2 reasons.  We wanted to first test our process and make sure the students were capable of completing each station in 7 min. Second of all we wanted the pharmacy students to “see” what this was all about so that they would be adequately prepared, and hopefully not as stressed, for the real event, which will occur at the end of next week.  The “real” event will contain 5 stations. This is the minimum Dr. Austin suggests for validity but even just 5 stations will take us 2 whole days. We need to get 75 students though each of the stations. We will have to train 5 standardized patients to accomplish this. This basically means we will have actors and actresses portray the patient using a standardized script. They will have to be taught the nuances ahead of time and try their best to replicate the scenarios exactly the same for all 75 students.  Ideally we would hire professional actors, as many US Medical Schools and Pharmacy Schools do, but we have no budget for this here in Uganda, so we will do the best we can with second year pharmacy students.  I have also had to give the faculty here a crash course in OSCE development so they can help make sure the scenarios are close to real-life and the standards are appropriate.

The practice OSCE on Monday went incredibly well and did exactly what it was supposed to do. We were able to identify some areas of weakness which will be corrected for the real event and the students got a sense of what this will be like.  Tomorrow I will be debriefing this OSCE, giving them information about how it is determined whether they Pass or Fail and the results from Monday’s Practice OSCE.  One thing that amazed me is how much can be accomplished in the 7 min we allot for each scenario. The timing was probably what worried me most because when this is practiced in PCSL class, the groups work together and are given much more time, sometimes up to an hour, to work through the cases. Of course, for assessment purposes, each OSCE case only tests a few skills, rather than the many that are often packed into the classroom cases.  I’m now eager to get working on the development of the real OSCE stations.  The ideas have been in my head awhile now, but it is time to buckle down get them on paper so the faculty review process can start.

 

 

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Upcountry For The Weekend in Tororo,Uganda

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.

View from the Window at Professor Odoi's home in Tororo, Uganda

View from the Window at Professor Odoi’s home in Tororo, Uganda

I am back in Kampala now and refreshed from a nice, relaxing visit to Professor Odoi’s weekend home in the country. I was invited to accompany Richard and his wife, Nora, to Tororo, which is slightly north and far east of Kampala. It is actually only a few kilometers from the Kenya border. On the 4.5-hour trip, we stopped several times at roadside stands to gather fresh produce for our meals. This also included a live chicken, which was simply placed in the back of the car with my luggage for the remainder of the trip there.

This is the chicken purchased along the way to Tororo, Uganda

This is the chicken purchased along the way to Tororo, Uganda

I had to take a picture since it would be a rare site for an American to have a chicken in the car. It was so quiet the whole trip although I had half expected it to be trying to get out and be squawking. But, upon arrival, I found out that the feet are tied so it can’t move around. I’m surprised, though, that it still didn’t make a sound. The Professor’s home with its beautiful grounds was a nice oasis from the busy traffic, noises, and millions of people in Kampala.

Couches and chairs were sat out on the lawn and this is where I graded most of my papers (Nora is pictured)

Couches and chairs were sat out on the lawn and this is where I graded most of my papers (Nora is pictured)

We ate delicious papaya on the lawn, purchased right from the local farms along the road to Tororo

We ate delicious papaya on the lawn, purchased right from the local farms along the road to Tororo

I had to bring some work with me but grading papers under the shade of a tree is so much better than doing it at my desk in my bedroom at Edgehouse on Makerere Campus. There was also time for a nice walk which Nora and I took to a hotel with a garden where we sat and relaxed some more.

As I graded papers, I enjoyed watching the turkey and chickens wander around the yard looking for tasty nuggets of bugs, I think. These fine creatures belong the the Odoi's caretaker of the house.

As I graded papers, I enjoyed watching the turkey and chickens wander around the yard looking for tasty nuggets of bugs, I think. These fine creatures belong the the Odoi’s caretaker of the house.

This is the front entrance to Sacred Heart Roman Catholic Church in Tororo, Uganda

This is the front entrance to Sacred Heart Roman Catholic Church in Tororo, Uganda

On Sunday morning we went together to Sacred Heart Roman Catholic Church and it was jam-packed full of people. It was definitely the most traditional and formal service I had been to in Uganda. The priest even used incense. I thought this was because it was a festival Sunday- we were celebrating the anniversary (9Nov324) of the dedication of the Basilica of St. John Lateran, which is the Pope’s Cathedral. And they had a wonderful Children’s Choir lead the music, which was accompanied by percussion instruments and what sounded like a Ukulele. It turned out that incense is always used. The service lasted a full 2.5 hours.

A beautiful view of Tororo Rock from the parking lot of Sacred Heart Church

A beautiful view of Tororo Rock from the parking lot of Sacred Heart Church

I sat there wishing I could take some photos so I could show Americans- even when we think our churches are full, it is nothing like the Ugandan Churches. This seems to occur regardless of the denomination of Christianity here. It lifts my soul to see so many others engaging in praise and worship through singing, dancing, and clapping, although the body movements at Sacred Heart were quite toned down as compared to every other church I’ve been to here. I can’t speak for the Muslim worship services, since I’ve never been, but I wonder if it is the same as well?

All in all it was a lovely weekend and I’m very thankful to the Professor and Nora for sharing it with me.

Professor Richard Odoi, his wife Nora, and me (KarenBeth) on the grounds of his weekend home in Tororo, Uganda

Professor Richard Odoi, his wife Nora, and me (KarenBeth) on the grounds of his weekend home in Tororo, Uganda

Posted in Fulbright Specialist Project, My Safari (My Journey/Adventure) | Tagged , , , , , , , | 1 Comment