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.
On Monday I taught the second Pharmaceutical Care Skills Lab to both the 3rd and 4th year pharmacy students. Once again it went quite well. I’m so pleased with the student’s engagement in learning and practicing the Patient Interview skills and their attention during the lecture part. Their participation in answering questions, though, is just American students- you have to “pull teeth” as the saying goes, sometimes, to get them to answer questions. I will often hear mumbling in the group in answer to questions but then when I ask for one person to talk, no one volunteers. As with my Wilkes students back home, it is hard to tell if this is because they really don’t think they know the answers or have an opinion or whether they are just shy to speak up. But in general, I am happy with the progress of the course so far in terms of the students’ learning. I am also thrilled that I am now able to access and post to the Makerere eLearning site (their online component to courses) so that I can provide electronic copies of the documents for the students to read prior to class. This will also be helpful in reducing the need for printing.
I have realized since my early visits to Uganda one of the barriers to advancing education and patient care is the difficulty with some basic infrastructure issues like printing and paper (or stationery- as they call it here) costs and availability. Not only will the Pharmacy Department at the hospital run out of paper but often when the printer ink cartridges are gone, there is no money or supply to replace them. In the USA, we take these things for granted. If supplies run low, there is usually a storeroom where we can get the materials needed the same day, if not the same hour and “someone”- our highly capable administrative assistants- always make sure the supplies are readily available. Budgets for departments and businesses are usually plenty big enough to cover printing costs as this is accepted as a necessity of the workplace and accomplishing our tasks. Back home, the handouts for each of the PSCL sessions are often 10-15 pages long. They contain material for the students to learn from but also the detailed patient case scenarios that will be role-played to learn how to use the Pharmaceutical Care Skills. There is often room for the students to write their communication notes with their management strategies. There are many “tools” we use in the process of trying to figure out what the potential drug therapy problems are so we can investigate and offer solutions and these are usually printed for the students to follow and use to document the correct data on the paper. There are documents which are printed and used for students to peer-assess each other so they learn how to improve their patient communication skills. I think my first handout for last week’s lab was 11 pages front and back, which the University printed, but that was certainly a lot of paper because there were in excess of 70 students between the 2 classes. Although I was aware of these printing issues at home when I developed the lab and I had asked about the ability of documents to be printed ahead of time and received an affirmative answer, I guess I didn’t fully realize the length of the handout until I got here. I ended up printing the 2nd week’s lab myself, but this was mostly because I didn’t give the department enough time to do it and I had to get it done over the weekend. But, from this point on I am keeping this in the front of my mind and I am going to be creative in trying to find ways to keep the printing and use of paper to a minimum by posting online documents for the students to review on their laptops and by projecting the documents at the front of the class for review instead of giving each student their own copies. I think my cases have been a bit complicated anyway, and I will try to simplify them. We probably should be more cognizant of our use of paper and printing in the USA as well. Even if we have the resources and finances, there is the impact on the environment and the use of energy and waste that results from using supplies when maybe they aren’t always necessary.
There are a number of other barriers that I will discuss in future posts- Internet availability and reliability, availability and reliability of electricity/power, and safety, effectiveness, and availability of the drug supply, to name a few.
Today I’m off to Mulago Hospital to work with some 4th year students as we run a trial of the Experiential Component to the PCSL, Pharmacy Rounds. We will work together to see if the process I think will work, will really work and then fix the issues so that the Pharmacy Rounds can start in earnest next week.