Wednesday, April 29, 2015

This is one of the 4th year students going through my OSCE station, which was about a patient with sinusitis that came to get a prescription filled. Hillary, a pharmacy intern was portraying the patient and I must say his acting skills were terrific! He brought a handkerchief with him and kept dabbing his nose. When he spoke he used a nasal-congested voice and he looked like he was in pain from his bad headache. This obviously seemed real to the student by the empathetic and concerned looks on their faces as they proceeded through the station.

Kristen and I are back in Kampala and we had to say goodbye to Hanna, Lizzie, and Amanda earlier this week. They have all arrived safely back in the USA but Kristen and I have the pleasure of savoring a little more time in Uganda. Now we are working with the faculty at the Pharmacy School at Makerere University to administer an Objective Standardized Clinical Examination (OSCE) to the 3rd and 4th year students to assess their pharmaceutical care skills and knowledge retention from the course I helped teach last fall. The students aren’t that happy to be doing this when the course was last semester and they haven’t had any clinical content or experiences at the hospital this term. But, that is exactly the point. We need to find out if the students are able to retain what was learned last fall and apply it now because if not, then perhaps something needs to be changed. Maybe clinical content needs to be added in both terms.

This was another station where Nicholas, the “soon to be pharmacist after intern year” was portraying a patient with a wound infection from Boda-boda accident, the most common of causes of accidental death and injuries in Uganda. (Motorcycle accident)

Or maybe we need a different approach to teaching or better reinforcement to the students that these skills will be used lifelong as a pharmacist and are not just to be crammed for a course and then forgotten. This is especially important for the 4th year students as they are soon to be done with all classes and will go out on internship where they will need these skills. I don’t want them going to the hospitals and saying “I don’t know how to do that; we were taught that a year ago.”  Hopefully that will not happen and today I was generally pleased with the 4th year results for my OSCE station.  Putting on this OSCE Assessment is quite a feat, as Kristen noted today. Her help was invaluable.  It takes the dedication of many to pull an OSCE off.  We had to engage current pharmacy interns and soon-to-be pharmacists to help out by role-playing the standardized patients. Everyone had to come by 8am to be trained and all, including faculty, had to dedicate their entire day to this event.  And, it has to happen again all over tomorrow for the 3rd year class.  But I was really impressed- not a single person was grumpy about this and many of the intern helpers mentioned they were glad for the opportunity.  In addition to the event-day, planning is also very time consuming, which is why I haven’t posted for 2 days.  But, this type of assessment is really good for the students. It is an individual event and may be the only time, before real-life practice, for them to get a chance to see if they really have the skills needed.  And for faculty, we get to see if what we are teaching is actually “sticking”. And if not, it give us the motivation and direction to make improvements.

Dinner with new friends from the Infectious Disease Institute in Kampala: Eva, KarenBeth, Shadia, Kristen, and Julian

Yesterday Kristen had the opportunity to spend 5 hours with the pharmacy staff of the Infectious Disease Institute (IDI) in Kampala, on the campus of Mulago Hospital.  Ever since I started coming to Uganda I have wondered about their activities. The only experience I’ve had so far is using their bathrooms- last fall I needed a facility and one of the interns said that she would take me to a bathroom. She said it was far, a long walk, but “believe me, it will be worth it”. Wow, she was right! Anyway, this trip I was able to get in touch with one of the IDI Pharmacists, she had emailed me to inquire about the Pharmaceutical Care Program I was advertising for (more on that later) and we started an email conversation that led to the opportunity for Kristen yesterday.  I would have been there as well, but my energy was needed to prepare for the OSCE.  When Kristen was done for the day at IDI, she was just glowing and couldn’t stop talking about all she had seen and learned. The IDI focuses on care for patients with HIV and AIDS. It is funded, at least in part, by the U.S. government. They do a lot of research to make sure patients are getting better with the current therapies and to make sure there aren’t drug interactions with antimalarials, which they actually have found a problem with some.  Patients get all their HIV meds and visits for free. The pharmacists at IDI are really involved with both the research and monitoring patient safety with the drug therapy, called Pharmacovigilance.  Since I couldn’t meet Eva and her crew earlier, we arranged to go to dinner at a lovely place called The Bistro.  We had such a good time!  Eva brought Julian, another pharmacist, and Shaida, a physician they work with.  We had many laughs- Julian is so funny. Since we told him about the OSCE’s we were doing, he regaled us with his OSCE stories from his education at Makerere. Boy, after a number of year, he still remembers all of his mistakes. I’m sure he did well on many of the stations, but I guess what sticks in your mind are the times you messed up.  It was a great evening and hopefully Wilkes students will be interested in working with the IDI pharmacists in the future.