Precept2Practice: Designing High-Impact Rotation Experiences for Pharmacy Learners

Well-designed rotation experiences are essential to developing competent and confident student pharmacists and residents. This course discusses how to structure rotations, align with institutional expectations, and create meaningful schedules, activities, and deliverables that balance service and learning, while introducing principles of deliberate practice to support ongoing skill development. You will gain practical strategies for designing engaging, well-organized, high-impact experiential learning experiences

 
Host
Kate Newman PharmD,
Director of Experiential Education
Clinical Associate Professor, Pharmacy Practice
Southern Illinois University - Edwardsville

Guest
Mayank Amin, PharmD, RPH, MBA
Pharmacist
Owner, Skippack Pharmacy


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CPE Information
 
Learning Objectives
At the end of this course, preceptors will be able to:
1.  Describe key elements of effective rotation design, including structure, expectations, and learning activities. 
2. Identify strategies to create engaging and high-impact rotation experiences for pharmacy learners. 

0.1 CEU/1.0 Hr
UAN: 0107-0000-26-246-H99-P
Initial release date: 6/17/2026
Expiration date: 6/17/2029
Additional CPE details can be found here.

The speakers have no relevant financial relationships with ineligible companies to disclose.

The examples shared in this episode are intended to illustrate approaches to experiential learning, service development, and patient care innovation and are not endorsements of any specific service, product, or practice model. Certain examples discussed may no longer be viable, appropriate, or permissible under current regulatory requirements. Pharmacists should exercise professional judgment and ensure compliance with applicable laws, regulations, payer requirements, and evidence-based standards when evaluating or implementing patient care services.

This program has been:
Approved by the Minnesota Board of Pharmacy as education for Minnesota pharmacy preceptors.

Reviewed by the Texas Consortium on Experiential Programs and has been designated as preceptor education and training for Texas preceptors.

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Transcript

Welcome And Why Rotation Design

SPEAKER_00 0:03

Welcome to Precept to Practice, your dedicated resource for advancing precepting, your practical strategies, applied insights, and conversations shaping the future of pharmacy education. I'm Kate Newman, and if you've ever wondered how to better support your learners, challenge their thinking, or help them step confidently into practice, you are in the right place. Today we are diving into how to design a high-impact rotation. A topic that's valuable whether you're welcoming your very first learner or you've been precepting for years. Intentional rotation design can enhance learning, clarify expectations, and create a more rewarding experience, both for learners and preceptors. By the end of today's discussion, you'll gain several practical strategies to create well-organized, high-impact experiences for your learners. I am excited to be joined today by Mayan Kamine, an independent community pharmacist and owner of Skidpack Pharmacy in Pennsylvania. Dr. Mack has transformed a once-closed pharmacy into a thriving patient-centered hub for care. He has more than a decade of experience as an entrepreneur, educator, and strong advocate for reimagining the role of independent pharmacy in improving access and outcomes. And perhaps most important for our discussion today, he is especially passionate about precepting and mentoring student pharmacists, helping to shape the next generation of practitioners through hands-on community-based learning. Dr. Mack, I'm so excited you're here today. Thank you for joining me. And to get us started, can you share a little bit about your journey to becoming a preceptor or maybe how you became interested in educating pharmacy learners?

Dr. Mack’s Path To Precepting

SPEAKER_01 1:44

Okay, thanks so much for having me here today. Precepting and students is one of the most passionate things that I can say I've done in my career. It's only been, I guess, 15 or so years since I myself was in pharmacy school. And I still remember those days where it was the last year of rotations, and we had to go out and learn about the different aspects of pharmacy because we had the opportunity to go and explore potential different career paths for ourselves. And at that time I didn't think much of it. I loved my preceptors, and they were actually some of the reasons why I wanted to one day be a preceptor myself. But the ones that really stood out and that I still remember and keep in touch with even years later are the ones that set up a rotation for me that not only made use of my time, but left a lasting impact for myself and the actual company that I was at. And my journey has been one with many curves, uh hurdles, and obstacles along the way. But like with any pharmacist, uh, that's the beauty of our profession, is that you have a lot of options when it comes to rotations. You have a lot of different choices in the field of pharmacy. And for me, I've gone from working for a pharmaceutical company, being in movies, starting my own wedding planning company, to actually opening up uh an independent pharmacy that had closed after 50 years of helping its community out. And that's where I'm currently at today. I own Skidback Pharmacy. It's a small little pharmacy outside of the city of Philadelphia. I'm so glad that I made the decision to reopen this pharmacy that was for 50 plus years protecting and serving its community. And then one day a pharmacy decided to buy this little pharmacy out. We're seeing this as a more common practice happening. More and more pharmacies are closing, unfortunately, and larger chain pharmacies are tending to buy out the little guys. But I thought that if I could bring the community together and truly make it a community pharmacy where it was a pharmacy that I opened up, but it's for the community, I think we could make uh wonders happen. And sure, in the seven years that we've been open, magic has happened and we've been able to change not only our local community, but inspire people around the world.

SPEAKER_00 3:51

I love the story of kind of the, you know, bringing the pharmacy back into the community and bringing that, you know, patient-centered care back into the community. And I'm sure that that is something that really resonates with your learners as well to see something different from what maybe they're seeing happening around them in other areas. So I'm sure that that's inspiring. I also love that you were thinking about your experience as a student and in a learner. Um, and you know, I think when we think about experiential education and why do we have students do these rotations, it really comes to that journey of developing a skill to be a pharmacist. And you can only do so much in a classroom or in a lab. It's really those real life experiences that uh help students really grow and develop those skills. So when you when you think back to your experience, you know, as a student or to those preceptors that you found really, you know, inspirational.

Experiential Learning As Real Practice

SPEAKER_00 4:47

What do you see as kind of the big picture goals of experiential learning?

SPEAKER_01 4:52

Well, you had mentioned it where when you're in school, you're constantly focused on exams and studying and the practical things that you're gonna one day apply. But education simply teaches you to learn things, understand them, and be able to apply them. You don't really apply them until you actually go out in the real world. And that's why when students come to our pharmacy, the major thing is that this is the real world setting. And although they are not an employee of the pharmacy, we want them to imagine that this is theirs. They're not just coming into somebody else's pharmacy. Let's imagine that that student is the pilot. This is their pharmacy, they're navigating the challenges, they're they're faced with hurdles and obstacles along the way. And I love the opportunity of giving them the power. Oftentimes people are scared of saying, All right, hey, I'm gonna give you the authority to decide what to do. Obviously, we're there as the co-pilot along the way, and that makes the journey fun because sometimes if they fail, it's not gonna be a failure that reaches the patient. You still are there holding their hands, just like my own little three-year-old. Uh, when she's when she learned to walk, when when my five-year-old learned how to ride his bike, we're there right next to them, guiding them along the way, giving them tips and pointers. We may already know the answer to the things that we're asking them, but sometimes they learn by us just letting them try to think. Because oftentimes we're just force-fed things, or here's here's how it is, and this is what you have to do. And that often negates and hurdles creativity. And we're in an era where you have to be creative to survive, you have to be willing to adapt. Those that are not adapting, those that are not changing, unfortunately, those are those are the pharmacies and ideas that are being shut down or closed. So we really try to make it an impact by allowing students to be creative and kind of to be in in control and in charge because of those things that you learn in school, the only way that they can actually have an impact is if you apply them in your day-to-day.

SPEAKER_00 6:46

I love that you talked about their independence and trying to give them more of that kind of independence and experience. I I also really love the pilot-co-pilot analogy. I think that's a perfect uh descriptor.

Must-Haves For A Structured Rotation

SPEAKER_00 6:59

When you are thinking about what you include in your rotations to give students that autonomy and that learning and that you know creative experience, what do you think are like must-have elements of a well-structured rotation?

SPEAKER_01 7:13

So oftentimes I think about our first students that came when we did not have a structure. Sometimes the best way to learn is from the mistakes that you made. And oftentimes you make them over and over and over again. But at some point you you realize by getting feedback from the students, like, what could I have improved? So I know for me, and it wasn't until four years after I started precepting students where I asked, you know, one of our recent students, her father is a principal of a local high school. And I asked her, I was like, I know you're here for five weeks, and I know you have education within your family. I want you to turn this rotation experience to something that will last many, many years, even after you're gone. And she was actually the person that made skip back university for us. So it's like it's basically getting her feedback in the sense of, all right, what would you have wanted to know when you started here at the pharmacy? Would you have gotten an email two weeks in advance? Would you have wanted to know what kind of clothes to wear, where to park your clothes, or where to park your car? A lot of details that preceptors may forget to give the students are oftentimes things that students wish they might have had. And if we've had students ourselves, the best thing is to ask them for honest and open feedback. Because you're gonna have so many people tell you that you're the best and things were amazing, but you can't improve if everyone's just telling you that you're absolutely amazing. So, one of the things that I personally learned is that providing information to the students in advance. We have a set uh structure now where four weeks in advance we send out an email reaching out to the students, just letting them know of what to expect. And the we call it an experience guide because they're not just here learning, but it's gonna be an experience for them. So they're sending an experience guide that was created by students, telling them what to expect when you arrive at the pharmacy, what you're gonna see in your four to five weeks at the pharmacy. When we write things, it can be viewed as one thing. When students are writing things, they're speaking the same language as another student. So we've allowed our students to edit, modify that rotation guide, and then continue to change it as time goes along, just so that the next generation, the next students that are coming are able to experience it way before they even walk through our doors. And that experience guide has really helped us. So that four weeks prior to the rotation that our students came up with is an amazing way for them to actually get their feet wet before actually physically walking into the building, telling them to check out our website, look at some of the other student projects that were created. There's a list of previous students that came to our pharmacy, including which school they went to. That actually allows them to grow their own network, that they're not just coming to learn, but they're going to be building their network and potentially have the opportunity to speak to some of the students that might have walked through and been here at this pharmacy, even if it was just for five weeks. Because our goal is not only for these individuals to come and learn for five weeks, but to be part of our alumni network. Just like the large companies have an alumni network of people that work for them. They might, these students may not have worked for us, but we want to be able to continue to establish that database of students and allow them to connect with each other. So when we have outings, we'll go back and invite other students that might have come back and been at our pharmacy two, three years ago. So the invitation is always open and they can connect to some of the newer students that might be in their shoes, wanting to potentially get a residency or a fellowship or work for a pharma company. And allowing the students to connect like that has been amazing. So for me, the main thing that I could say is you want to have a structure and you want to explain that structure in advance. The universities do a fantastic job. Some of them have a 30, 40, 50 page manual, which is phenomenal. They have to have guidelines in place, rules set. Amazing. But you as a preceptor should have your own guidelines. Um and guidelines, meaning also what to expect. Sometimes we're so focused on setting the rules that we forget that there's a student coming wanting to learn. We don't want them to walk in thinking that all they're gonna have to do is look at this rule book and follow the rule book. They're gonna be using the rules, of course, but they're also gonna be using that to create impact in your pharmacy.

SPEAKER_00 11:18

I you shared so many incredible ideas, just even in that part. I I agree. I think knowing what to expect is really important for a learner and it helps them get the most out of the experience when they can prepare a little bit coming in. And you know, many students are nervous going into new settings too. So it also kind of helps everyone start on a clear start. I love that you have students writing that and editing that. So it's in their their language and their tone. And I think that that's a beautiful example of a way too to help with your own workload as a preceptor by allowing students to help you with that. Um and you you mentioned clarity and expectations, and I would agree too, that those things are all really important. And you're right, the school can only do so much, right? Every rotation is unique and different. And that's the beauty of experiential learning, is that it's not the standard experience, but the ability to kind of share that in advance. So I'm hearing, you know, having a structure, having some sort of schedule or guide. And I would add that sometimes I hear feedback from preceptors that say, like, well, it's really hard to do that because my my rotation changes all of the time. And of course, healthcare is an ever-evolving uh environment, but I I always encourage like to at least have something, right? A list, an idea. Um and I'm sure since you take lots of students from lots of schools too, you know that sometimes it's easy to forget. Like, did I tell that student this or was that the previous student? And so by having something standard in writing, it can help with your workload, but make sure students are all getting the information that they need. I'm curious when you think about like what activities and and things you have students work on while they're with you in the

Meaningful Work Without Busywork

SPEAKER_00 13:04

pharmacy. Obviously, there's you know, pharmacist work, uh, but that can look different in lots of settings. So when you think about the types of meaningful kind of experiences that you give to students, are there some examples you could share that might be helpful for other preceptors?

SPEAKER_01 13:19

I guess one of the main things that I could emphasize the preceptors is we have to remember that these individuals are coming to learn. While we might already be overwhelmed in our current work environment, they're not here just to be your technician and fill prescriptions all day. And I hear from many, many students that this is happening to this day still. And I discourage students from just spending all the time solely focusing on filling prescriptions because that's something that's evolving and changing. Yes, there is the art of filling a prescription, counting by fives, or using an icon device and pouring the tablets in. That's all great. If if you're if you tell a student, I want you to find a way to help prevent errors that I can, you know, filling is important, but while you're filling, can you see what we're what's a downfall or what's something that we're doing that can be improved, that can help, you know, either with patient safety or with counseling. What are some labels that we can add? Those are the aspects of turning a monotonous task into something that has an impact where you can utilize someone else's ideas. You might have been doing one specific thing for the last 10 years, and now all of a sudden you have a student that came in and suggested an idea to you. And that's one thing as a preceptor to be open to is be open to feedback from your students. While we're, you know, we love giving feedback to people, it's it's great, but we should also get feedback from our students. So I always tell our students from the first day that they walk in, we have so many people in our community and our staff and alumni that have said they absolutely love our pharmacy, which is great. We love that, we love hearing that from our community. But I want someone to say, hey, Dr. Mack, this is actually not that good with what you're doing. Or I have an idea that of you to improve XYZ. And I tell them, I'll probably give you a hug the moment you tell me that something is terrible because that's what I want to hear. I want to improve an experience for a patient. I want to prevent a medication error. I want to help uh counsel a patient on a specific medication or a topic that we might not have been doing properly before. So when people provide feedback, it's it's absolutely amazing. And realizing as preceptors that we're not here just creating busy work for our students. And that's that's what often differentiates just a rotation site where someone goes, they just do their nine to five and get out when they when when 5 p.m. hits. They're just looking to the clock and hoping to get out of that rotation. And you hear students talking to each other, they share their feedback with each other. I always ask students, you know, how was the last rotation, or what was the good things that you liked about it? What was some of the things that you wish would have been different? And oftentimes they hear that they just spend time doing monotonous tasks, not actually learning. They were just like an employee of that pharmacy and they weren't able to apply some of the things they learned in school. So I think it's important to avoid busy work. Uh, obviously, there is going to be tasks that they might have to do, ringing out a patient, for example, in the pharmacy, which is great, but turn that ringing out of a patient into something different. Instead of saying, Do you have a question for the pharmacist? Tell them a counseling point at that at that point. Don't even wait for the opportunity for them to select no, because 99 times out of 100, they're just so used to hitting no, and you're already used to them saying no, that they don't have a question, even if they have a question. Look up that medication in advance. If you've never seen it before, look it up and see what's a clinical pearl that you can tell this patient when they come to pick up that medication and just tell them, hey, did you know that you have to separate vitamins two to four hours? And I bet you they probably don't know that. Uh, and you just told them something that they would not have asked you otherwise. So it's taking a simple task and turning it around. And obviously, while you have students at your pharmacy that are doing this, the goal is that the beautiful things that they bring to your pharmacy, they should hopefully set the footprint that that lasts far beyond the time that they're at your pharmacy. So I always tell my students, I love having you guys here, but I also have to remember that you're not going to be here after five weeks. And while I love these five weeks of you coming up with these creative ideas, you counseling patients, doing all these things outside of the box, let's bring that outside of the box idea in the box. So your goal is not only to find creative ways and different things to do here at the pharmacy, but true success is when you leave this pharmacy, Kate was able to do XYZ and not only do XYZ for the patients, but train the current staff to do this. And now that thing that Kate did is going to be here at Skipack Pharmacy forever. So it's leaving a lasting impact. And I think that if we as preceptors focus on uh allowing students to be creative and um allowing them to find little flaws in the system or find opportunities for us to improve patient care without just focusing on busy work, I think that allows an even more meaningful impact for them and for us because the things they do will be something that will last in that pharmacy forever.

SPEAKER_00 18:10

I think there's such a big difference between a project that is a project and then it goes into a binder and no one ever sees again, and a project that is implemented in the pharmacy. And I think we've probably all experienced that when we were students too, the difference between maybe it's the same project, but if one is going to be used, it feels like a more impactful experience, I think, for learners. And I think, you know, you shared earlier that you have, you know, kind of this repository list of projects students have done before. And I'm sure you're able to point out things that you're still doing that a previous student started. And I think that also signals to students that you mean it when you say, like, this is something that's useful to the pharmacy and we want to continue to use it. Um, and that creates an environment where there's more buy-in into that experience and they feel more excited about it. So I think you're you're pointing out uh that there's a lot of nuance. It's not just about what you have students do, but it's about how you talk about it and how you talk about feedback and that you want the feedback on your experience. Um, and I appreciate when we started you being honest about it, it took you a few years to really see the improvement. And we've all been there

Building Projects That Outlive Rotations

SPEAKER_00 19:22

for sure. And I that's one reason I hope this conversation is helpful to preceptors of of any experience level.

SPEAKER_01 19:28

You mentioned the projects. So I want to mention, you know, sometimes you have success and sometimes you have failures. So one project is uh one of our first IP students that came to our pharmacy when we first opened, she had diabetes. And I try to connect our rotation to something that that they are experiencing or their family members experiencing, because I wanted to connect to them. When you when something's connected to you, you can actually spend more energy, effort, and you feel like it's your own baby by the time you leave. So she had diabetes. So I was like, okay, at that time we're part of the PPCN CPSN network. There was a project going on for diabetes education awareness, DSMES. I didn't know anything about it, but I was like, here's an email that I got. I want you to look into it a little bit further. It connects to you, and it truly did connect to her because she was the one that put our initial framework together, our application for DSMES. She put everything together, great, but she left. At that point, you wouldn't believe it, but it was three years later that we were able to pick up on it. So sometimes students create amazing things, and that's where I realized that you should have the ability to pass the project on to the next student or to a staff member. Because if it just sits there, it will just sit there. And that amazing work that she had spent five weeks doing, it just sat there for a few years. And then a few years later, one of her classmates from Wilkes University had come to the pharmacy. This was post-COVID at that point. Uh, so we were through all the chaos. And I was like, you know what? There's a project that a student from Wilkes started a few years ago. Let's see if we can continue that. She's already put the framework together. And that next next student put, you know, spent a few weeks putting that project together and sending the uh hitting the submit button and getting the application reviewed. We didn't get approved for uh DSMES, it takes some time for them to review the application. So during her time, we didn't get approved, but we did get the approval a little bit later. And now, going back to the last rotation, another student came from Wilkes in her appy. And I was like, Did you know your two previous classmates started this, one submitted it? Can you close the final gap and let's get this DSMES program actually going? And she applied for Medicare for us, like for us to be able to build Medicare. We had a we had inspection by the Medicare auditor. A lot of things that she did now finally came to fruition. We got approved. And the day after she left her rotation, I got an email from the Pennsylvania Pharmacy Association saying there's a grant for $8,500. Pharmacies that are accredited with DSMES. And then I sent her a text message. I was like, Kimmy, look at the amazing work you did. And I sent it to our dean of our school too. This is what your student did. Now we have $8,500 to be able to get supplies for us to actually apply this program and help people that have diabetes. The thing that the first student with diabetes wanted to get us involved with four to five years later finally came to a closure. And it's truly not the closing of it, it's just the beginning of it. Because now students will expand. My current student is actually now going to be able to get us a CLIO waiver to be able to test people for A1Cs. And it's going to be an ongoing project, but that was a project passed on from one student to the next to the next. I learned a lot along the way in terms of making sure that these projects, they're not just busy work to for someone to do and close and put it in a binder, like you mentioned, but actually to get passed along until it actually completes. And sometimes you're going to have projects that don't actually succeed, which is okay, because at the end of the day, that student learns something and you learn something too.

SPEAKER_00 23:00

So important to remember that failure is part of process and things don't always work like they're supposed to, and or that you hope that they will. And so I think that that's a really important lesson for students, but also for us as preceptors to remember as well. And I love that you have this continuity, you know, and seeing projects grow and continue to expand. And I think as a preceptor, it can be challenging sometimes to imagine projects broken down into manageable sections. And I and I also appreciate in that example that you were talking about Ippie students and what they did and appie students, because I think sometimes too there's a perception that, well, Ippie students, you know, may not be far enough along in the curriculum. And so their projects may not add as much value. And I think your example is a perfect one to showcase that regardless of their level, students can help grow and advance the practice in your pharmacy or add value to the pharmacy. And even if there's a gap in time, you know, it still is a valuable step. So I think one maybe takeaway from that is thinking about how you can break projects down into smaller steps because you only have students for a short amount of time. And they are learning other things while they're there, of course. You know, we talked about filling, and we don't want students to just fill or serve as a technician all day. But sometimes they do need to learn the process, and so that might be a little piece of it too. But I think that that's an important way to think about those learning experiences. When you are thinking about these experiences and you've talked about getting feedback from your learners to help improve things, how do you kind of determine ahead of time or maybe in the moment if you think an activity is really going to be meaningful for a student or like how do you differentiate? Like, is this busy work or is this a valuable, meaningful activity for them to engage in?

Students Spot Problems And Innovations

SPEAKER_01 24:57

Oftentimes for us, it's it's been when this student actually comes to the pharmacy. And our pharmacy, it's we've been on the front line of navigating change for patients, navigating hurdles, whether it's COVID or you know, testing crisis situations. Right now, there's an estradial patch shortage. There's so many different things that students walk into. And sometimes we as the owners or we as the pharmacists know that this is a problem that our community is facing. Other times the students actually see it because if they answer the phone and three out of five phone calls is someone asking, do you guys have estradial patches? That's a red alert for you that, hey, this is an opportunity. We might not have estradiol patches, but let's try to help these patients who might be facing this crisis situation. Let's look into alternatives. Some of our most successful ideas that came to fruition were actually identified by a student. About a year and a half ago, I had an appy student from Pittsburgh. She had come and she was answering the phone calls. Uh, and multiple calls she got were, Hey, do you guys have this GLP one medication in stock? And many, many calls in the day were those calls. And I said, Unfortunately, we don't have them in stock. And, you know, she probably got tired of us saying, unfortunately, we don't have it in stock, and probably felt bad for a lot of people because we were turning them away. But she also thought, what can we do? We're often faced with the challenges of, okay, we're stuck in this tunnel, and this is a roadblock we've hit, but you can also turn around and try to go a different route in the maze. So she said, Okay, I understand that we're stuck here. And I gave her free rate, and I was like, do some research, look to see what others are doing, and use some of your clinical knowledge to see if there are alternative solutions that we can do. And she looked into the option at that time, which was compounded weight loss medications. I knew nothing about it, but I said, I want you to put together the information, safety, efficacy, because anything new that we're bringing into the pharmacy, I'm the gatekeeper in the sense of I have to make sure it's safe for our patients and we have to be able to describe it to the providers in the area, also to let patients know. So she looked into that project uh in the sense of weight loss medications a year and a half ago. We were turning every single patient away, and she did some research behind compounded weight loss medications. And we look, I was looking at our job form, which is uh an appointment form. It's a form that people submit different things, like a medication request on. Since that time that Abby, the Appy student from Pitt, was here, 15,000 people have filled weight loss medications. And to imagine that a student who was on her last rotation came up with that concept to help the community, and you have people coming in and hugging us because they've lost 50 pounds and they're all three medications. We have providers who will only send these types of medications and consults to our pharmacy because they trust us so much. And all of that was started by a student who was just in her last year of rotations, who identified a problem. And to this day, you know, I'll send her a message saying, Hey, Abby, guess what? Here's the success story of a grandma who you just, you know, who came in here dancing and who was way overweight and she has pre-diabetic. And this is the success story of something that you attribute to a couple years later. She doesn't work in community pharmacy right now, but it feels good to the students when you actually let them know that something that they did during their rotation period actually had a lasting impact even years later. And I can attribute our whole entire weight loss program. The foundation was built by her, and then she passed it along to the next student who passed it along to the next student. And the changes came along the way, different, uh, you know, different challenges, different things changed along the way. And the other students knew that, hey, my fellow student did this, they created this project, we were able to help this many people. What can I do to help the current environment, the current situation? What might be happening next? Our most recent uh innovation was we bought this machine called the in-body scan. One of our students, like, Dr. Mack, we're, you know, we're helping all these patients lose weight, improve their A1Cs, but they don't have a way to measure whether they're losing body weight in the sense of muscle mass or fat. And I was like, that brings up a good point. He said he saw something at a gym where you can actually check, you stand on a scale and it gives you the measurement of muscle over fat. And if you're, you know, you you check every few months and you can see the difference of weight lost, whether it's you know one or the other. And I said, okay, look into it, do some research, see which other pharmacies have it. Put put a proposal together. Uh, we like to think of our pharmacy as like shark tank, where we're the sharks, the most friendly sharks, because uh whether the student has an idea that's we're gonna accept or not, uh, we're gonna, you know, obviously try to think about what the student's mentioning to us. So the student was, okay, these are all the amazing things about it. The downside is it cost $10,000. I was okay, we're gonna forget that it costs $10,000. But at the end of the day, his pitch was amazing. We bought that $10,000 device and it was a student idea. Now we have something that differentiates our pharmacy from any pharmacy within a few hours of skip back because no one else has this device. And not only that, but I had a few doctors reach out to us saying, Dr. Mack, I really appreciate you guys giving us this insight because these reports that you're giving the patient to give back to us are now allowing us to modify their therapies or see what we need to recommend of whether they should, you know, see a nutritionist or have additional counseling in regards to their diabetes. So these are all small little things. And while the initial idea for weight loss medications was created by a student a couple of years ago, it's continued even to our last student who has added a tool that can help these patients navigate their journeys.

SPEAKER_00 30:38

That's amazing. It it is very clear to me hearing you talk about these student examples that you um have a relationship with the students and you're able to build and they're part of the team. It's not just, oh, here comes a student and then they leave and we can't remember who they were, and here's the next student. And I think that that definitely contributes to the environment. And I think when you're thinking about setting up a learning experience, you know, part of it is the structure, part of it is what you're having students do, you know, what kinds of projects or what kinds of tasks. Uh, but part of it is also that environment that they're in. And is it an environment that they are able to thrive? And so what are some things that you can think of, maybe strategies or ideas for other preceptors or sites to help create a positive learning environment for students?

Creating A Safe Compassionate Culture

SPEAKER_01 31:32

Yeah, so in terms of environments, we all know that community pharmacy can be a very stressful environment. When you're talking about jobs out there and you Google the word pharmacy plus, you know, stress or something like that, you're gonna see a ton of articles in there. And that's not to scare away people from our profession. It's all how you navigate things. And I tell students that you don't have to be the smartest pharmacist. I was not a straight A student, but you have to be confident in what you do, and you have to remember at the end of the day, you're filling something, you're counseling somebody. And let's not pretend that patient is um 473256. That patient is your brother, that patient is your daughter, that patient is your grandmother or your grandfather. If we start viewing patients as their own family members, we're gonna start changing the way that we do things in our pharmacies. We're gonna start changing the way we treat each other as fellow staff members or student to staff. And we build that culture and that environment that uh everything we're doing is family. So when students come in, they're part of our family. When they need help with something, even years later, they're looking to get a recommendation letter. Shoot me a message. Remember, you're you're a part of my family. You don't just come here and stay for five weeks, you leave, we forget who you are. We're gonna be reaching out to you if we ever have questions. Likewise, our students know that when you leave here, if you don't close the gap and provide enough information for the next student to take over, you will be getting calls from the next student. And they all know that joking around, but we set that uh environment from the beginning that uh we're we're here, and you know, during COVID, we became known as the superheroes fighting COVID. But we are, you know, we're here, superheroes fighting different crisis situations that happen for patients and trying to change the experience that patients have at their at their pharmacy and change it from one that's stressful, upsetting, long waits, long lines, disturbing, lack of communication, all the negative things you hear about pharmacy and doing the exact opposite. So when you see some of these things that are in the news that are negative, I want to find a way to completely change that narrative in my pharmacy. And that starts with our own staff and students. So the culture that you set with your staff members is the culture that's gonna be passed along to your students. When they walk in the first day, they walk in. If they come in and they see everyone stressed out and just upset and angry about things, and that's how people communicate with each other, and more importantly, the patients, that's gonna be a precedent you set for the next five weeks. From the get-go, our students know that we'll do absolutely anything for our patients and that we care and we always put them first. And they have that in their mind and in their hearts because at the end of the day, these students might have chosen pharmacy because you know they want to protect our oath of being a pharmacist and to serve our community. We're practically, you know, service men and service women, except we're not going on a battlefield with guns. We're going with our hearts to take care of people and you know, some of the most dire situations of their lives. I always remind students and staff that when you have a patient that comes in, if they potentially cursed you out, just take a deep breath to yourself. There's no need to be uh reactive and give them that anger back. You don't know if that person has cancer and they only have three days to live. What if that was your family member? If we start treating each other with love and compassion, the way we respond to people is also going to be different. And you never know, maybe that person just got a divorce or just came from a pharmacy who told them to get out or might not be able to find their medication and they looked at 35 different places. So there's a lot of different scenarios that we have. And if we put ourselves into their shoes, the way that we practice as pharmacists and as students can truly uh shape things. And and I and I tell students that you're not coming here to get textbook education. You guys already did that. You had five years of that in your pharmacy schools. Every school did a phenomenal job. You're gonna pass your Netflix exams, but you're here to learn how to lead with compassion. You're here to learn how to take care of a patient. You might learn more human skills than physical pharmacy skills, but the most successful pharmacists are not those who are the smartest per se. They're the ones that know how to care about somebody and who can help that patient navigate that they can't afford a medication, that they need to live. We're gonna not say, okay, just go down the street and look somewhere else. We're gonna try to help that person, even if we don't have the solution. And that's kind of what differentiates us and what students appreciate and how they develop that culture from the time they walk into the time they leave, and beyond that, even years later when they're practicing in their respective fields.

SPEAKER_00 36:01

I think you pointed out the modeling and how important it is to model the environment you want to have. And you know, talking about your whole team at the pharmacy and and it's a it's a group effort, right? And I think when we it comes to environment, it really some of it is the stuff we do intentionally, right? We're orienting the students before they come, we're introducing them on their first day, we're showing them where things are. I mean, those things feel small to us sometimes, but it can make a big difference in feeling welcomed. It's how we respond to when students ask us questions. And I mean, to be you know clear, students ask questions sometimes at the worst possible moment when you are in the middle of things and it is not the time where you have the moment to respond. And it can it can be easy to get frustrated or to feel, especially if things aren't going well, right? Like if you have someone who is struggling or you're you're putting in a lot of time, you know, precepting does take time, and I think it's important to recognize that. But modeling how we react to one another, students see that. Um they see how you talk to your own, your own teammates. Um, it's not always what we intend. It's that like hidden curriculum that comes up, but it really does have an impact, I think, on their experience. And we know that students learn more and have better experiences when they feel safe in the environment. You know, when students come back and say, like, I didn't feel like I could ask that person any questions because they kept snapping at me, or they never answered a question. They just always responded with a question, which could be a good precepting technique to get them to think on their own. But sometimes perhaps we go a little too far and they they really just need some reassurance or some feedback about how they're doing. You know, students are sometimes hypercritical of their own performance, and occasionally we need to remember to tell them what they're doing well, in addition to the things we want them to work on. So I I think those are great examples of things you can do. A lot of what we've talked about today, you know, is time consuming, right? The the creative problem solving, not all students may be well prepared for that. They might need a little more guidance or encouragement. How do you balance or how would you suggest to other pharmacists too to balance the time it takes to work with learners along with your patient care in your environment, which obviously is a priority

Time Balance And Tailoring To Learners

SPEAKER_00 38:29

too? Like, how do you navigate that?

SPEAKER_01 38:32

I'm so glad you asked that question because you're gonna get students of all different types and backgrounds. Some that have worked in community pharmacy that kind of already know what it's about, some who have never set foot into a community pharmacy, some who have a good taste of what pharmacy is about, and some who have a sour taste about what pharmacy can be in the community setting. You're also gonna have some students that are very eager, excited, wanting to change the world. And then you're gonna have some students that just want to come in and do the nine to five and and leave. And that's okay too. There's you can't force what your creativity, what you want someone to do. And I and I've learned because unfortunately, sometimes you learn by your own experiences. And we've had some students like that, in which case I understand that if I want to assign them a project that's gonna change the world in my local area, I think that's the best thing that they possibly can do. But I realize that that might not be everyone's intention or want while they're here for the rotation. And they simply want to focus more so on the counseling of a patient or the filling aspect or looking at drug interactions, which is completely fine. And I've learned that myself over experiences. And we try to tailor the rotation to what the specific person wants to. Because at the end of the day, this person, they're not being forced to be here at your pharmacy. They're here to learn, but learning comes in many different ways. You you know, that's why teachers have different ways to teach students that one might have a PowerPoint, for example, one might have handouts, one might be very uh, you know, dramatic and acting or try to create acronyms to help you uh learn things, and another might be straightforward in terms of just memorize a section in the book. So we have to be uh open to different learning environments and be able to tailor our own rotation experience to that student, knowing that no two students is the same. And a lot of that for me has come through learning. But I think that it's important that we identify that earlier. So what one of our past students actually put it in the experience guide that why don't we have something to know about the student before they come here? Why even wait till the first day or the first week or three weeks after that student started to learn that this patient doesn't care about this or to find out what they're passionate about. Maybe they're really passionate about and they want to go into a fellowship and or a residency and they're specifically focused on something that they're come that they're really passionate about. If there's a way to tweak a little, even a percentage of your rotation to do that, they'll know that you actually care about them because you took time out to learn about them. Oftentimes we just think that it's the student's job to learn about us because we're the big bad wolf. We're the owners of the pharmacy. We have a thousand patients walking in looking for us. But at the end of the day, we're taking away this student's time. You know, they're here with us multiple days for five weeks or however many weeks that they're gonna be here with us. Let's utilize them for something that can also help them learn. And the uh pre-rotation survey has helped us learn about the students because, like you mentioned, sometimes you're not gonna get time during the actual rotation experience. So, like, all right, let's have a seat. For example, when I went to a pharma rotation, the the preceptors are all right, come to my office. All right, we we sat there for a couple hours, we had lunch, talked about life and kids. Can you imagine a community pharmacy pharmacist going in the back office, just sitting and have a conversation for like two hours and talk about lunch and kids? That's not happening. We barely have time to go to the bathroom. So if you can learn some of this stuff beforehand, amazing. We also try our best to make the student feel important when they come. I love the fact that you said introducing them because sometimes they'll just come and go. And then you have patients that walk in that know every single person in your pharmacy and they just see some oddball, random person that's there. They don't know who that person is, but also why for us, we like to post on our social media, hey, get uh skip back community. We're gonna have Bryn here for the next five weeks. Brynn is in her last year of pharmacy school. This is what she's passionate about, this is what she plans on doing when she graduates pharmacy school. She's excited to serve you in these next five weeks. Feel free to say hi. Well, guess what? Now people are coming in to get their vaccine and like, hey, Bryn, we saw you on Facebook. We're so glad that you're here. And then they connect with the student. And to this day, we I mean, on our Google reviews, or if you go on our Facebook for Skiback Pharmacy, we have over 1,500 positive reviews. I could say hundreds of them are because of students that we've gotten. And it's because of that connection that that student has made with the actual patients that walk in. And when what's amazing is a couple of years later, when I when I'm speaking to some of these students or we invite them back to an alumni event, and they're like, How's Miss H doing? Or they still remember the patients, which is incredible because there's going to be certain patients that they'll have that personal touch moment with. And I think equally important is that we actually introduce our students to the patients and our staff because the the actual people walking into your pharmacy love that there's someone there learning. And they'll even be more nice to you, for example, even if they have to wait an extra five minutes, because now they have somebody that's learning alongside with you. If they're giving that the patient a vaccine, for example, the grandma will have a conversation. She's always wanted to have a conversation with somebody. But guess what? Now you're allowing her to have that conversation with someone who's like her granddaughter or grandson. And you know, they'll share their stories and some the some of the best memories are created in those kind of Patient interactions. And that's one of the parts that I love best is the the aspect of having the student uh be there as a part of your pharmacy. So they're not just an extension of it, but that the people that are walking into your doors actually think they're part of your team.

SPEAKER_00 44:13

Yeah, I think uh there is so much value in a community and helping people feel welcome in a community. And again, I think it's something that we just forget or it gets overlooked, or as things get busy, it's it's one of those things that just slips by sometimes, but it can be a real difference maker for students about if they're having again a positive learning experience or not. And we learn better when we're open, right? And and having a positive experience. I think, you know, you also point out that different environments have different challenges. And we've been talking a lot, obviously, with your experience about community practice, but I think this translates to any rotation type. Um, there are certainly a variety of experiences out there where somebody doesn't have time to schedule, you know, a couple hours for feedback or for discussion. Um, I I always encourage preceptors though to still think about building in wherever they can in their own calendar, where might you have a few extra moments compared to the rest of your schedule to have a more purposeful conversation with students. Um and it's helpful for students to know that there's going to be kind of some formal assessment and evaluation, because that's certainly part of experiential learning, but that you're also going to be giving them informal, you know, feedback on the skills they're doing real time. And I think that's another important component of impactful learning. So not only is this something that's structured and we've given them, you know, clear expectations, we're giving them that autonomy you talked about earlier to practice something on their own. And then we're going to give them feedback about hey, this was great. Maybe next time you might do that. Or if it were me, I might have said it this way. Like, why don't we try that next time? And then a next time, right? So that they can try it again. And so I think that's another helpful reminder sometimes is that students need to practice things more than once. None of us figure it out the first time. We don't figure out precepting the first time, right? So why would we expect students to know how to be a pharmacist once? So I think that repeated practice, but building in some of those anchors for yourself as you're designing that rotation proactively can help you remember, like, oh yes, I should sit down and give them a more, you know, thorough feedback, or I want to make sure to follow up with the student about these items. So yeah, I just wanted to highlight it is hard to find time for all of these things, but the more intentionally you design it on the front end. And I think your experience guide's a great example of this. You can reuse that experience guide. You're not recreating that every time a student comes through. So that's one way to help with your workload, but still give students that individualistic experience.

Advice To New Preceptors

SPEAKER_00 46:56

I'm curious, you know, when you think about if you could go back in time when you were in a new preceptor, what advice would you give yourself? Or what advice might you give to a new preceptor now? Like, what's something that you're like, make sure to do this? Like, start here.

SPEAKER_01 47:12

I would say don't don't overcomplicate things. Oftentimes we just think that uh a rotation student's coming, and if it's your first student, for example, you're gonna make mistakes yourself during preceptorship. So realizing that there's gonna be some challenges that you face. You're not gonna be liked by every student because there's there's no way to actually please every single person, but you're doing your your duty and your job to actually make sure the student's walking away with a meaningful experience. Um also another thing is that realizing that sometimes your staff's gonna see that you have new students coming all the time at the pharmacy, but realizing that they're not there to replace anybody. Because oftentimes students come and then, you know, that they might get the staff might get used to this person being the the go-to for ringing everybody out or picking up every phone call, but it doesn't stop there because that student is gonna be leaving, realizing that they're only there for five weeks. So they're here to help us and help our patients, and also to help themselves learn. They're not a permanent placemarker there at your pharmacy. So because oftentimes you think that, okay, they're gonna be here, but the moment they leave, you have this big like void or gap, and everyone misses that person. I mean, we all miss we miss every single student that comes through our doors and our and our staff is that you know, they'll text me and say, Mac, is there any way you can ask them if they can come back for the summer? And to this day, students that we absolutely love, every one of them is given a job opportunity when they leave for in a come back, come back to the pharmacy to learn about uh or to help us with XYZ project during the summertime. So we still get a lot of people that do come back to us uh after their hippie or appy experience is over. Our student currently at the pharmacy, she was here doing her hippie rotation a few years ago. Uh, she's from the University of Rhode Island. That's not anywhere near Skipack, but she loved her Ippy rotation so much that she's back here right now. And she it feels like just like walking back home for her. And if it I think as preceptors, we have to realize that uh as we move things along to take mental notes that okay, I didn't do this well with this student, or I wish I could have done XYZ. Let me make sure I do this with the next one. And for us, these are all things where if there was a I wish I could, I put those right into the experience guide right away. Like I wish if a student says, I wish you would have done you would have told me about this or that, we just add it right in because I've had some of the most crazy, you know, uh requests like, hey, it takes me an hour to drive to the rotation. Can that count as part of the eight hours I have to be done? Like, don't ask me, ask your school that. And then they're not gonna ask their school that because they know the answer to that question. So, like, we have to put some things in, even if it seems like this is a common answer, like we know what the answer should be. Well, guess what? We do have to tell people that okay, this is what's required. And and sometimes putting your foot down when certain things are questioned, because when it comes to patient safety, for example, if you notice that this student, although they know how to, they've gotten trained to give vaccines, I personally like to be right next to them and just make sure that, and if they go too high, for example, on the arm or they're not using the right technique, because some of these things they might have learned once while they're in school and they might have done it incorrectly on the spot. Or I'll say, All right, practice on this bulk so I can make sure you're doing the right technique before we actually do it to a real patient. Many times our students, uh, I was like, This is an opportunity. Bring your parents in here, practice vaccinating your own parents, your boyfriend, your girlfriend. This is where, you know, like they can't get mad at you for doing something incorrectly.

SPEAKER_00 50:51

I love that.

SPEAKER_01 50:52

Um and even when it comes to counseling points, uh, like while we're doing so many things, my ears, it's like bartender ears. You still know exactly where the student is, what they're talking about, because if there's ever something that's incorrectly said, you can hop right in. So it's allowing them to have freedom, but them silently knowing that there's still someone right next to them. And that makes them feel comfortable too. Because this might be the first time in their life where they're allowed to do something on their own, because oftentimes there's hand holding all along, but it's also that final moment because when they graduate and you start as a pharmacist somewhere, that company is gonna be like, okay, go ahead, like you're starting now. They might give you a week or two weeks of training, but you're gonna be on your own very soon. So it's realizing that these students are very educated. Many are confident. You might have to help them improve in confidence. I always like it's the basic building blocks. I want students to be able to look at someone eye to eye. It's crazy that we even have to mention this, but I have students that come in and they're scared to talk to a patient, which is, you know, that's why there's so many different fields of pharmacy. But I want them to still be able to speak to someone looking eye to eye, because even if they're in a pharma company working in an office, guess what? One day you're gonna have to go talk to your teammate or how to get through confrontation in a friendly way and in a proactive way, you know, in a productive way, that you're not arguing or yelling at somebody. It's okay, this is what we've learned as a team. Fantastic. Let's let's move on to the next thing that we have to do. So, some of those life skills, I think as preceptors, we can do a fantastic job, just like we're teaching our own children. If I know it sounds kind of crazy, but sometimes the things that I teach uh our Ippy Abbey students, high school students that shadow are some of those qualities and characteristics that I want my own children to learn. Like, don't tell grandma Smith that the time law with whatever for you know seniors is in aisle six on the bottom shelf. Get your butt out there and go with her to that section and help her. Because you wouldn't do that for your own person that's in your family, your own grandmother, for example. So teaching those little things, I think are so important because a lot of the things like, and they might not teach you that in school. Obviously, your parents might teach you some of these things, but they need to be reiterated to the students and things that we just think are common may not be how to talk to somebody, how to work through challenges, how to come up with ideas, how to give feedback. But these are just some of the some of the many things that preceptors, and the beautiful thing is that when it's your site, your location, yes, if you're working for a chain pharmacy, for example, or a larger company, you're gonna have parameters and rules that are already set beforehand, which is okay, but you can still use your own creativity. If you have your own pharmacy or you're you're the preceptor in charge and you have all the creativity, it's in your hands. You can kind of guide and navigate that to wherever you want. But there's that opportunity for pretty much everyone. You just have to know where to turn and uh when to hold the student's hand and when not to, and allow them to learn and learn yourself along the way.

SPEAKER_00 53:50

I love that you're pointing out that there are a lot of things we do that are actual skills. But some of us have already figured out those skills and we forget that that is a skill that someone can learn. Um, and different students come to us with different skills, and different generations of students have different skills. And so I think reminding ourselves as preceptors that our our job is to provide a learning environment that allows students to practice skills and improve them. I mean, that comes from things you talked about structure, clarity of expectations, sharing that in advance. We talked about giving feedback, autonomy to try. Might not work out. Give feedback, let them try again. So I think framing it as a learning experience and not just as a well, they have to come in on day one and do everything perfectly, I think is a is a good helpful reminder for all

Final Challenge And Key Takeaways

SPEAKER_00 54:43

of us. We were there once too, but it's it's easy to forget. So as we wrap up our discussion today, you know, my hope is that preceptors who are listening are leaving with at least a few practical ideas that they can start using right away to create, you know, even more learn impactful learning in their rotations. Dr. Mack, it has been a pleasure to have you here and to sharing your insight and your experience. As we close, I'm curious, is there just one thing that you could think of that a preceptor who's listening could do today that might impact the value of the experience they're providing?

SPEAKER_01 55:19

For preceptors that are listening today, one thing I would say is just think differently, be different, and act different. Because if we're just going to do what we've always been doing, things aren't going to change. Not for yourself, not for the profession, and not for our students who are coming to us in a time where there's just so much negativity all around us. And I mentioned this analogy before, but if you just Google the word pharmacy, you'll just see so many negative stories that are out there. But why not be the one that changes that narrative? And we have that in our hands. And also to realize that no one's alone. There's preceptors around the country. If you were to message me on LinkedIn and you need some feedback, you're gonna get feedback because I learned by reaching out to people. Trust me, I have my circle of friends and pharmacy owners that I reach out to all the time and I'm asking them every question. There, there is no such thing as a dumb question because we were all there. And we uh we obviously have an opportunity to learn from each other. So there's things when I go to conferences, I'm heading out to one tomorrow morning where I'm going there to learn from other owners that are there, other pharmacists, to see how I can make the experience better for our students, for our patients, for ourselves. And at the end of the day, realize that we're here for our patients and for us as long as we keep them in the forefront of all we do and realize that sometimes we're gonna realize that this is not uh we're gonna have people that walk through our doors that believe that, okay, they're just here for eight hours or for their five weeks to do their job, which is fantastic. But we're here to make a difference for our patients. And as long as we can keep that at the forefront of our minds, I think we can we have the ability to create something that'll be so impactful for our students and for your own pharmacies. If you were to go on our website, if you go on to skipbackpharmacy.com and you click on any section of our website, every single program at Skipack Pharmacy was created by a student. And I take great pride in that because it wasn't me who did that. This is a combined effort of every single student that walked in. The universities are so proud because this is their students that have made this difference for literally 100,000 plus people in less than seven years that we've been open. Um, and and our story could be anyone's story. We're all here to help each other. And I'm just thankful that you have we've had this opportunity to share this time together.

SPEAKER_00 57:31

I love that. Thank you again uh for joining me today. And to anyone listening to continue building on what you learned today, be sure to explore the companion practice resource that will be included in the course materials. It's a downloadable resource that highlights some of our key takeaways from our conversation, including practical tools you can use in your own precepting environments. Don't forget, learning is most impactful when we apply it in practice. So thank you for joining us for precept to practice. Until next time, keep bridging the gap from precepting to practice. Thank you.