Helping to train Binghamton’s PharmD students

As any preceptor knows, working with student pharmacists can be challenging, but also very rewarding.

Karen Conn, manager of The Medicine Shoppe on Vestal Avenue in Binghamton, has been a pharmacist for over 30 years. Jim Jester, director of pharmacy for Clinical and Ambulatory Services at UHS Hospitals, worked in critical care pharmacy for almost 15 years before moving into management. He’s been in his current position for nearly a decade.

Both have been on board as preceptors for the School of Pharmacy and Pharmaceutical Sciences (SOPPS) since the first cohort of students began IPPEs and APPEs.

Both also give priority placement to SOPPS students.

“I’ve been precepting for other schools right along, but It’s exciting to have a school in your hometown,” said Conn. “My priority is Binghamton, and I take others if I have room.”

“We do take a few students from other schools,” Jester echoed, “but not nearly as many as from SOPPS. It’s our community.”

Last year alone, The Medicine Shoppe had two Introductory Pharmacy Practice Experience (IPPE) students for every block, so 10 in all; every Friday for almost every block, two Advanced Pharmacy Practice Experience (APPE) students come in. “Everybody contributes to the learning and I do the official precepting,” Conn noted.

UHS Hospitals precepted 67 students in the past year, one way or another, Jester said. “Many are repeats, but we have an IPPE and two or three APPES with us at any given time. And the last time I checked, we had 23 preceptors.”

Conn and Jester share a philosophy of involving colleagues in the preceptor process.

“The biggest challenge across healthcare is the massive shortages of staff, particularly in our region, but we see it everywhere,” said Jester. “We’re quite low on the pharmacist census for preceptors, but we’ve made it work by being very creative. In 2022, it was a big lift to ask someone to have a student glued to their side for two weeks, so we centralized our precepting.

“I was the main preceptor and we had 10 different activities over two weeks, where we rotated students through so they had more exposure to more preceptors and activities and they received broad exposure,” Jester explained. “The last day was a fun day, when we asked students what they would like to see. One request was to see brain surgery and to learn our involvement with it, so we set it up. We’ve also put them through the electrophysiology lab. We made it happen.”

Under this model, students get to see things they wouldn’t otherwise, Jester emphasized. “We’ve been getting creative as we meet all of the standards. We just navigate students around to different positions, and it’s much easier to coordinate with our preceptors. If they have a student for only a day or a few days, it’s easier for them. The feedback has been good.”

Students also appreciate the model. “When I ask how this experience was for them, they generally say: “I’m telling you, my roommate did this at another site and they just counted all day,’” Jester said. “They’re willing to get creative with us so we both get that much more of an improved product. It’s really about the collaboration.”

Jester works with the students directly as well. “For example, one of the things we cover is pharmacy and therapeutics, and we have them do a monograph (a study of a single medication) and have them present to a committee,” he said. “I give them pointers on what the committee really wants to hear — just a 5-minute or less summary. After that I ask how was this experience? And that’s why our relationship has grown with Binghamton and why students are professional. We have some skin in the game. We’ve also hired some of these students and they’re working side-by-side with us.”

Conn, who also assists in the SOPPS Skills Lab when students are earning their American Pharmacists Association (APhA) immunization certification, said that, at The Medicine Shoppe, students gain experience through immunization clinics, but also have a hand in compounding. “Through the clinics they get out and get to talk to people, and when they do compounding (making a medication that is not commercially prepared), they love it,” she said. “I lose them once they go in the compounding room. I don’t like it because it’s like cooking, but they love it.”

When compounding, the students are often working on medications for veterinarians, dermatologists or physicians who require a pain management medication, Conn said. “It could be a cream, liquid or suppository, or something for a child who can’t have any flavors. The students will go into the room and spend the day measuring out powders, making these compounds using the equipment.”

Compounding is kind of a dying process, Conn added. “We get about 350 compounds a month. And I’m hoping to grow that and have some students helping us with that. They’ve been coming up with flyers to market to doctors and making them aware that we’re available to them.”

Conn sees the students grow, in particular during their IPPEs. “They’re here only two weeks, but I see their confidence grow,” Conn said. “I will have them vaccinate when they’re here, and they’re so scared at first, but after their first few times, they leave and say ‘I got this.’

Conn also sees APPE students serving as mentors for IPPE students. “The APPEs often overlap with IPPEs and the APPE students are such great teachers and mentors. They tell the IPPEs what to expect in classes and things like that. I’m impressed with everything, including when the APPEs do a presentation for me. They’re interested in teaching me.”

Students also gain experience talking to patients when working with Conn, who steps them through the patient counseling process. “First, I call the student over and have them shadow us,” she said. “The next time, I’ll introduce the student to the patient, and the student will try to answer questions as I stand by them, encourage them and prompt them for what else they can say.

“The patients love the students,” she added. “One Saturday, I had to do vaccinations and the patients were disappointed students were not there. They’re part of the culture. My patients expect to see them.”

As for preparation to complete their IPPEs and APPEs, Conn and Jester agree that Binghamton students are very well-prepared.

“These students are better prepared and more invested than some others I’ve worked with,” said Conn. “They’re excited to be here and more interested in what they’re doing. I’ve never had a complaint about how well prepared SOPPS students are.”

In fact, Conn said, the students have become part of The Medicine Shoppe’s culture. “I miss them if I don’t have any students,” she said. “Our staff loves working with them. It’s a very symbiotic relationship that we have.”

“I’ve seen a progression in SOPPS students’ abilities and a lot of that comes from the collaboration from both Binghamton and UHS, and other area providers,” Jester said. “After the first round of students, there was a lot of feedback back and forth; Binghamton would say ‘we need more of this for our students,’ and, from what we were seeing, we would say ‘your students need more of this.’

“We’ve seen that clinical progression,” he added. “We’ve taken other students and are definitely seeing a much higher caliber of student of late due to the feedback and the partnership we have through collaboration and capstone projects. We also have many embedded faculty at UHS. We’re all part of the community and that has improved the end product.”

“I feel that I learn so much from the students, too.” Conn concluded. “I have had the same job for almost 34 years, so when the students come in with fresh ideas or things that they’ve seen or learned at other rotations, I love to hear about them and learn from them.”

“Every day, new medications come out and we’re often not faced with them at the hospital for several months,” Jester said. “The students can sometimes educate us. There’s an expectation that we’re prepared for these students so our preceptors sharpen their skills in anticipation of these students coming. They up their game.

Jester recounted one situation when a student was rotating in the hospital’s medical oncology center and had learned something at another site that ended up saving UHS $38,000 a year. “To bring that fresh set of eyes from someone who comes in fresh is good for us. Sometimes what they bring to us is gleamingly obvious and we look at them and say ‘this makes total sense.’ They bring the new and the best to us. When they come here, they challenge our preceptors. It’s great for UHS and our community.”