My year of APPE opportunities

On Rotation Diary

Over the next year, I will share my unique experiences while on rotation. To speak honestly with you, I will write this column anonymously under the name “Stephanie.” It is my hope to provide you with insights about rotations and the many opportunities I encounter. I will also use artwork to illustrate my thoughts and feelings.


I like to think of APPEs as the year of opportunities and I think that’s why I am so excited for this upcoming year. Along with all the excitement I feel, I am also terrified. What if I don’t meet the expectations of what a final year student pharmacist should know? I invite you to join me on my journey as I navigate through my rotations.


Medication safety role


To kick start my APPEs, I completed an elective rotation in medication safety at a teaching institution. Honestly, I had no idea what the role of a pharmacist in medication safety was, but I quickly learned that a safety manager was an additional role that pharmacists could embrace. 


My first preceptor was immensely intimidating! Not only was she the clinical director, residency director, and safety manager, but she had now taken on the role of preceptor. I remember worrying whether I would get anything out of the rotation if my preceptor didn’t have time to meet with me. I was also worried that I was bothering her with my endless stream of questions, but I wanted to ensure I completed my projects properly. 


A sea of questions


I was assigned a research project where I had to develop endpoints, collect data from patient charts, evaluate the data, and then present it to the 
director and assistant director of 
pharmacy. Sure, it sounded simple enough, but the only problem was … I felt that I didn’t have enough clinical experience to be able to properly evaluate patient charts. Who was I to determine whether the patient’s insulin dose was correct? What if it was normal or this was an exception and I just didn’t have the experience to know the difference? I found myself filled with doubt. The only solution I found to ease my concern for my lack of clinical experience was to ask questions. 


I lingered by my preceptor’s office to ask her quick questions. If I didn’t see her for a while, I would make lists and schedule a meeting where I could ask her everything in one sitting. Or if asking my preceptor wasn’t an option, I would ask the resident, a clinical pharmacist, or anyone with the clinical experience I was currently lacking. While I thought my constant questioning would be taken as annoying, I was delightfully surprised when my preceptor shared that she appreciated my questions because it showed her my understanding of concepts. Her feedback only encouraged me to continuously inquire, and toward the end of rotations, I no longer felt as a bother. 


Regulatory affairs


My second APPE took me to a wonderful land of departments where I was eager to explore them all. I was at a pharmaceutical company, a setting where I had very little experience. But since this was a setting that I am particularly interested in, I was very enthusiastic to start. My preceptor is the current fellowship director at the company and was a fellow the previous year. I was very open with him and explained my goals and ambitions in industry. 


He actively helped schedule meetings to help me discover my interests. I voyaged through medical affairs, medical information, pharmacovigilance, and many other departments until I reached regulatory affairs. Here it was, the department I had patiently waited to experience! I soon learned that this department was a difficult setting in which to incorporate students. Their long-term projects and involvement with multiple departments made it only possible for me to see a glimpse of their responsibilities. Regardless of how much I wanted to immerse myself with everything industry had to offer, I was limited. Although my preceptors noted that I asked all the right questions, I confess that I have more. What is the best way to interact with your preceptor when they have multiple responsibilities? How can I ensure that I am learning all I can during my APPE when my preceptor is new to his position? I know that the new practitioner author in the “Preceptor Feedback” column can help me along as well. 


I look forward to giving you an update on my rotation life in the next 
issue!