A year of growth

Preceptor Feedback

“Brandon,” congratulations on starting rotations! As you have already noticed, this year will be one of tremendous growth, learning, and change.

Embrace change

I think it is a very real and expected reaction to have some apprehension about being so far away from friends, family, and the places you are used to. I applaud you for undertaking such a big change.

To make your transition easier, start by seeing what resources you have around you. Are there other students on rotation at your site? If they are local, then they may be able to recommend restaurants or activities to experience while you are in town. If they are from far away, then their fears are probably similar to yours. Either way, consider getting together for lunch, meeting for a topic review, and having dinner after rotation. You may find both a great way to stay on top of clinical material and a group of friends that could last beyond your 6-week rotation. Plus, you never know how the relationships you establish on rotation could impact your future career.

Another resource is the residents and pharmacists at your site. Talk with your preceptors about what they like to do outside of work and how they dealt with similar transitions in their lives. Keeping an open dialogue can help minimize the impact that this new environment has on your performance and it will give your preceptor a better understanding of the external factors you are experiencing.

You can also try to maintain consistency in the other things you do. If your morning routine at home was to go for a jog before class, continue to do so. Or, maybe you watch a certain television show or sporting event with your best friend. Consider ways to make that happen—maybe you trade comments about the show or game via text. Maintaining even small parts of your routine can help give you a sense of normalcy and make you feel more comfortable and at home even when you are far away.

Establish relationships

Communicating with patients is an art that I personally feel I will be working on for the entirety of my career. I encourage you to stay positive and to approach effective patient communication as a long term journey rather than a short term skill to master. Every patient is different. Keep in mind that in ambulatory care, where you see the same patients over the course of time, even the same patient may require different communication techniques at different visits.

Fortunately, there are lots of ways to improve your communication skills. First, familiarize yourself with the resources at your site. You mentioned that many of the patients you see have language or cultural barriers. Often there are interpretive services available or written documents that have already been translated. For patients with literacy issues, take time when you are preparing for clinic to think of techniques you can use to help them. For example, for my patients that cannot read, I often make them a table with pictures of their medications and a sun or a moon to help them remember when to take each pill.

Finally, use the providers at your site as role models by asking to sit in on counseling sessions or appointments. If you have a difficult patient, talk through what you plan to discuss before you enter the room, or ask your preceptor to sit in to help if communication breaks down. Most importantly, spend time after these interactions to think about what went well, what could have gone better, and what techniques were used that you could incorporate in the future. Over time, you will find yourself with a box of communication tools that can be combined to address nearly any situation.

Let me look it up

Don’t be discouraged by your perceived loss of knowledge. Application is much different than recalling information for a test. I remember a similar feeling when I started rotations, but I found that spending extra time before a rotation and before clinic to review and asking for extra discussions on topics I was struggling with to be a big help. Also, know that it is okay to say “let me look it up” if you don’t know an answer. By the end of the year you will be surprised how far you have come and how much confidence you have gained without realizing it! Best of luck!