‘We won’t go back to what we did before.’

AJP speaks to a Melbourne pharmacy professor and a student on how education and placements have been transformed during the COVID-19 pandemic

The pandemic has sped up changes which may have taken educators a decade to implement that have now occurred in the space of just a few months, says Tina Brock, Professor of Pharmacy Education and Practice at Monash University.

Some of that process involved adapting the curriculum to the online space.

“We went through a couple of weeks of experimentation because the technologies were changing, we needed to see what students responded to. There were 3-4 weeks where we tried new things every week and then we were like, ‘okay this seems to work consistently, the students are able to access [everything], let’s keep doing this for the rest of the semester’,” she told AJP.

“We really had zero [content] about global pandemics in our curriculum before this year. We wanted to actually be talking about the virus, the pandemic, the social response, the amplification of gaps in care, and bringing that to the classroom.

“This has been a tough year in the health professions education community but we’ve learned so much together!”

Not only did the Monash Faculty of Pharmacy develop an online mode of education which was essential during lockdown, but they managed to partner with the practice community, allowing pharmacy students to learn on the ground during the pandemic.

“We couldn’t control what was happening but we can control how we responded to it,” said Professor Brock.

“We had a lot of conversations, particularly starting with the fourth years, and then with [the third years] who were going out on placement in May, to say – ‘this is what we think, if you do not feel safe to go out, absolutely take a break, no problem. But if you do, we think that this is an amazing learning opportunity for you and you will feel good about what you’re able to contribute’.

“We actually had some hospital partners who said ‘send us more students’, because they were changing their entire workflow to minimise the number of people on certain wards and optimise for example home delivery of medications.

“We also had some of our community pharmacists that said, ‘look, if we have students on our sites, they can do more screening, more information, we have a dedicated person who can continue to do that’,” she said.

“In some cases, COVID-19 actually amplified and made possible those connections. Before, a preceptor may have said ‘a third-year student doesn’t know very much, they’re not going to be able to help us out’. Now they’re saying, ‘wow, they can talk to patients, get on the phone with providers, they have the skills to be able to contribute to this’, which then builds their confidence and also gives them a sense of control over a pretty uncontrollable year.”

The education system has been “absolutely” transformed by the pandemic experience, says Professor Brock.

I would say that we will never go back to having large group lectures—not just because of safety.

“Large group instruction, we finally got to a way that we thought the students have responded pretty well to. We believe the hands-on part, the placements have been able to continue, the workshops went to online format, and for some of them that works perfectly well, for others we would like to get some face-to-face [contact].

“Just like the telehealth movement, something that might’ve taken us a decade, a planned decade, we’ve found we can achieve it and achieve it quickly – and it’s better. I think the same of education. Some of these advances, we won’t go back to exactly what we did before, we’ll take the best parts of that and feed it through what we’ve learnt during this time.”

However she added: “Next year’s students will have done a large portion of their year online before they even came here. We’d like to figure out how to do virtual community building and really strengthen that in second semester.”

A student’s perspective

Olivia di Giovine, a third-year pharmacy student at Monash University and president of the Victorian Pharmacy Students’ Association, has enjoyed the online learning experience.

“It’s been different of course, and it had its challenges, but I think we already had online material that we’d been doing for the past couple of years so that sort of set us up for the content for the week anyway,” said Ms di Giovine.

“The Monash teaching team had a couple of weeks to prepare but they did a really great job.”

However she added: “I think placement was a really nice way to break it up to be honest, even though it was only two weeks”, referring to her time spent at Austin Hospital in late May.

Ms di Giovine relished the practical experience, which included a unique opportunity to see two patients treated with medicinal cannabis as well as servicing oncology, renal and liver transplant patients.

However as processes had changed due to the pandemic, she only spent about two hours during the whole fortnight actually on the ward.

Meanwhile the hospital dispensary was packed “because a lot of the pharmacists obviously could no longer work on the wards”.

“We couldn’t visit the patients so we had to call the patient and get all the information from them that way,” she explained.

“They were trying do as much as they can remotely, so if they had to visit patients in their rooms they could call them or they could call the local pharmacy, and a lot of that could have been done from the dispensary. They have their patient notes all electronic, so a lot of them were able to work that way.

“A lot of work can now be done remotely where they never thought that was possible before. That’s something I didn’t realise before, because on a previous hospital placement last year, everything that the pharmacist did besides going down to the dispensary to actually bring the medication up to the ward or to get consumer medication leaflets, besides that happening from the dispensary or from a satellite pharmacy, almost everything else was conducted out of the ward,” said Ms di Giovine.

“I didn’t see that a lot of that work can be done remotely, so that was probably one of the biggest things I learnt from the experience.”

Meanwhile Ms di Giovine has a community pharmacy placement scheduled for September, and she has also worked as a casual in a community pharmacy over the past year.

“Back in March it was really chaotic, that was like the rush, and then a couple of weeks later when April rolled around, you could really see the difference, it had completely slowed down, it was much quieter,” she told AJP.

“My pharmacy, we have quite a loyal customer base, lots of regular customers. They come to us for more than just pharmacy advice, for all sorts of things,” she said.

“Now with the pandemic I realised if you have a strong bond with your local pharmacy, they can be one of your greatest assets. I saw that my pharmacy, we had never done deliveries before and we started doing deliveries. My boss and the head pharmacist, even they might go out of their way after their shift to go deliver to these patients’ homes. I guess what I realised, and it was amplified in this pandemic, is that community pharmacists can be more than just a community pharmacist, they can be a great source of support, help, advice, and there’s a lot of loyalty of there.”

Professor Brock has recently had research published in the American Journal of Pharmaceutical Education on ‘Sustainable Pharmacy Education in the Time of COVID-19’. See the full article here

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