Episode 3 – What to expect in Medications and Terminology with Dr. Adam Welch

Dan and Michele interview Dr. Adam Welch, Associate Professor of Pharmacy Practice at ETSU Bill Gatton College of Pharmacy and nationally-recognized vaccine expert. We learn more about his Medication and Terminology Course as well as his work providing COVID-19 vaccinations to thousands of East Tennesseans through multiple vaccine clinics in the region. Transcript: Michele Williams Welcome to White Coat Radio, a podcast from East Tennessee State University Bill Gatton College of Pharmacy, in Johnson City, Tennessee. Each episode, we cover a wide range of topics about the pharmacy school experience, from study tips to deep dives with faculty and student pharmacists. We are your hosts, Doctor Michele Williams. Dan Vanzant And I'm Dan Vanzant, instructional design and technology manager. In this episode, we'll be talking with Doctor Adam Welch, associate professor of pharmacy practice at the Bill Gatton College of Pharmacy. Welcome to White Coat Radio, Doctor Welch Adam Welch Yeah, pleasure to be here. Dan Vanzant So, students, know you as a professor who teaches the medication and terminology course as well as nonprescription drugs, but they may not know that you are a nationally recognized expert on vaccines and that you were instrumental in ETSU's Covid 19 vaccination clinic effort. Can you tell us a little more about how you came to be a pharmacist and, and a vaccination expert? Adam Welch So, so vaccines. I started by taking the same course. Pretty much every pharmacy student takes in this country is an American Pharmacists Association's pharmacy based immunization delivery certificate course. Been around for several years. 350,000 pharmacists are taking this course. So I took the same course and I was, you know, I went into residency and I had done some research on perceptions of vaccines and pharmacists giving vaccines. Adam Welch I was looking at some some physicians in the area and seeing how would they felt about pharmacists joining that, that, vaccination effort. And when I took my first job out of residency, I was working in Pennsylvania at a school of pharmacy. Pennsylvania at the time did not allow pharmacists to vaccinate. In fact, they were the 44th state in the country to allow pharmacists to vaccinate. Adam Welch So they were kind of late to the game. Relative to other states. Now, Tennessee, you know, they've been allowing pharmacies to vaccinate for much, much longer. I think Washington State may have been the first. In any case. You know, I was my job was to work with community pharmacies, and part of that was to help, as this law was coming out in Pennsylvania, was to allow community pharmacists and give them the skills they needed to be able to start vaccinating their patients. Adam Welch And I was thinking, working in academia, but wow, this is going to really get big. It's been big in 43 other states, 44th being Pennsylvania. We need to make sure all of our graduates are ready to give vaccines. So this training, this APhA training, we adopted it into our curriculum and mandated for everyone. And it was kind of a big deal. Adam Welch People weren't ready to, you know, they didn't go to pharmacy school to, to start poking people with needles. It wasn't, you know, it wasn't what they signed up for originally. But, but it became important. It became part of their job description when they when they graduated. And now, every state, Puerto Rico, Washington, D.C., allows pharmacists to vaccinate. Adam Welch So it really was the right move at the time. But what that did was it got me in with a started to meet the staff, started to understand what their needs are. When they had a project, they would call me, to it to work on it. And I made sure I said yes to those opportunities. I didn't want to pass it off. Adam Welch If I was busy, I probably still said yes and just worked a little longer during the nights to to get something done. But I established that rapport with some of the staff members at, at and that became important. So I said yes to that opportunity. I also got to know people in in the academia world, in the association world and pharmacy in general. Adam Welch And what that did was as more opportunities came up, they were thinking of me. I need someone who knows vaccines. Well, I had them up there in Pennsylvania, knows that. Let's, let's let's go call him. And moving forward, I became then a national speaker for the immunization training program. So I started training other companies. I went to probably a dozen different locations, drug companies, chain pharmacies, and taught their folks how to teach the training program for on behalf of APhA. Adam Welch Few years later, I was asked to serve on a, a workgroup for the Advisory Committee on Immunization Practices. So ACIP that's the group that makes all of the vaccine recommendations in our country. They are they're part of the CDC. And what. Michele Williams Does that stand for? Adam Welch The Advisory Committee on Immunization Practices? Yeah. So ACIP so they meet, several times a year and they make all the recommendations for how we use vaccines. Well, all the busy work gets done by a workgroup. So 1 or 2 members of the ACIP work with a series of other experts across the country, and they go through the studies, they go through the evidence, and they figure out how they're going to recommend, you know, what the evidence would suggest for recommendations for these vaccines. Adam Welch So for a number of years, I was the APhA liaison, meaning I was the only pharmacist on the zoster workgroup. So any shingles recommendation that ACIP put out, I was providing the pharmacist perspective on behalf of the entire profession on behalf of. So that really, I think, step my career forward because I was seeing the folks who are making the decisions about the way we use vaccines, all the way back from Zostavax. Adam Welch I was on that committee when that became that's no longer on the market now. Shingrix, which is the product we use now for shingles vaccine. So, so it's been a long journey, which got me here and maintaining those, that all of that expertise, you know, when Covid came around, it became, a huge opportunity to provide Covid vaccine to people, as you all know, the pandemic and, I began working with, a physician in the College of Medicine to, to establish those clinics here at ETSU. Michele Williams Wow. And that that's such a, a good story for students to hear. I think about, saying yes to things even when you're a bit busy. Right. So all these sorts of opportunities seem to come up when you do that. So, as Dan mentioned, you teach the medication and terminology course here at Gatton. And P1, P2 and P3 take that course. Michele Williams It's also of course, I, I've learned since I've been working here this called drug cards. So obviously knowledge about medications is really at the heart of what pharmacists do. But students can underestimate how difficult this course can be sometimes I think. So can you talk a little bit about the role of the meds in terms course in the curriculum? Michele Williams And what students can expect as they progress through the course. Adam Welch In medicine terms, is, is that course in our curriculum? It's it's self-paced. So it's kind of always been the background because because you're not in class, specifically every given Monday, Wednesday, whatever it may be. But it's such an important course because it's focusing on basic knowledge of the top 300 most commonly prescribed drugs in our country. And that list evolves a little bit year over year. Adam Welch But for the most part, the drugs are very similar on that list. And why that's important is because when you get out onto rotations for your final year of rotations, your P4 year, you need to have that baseline knowledge so that you can begin applying it to patient scenarios. This patient comes in, you have these options because you need to know a little bit about those drugs before you can start applying that. Adam Welch It's to the higher level, care that you would need. So so this course becomes a way to help you, maintain and polish that that foundational knowledge. We found that, about 30% of our first year class, doesn't have any work experience in a pharmacy formally just yet. They may have shadowed here and there, but formally, they don't have that experience. Adam Welch So a course like this helps them learn the drugs, and the names of the drugs. And it helps them, be able to associate what we're going to cover in class with something a little more tangible. They remember, and this list of drug, they've seen identifications of the tablet or the capsule, and they've seen some information about it. Adam Welch So it really ties in the other aspects of the curriculum. By having this medicine in terms course and we build upon it, we, we do it in first year. It's very basic information. We add a little bit more information, we add a few more drugs. So by the end of the third year, this cumulative three year meds in terms course will give you that foundational knowledge. Adam Welch You need to be successful during your P4 year. Michele Williams So I've seen the course materials for for the medicine terms course and the spreadsheet of drugs that students are required to learn. It seems quite daunting, I think, especially when someone is first starting the course. So what can students do if they're struggling to remember all that's required? For the drugs in medicine terms, and especially, as you mentioned, if they don't work in a pharmacy and they really haven't had that kind of experience. Adam Welch Oh, that list can be extremely overwhelming the first time you look at it. It's kind of like buying a loaf of salami. And you may not like salami, right? No, no. All right. So salami. Right. I can tolerate a slice of salami maybe once a day, maybe once every other day, maybe I don't. Maybe you don't like salami. Adam Welch Pick your whatever. But if I had a whole loaf of salami and I was asked to eat it right now, I couldn't do it. Nobody could do it. I mean, it's a loaf of salami. Dan Vanzant Gross. Adam Welch So the idea is that you slice, you take one slice and you eat it, and then you take another slice the next day and you eat it. And by spacing out your consumption of salami and in the educational world, as you know, spaced learning is what they call it. You're able to, you know, by the time you look back, over time, you're able to make it through an entire loaf of salami. Adam Welch You're able to make it through the entire list of the top 300 prescription drugs, by taking little bits and pieces over time so that repetition in that continuous approach to it, where you’re doing a little bit each time is really the best way to approach a course like this. Can’t eat a whole loaf of salami in one sitting. Adam Welch You can't study the entire top 300 drugs in one sitting, so you got to space it out. Michele Williams That makes a lot of sense. Adam Welch So students, when they approach quizzes and assignments, they really want to get the highest grade. It's just this desire to succeed. You know, certainly with a test you want to score the highest grade because that's a big indicator of your knowledge, skills and abilities. And that's what we use to pass you through the course. But but the quizzes are often worth a small percentage of the course grade. Adam Welch And in many students that becomes sort of the the easy A. If I just do the work, I can, I can get through that. And and that's important. But the way it's designed in medicine terms is a little bit different. The quizzes themselves are truly designed as a learning tool. So I would rather you take the quiz, score poorly on it, but understand where you scored poorly, which questions you got incorrect, go back and look through it and then take the quiz again. Adam Welch Maybe you score poorly or a little bit better and you take it again. You score a little bit better. So by that repetition you're able to learn through the process of taking quizzes. It really is a study tool, not an evaluation tool, an assessment tool, the way it's designed in this course. And I think a lot of courses don't always set it up that way. Adam Welch So, so in order to do well in our version of medicine terms, you need to complete several of these practice quizzes because you're seeing questions about the top 300 commonly prescribed drugs, and you're picking up little tidbits about these drugs through taking these questions on these quizzes. So all we're interested in is at some point you get a 90% and then you can move on to the next one. Adam Welch But your process to get up there, I don't want students to worry about their grades. I want them to worry about learning what they got incorrect and fixing it for the next time. Dan Vanzant Yeah, because it's about the exposure to these drugs or the repeated exposure to these drugs. And what they're what they're good for. Adam Welch Yeah, it's it's important. It's one slice of salami every day. Dan Vanzant Adam Welch Yeah. Michele Williams And I can't read the lunch and meat of your choice. Dan Vanzant Yeah. Adam Welch And I will say, you know, I want to give credit to a former colleague of mine, Doctor James Cohan, who, who used that salami reference one time, and I overheard it. So I'm kind of borrowing, so that's a great reference. Dan Vanzant It is. Yeah. This is a symmetrical question. Again, this is not on the list, but drug cards. Where does that where did that name come from? Like why why is it called drug cards. Adam Welch So in our textbook which is, it's online here at Gatton. And we use a system from McGraw Hill called Access Pharmacy. And in there are cards that have information about the top 300 most commonly prescribed medications in this country. So these they're on there printed on what looks like cards. And and I think that's where the term came from that they're drug information on cards but virtually. Adam Welch So drug cards. Dan Vanzant Gotcha. And so, so they've it's always been kind of a flash card almost. Yes. Yeah. Sure. Okay. Cool. Thanks. So as a student, you know, going through these 300, 300 slices of salami, or have you found that, there any apps or programs that students have, you know, used? You mentioned that we're not using physical cards anymore. Dan Vanzant We're using, you know, virtual cards. But what kind of apps? Students found. Adam Welch Yeah. So as I mentioned before, Quizlet is used a lot now, I think the benefit and something like a Quizlet and there are other apps out there similar to that, and people like the old index card, you know, I'm a little more traditional. I'd rather go buy a package of index cards, but, part of the learning process is the creation of those cards. Adam Welch So if you rely on somebody else's Quizlet, if you start taking it, yeah, you're going to pick up some information as you go through. But if you have to physically write or even type out the information onto a card, it adds one extra layer of of studying by just simply creating the content that you're going to be studying from. Adam Welch So with any of these apps, I think if you create it yourself, you're going to get a little bit more out of it than if you're borrowing somebody else's. Michele Williams It's interesting that you should say that, because often when I talk to students and they say, you know, so-and-so created some some drug cards in Quizlet and they really know their drug cards, and I'll say it's because they created the drug. Adam Welch Cards through a cards. Michele Williams So, you know, we've talked a little bit about about vaccines in your expertise and, and vaccinations. And the ETSU vaccine clinics, have provided Covid 19 vaccines to hundreds of people in the region, including me and Dan. That's right. So thanks. Yeah. Can you give us an update on these clinics? Yeah. Adam Welch Yeah. And we've actually vaccinated thousands of people. We've been really out there in the community, and our students have been involved with tens of thousands of vaccines. So we will go out to hospitals and help them. I remember early in the pandemic, I was volunteering at, the local hospital here and, just going in 530 in the morning and just preparing the doses to give to their staff. Adam Welch This is early in the pandemic. So we've been involved with a lot of the vaccination efforts. So what happened with ETSU early on? The state, the Tennessee Department of Health, they had some money from the Centers for Disease Control, and they, reached out to universities and said one of the ways we can help vaccinate people is to set up clinics in universities. Adam Welch They seem to be a community hub in many areas across the state. So, the physician that I was working with and I, developed this pod pod point of distribution for vaccines here at ETSU. Now, I'm not talking ETSU health clinics. This was East Tennessee State University. Let's find a room. And that was the first challenge. And we said, well, you know, at the time we needed free flowing air and space, social distancing and all of that. Adam Welch So we said, well, what if we did it outside and, you know, it was cold in December. We didn't want to do it then. So then we ended up centering in on, a ballroom that we used for conferences. We have a conference center here called the Millennium Center, and that became our hub, and we started providing vaccines out of it. Adam Welch And the first time we did it was with a test sample just to work out our kinks for about 50 people. And I think that's where you all may have gotten it. So, and then we moved and provided the vaccine to hundreds of more people in this mass clinic where we there's hundreds of people flowing into the ballroom. Adam Welch We had stations set up. We mapped out the entire process. We had all these policies in place. All of this took a lot of time. And we're able to vaccinate a large number of people in small amount of time, with lots of help from volunteers, from all of the health science colleges. So, you know, they were certainly instrumental in this process. Adam Welch And then, you know, as we got that first wave of people vaccinated, we started to notice that the demand for the vaccine started to drop off. And we needed to do more than just have a big mass clinic set up in the Millennium Center. So we started taking our vaccines on the road and we went to small employer groups. Adam Welch There's a there's a company in Johnson City here that makes hot tubs, and they have a staff of manufacturers that, many of them were not vaccinated. So they invited us down. We set up a table in their lunchroom, the breakroom, and started vaccinating people. We did that a couple times. We went to local churches. We went to, other areas. Adam Welch We even went to around our own campus, our student union building, where there was a lot of traffic going through, and we started vaccinating people. And even if it was 5 or 6 people a day, it was better than nothing. And it was vaccinating those 5 or 6 people, were important. We did find, we had an early voting site. Adam Welch We found we set up a booth next to an early voting site that we had. A lot of folks came in to vote inside to get their booster vaccine while they were here. So it was a nice complimentary business. So we did that for a while. That funding dissolved. It served its purpose. And our next project is to really reach out and provide Covid vaccines to people who may not have already gotten it. Adam Welch So, Tennessee, they're about 45th in the state for Covid vaccine rates. There's a large portion of the population in the state that have not received the vaccine at all yet. I think about 55, 60% of people have been vaccinated. So there's, you know, 40% plus that have not. And that's where the aim is of this next project is to go into socially vulnerable areas, particularly in northeast Tennessee. Adam Welch There's about nine counties that we're looking at and provide Covid vaccine to people who may not have otherwise gotten it, whether it be to certain barriers or just haven't made the time to go get vaccinated. And I think as flu season picks up and as we cycle through, you know, the time of the year when people have a lot of upper respiratory things happening, I think this will be a great service to the community. Adam Welch We're also going to partner with some of our College of Nursing clinics, in and around this region that will, provide vaccine were previously they hadn't had vaccine. And that's going to also target that socially vulnerable population. So we're excited about this new project and about being able to, kind of reach out and bring the vaccine to people who may not have otherwise had access to it. Michele Williams That just sounds great. Dan Vanzant Did so when you go into those areas where they're, you know, a large percentage of the population that have been vaccine vaccinated, are you doing any kind of media or creating anything in order to kind of make it get the word? Yeah, get the word out or increase people's willingness to come do it? Adam Welch Yeah, that's the idea. We're going to one. We're going to try to partner with some community leaders within that particular county, that particular area. So we'll have a reason to go. We'll have a liaison there as a partner. And then we're going to utilize ETSU’s marketing team to create messaging to help, help people, be informed when they when they make the decision to get the vaccine. Adam Welch So so that's the idea. It's going to be a multi-pronged approach to, to help improve the health of our region. Michele Williams Well, doctor, Welch, thank you so much for joining us today. It's just been a fascinating conversation and we really appreciate you taking the time. Adam Welch Yeah. Thanks. So much for having me. Dan Vanzant Yeah. Thanks so much.