Episode 7 - Tips for success in Cardiology with Dr. David Stewart.

In this episode, Dr. David Stewart, Interim Associate Dean of Academic Affairs and Institutional Excellence and Professor of Pharmacy Practice, talks with Michele and Dan about the Integrated Series at ETSU Bill Gatton College of Pharmacy and offers important context and advice for success in his cardio course.  Transcript: Dan VanZant Welcome to White Coat Radio, a podcast from East Tennessee State University Bill Gatton College of Pharmacy in Johnson City. 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. I'm one of your hosts, Dan VanZant. Michele Williams And I'm Doctor Michele Williams. Today we'll be talking with Doctor David Stewart, interim associate dean of assessment and academic affairs and professor of pharmacy practice at Gatton. He specializes in cardiovascular pharmacotherapy and is the course coordinator for the Cardio course in the Integrated Series at Gatton, which students take in the spring of their P2 year. In this episode, we'll talk with Doctor Stewart about this very important and challenging course and get some advice on how to get the most out of it. Michele Williams Doctor Stewart, welcome to White Coat Radio. David Stewart Thank you. It’s good to be here. Dan VanZant So I think many students are a bit intimidated by your cardiovascular course—or “cardio,” as it's known. What do you think makes the course challenging? And should students be nervous about cardio? David Stewart Well, Dan, thanks for the question. I was kind of surprised when you said students are intimidated. Makes me sound like I'm a whole lot meaner than I think I am! Anyway, it is a transitional period for our students. As I talk with students going from P1 to P2 year, they’re beginning to transition from the foundational pharmacy science classes into more of the clinical courses. Their first experience with that will be the Integrated Series in the fall with the Pulmonary course and the Infectious Disease course—that’s about 4 to 5 credit hours of material from an Integrated Series or clinical pharmacy standpoint. Contrast that with the spring semester: when they return after winter break, they’ll have a five‑credit‑hour course in cardiovascular pharmacotherapy, a two‑credit‑hour renal course, and a two‑credit‑hour GI course. So for the semester, they’ll be focusing nine credit hours on clinical pharmacy practice and the pharmacology and medicinal chemistry associated with those disease states. That’s about 50% of their time in the classroom. Meaning at any given time, they are in two courses: cardio plus either renal or GI, depending on the half of the semester. That’s nine hours of material per week. Students sometimes think, “Oh, I have two classes to study for,” but they must think: “This is half of my curriculum.” They need to spend about half of their study time devoted to these courses. Michele Williams That makes so much sense. I've never thought about it that way before, but that's a really important note for time management—to think of it as, “I should devote at least half of my study time to these courses.” David Stewart Well, and Doctor Williams, I’m not surprised you say that, because when I ask students on day one—while we're going over the content of the course—and I ask about credit hours, I realize students often don’t appreciate what a credit hour means. There’s a criterion behind it. So I explain on day one: allocate time based on credit hours. One credit hour doesn’t deserve as much time as a five‑credit‑hour course. And also—they cannot get behind in a five‑credit‑hour course. If you think about compounding interest, time compounds like interest. If you put it off until the first exam at the end of month one, you're going to be so far behind, you’ll be in a very deep hole. Michele Williams That's really good advice—to be proactive and think about it that way. So at this moment, we're at the end of the fall semester. If I’m a student listening before cardio begins—or maybe I’m a P1 thinking about my P2 year—what’s the best way to prepare? What can students do to be ready for cardio? David Stewart One of the biggest challenges students face is the mindset of making a grade, achieving a bar, then compartmentalizing and moving on. It's understandable—they’ve been doing that for years. But in pharmacy school, you must apply foundational sciences. You build on them continuously. If a student asked me in December how to get ready for a course that begins in January, I’d say: understand the cardiovascular system. How does the heart work? How does the vascular system work? Blood flow, basic anatomy, heart physiology, contractility, action potentials. Knowing those fundamentals makes it easier to understand arrhythmias and antiarrhythmic drugs. Number one thing: Blood flow through the heart, coronary arteries, vascular system. We’ll talk about stroke, VTE disease, venous and arterial vasculature. Coagulation is also important—we discuss anticoagulants like warfarin and the DOACs (apixaban, rivaroxaban) versus antiplatelets like aspirin. Students need to understand mechanistically how these drugs work. Michele Williams That’s interesting. Dan VanZant Yeah. I never really thought about that before. Michele Williams So would you say it would be a good idea for a student who struggled with the cardio aspects in physiology to go back through that chapter and review it? David Stewart Absolutely. Physiology of the cardiac system would be very worth your time. Second—review the Top 300 cardiovascular medications. There are roughly 75 drugs from the top 300 that we discuss. Knowing the class, generic/brand names—that gives students a leg up when we begin discussing pharmacology, mechanisms, etc. Dan VanZant Makes sense with the drug cards. Are there any apps you recommend for review? David Stewart Great question. I remember getting a PalmPilot in 2001 and thinking it was incredible. Today, we have smartphones—everything is apps. But somewhere around the 2nd or 3rd generation iPhone, I realized technology was moving faster than I was. I used to love it, but now I only use what I need to do my job. And honestly, I use less technology today than 10–12 years ago because it can distract students. So instead of apps, I recommend learning how to learn. Read books on academic success, or how to teach yourself material. On day one, I tell students: here is my responsibility as faculty, here is your responsibility as a student. My job: facilitate learning. Your job: apply yourself and learn the material—not memorize and regurgitate slides. Students who survive on memorizing slides haven't truly learned foundational skills. If students recognize they are not using good study skills, cardio is a great opportunity to fix that. If I could get away with it, I’d throw PowerPoint away and go back to handwritten notes. When I hand‑wrote notes, I learned better. PowerPoint often becomes someone else’s way of thinking—not your own. Michele Williams I agree. And handwriting notes is supported by cognitive science. Writing things down starts the encoding process. It's why you remember your grocery list even when you leave it at home. And it’s more efficient to shop when you create a list. David Stewart Exactly. Michele Williams I also have a question about case‑based questions. Cardio requires students to apply what they know. By cardio, they’ve already had some courses with these questions, but students still struggle with them—even P3s. And NAPLEX uses these sorts of questions. How can students become more adept? David Stewart Great question. And I’ll be blunt: our society wants cheap, fast, easy. But learning clinical material requires time and deep engagement. Students say: “I struggle with Integrated Series because of the case questions.” So I ask: Do you understand the material? Or do you only think you understand it? I often pull up exam reports with Bloom’s taxonomy tagging. Students will say they know the basics but struggle with application. But when we look at basic recall questions—classifications, mechanisms—they miss those too. So they think they know it, but they don’t. It’s like sports. You don’t learn piano by reading about it. You don’t practice only on the weekend and expect to perform well. Students often misuse practice tools. They click through quizzes fast, eliminating answers. They get the correct answer the third time and say, “See? I knew it!”—but they didn’t learn. Correct method: Take the quiz slowly—as if it’s an exam. Justify why each option is wrong or right. If you get it wrong, go back to notes or textbook. Retake it only after reviewing the content. Another tool is the Pharmacotherapy Casebook. Students hate it because there’s no answer key. But that’s the point. Like a clinician, you must think through it. Michele Williams Yes—flashcards and Quizlet can cause illusions of competence. When the answer is close to the question, you don’t struggle—and struggle is how learning happens. David Stewart Exactly. And another disconnect: students don’t understand the federal definition of a credit hour. For every 1 hour in class, you must spend 2 hours out of class. Minimum. Most students don’t. They need to budget their time like money. Pencil study blocks into a calendar. Students try to read slides seven times in 20 minutes instead of spending two hours in deep work. They avoid cases because they “take too long.” But deep learning requires that time. And distractions make it even harder. Social media apps are engineered to steal attention with dopamine hits. Research shows: When you get distracted, it takes 25 minutes to fully refocus. Turn phone to silent. Mute laptop notifications. Focus for an hour, then reward yourself with a 5‑minute break. When I was in school, the library had no phones, no distractions. Students today are at a disadvantage—they have to create their own quiet. Michele Williams I agree completely. Dan VanZant So in summary: unplug, get some books, study deeply. David Stewart Exactly. I’m a huge proponent of classical learning: reading, writing, thinking. Dan VanZant Do you remember the viral “Death by PowerPoint” video? I showed it yesterday—talks about distractibility and keeping slides clean and clear. Michele Williams Yes. And I do love that tablets let students keep everything in one place. But technology is a tool, not a replacement for thinking. Use it; don’t let it use you. David Stewart I also think students have been conditioned by bad teaching. They come to expect passive PowerPoints instead of real learning. Michele Williams I agree—it goes both ways. Dan VanZant Definitely. Michele Williams Well, this has been so interesting, Doctor Stewart. Thank you so much for your time. And I believe we’ll talk with you again about Academic Affairs and some insights regarding that. Thank you so much for your time today. David Stewart Thank you. It’s a pleasure to be here. David Stewart And—