White Coat Radio

On this episode of White Coat Radio, we’re joined by Dr. Debbie Byrd, Dean of East Tennessee State University Bill Gatton College of Pharmacy. She discusses the latest news regarding state funding and reduced tuition, the college’s 20th anniversary, her philosophy for overcoming challenges, and answers questions from student pharmacists Dean Byrd is celebrating her 10th anniversary as dean of Gatton this year. In March, she was named a Distinguished Fellow of the Pharmacy Academy by the National Academies of Practice (NAP), a prestigious honor that recognizes excellence and leadership in interprofessional health care. TRANSCRIPT: Dean Debbie Byrd I also view challenges as opportunities because I've seen that play out that when we do have those obstacles, many times they have resulted in some of our greatest successes.   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 students pharmacists. I'm one of your hosts, Doctor Michele Williams, assistant professor and director of academic success.   Stephen Woodward And I'm Stephen Woodward, marketing and communications manager. On this episode, we chat with Doctor Debbie Byrd, dean of ETSU Bill Gatton College of Pharmacy. This year, Doctor Byrd is celebrating her 10th anniversary, coming to Gatton as Dean in 2016. In March, she was named a Distinguished Fellow of the Pharmacy Academy by the National Academies of Practice (NAP), a prestigious honor recognizing excellence in leadership and interprofessional health care.   Stephen Woodward Learn more about Doctor Byrd on our website e-t-s-u dot e-d-u slash pharmacy. Now let's get to our interview. Well, Dean Byrd, welcome to White Coat Radio.   Dean Debbie Byrd Yeah. Thank you for having me. Glad to be here. It's great to have you here.   Stephen Woodward We'll start by telling us what is a typical day. Being a dean look like.   Dean Debbie Byrd You know, there's not a typical day. But I think that's probably one of the things that I enjoy most is just the variety and, you know, the work that I get to do internal to the college, which you know, most in the college would be, you know, very familiar with and, but there's also a lot of external work at the university and then even beyond the university.   Dean Debbie Byrd So, a lot of my time is spent problem solving. I've described myself as a fire chief sometimes, putting my fire hat on putting out fires. But it's it's usually not to that, that level, but it's, a lot of serving as a, as a soundboard for people. It's been a lot of time in meetings. And that's where a lot of that, you know, problem solving and coaching and, and just, you know, hearing what, what others have in mind to do. I know when I was new to this position, I was very taken aback by all the meetings or how much time I was spending in meetings. And I remember, talking to my boss at the time, Wilsie Bishop. And I said, you know, when I've just. I'm in meetings all the time. I went, when does. When will I do my work, you know, as these, and this is my first job as a dean, and she, you know, paused and smiled and looked at me and said, this is the work that is that is the work which is very different from what I had done previously. But, you know, whether it's meeting with, members of the leadership team or executive committee individually, or, you know, as a group, with the faculty council, we have the dean student advisory Committee today. I was kind of I had to think about it a little bit because there are so many different things. But, just all of the stakeholders within the college, and our alumni here, those, those meetings go on on a, on a pretty regular cadence. But then at Etsu, there are a number of different councils that I serve on the university council, academic council, deans, council meeting, council deans meet on a regular basis. So, you know, all of those things are, you know, trying to make things better, whether it's here at the college or at the university that, you know, even beyond the university, there's opportunities to, you know, work on behalf of the profession or the college in terms of advocacy with legislators. College has been very active with the Johnson City, Washington County Chamber of Commerce. So, yeah, there's just so many, folks to to meet with. And then there's lots of events that we have, at the college. And so I just represent the college in a lot of different, arenas.   Stephen Woodward Great. Thank you for sharing.   Michele Williams So the college's, of course, celebrating its 20th anniversary this academic year. What do you think are some of the biggest challenges the college is facing?   Dean Debbie Byrd You know, that's a great question. And I can say I think that, you know, Gaten is facing any challenges that are unique to us that are really any different than other colleges or schools of pharmacy or, or just higher education, in general. But challenges in general, I do think are accessibility and affordability for our students, is really paramount.   Dean Debbie Byrd The perception of the value of higher education, I don't think that that pharmacy faces, that as much as maybe other, degree programs, because the return on the investment for, a doctor pharmacy degree is pretty clear. You know, it's was life changing for me as a first generation college student. You know, really, generational change can come about, for those students who have those opportunities. And that's why that accessibility and affordability is so, important. Yeah. For us to focus on, I also have a philosophy which I would say is something that has developed, especially since becoming a dean is, I used to have the perspective of, I could prevent problems, you know, if I planned well and and that's true to a degree. But you can't plan away all the potential problems that that pop up. And so that perspective has changed as I've gotten wiser. But I also view challenges as opportunities because I've seen that play out that when we do have those obstacles, many times they have resulted in some of our greatest successes. That's so true as a college. And that's not at all how I used to think about problems. So I think it's important, important to have that mindset of just not that we like problems, but just embracing them. But they inevitably pop up and think of them as opportunities to, you know, make something better for someone. You know, face them with optimism and creativity because you might as well, and just roll up our sleeves and, and get to work.   Michele Williams That's, that's one of the things that I really love about working here and working with you is that when a problem comes up, there have been times when you come to my office and said, what are we going to do about this?   Dean Debbie Byrd Yeah, I, I love that. Yes. Like, oh, okay, let's problem solve us figure it out. So yeah. Yeah. Because it's not an option you know not to address the problem. It's that way. So we might as well. ...Yeah. And and I certainly don't have all the answers. And so, you're not the only person that I, that.... Well, what do you think about this? Yeah. You know, our, thinking about this. What do you think about that? To try to get to the best solution for whatever it may be?   Stephen Woodward Well, kind of along those lines, what are some of the those opportunities that you see for the college?   Dean Debbie Byrd Yeah. You know, I think there's no question that excellence is an important part of our culture here. So, we're always looking for ways to improve things, to make things better, whether that's, you know, for students or faculty or staff, you know, how do we just just make things run smoother in some cases, take something that's that's good and make it great. But we have made the most of some of our challenges here at the college. But I think some of the things, thanks are thanks are, are. My gosh, I probably should not go it, you know, we don't have any major, major things going on right now. We've had some major initiatives that the college is, is, you know, kind of bringing to fruition now a major curricular revision as one example, where I do want to give, you know, faculty and staff major kudos for that work because, you know, not only did they, you know, revise the curriculum, which happens periodically everywhere, but something that our faculty did really combined, you know, that academic excellence piece and, and thinking about student success, but they also really considered well-being in that and well-being in the perspective of, you know, what's the best combination to help our students perform at their very best? And to that end, you know, we looked at a lot of data and found that our curriculum at that time, before we revised it, had more credit hours than most programs in the country. And, and at that time, our students weren't performing where we would like for them to have been. We were thinking about the now flex. We were more, you know, just around the average or maybe just slightly above average. And so part of that we felt like, maybe it's just too much and there's a point of diminishing returns. And I think we can reach that with our students, that we were just overwhelming them in terms of just information and time. And, and so they were very thoughtful. The faculty were in really bringing it back to the essentials of, of what do our students need, to be the best pharmacists and to perform at their very best and to, to really, you know, learn and retain everything. It's not, you know, if you're just you can give them everything. But if they're only going to retain a third of it, what what's the point? And they've really given that a lot of consideration. So so with that in mind, you know, there's been a lot of, work at the college over the years about, student will be that I think, now we've shifted to, to think more about faculty and staff will be about the college. And, you know, there's a we oh, you're often, very data centric here as well. So, you know, there's a, faculty and staff well-being survey that's going to go out to get some good information. But during work that's already happened, several years ago, I served on, the American Association of Colleges of Pharmacy. I had a, a faculty workload task force and, trying to come up with, you know, the ideal workload policy and, and just the best practices when it comes to that. And one of the most important things was, just transparency and and helping, you know, faculty understand what the what the expectations are and matching that with effort. And the university is now embarking on some of that work with, workload policy and promotion of tenure guidelines. And so, you know, with that in mind, you know, that's something that aligning those things, I think is going to help, our faculty and staff will be, and then also just growing our faculty and staff as our enrollment has continued to grow. Obviously, that's going to help a lot with workload and supporting developmental opportunities. And then nurturing our positive culture. You know, that's a foundation that was laid at the very beginning. And I think it is something that could be taken for granted. If, if we're not intentional about nurturing that culture. So I think that's something that we're all very committed to. But I also think, as we consider, you know, bringing in new faculty and new staff, that we have to be very, considerate of that and making sure that that we bring in people that will continue, you know, this culture that's been built and, and supported for so long, you know, research and scholarship is something that is, is an Etsu initiative. I serve on their research, strategic planning task force. And so with that in mind, you know, how do we create opportunities for, for faculty to, you know, be more successful in those areas, whether it's setting aside time or, providing opportunities for collaboration, development? You know, our faculty are doing great work and there's no, no question, no shortage of great things for our faculty to share and write about. But I want them to have the opportunity to do that work and to ask the questions that they're passionate about and then share, you know, their findings with, with the world and, and practice. Transformation is one example of that that many of our faculty are very engaged with that's, unique, what they do every day, in their practice, and then I guess another opportunity and, and again, we're, we've been working on these things, but, just engagement and particularly alumni engagement. You know, when I first came here, there had only been a few classes that had even graduated. And so, we really didn't have any, sort of programing or anything intentional with our alumni. And so thinking about that, how do we bring those former students and those graduates back that we're so proud of, and give them opportunities to connect with one another and with the college? We started homecoming a few years ago, and, Etsu held tailgates last year. So, so hopefully those opportunities will continue to grow. We have another survey that's out with faculty and staff right now asking how how do we currently engage with our alumni, and whether it's in the classroom or with, professional organizations, student organizations where we currently dealing with our alumni. And then that's going to be shared back with the alumni and sort of sort of a menu of, here, here, the current opportunities and get their input on what else would you like me to be doing with the college and how would you like to, engage with that? So those are those are some of the things that I think are major opportunities for us on the horizon.   Michele Williams That's great. Yeah. So you mentioned the that our faculty are doing a lot of really exciting things. But in March, you were named the distinguished fellow of the Pharmacy Academy by the National Academies of Practice. Nap. And this is a prestigious honor recognizing excellence in leadership and interprofessional health care. Can you comment on this honor.   Dean Debbie Byrd And what it means to you? Yeah, it really does mean a lot because, throughout my career, I've been involved in interprofessional patient care. My practice, you know, was always with family medicine physicians. And and that work and within family medicine, residency training, practices in academic settings in some always worked in that you know, physician, pharmacist, interprofessional, you know, patient care model. And so, so that's something that's just been been part of my entire career, that practice piece and later the education piece. But I feel like that expanded greatly for me several years ago when, I was asked to be the interim dean for the College of Nursing. So I learned so much, you know, during that time period. And, and I was fortunate to be inducted with, one of my nurse faculty colleagues, at the ceremony last weekend. But, another piece of it that was, especially meaningful is I don't seek awards and recognition. You know, for myself, it's, you know, a college focus typically. And so, in this case, it was a nomination, you know, by a colleague that, I had given a presentation at, and a CCP meeting about the imposter syndrome, and, had encouraged him to, pursue something that he was thinking about. And, and he'd sent me an email several months later and said, you know, I did it and thank you. And then a couple of years later, he was he was inducted, and he was telling me about it, and I was like, oh, congratulations. That's really cool. And, and he said, well, you should be a member of this and I'm going to nominate you. So so that was special. Just that awesome connection as well. Yeah.   Stephen Woodward This spring we had some big news with state funding. Do you want to tell us more about that?   Dean Debbie Byrd Yes. I'm glad to you. So this is something that the college has worked on since 2017. When the college was founded back in 2005, the state really didn't have the funds to support a second college of pharmacy at that point. So the college was founded really based on a private tuition model. And because of that, is that being our only revenue, your tuition historically has been very high. So, you know, before we received any state funding, our tuition was as high as $38,000 a year, actually a little more than $38,000 a year, which was typical for a private college of pharmacy. But so many of our students are first generation. And, you know, come from rural areas. You know, when I came in as dean in 2016 and sort of learned, you know, the history, it just didn't seem fair. And it certainly limited accessibility and affordability for our students. Our debt load was significant as a result of that. So that was really the impetus for trying to achieve state funding for the college so we could pass that along to our student. So, you know, we worked on it for about six years before we received the first bit of state funding in 2023. And at that time, the state, appropriation was about half of what we asked for. And so we lowered tuition at that time. Actually, beyond what the state funding supported, with the idea that I guess the idea and the hope that we would receive the other half the following year, and unfortunately, we didn't it took us an additional three years to finally receive the other half. But in the meantime, I feel like that initial funding allowed proof of concept because our proposal was that if we receive state funding, we can lower tuition, our enrollment will increase. And particularly among Tennesseans. And so from, you know, 2023 to 2025, I guess, or the data that we shared with legislators, our enrollment went up from a class of about 45 students on average and had been for the last several years, to, I guess, the the year after funding, it was around 58 seniors and 64. Oh, wow. And and so this year we're expecting over 70 students grew in the percentage of Tennesseans that, you know, we we expected it to go up. But it was really remarkable that it went from, about 40% Tennesseans among, you know, our class, incoming classes to almost 70% at Tennessee and in our incoming classes. So we had those data. And by showing showing them that proof of concept that, you know, look, look what the state dollars, you know, have done. And then also, especially since 2017, there's a pharmacist shortage that has developed over that time. And so, there's a real need for pharmacists, and particularly in rural areas, that's where a lot of our students come from. They're willing to go back there. So, ultimately our tuition, was lowered and will go into effect July 1st, and it will apply to all of our students, not just our incoming students. For Tennesseans, tuition will be $24,785 a year, which will be significant savings for them, especially if you multiply that over four years. Their ultimate, you know, student loan debt will be significantly reduce over $50,000. They'll graduate with. And, tuition is also less for out-of-state students as well. So, our, our state tuition, starting July 1st, will be $30,329 per year. And really, our ultimate goal in terms of that accessibility and affordability was just to match the tuition of the other state school. We just felt like, you know, taxpayers, you know, our funding, the, the dollars that go to the state and, and, you know, that's who's going to benefit and that we felt like our students deserved, you know, the opportunity to to go to pharmacy school and, and then turn around and serve, you know, the people of Tennessee in this region. So, you know, it is very exciting to to finally, be at the point where we can offer that to our students. And I know they're very excited and, you know, we we expect, you know, ultimately, you know, our class size historically has been 75 to 80 students. And so, you know, we we did learn about state funding just with the legislative cycle until April. And our recruiting cycle is essentially done by the end. So we we didn't really expect it to affect, our class size for this fall, but we expect that we'll have, you know, full class and full classes going forward as a result. So, nine years total. We finally made it. We had some persistence going on, but I have to thank, President Noland for his support. We would not, have have achieved this without, you know, his commitment to the college and his willingness to, you know, really make us a priority, you know, this year and also in 2023 to, to make this happen. But also, you know, our local legislative delegation, you know, has always been supportive. And I would say they, you know, they were supportive from the very beginning. And in particular, Gary Hicks has been a huge champion on the House side. And, you know, from over that nine year period, you know, he was a new legislator whenever we started this effort. And over time, you know, he's become a leader in the House and and on the finance committee. And so, you know, that that time helped us in some ways to to have, some of our local delegation be in positions where they could have more influence with their colleagues. And, and then, you know, most recently with Senator Harshbarger, you know, as a pharmacist was very supportive of us as well. And, and I would say all the pharmacists, in the Senate, there are four pharmacists in that, Senate and the Tennessee General Assembly. And, and they were all supportive of us. And, and that meant a lot to you. So, so we're just we're just very pleased, to finally have this opportunity to to offer this to students. Yeah. One other, I think major piece to this in addition to that proof of concept that I was talking about earlier that I think really, helped, you know, push this across the finish line were our season outcomes? Yeah. Yeah. To be able to to, you know, show that, you know, we're worth the investment. And that students that come to get and we'll have, you know, a great outcome. And so, specifically speaking about our Netflix pass rate, you know, being top five in the country in 2023 and, again, with our class of 2025, I think definitely caught their attention. And many of the legislators that I met with commented on that. Yeah, they were they were impressed with, how well prepared our students are. And I think that helped them make the decision to be willing to invest in the college. And our students.   Stephen Woodward That's great. Well, thank you for your tireless effort and dedication to to doing that over the past nine years. Did you log how many trips to Nashville you've you've made it.   Dean Debbie Byrd I did that time. I probably should have stayed. Yeah, for sure I didn't, but, it's, you know, it was a long nine years, but, you know, I'd never had any, you know, responsibility before becoming a dean of interacting with legislators. And so I really came to enjoy that. Maybe not the trip. It'd be nice if I could, you know, just go across town, to meet with folks that, you know, just to develop those relationships over time and, yeah, you know, realize, I mean, they're, they're they're here to help us and that's that's their role. And, and, and they, they really work hard, you know, to help us. So I appreciate those relationships and the opportunity just to better understand the process and how things work. I really had no clear understanding of that either. So, it was a lot of work, but, certainly enjoyed it and were thrilled with the outcome.   Stephen Woodward Well, we asked some students to, to provide some questions for this interview. So P2 Bonilla asked, what has been the most challenging leadership decision you've had to make as Dean?   Dean Debbie Byrd Well, I think probably the hardest thing that, I have to do as a dean, unfortunately, it's very rare that it happens, but is to dismiss a student and, you know, any decision that affects a person, even if it's in their best interest, and it's the right thing to do is, is difficult. And, and I would say those decisions, because the question was, what's the most challenging decision? And the decision itself is, not necessarily challenging, you know, it's the right thing to do or that individual, and, and it could be, I think especially if you ask those questions, what is in the best interest of the profession of the university? What's in the best interest of the college, and what's in the best interest of the individual? Then the decision itself usually is pretty clear. And and how would I wish to be treated under these circumstances? The decision becomes pretty clear. But it's still, difficult to sure, you know, that you're, you know, going to cause pain for someone, even if it's in the short term and even if it is the right thing to do, it's always very difficult.   Stephen Woodward Brunella also asked if you weren't working in pharmacy or academia, what career do you think you would have pursued?   Dean Debbie Byrd Well, I initially I, I remember in the first grade.   (laughing)   Mrs. Highberger asked me to help her, do something. I don't remember what it was. You know, during recess one day, and I, I got off the school bus and ran inside and told my mom that I was going to be a teacher. When I grew up. And so that was, you know, my plan as a six year old and was was by playing for a little bit.   Dean Debbie Byrd And, and as I got older, you know, my family always, struggled financially. And so once I realized that maybe, being an elementary school teacher might not give me the financial security that was really, really important to me under those circumstances. And then I just said, okay, I guess I won't do that. And so it's been a real bonus career, you know, pharmacy school to be a pharmacist. I didn't think that I would get to be a teacher to. So I got to do both of those things that, another, I don't know if it would have been a career, for me, per se, but I had a backup plan going to college that, I was I was waiting for scholarships to come in and out. It was about two weeks before, classes started. I went to Middle Tennessee State University, and I had applied for one scholarship and hadn't gotten it. And I'd gotten, some Pell Grant funds, but it wasn't enough to to cover things. And so I applied come last chance scholarship to get and, and so my thought was, well, if I don't get that, then I was going to join the military and, to give me the opportunity to eventually go to college. I'm not sure if that would have been a career, but that was my my clear plan. At that point and then, maybe a more unique, career path that didn't come to me until about, I don't know, 10 or 15 years into my career. Just because I didn't know that it existed is forensic anthropology.   Michele Williams Oh wow.   Dean Debbie Byrd Yeah, totally. I  guess I didn't even know that was a thing, but, you know, Bill Bass is a forensic anthropologist, and that if you've read the Body Farm books, my my office at one point overlooked the body Farm, in Knoxville. And so, yeah, just the idea that you could, you know, look at bones to human osteology was one of your specialty areas or is one of his specialty areas. And. No, and not just, you know, is this male or female, but what kind of work they did? Because, you know, if they, you know, did work that, you know, required heavy lifting, like, you could see that in their bones that, so, I don't know, I was just I was fascinated by that. And so I kind of thought for the first time, well, you know, if I'd known this existed, I might have gone out On something like that. But I don't know. How many forensic anthropologist are really needed in the world. Whereas I think we need lots pharmacies now.   Michele Williams And lucky for us, you know. So, another student question that we have is from Ryan, who is actually the president of P-1 class. Class of 2029. His question is, leadership can be a challenging journey. Is there a specific mentor or role model who helped shape your own leadership philosophy? And what is the one piece of it of their advice that you still lean on today as the Dean?   Dean Debbie Byrd Yeah, there's there's not just one. You know, I if I started to name or try to name people, I would definitely leave people out. So, I think about, you know, the faculty member, I was an average student. And do not tell our students this all the time. I was a very average student in pharmacy school. Not for lack of trying effort, but, you know, I had a faculty member and preceptor that encouraged me to think about residency, and I'm not sure I necessarily would have thought about that. Even. You know, it's one of those things that, you know, sometimes a mentor is not someone that you necessarily are spending a lot of time with. Someone may just literally ask you a question, have you ever thought about it? So, I would just encourage, you know, everyone, whenever you see, something in someone and you're thinking in your head, oh, you'd be really good at, you know, whatever. Have you ever thought about to always ask those those questions?   Michele Williams It can be life changing.   Dean Debbie Byrd Oh, no, no, no, no doubt about it. And I mean, I had, you know, former students that, you know, went on to do something and years later would come back and say, oh, well, you're the reason I did this. And I would look at them in confusion and say, oh, remember that day? You ask me, you know, have I ever thought about. And no, I didn't remember that. But it does, you know, can make a real impact. So that's that's important. But I had other, you know, my residency preceptors, you know, who really, developed me exponentially. Department chairs, campus meetings and really, everybody I've ever worked for has has served as a mentor, the president and provost here. But fellow faculty and staff, meet your peers, you know, can be those mentors, because I do think a lot of it is just, you know, serving as a sound board and just being somebody that that listen, sometimes, you know, sometimes you know what to do, but you just need to say it all out loud and have somebody, you know, not at the end, you know, instead of running from the room that, you know. Yes, that's a good thing to think about that, you know, colleagues I've mentioned in professional organizations, certainly have been, students, teach me something. You know, every time. But I have an opportunity to interact with them. And it's interesting and just funny that you asked me because I had lunch yesterday with Wilsie Bishop, who, is the retired vice president for health affairs and, who I worked for for many years. And so, you know, she continues, at this point, even her in her retirement, you know, to serve as, as a mentor. But, my number one strength, according to Strengthsfinder. And I've taken it many times over many decades now, is learner. And so I think every experience that you have and every interaction that you have is an opportunity to to learn something and to gain something. And I think my experience has been that people are very generous. And so if you, you know, ask for advice or ask, to draw upon somebody's wisdom. So far, I haven't run across anybody that's been unwilling, you know, to to talk with me or, you know, listen to that dilemma that, I'm facing and, you know, give me their two cents. And so that's another encouragement that I would put out into the world that, you know, you never know until you ask. And, but it doesn't really matter who it is. I think sometimes we think, you know, a lot of the people that have the most wisdom and could potentially give the best advice are some of the busiest people. You know, in the world, potentially. And it's really easy to say, oh, gosh, I don't want to I want to bother them, I don't want to inconvenience them. But again, I found them. You know, it doesn't matter who you ask. I haven't had anybody turn me down. Yeah.   Stephen Woodward That's great. As we come to a close, is there anything else you'd like to to add to our listeners?   Dean Debbie Byrd You know, this is our 20th anniversary for the college. And, in July, I will have a big year, ten years. And so it's caused me to do, you know, some some reflecting, about the ten years and, and thinking about I don't think that I answered one part of the last question about, you know, what piece of advice of about do I lean on? And I, I think it's maybe a couple of things, you know, one is I mentioned earlier just treating people the way we want to be treated. I mean, many years ago, the college, did some developmental program with outward mindset. But that's really what it boils down to. But I think the other piece has is just being intentional, that, you know, just because you wish things were different doesn't mean that they're going to be different. That you're making those changes for the better and trying to think about, you know, how to make things easier, how to facilitate success, whether it's for students or faculty or staff. I think that's a big part of the job. And, you know, sitting here with you, too, I think the first new position that I created when I came here was the marketing position, and like you and. I kind of from that, you know, solving a problem I came here in realized I knew very little about this college, and nobody did. There were people in Johnson City that didn't even know that there was a College of Pharmacy, which is crazy to think about all the community support that we had. But, you know, I have lots of people, you know, moving to the area. So I was just then I was amazed by all the great things that were going on. So, you know, I feel like you've done a great job and, you know, getting the word out there about all the great things. And then maybe I'm not sure if it was literally the second position, but, we had a retirement and, academic affairs and we thought about, you know, what do we do? We want to just replace, you know, have the very same position, or do we want to, you know, reimagine what that would be. And that's when the director of student success position.   Michele Williams That was a great decision.   Dean Debbie Byrd But a lot of those, you know, student success efforts that that you have been led and, you know, we have relatively new student success coordinators. It's probably been the most recent addition to that. But, you know, we just are always thinking about, you know, who are our students. And as we've said, many of them are first generation, you know, coming from rural areas. And, and they, they bring, incredible assets that sometimes come with some things that have left them behind a little bit. And how do we take those, students that come to us with great potential and make sure that, you know, as long as they're doing the work, that they're going to be successful in the end. So just that intention with student success, you know, revamping our athletics prep, you know, is a big initiative that has certainly paid off, you know, for students recently. You know, admissions and enrollment is up. Yes, due in large part to marketing. But, you know, we have a full time recruiter, you know, now, and we haven't always had, you know, the ERP program, is something that is is new to the college, relatively new to the college. And I've mentioned, you know, some of the great engagement activities that happen. But, you know, there's those are all, I guess, circling back around to their problems or obstacles and some of the things that I think we're proud of, staff as a college came from a need to address, a problem or a situation as you have to see Will now.   Stephen Woodward Well, thank you for your service to the college and for being on the podcast today. We appreciate you coming.   Michele Williams Yeah. Thanks so much. Yeah.   Dean Debbie Byrd Well, thanks again for asking.   Stephen Woodward Thanks for listening to White Coat Radio. If you haven't already, be sure to subscribe and leave this review to learn more about ETSU Bill Gatton College of Pharmacy, visit us at e-t-s-slash pharmacy or follow us on social media @ETSUpharmacy. We'll see you next time.  

On this episode of White Coat Radio, we’re joined by two specialty pharmacists making an impact in Tennessee. Dr. Tabitha Sineath (’24), an ETSU Bill Gatton College of Pharmacy alumna who earned both her PharmD and MBA through the college’s dual degree program, now serves as Lead Pharmacist at Walgreens Specialty Pharmacy in Nashville, where she is the Clinical Lead for Transplant and Chronic Inflammatory Conditions. She is joined by Dr. Katie Cox, who manages Walgreens Specialty Pharmacy in Knoxville. Together, they share insights into careers in specialty pharmacy, their work in women’s health, and the real-world applications of their training.  Full transcript: Tabitha Sineath Because you take back bits and pieces from every experience, whether that be as a student on rotations to your first job or what you ultimately grow into. It's the bits and pieces that you know as part of your experience that truly kind of define you over time. So don't. My advice to students is don't give up on that and continue to kind of seek those out because you know in your heart where your passion lies, you have to make the pathway. 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. I'm one of your hosts, Doctor Michelle Williams, assistant professor and director of academic success. Stephen Woodward And I'm Stephen Woodward, marketing and communications manager. Today we welcome Doctor Tabitha Sign at the 2024 alumna from Gatton, who, in addition to earning her PharmD, also completed our dual degree program to earn a master of Business Administration while she was here. That prepared her to now serve as leave pharmacist at the Walgreens Specialty Pharmacy in Nashville, Tennessee, where she is a clinical lead for transplant and chronic inflammatory conditions. Stephen Woodward But today, we have not one but two specialty pharmacies joining us. Doctor Katie Cox, who manages Walgreens specialty Pharmacy in Knoxville, also stopped by. Let's hear from them now. Doctor Cox, doctor Sineath welcome to White Coat Radio. Thank you all for coming out today. Katie Cox Thank you for having you. Stephen Woodward Can you start by telling us about your roles at Walgreens and where you work? Katie Cox Yeah. Tabitha Sineath So I am, lead pharmacist at our specialty site in Nashville. And, oversee primarily our transplant in chronic inflammatory condition patients. Stephen Woodward Okay. Katie Cox So I work at Walgreens as well. I manage the, specialty pharmacy structure at Walgreens is a little bit different. I mean, it's the site that's in Knoxville. And, what's called registered manager, local specialty. So I'm over the whole site. I'll own kind of your accreditation and specific accreditation, not just for specialty pharmacies, but it does apply, within the specialty pharmacy field. Katie Cox Then there's an M.O., which is a pharmacy manager, and what we traditionally think of as a pharmacy manager. And then they're all kind of structured differently, which is what I love about specialties. It's like each side is a snowflake. It looks a little bit different. So the Nashville site has care. Teams are a little bit larger site. We are a newer site. Katie Cox I launched our site in 2023. And then we've got five pharmacists now, but we don't have a specific care team, so we kind of all share and own the disease state since we've structured a little bit differently than Nashville. Tabitha Sineath Yeah. And we talk about care teams a little bit. That's just kind of a delineation of what type of disease state we're managing. So in in Nashville, we're a little more bucketed. We have a virology and oncology pharmacist who oversees those patients, neurology, who oversees, like migraine and seizures. And, I oversee chronic inflammatory in our transplant, which includes not only solid organ but stem cell. Tabitha Sineath And we have a unique partnership with Sarah Kane and clinic across the street, as part of the tri star network, to help those patients. And then we have a lot of miscellaneous specialty that kind of filters in, that don't really fit nicely into a bucket. So that's kind of where we all cross-train and help out. Stephen Woodward Okay, cool. Thank you. Michele Williams Yeah, that sounds great. So can can each of you tell us a little bit about what led you to specialty pharmacy? What it is about your your background, your work experiences, those kinds of things. And, Tabitha, if we could start with you, that would be good. Sure. Tabitha Sineath I started out, as a pharmacy technician for Walgreens, many years ago. I'm not going to say save a year, but, a few decades back, and, my path has not been linear in that sense. But I advance kind of to the top of my level as a technician and wanted to go back into pharmacy to get my pharmacy. Tabitha Sineath And always had been that drive in that pull for me. And finally just took the dive. But I think the catalyst for me was more of like a personal experience that led me to specialty. When I was trying to start our family and a lot of family planning, we realized that we would need a lot of additional help. Tabitha Sineath So in terms of, fertility specialty, we had to go through in vitro fertilization. And with that came a lot of specialty medications that, there was not great education around. And these are really expensive medications. And I, I said to myself, you know, there's got to be a better way to handle this for patients. And so that was really my draw to say, you know, this is this is my niche. 00;05;24;09 - 00;05;31;21 Tabitha Sineath This is where my passion lies. And that's really what I want to do. I want to help those patients, and have great outcomes. Michele Williams That's wonderful. Yeah. Katie Cox So, I also have a very nontraditional path towards pharmacy. When I was in undergrad, I studied chemistry and biochemistry, and I did research for the government on, carbon nanotube technology. I went to medical school, and I got, my medical doctorate, and then I had some health issues, and was trying to figure out how to restructure balanced life. Katie Cox For someone who is a high achiever, that can't work less than 120%, and we give you a lot of leeway for the optimal work life balance. I did not know I would have the additional years that I got so thrilled and pharmacy kind of looked like a great career to dovetail my chemistry biochemistry interest, along with what I had learned in medicine. Katie Cox And so, I finished pharmacy school and I went and graduated in 2016, and I started in, management. So I started out as a staff pharmacist, was not there very long and then started managing. I mean, it's 5 or 6 different sites, kind of jokingly say I was like the cleaner where they would send me to a pharmacy that maybe needed to implement better workflow or had some structure issues, or maybe had lost a really good leader and was trying to kind of figure out how to get back to where they were. Katie Cox And so I would kind of get us realigned and going well. And then specialty pharmacy, which I think is a great topic to talk about because I think a lot of times when you think of Walgreens, you don't necessarily think of specialty pharmacy. But it is a huge section of Walgreens. And I even when I started working for Walgreens, I did not know that we had specialty pharmacies. Katie Cox At that time, there was not one in Knoxville on the closest ones were either Nashville or Bristol, Kingsport. And so I took the opportunity to go and shadow at those sites and kind of see what it looked like. And it was a really great niche sort of space and community where you still do a lot of clinical work. Katie Cox And have long term interactions with your patients. I similarly had a fertility journey when my husband, we were trying to have our daughter and so helping patients navigate some of the fertility and understanding how much of the communication gets dropped off between the patient walking out of the physician's office and then coming into the pharmacy or getting the medications, and how probably a lot of the issues with our health care system are kind of this lack of continuity of care or like regular check ins with the same person who knows your history. Katie Cox And so I feel like specialty pharmacy fits so great into that space. And it's kind of under utilized in some capacities for patients both with billing access and then like long term management. And so I always like to include to you, like when I talk to students, they say, well what is specialty pharmacy like? Why is it special? Katie Cox And I kind of always joke, you know, it's it's an interesting and really great question to ask because there's not technically a specific definition of specialty pharmacy. Right. Medicare, Medicaid, our two biggest payers don't actually define specialty pharmacy, which kind of means that it ends up being defined by third party payers in some capacity, by manufacturers and access points and by some capacity, because there's drugs that are limited distribution drug, you can only get certain places. Katie Cox But a really good point like definition would be highly expensive, medications or medications that potentially would have chronic issues or adverse events that could occur because of the conditions that we're managing would make it more difficult to distinguish between like maybe an adverse event versus something that's happening with like multiple comorbidities. So it helps with tracking for data. Katie Cox So we learned in school, you know, about the four phases of studying drugs. And so I'll always talk about specialty pharmacy really fits into that post-marketing phase of study. And so always ask my students like how how did you decide. We tell patients 5% of patients have migraines, right? It probably wasn't the thousand patients we looked at in phase three is probably when it hit the market. Katie Cox And we were looking at phase four. Where do we where does that data come from? Right. And so specialty pharmacies usually provide data points. That go towards far more manufacturers and really also help us as pharmacists or clinicians tell patients about what to expect with the medications. But a lot of that is related to the adverse event reporting that we do. Katie Cox So we do track patients very much long term, talk to them on every refill, track adherence, track side effects, and then report that back so that that data can be used to help, you know, benefit patients in the future. And so it's really helpful. So you're kind of participating in the research around drug habit in specialty pharmacy, whether you recognize it or not, because there's so much data reporting that we do within the pharmacy industry, which is helpful in the long term for us to determine which patients should be optimally on that therapy, especially if it's an orphan drug or an unusual one that's going to have a small patient population using it. Katie Cox How do we get enough data to make that tractable for us to make better decisions in the future, when we're setting up guidelines or taking care of patients? Michele Williams I hadn't realized, although. Yeah. Stephen Woodward What does this what does your sites look like physically? Are they like the Walgreens on the corner, or does it look like something else? Tabitha Sineath Yeah, they're I mean, they're open door. So it's not, closed door pharmacy. We have patients that can come in and fill antibiotics if they want to. But primarily we serve more like a mail order type facility. Okay. Probably 95% of everything that we do goes out the door via Fedex. And that's just our courier that that we use. Tabitha Sineath But everything is communicated with those patients and, basically effectively shipped, so. Okay. But yeah, we have patients that walk in, in Nashville, we are situated very close to Vanderbilt University. So we have a lot of students that, even though there are two community sites that kind of flank us on either side, patients tend to find us either via walking route or some other way, but typically, our sites don't appear like a normal Walgreens, so you may pass it or you may just not even notice it in general, it's kind of very indiscreet. Stephen Woodward Okay. Tabitha Sineath And we don't have the big neon out front. And, you know, we always try to tell patients that are coming in to pick up either because of, you know, a delay. They don't want to wait for overnight delivery. I want to get started on therapy immediately. They're welcome to come in and pick that up, and we'll make those arrangements. Tabitha Sineath But we always for that visit. This is not your run of the mill big box. Stephen Woodward Yeah, I want to yeah. Katie Cox There's two. So there's two flavors of Walgreens specialty pharmacies. There's health systems and then there's community based. So health systems, what it sounds like do you located within the health system, usually inside a hospital. So within Tennessee we have one at Bristol. So the Bristol Regional Medical Center and then we have one in Kingsport. Those are both inside a hospital. Katie Cox Otherwise they're most often close to a campus, except for my site, which was the first or site in the company where a pharmacist flipped a retail site to a specialty site. So most specialty sites are built organically because the the structure inside the building looks different. I started with what was called a Cooper site, which was an ideal Walgreens had, where a lot of the, the, profit is made in the pharmacy. Katie Cox So it was a shrunken front end with a pharmacy and the main portion of it. And so we ended up converting that. So so what did we do? We gutted the front. So when you walk in. So ours is located in the strip mall, you'll notice, a lot of the community, specialty sites are located in the strip mall. Katie Cox And they'll say it'll say Walgreens Specialty pharmacy. But when patients walk in is when they notice a difference. So they might say, oh, Walgreens on the swing in here. And then they walk in and go, where's where's all your stuff, you know, and no, we have no friends. There's nothing. So there's just a counter. And then it's like, oh, I'm sorry, we only have like prescription medications here for you. Katie Cox And we do about the bulk of what we do. We also originally had a drive thru. We would close to that drive thru because, an a hole tell students when you come in and when you go to a normal retail site, where's the hustle and bustle? It's in the fill zone, right? Like if we're filling, we're checking prescriptions. Katie Cox We're counting at the window. When you're in a specialty site, the bulk of what we're seeing, the stress to you is a phone list that you're doing. And so you're going to see way more desks. You're going to see way more people on the phone. There's still patient interactions. It just looks a little bit different. And so anytime someone's been a traditional Walgreens pharmacist and they come to Cross-train in specialty, we kind of joke within the first hour, really high level, community pharmacists will go, oh, I see my skill set does not necessarily apply here because I'm used to the workflow structure being so different. Katie Cox And so it looks a lot different. So I always tell people, if you I hope you really enjoy talking to patients and having longer conversations, because that's kind of what we do here. And spend a good bit of time in doing a consultation with the patients. So before we dispense a drug, we do what's called an initial. Katie Cox And you may be on the phone with a patient for 30, 45 minutes, you know, very extensive discussions around the medications and what it might look like. And like we talked about before, continuity of care. Sometimes we're the first person really having a conversation with the patient about the diagnosis that they may have received. We have just found out I have multiple sclerosis. Katie Cox I've just found out that I've got Parkinson's. I've just found out I have cancer, you know, and now I'm talking to you all trying to navigate the drug aspect of this. And you're telling me very large numbers and lots of side effects, right. And so sometimes we call it kind of like a, we jokingly call it can like the specialty come down like you come in on the phone and then at the end we hope that you feel like, oh, I now understand a little bit of what I'm what I'm about to do and have some ownership in the process, being the patient in this and not feeling like I'm just kind of Katie Cox getting subjected to a lot of information and not knowing how to take like actionable next steps on it. And so example of that would be in specialty, which I think is a little bit different than a retail pharmacy is. We set a goal with the patient for every drug. And so how do we decide that that's the drug's working for you as an effective is it not effective. Katie Cox What does that look like? You know, we might have drugs that are very specific, like, oh, we're going to see a lowering of this lab, but you're not going to feel different versus another drug that might be, hey, this drug only allows you to live to a life of that. Right? So that's a good example I give to my students all the time, is that's a really specific drug that maybe we want a lot of adverse event data on, because while the drug is designed to let you live a little bit longer, unfortunately the condition that you have, most likely you will pass away when you're on this medication. Katie Cox So we want to make sure to tell them exactly specific of what to expect, what, how many days we think we're going to get and set a realistic and like logical goal for the patient. So maybe for a long drug, it might be I want to be able to play on Saturday when my grandkids come over, a lot of our pulmonary drugs, it's, my laundry room is downstairs. Katie Cox I can't do my laundry because I get out of breath. I have to sit down for an hour. So I want to be able to go down and come back up. And so I think it's really helpful in creating conversations for patients to determine, like, how do I decide this is going well, and then how do I use it appropriately to try to get the results that I'm talking to you guys about that are possible. Katie Cox And then even more so, maybe setting realistic expectations, right? Sometimes we feel like, particularly in this day and age, that we might have a cure all with a medication, and being able to set realistic expectations like, hey, this drug is going to help, with your liver, liver fibrosis, but we're also going to have to do like diet and exercise for you to achieve the goals that we're talking about and things like that. Katie Cox So that I feel like they really understand the process and can define what good would look like and how that might be different between different patients. Michele Williams That's very cool. So it's like really, really specific patient counseling relationships, talking about how the medication is really to a very specific degree. Katie Cox And then kind of gauging it based on the individual. Right. Something that we don't always in a lot of health care settings have the time to do. And that's one of the things I like about specialty pharmacy is you kind of have unlimited time. So I always joke to to my students, I'm like, it's like something so fantastic is something so terrifying, right? Katie Cox So somebody might go, oh my gosh, I can sit on the phone as long as I want. That sounds fantastic. And another person might go, oh, it sounds terrible. You know, I don't know where it's going to end. Right. And so it's like we're yeah, figuring out how to optimize it for what you feel like and how you want to be a pharmacist. Katie Cox And and that's one of the beautiful things about specialties. I feel like, like especially at a site like in Nashville, where you've been established for a really long time, you've got a lot of varied pharmacist roles at your site, and you can kind of gauge based on some of these goals and like what makes them happy at work, where you're going to pocket them for how much interaction they have with with patients and counseling versus leading to a team members versus, you know, like compounding or. Katie Cox Right. So you know, it's a beautiful profession because you can decide exactly what makes you happy during the day and then cater the role towards what you would you would want to get out of the day. Tabitha Sineath And there's so much variability even to between our care teams. I mean, I think the skill set for virology and oncology is very different from, say, miscellaneous specialty or somebody who's doing, a cardiac medication. And then we have, you know, non non-sterile, compounding that, we also do and we ship to ten different states. So with our site, we're dealing with patients from Maryland to Ohio to North Carolina. Tabitha Sineath I mean, it just varies all the way down to the south, Louisiana and Mississippi and Georgia. So our patients truly are all over, and really, I think you kind of hit on that. The beauty of what we do is the relationship building, because that in a sense, not only gets patients access, but it gets them engaged not only in their care, but also kind of what that outcome for them looks like. Tabitha Sineath And we can partner that with a lot of resources that we have the time and the functionality to do. And some of that is like the financial aspect because these medications are crazy expensive. Some of our neurology medications are about $100,000. Our, you know, hepatitis C treatment. You're looking at anywhere from 30 to 90,000, depending on which avenue in which vein we go down. Tabitha Sineath So, you know, in terms of like the payor aspect, you have to have great control, which is why access as many times is restricted just as specialty because of payers are going to be investing in that medication for that patient. They want to make sure that their outcomes are positive. So we do a lot of education and a lot of resource, facilitation with those patients to make sure that, you know, my goal is for them to walk out with zero. Tabitha Sineath So there's no out-of-pocket expenses to them. And we have access to grants and different foundations that can also kind of help funnel and provide those resources to make that happen. So when you talk to a patient who, you know, has a make applied prescription, that's $100,000, Tabitha Sineath That financial burden down to zero. I mean, that's that's the difference between, in some cases, life or death for these patients. Wow. Michele Williams So, thinking about our current students here again, what what sort of advice would you give? Student pharmacist who would be interested in going into specialty pharmacy? Tabitha Sineath I always say, if you can shadow get your foot in the door. Certainly work as a technician. Work in the field. That's going to give you the best access. You not only find out, is this really where you want to be? Because that's the most and part, the most important part of it. Nobody wants to, you know, show up day in and day out. Tabitha Sineath If that's not where your passion lies. Yeah. So finding that niche I think early on, is really helpful. But a lot of that begins with the proactive nature of that student. And then you have to step out of your comfort zone and say, this is something I'm interested in. How can I help facilitate that? You should network this around you. Tabitha Sineath Talk to people who are in that field. You know, we all have we all have connections. So it's really kind of navigating who, you know, and, drawing those, those webs together. Katie Cox You know, I get asked this question a lot by my students, and it's evolved over the last decade of me being a pharmacist. So I think when I was a newer pharmacist, I used to give the advice of like find a really good. And it's still not wrong advice. It's just evolved a little bit. I think in the beginning it was fun, a really good mentor and and make sure that you're like, find somebody who you feel like optimized in their career the way that you want to be, and then ask those questions and figure it out. Katie Cox And I think as I've been in the profession and trained a lot of students, I precept for for schools, I've recognized maybe two, just like how I define that for them, because we don't do a fantastic job in grad school, we're very focused on like making sure we enter the profession well, right. We're going to be good professionals. Katie Cox We want to learn what we have. And I kind of joke like we have we're really good at herd mentality, right? Like you're joining the profession of pharmacy, right? We're all joining this together. But self-awareness and like an individualized approach to your career is a trickier thing. And it makes sense because that's how we kind of do education. Katie Cox But I think a different way of saying find a good mentor is doing what you would like to in your career is saying find out, like become more self-aware of what makes you happy. So I always tell students when you're on rotations, and I know, you know, I always ask them their biggest fears to not like great on rotation around, but typically ask the question that I don't know the answer to. Katie Cox Well, let me tell you, you're going to get asked a question that you don't know the answer to. Precept. Every month I've teed you up so that I can teach you with the question. Right? So get over that hurdle and start thinking about what days when you're on rotations, do you leave and think, because we all have a day at work out where you leave and you're like, oh, I picked the right job. Katie Cox I'm so happy. I love what I do. This is a great day. And then equanimity of life, right? There's another day where you leave and you think, oh, oh shit, that's something else. I wish I'd opened that little shop I should have, like, learn how to do interior design. So you like, you know, it's like equanimity, right? It's both of those days. Katie Cox But I think there's if you can track like some trends to that, especially on rotation. That's the idea of rotations, right? The joke at school was always the moment you felt comfortable with where you were going, was the moment you were going to stop going there. Right about week 3 or 4, you start getting comfortable. You love the team you're with and and boom, it's like, oh, 48 hours later, you get to go on and like learn how to like adjust another month. Katie Cox That's a really great life skill to build on. And then recognizing when you're on those rotations, when you love the day or hate the day, what was it? Was it what you did? Was it who you were with? Was it your schedule? Was it the environment? You know, and then figuring out when with self-awareness like what that looks like, which is really hard with how we do grad school. Katie Cox Right? Like I joke, when I have most students, especially when I have a couple of them, I'll say before you make a decision, what do you do? Right? What do you do? You call your friend and you go, hey, I was thinking about doing this. Tabitha, what do you think about me doing this? You think I should do this? Katie Cox You think you should do this rotation? Do you think I should go and do this internship? You think I should take this job, right? We vet it from someone else. But. So I'll give the example. We have five girlfriends that all are pharmacists. We all have different jobs, we all live in different states and we all have different personalities. Katie Cox And so we all, so we have one who works at Kaiser Permanente. She's an inpatient doing it there. I have one who worked in a nonprofit HIV community clinic, that helps patients there. I have, me that means in a specialty pharmacy, I have someone else who manages a retail site. And we all have equal complaints because work is work, right? Katie Cox It's not one or the other, but we all have different personalities. So one of us loves talking to patients all day. Wonderful. One of us is like, no, I'm good on that. I'd like to lead over here in the office and not do that right. And she loves that. Right. And so I think sometimes we lose that in school, a little bit of of utilizing the APIs to learn about ourselves we get so stressed about like especially here at Gatton, like you're good, you're going to pass for that. Katie Cox Like you're going, you're going to be a pharmacist. So focus on being your happiest and best self and then figuring out how to use those APIs to figure out what is your best day look like. And then how do I figure out how to create a career for myself where I have the best day? And so I always tell my students, I'm like, I'm sure anyone can think of that one disgruntled person, right? Katie Cox He's like, well, I can't believe you went to pharmacy school, which I went through here, you know, waste your time. But it's probably not because of pharmacy, right? It's probably because they're not optimized to like, their self-awareness or their happiness. And so figuring that out early on and and then the other thing that I think is a really great piece of advice is careers aren't where they used to be. Katie Cox This is in the 40s and 50s where you picked your job, and that first job is the job you retired from, right? Like, you can move around in your career. And while change is hard for us as humans, I think it's great to be able to explore. So you're just looking for your first job, right? And then figuring out what you use that to leverage to the next. Katie Cox I'm actually my first job as a staff pharmacist, and I became a manager. Then I managed a bigger pharmacy. Then I decided I wanted to do specialty pharmacy. Now I manage a specialty pharmacy, and I'm hoping to launch that into managing more specialty pharmacies over different states. But so what's that next growth moment and like space moment for you and then figuring out how to optimize it for you as an individual. Katie Cox Instead of feeling like you need to fit yourself into the career of pharmacy. Tabitha Sineath I think those breadcrumbs along the way to kind of help like define what that pathway looks like, because you take big bits and pieces from every experience, whether that be as a student on rotations to your first job or what you ultimately grow into. It's the bits and pieces that you know as part of your experience that truly kind of define you over time. Tabitha Sineath So don't. My advice to students is don't give up on that and continue to kind of seek those out because you know in your heart where your passion lies, you have to make the pathway, but you have to be proactive about it. Katie Cox Yeah, I think when I was younger, I thought lifelong learner meant drugs. And now I'm like, no, no, no. It means so much more than that. It's not just the knowledge for like what you're doing in your work, but it's also like lifelong learner about myself, about my profession, about how to interact with patients and engage them and advocate for them and give them agency and what that looks like. Katie Cox And it changes over time as you change, but like recognizing that so that you don't get in there in a rut and think, well, I'm not happy now when I was well, you've evolved, you know, evolve your profession with you and you'll always be happy. Michele Williams That's such great advice. Yeah, that's really good advice. Stephen Woodward We've we really appreciate you all being here. I think that was a great note to end on. But, thank you all and hope to see you again soon. Katie Cox Absolutely. Thank you. Tabitha Sineath All. Thanks. Stephen Woodward Thanks for listening to White Coat Radio. If you haven't already, be sure to subscribe and leave this review. To learn more about ETSU Bill Gatton College of Pharmacy, visit us at ETSU.edu slash pharmacy or follow us on social media at ETSUpharmacy. We'll see you next time.  

We’re joined in this episode by Dr. David Stewart, Associate Dean of Assessment and Academic Affairs. Dr. Stewart led Gatton’s efforts to improve NAPLEX pass rates, resulting in the college ranking among the top five accredited pharmacy schools nationwide for the Class of 2025, as well as No. 1 in Tennessee and No. 2 in the Southeast. He shares his thoughts on the excellence of our student pharmacists, alumni, faculty, and staff, as well as the collaborative efforts that led to this success.   Transcript Introductory Teaser: David Stewart I think for a student that's either here at the College of Pharmacy or maybe thinking about coming to the Gatton College of Pharmacy. I hope it gives them confidence that when they finish our curriculum, they go through our training program, they're going to have the tools that they need to be successful as a pharmacist. They're going to be able to pass those exams. Main Episode: David Stewart They're going to be able to get a license. 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. I'm one of your hosts, Doctor Michele Williams, assistant professor and director of academic success. Stephen Woodward And I'm Stephen Woodward, marketing and communications manager. Today we welcome Doctor David Stewart, associate dean of assessment and academic affairs, as well as professor of pharmacy practice. He is an inaugural faculty member at Gatton, joining the Department of Pharmacy Practice in 2007. Doctor Stewart led the college's efforts to improve its NAPLEX Pass rates, and today he shares about that process, as well as his thoughts on the excellence of our curriculum, our students and alumni, as well as faculty, staff, and the collaborative efforts that led to the college's success. Stephen Woodward Doctor Stewart, welcome to White Coat Radio. David Stewart Well thank you. Thanks for having me as a guest today. Stephen Woodward So we have some big news that happened at the college a few weeks ago. Demanded just tell us what happened. David Stewart Yeah. So every January we get a report from the National Association of Boards of Pharmacy or in NABP and they give us licensing reports on our licensure exams, the NAPLEX, and North American Pharmacy Licensure Exam, as well as the Multi-State Pharmacy Jurisprudence Exam, also known as the MPJE. And these are the two exams that students need to take in order to get licensed as a pharmacist. David Stewart And so we're able to compare our results against the results of schools across the nation. And so for the second time in three years, we had a really high pass rate. I'm proud to say that our class of 2025 was the number five, school in the country for first time pass rate on NAPLEX amongst all accredited schools in the United States. David Stewart Also was the number one school in Tennessee and number two in the southeast with a 97.7%, first time pass rate on the network's exam. Michele Williams That's amazing. Stephen Woodward That amazing. David Stewart Yeah. And then, you know, the cherry on top of that is that exam I mentioned the MPJE, our in-state first time attempt, pass rate on that. We were number four in the country, number one in the state and number two in the southeast again. So really strong work from our graduates in the class of 2025 for sure. Michele Williams They really did a great job. David Stewart Yeah. And I think the exciting thing for me is this is a, you know, just one group. It's it's mostly the students. We tend to celebrate a lot around here. But really see, alumni from the class of 2025 that did all the hard work and took the exam. But it does represent a team effort. It's the, you know, the students, the graduates taking the exam are faculty, staff working as a team to set them up for success. David Stewart So really, really proud of everyone's effort. Michele Williams So, you mentioned the people behind the, the, pass rates, including our amazing students and our faculty and staff. But these successes also reflect some recent changes to Gatton’s curriculum. Right? And so, what kinds of changes have taken place that sort of led to this success? David Stewart Yeah. So really, a couple of things. First, you know, we set out on a curricular revision. We've really been planning that revision since before the Covid 19 pandemic. Going back to the 2018, 2019. That did kind of put a damper on things. But in about three years ago, we launched a new curriculum. So our current P3 class is the first class that's, completely going gone through that new curriculum. David Stewart However, I will say that along the way, as we identified things that like foundational things that we needed to do better on a lot of that feedback from students after taking the exam or after going through our curriculum. Our faculty were really good, integrating small changes into our legacy curriculum. So I think that what we're seeing, even though these graduates weren't necessarily graduates of our new curriculum, they're graduating with a new curriculum philosophy in mind from the people that are delivering that curriculum to them. David Stewart So I do expect that things will only get better as we see graduates coming through our our revised curriculum, with our first class graduating in the new curriculum from, in 2027. Stephen Woodward And these recent results, as I've done, in my opinion, it's not just a one off like a few a couple of years ago, the class of 2023, they were ranked number two in the country for accredited pharmacy schools and number one in Tennessee and our region in the southeast. Right. So this is kind of part of continuing on from just incredible national recognition. David Stewart Yeah. And I think if you look back on the history of the Gatton College of Pharmacy, we've always been, you know, kind of at or above average, if you will, when about 4 or 5 years ago, we had, what I would say was a low point for us. I mean, we were right around the national average. David Stewart And, if you ask anyone here, our faculty and staff, no one's happy with average. We want to we want to have excellence in all that we do. And so we really embarked on this journey to improve our student success on those exams. And yeah, I think that class of 2023 that you referenced, there is a direct correlation with with some of those changes that we started 4 to 5 years ago about how to better prepare students for the exams. David Stewart Cool. Michele Williams So, what do you think these successes mean for the college and for students pursuing pharmacy? David Stewart Well, I think for a student that's either here at the College of Pharmacy or maybe thinking about coming to the Gatton College of Pharmacy, I hope it gives them confidence that when they finish our curriculum, they go through our training program, they're going to have the tools that they need to be successful as a pharmacist. They're going to be able to pass those exams. David Stewart They're going to be able to get a license. One of the newest things that we are doing that started last year with this class of 2025, is that we bring them back a month early, so they actually start their fourth year rotations or APPEs or advanced pharmacy practice experiences. In the month of April of their three year and then during the month of April of their four year right before graduation, we spend about four and a half to five weeks preparing them for the exam. David Stewart And that allows us to slow that process down and make sure that they have all the fundamental tools they need to be successful on that exam. I think the initial feedback, and that's been very positive, and of course, the results from this first class going through that model are very encouraging as well. So again, that's just another example of things that we're constantly changing and improving. David Stewart So if you're a student in our program or come into our program, you can rest assured that we're going to prepare you. And my goal, I tell them, in that training program, is that they're ready to walk across the stage and go the next week and take their exams and be licensed as a pharmacist without delay. Michele Williams So, Doctor Stewart, I know that this is a team effort. Certainly. But you were really the architect of this preparation program that you just described. Can you tell us a little bit more about your, your objectives in developing this program and, and how you put that program together? David Stewart Yeah, that's a that's a great question. And, and really speaks to I think it's something that's really important that we had to talk about and work through as a faculty and staff. I mentioned earlier about our our faculty and staff are always focused on excellence. And I think one of the initial, you know, knee jerk reactions when you start talking about exam prep is making sure you're not just teaching an exam, but we want our students to get the necessary skills that they need to go out and be successful. David Stewart Pharmacists in making a positive impact on health care and the profession of pharmacy. And so I feel like we really found a sweet spot where we made sure that what we were teaching in the classroom, was, was sound that we were getting those fundamentals in. But as we talked to students, one of the things I did early on is we started revision to this program was just gathered data. David Stewart What were the barriers that students were facing as they struggled with these exams? And there's just so many factors out there. Things like, for example, many students come to us now without taking the traditional standardized exams. A lot of folks don't know that. You know, SATs and Acts are not necessarily required for college admissions anymore. Several years ago, they, took away the, PCAT exam, which is the equivalent of the mCAT exam for medical school. David Stewart So some of our students, we realized, had never actually taken a high stakes external standardized exam before. So some so a lot of this wasn't necessarily that they didn't have the knowledge that they needed. They didn't necessarily know how to tackle a 5 to 6 hour, really large, standardized exam. And so some of the things we did was just prepare them for that exam process. Michele Williams So the environment you try to mimic that testing environment to give them a sense of so they're not surprised by it or they're not thrown off by it. David Stewart Yes. When we collected data from our first class that went through some of the revisions I've talked about, and this was about four years ago, one of the things they rated as the most effective in our program was a simulated nap. And at that point in time, we were able to put that together through practice exams that were offered through NABP David Stewart And now there's a new product from NABP called the NAPLEX Advantage, which we use for our students. It gives them more data. It gives us more data based on their performance. But it's basically a practice exam so they can take a simulated Nap exam beforehand. In addition to just taking that practice exam, we really strive to simulate the entire experience so the student knows what it's going to be like from the time that they pull up in their car, in the parking lot of that testing center, to the time that they walk out, that they're not surprised by anything in there. David Stewart So they're prepared and they can focus on the exam, in performing at the level that that they can perform at, versus being distracted by things that, that they didn't necessarily know were going to happen, like, oh, they're going to take my phone and put it in the locker. Oh, I have to turn my car keys in. David Stewart Oh, I forgot my driver's license. It's in the glove box of the car. It's just those little things that can get students flustered on exam day. And what we were hearing from students that weren't used to that or didn't expect that, is that made a big impact on their ability to think and perform well on the exam. Michele Williams That can really throw you off your game if you don't know how regimented that environment is. David Stewart Well, if you look at, you know, any you get high performing athletes. As an example, you can bet that they're simulating the game environment. They're preparing for that big game, whether it's the Super Bowl or the World Series or whatever. And we're trying to do the same thing for our students. We want to simulate that environment. And have them as prepared as possible for those things so they can focus on doing what they need to do. David Stewart And that's, using their knowledge to perform at their highest level on the exam. Michele Williams I think that's great. And then how did you put together the other elements of the the preparatory program? David Stewart Yeah. So the very first class, that, that I helped to go through the exam process, we did an assessment after the fact. And one of the things, that that is unique about, our data set, and we're in the process of publishing these data so that others can benefit from this is there's a lot of information getting students opinions and perceptions. David Stewart Preparatory materials or courses as they're in school before they take their exam. We actually surveyed our graduates after they sat for the NAPLEX exam. So their perspective may be different. And we found in some ways it offers additional information than a student who hasn't taken the NAPLEX exam. So then we use the information we got from those graduates after they took their knapsacks, asking them what components of our program set you up for success? David Stewart What was effective? What was less effective? And then each year in an iterative process, we make minor changes. But really the things that they said were the highest impact. The back to the the simulated exams, and then some of the, preparatory content that we provided for them. And then things that were less effective, like, for example, at one point we had faculty meeting with students every week during their fourth year. David Stewart The students told us that's really not effective. We don't feel like it helped as much as other things. So we've taken that away. It's less burdensome for the students. It's less burdensome for the faculty. Yet we're seeing a continual rise in our scores because we're focusing on the high impact interventions that we can make. Michele Williams So that constant feedback from students and at various points along the way have really informed the way you put this program together. David Stewart Yeah. We've really we've really room for a data driven approach to do all that we do. And looking at, you know, not just what do other people do but other people who have successes, what are they doing? You know, looking at your data from people that are in a position to tell us this is what was helpful for me to be successful on this exam. David Stewart And we're incorporating those things. Not that other perceptions aren't important, but we feel like those perceptions are more valuable in getting the outcome that we want, which is our students being successful on those exams. Michele Williams So it sounds like it's about a lot more than just, you know, the the content, the questions. It's it's the totality of the experience of being prepared for the exam. David Stewart It is. And I want to reiterate that this is really a curricular experience that starts in the P1 year. Yeah. And some of the things that we do are actually going back and reinforcing things like pharmacy calculations. Yeah. They're oftentimes questions on the exam are mirrored in the practice models that students are in in their fourth year. David Stewart And so we want to make sure that they know how to do those types of calculations. And if and when they show up on the exam. We also recognize that there are some things that our students do over and over and over and get really good at. But, for example, they probably are really good at taking care of patients with diabetes and heart failure. David Stewart Those are chronic diseases that we see a lot here in rural Appalachia. But not all of our students feel, real comfortable about, calculations around, nutrition support in an inpatient hospital setting. Yet there are questions about that on the exam. Had it in the curriculum, but they've not practiced it day in and day out. So we're just getting them. David Stewart I would I would say we're getting them reps on the types of things that they may not be doing every single day on rotations, that that we know are going to be on that exam so that when they see those questions, they're comfortable and able to appropriately, you're accurately answering them. Michele Williams So sort of a broader approach so that they don't get, you know, too much of a certain type of question, but kind of broader look at the content. David Stewart One of the things that I will tell the students is you can't re learn everything in our curriculum during your fourth year. There's a lot of things that you already know, as a fourth year student pharmacist, one of the goals of our program is to help our students self-assess what they know and then what areas they need to work on more, and then encourage them to focus their study time on the areas that they need to, that they need more work in. David Stewart And so it's not going to be the same for everyone. So while our program is somewhat of a one size fits all in that they all go through it in the same way, a lot of what we're coaching them and mentoring them on throughout the year is that self-assessment of don't waste your time studying the things that you know and are comfortable with. David Stewart I think, Doctor Williams, you probably see this in your own work as director of academic success and in my experience with students on rotation, was if a student understood, say, the pathophysiology and treatment of diabetes really well, they always wanted to talk about diabetes. They wanted to do their their presentations about diabetes. They wanted to pick up all the patients in the clinic or on the service that had the disease, diabetes, because they were comfortable with that. David Stewart One of my goals in this preparatory program is to get them to start focusing on the things they're comfortable in, and spend more time studying the areas that they're uncomfortable with so that they're prepared for that rigorous broad exam that ask questions across a plethora of disease states. Stephen Woodward Well, it's been really great talking with you, Doctor Stewart and seeing how Gatton is leading in licensure pass rates not only at the state level but on the national level. This is just been that's really exciting news. So we appreciate you coming out today. David Stewart Yeah. Well thank you. Thank you for having me. And again, just a shout out really to the graduates. Just the class of 2025. And we mentioned our graduates from the class of 2023 as well. They put in a lot of time and a lot of hard, hard work. So, the huge congratulations to any of our alumni that are out there listening today. Stephen Woodward Yeah, absolutely. Thanks for listening to White Coat Radio. If you haven't already, be sure to subscribe and leave this review wherever you listen to podcasts. To learn more about East Tennessee State University Bill Gatton College of Pharmacy, visit us at etsu.edu, slash pharmacy or follow us on social media @ETSUPharmacy. We'll see you next time.

We’re joined in this episode by Dr. Ralph Lugo, Senior Associate Dean and Professor at East Tennessee State University Bill Gatton College of Pharmacy. He has been with the college since its founding, joining in 2006 as the founding Chair of the Department of Pharmacy Practice and serving in that role for 17 years before being promoted to Senior Associate Dean. Dr. Lugo discusses the role of AI in pharmacy education, including both the benefits and risks of the technology. He also reflects on the college’s 20th Anniversary, how Gatton has grown and evolved over the years, and where he believes it is headed in the future. Transcript Teaser Introduction: Ralph Lugo What you're going to get here at Gatton is a great education, where you also have high impact opportunities and a wonderful culture, a community focused culture, a student centric culture with relatively small class sizes compared to many other schools where you're going to know your professors and they're going to know you, and you're going to develop lifelong relationships with your colleagues.   That doesn't always happen in all schools.   Main Episode: 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. I'm one of your hosts, Doctor Michele Williams, assistant professor and director of academic success.   Stephen Woodward And I'm Stephen Woodward, marketing and communications manager. On this episode, we talk with Doctor Ralph Lugo, senior associate dean and professor at ETSU Bill Gatton College of Pharmacy. He's been with the college since its founding, joining in 2006 as founding chair of the Department of Pharmacy Practice and serving in that role for 17 years before being promoted to Senior Associate Dean.   Stephen Woodward During this time, again, Doctor Lugo is primarily focused on administration, program development, and teaching. And before coming to Etsu, he served as vice chair of Pharmacotherapy at the University of Utah. Doctor Lugo‚Äôs practice experience and interest is in pediatrics, specifically in pediatric intensive care. His research interests include lifestyle medicine, pediatrics, neonatology, pediatric intensive care, analgesia, sedation, and his research has been supported by the National Institutes of Health.   Stephen Woodward Well, Doctor Lugo, thanks for coming to Waco Radio today.   Ralph Lugo Yeah. Thank you, Stephen, for having me. Doctor Williams, thank you for having me today. Look forward to our conversation.   Michele Williams We're happy to have you here.   Stephen Woodward So you came again as founding chair of the Department of Pharmacy Practice. Can you talk about your long history here and what roles you currently serve in?   Ralph Lugo Sure. I came to Gatton in 2006. I was hired in 2005, so I've been here 20 years now, which is just amazing to think that I've been here that long. And I was hired initially as the founding chair of the Department of Pharmacy Practice. As you all know, we have two academic departments Pharmaceutical Sciences and Practice. At the time, at the time, I was at the University of Utah as vice chair of Pharmacy practice and an associate professor in pediatrics.   Ralph Lugo I think most people know that my specialty area had been pediatrics in my up but in the air quotes. Former life as a as a clinician in the pediatric intensive care unit. And I had always wanted to come back to the East coast. Was born on the East Coast. I trained in North Carolina, worked in North Carolina. I really enjoyed the South East a lot.   Ralph Lugo So my wife and I, we started a family out in Utah, and we really had a desire to come back east and specifically the southeast. So I saw this position open up, and it was just a natural move for me to move from a vice chair position to a chair position. And I had been in academia long enough that 13 years at the time to be able to handle such a thing.   Ralph Lugo Of course, it's always very challenging, but really look forward to the opportunity. But there were some things in particular, I think, that really attracted me to Gatton. Number one, we were starting a college of pharmacy from scratch. There's not a lot of opportunities that come up in the country to start a pharmacy school from scratch, to no avail.   Ralph Lugo And and you know, there's as you go around the country and you train in different places, you realize that some things you know, I might do a little differently or the culture may not be as I would want it to be in certain places. And so here was this opportunity to start with a clean sheet of paper.   Ralph Lugo And I thought, what a wonderful professional opportunity that really doesn't come around very often. And and then I interviewed the for the position and was just overwhelmed by the community support for this for this college of pharmacy. Nothing I've really seen before coming from Salt Lake City. City of 1 million plus College of Pharmacy doesn't get much airtime or press.   Ralph Lugo And it seemed like here at the College of Pharmacy was in the newspaper towns, the city press constantly above the fold type of articles, on the news, on the marquees, on the bumper stickers. I mean, it was just all over and I was just amazed that the community support, so that really attracted me here, as well as meeting with Dean Calhoun at the time, really communicated a student centric focus to Gatton, which I really appreciated.   Ralph Lugo So between all of those things, the stars just aligned the right way from a career standpoint for me and Gatton seemed real attractive in a place that I wanted to live. And then, you know, the place sort of got pushed off into the background somewhat in front and center was there's a great opportunity here in Johnson City to establish something really unique, and I want to be a part of it.   Ralph Lugo So that's really what what got me here. And that's what's kept me here for 20 years.   Michele Williams That's great. So what is your favorite part about your job?   Ralph Lugo Well, I love working with students. I'm an administrator at least half my time, but I still teach a lot in the classroom. So depending on the semester, I may be teaching 30 or 40% of my time. In some semesters, I'm teaching 50% of my time. So I teach more than most administrators teach. And that's not something that I wish to give up.   Ralph Lugo I really enjoy being in the classroom. I really enjoy being around the students. That's not unique to being a founding chair of the department, but that's a part that I really wanted to hang on to and have hang on to, you know, because I could have given that up in various ways over the years, but I intentionally retain that, especially since I, I no longer practice, and I love practicing, too.   Ralph Lugo So I gave that up because there just wasn't enough time in the day to do all those things. So I gave that up, but did not want to give up teaching. So love teaching, love working with students, love working with the faculty. And that's the that was the hook for me about being a department chair is you really have an opportunity to work closely with the faculty and trying to create opportunities for faculty members, trying to promote them.   Ralph Lugo I don't mean promote the necessarily from assistant to associate, but promote them in their career development, to promote them in their daily practice and just just helping them come along as faculty members. That was something that was very attractive to me, and I've enjoyed that ever since. And that's the one thing I actually miss, in being in my current position right now, is I don't work as closely with the faculty members, but I still do work with them.   Ralph Lugo So, because I'm no longer department chair, I'm sure we'll get to that, soon, but, but those are the things I think that I really enjoy about my position.   Stephen Woodward Can you talk about your transition from department chair to senior associate dean now?   Ralph Lugo Right. So, so several years ago, after serving in that as a department chair for, for 17 years, Dean Byrd was, was provided with a wonderful opportunity to serve as interim dean of the College of nursing. And, in order to make that happen, we really needed to have somebody here that could assist, her to continue that leadership role.   Ralph Lugo And so she asked me to serve as it was at that point, it was called executive associate dean, which has since transitioned, entitled Who's Senior Associate dean. But essentially it functions in the same way. So, a few years ago, that transition occurred when she took over that, that interim role in the College of Nursing. And then she served in that role for a period of time and is now back full time here in the College of Pharmacy.   Ralph Lugo And I'm still in that position of senior associate dean. So that's how that transition occurred. That's what prompted that transition. I moved into the senior associate dean role, and then Sarah Thomas and moved into the department chair role. And it's been a wonderful transition, a wonderful new challenge for me as well. And I still do many of the same things I did before, even as a department chair, with the exception of working as closely with the faculty, as I mentioned earlier, earlier.   Michele Williams So, what is something that people at Gatton might not know about you?   Ralph Lugo I think.   Michele Williams Ralph Lugo I think many people, some people might know about my recent interests from a professional standpoint. As you all know, I trained in pediatrics, served in that capacity for a number of years, and still have an interest in that. But professionally, as the years went on, my interests sort of blossomed in other areas. And that particular area is lifestyle medicine.   Ralph Lugo And so about 25 years ago, an organization was formed called the American College of Lifestyle Medicine, and it was formed by a number of physicians. And the primary goal and mission of the American College of Lifestyle Medicine is to try to address the root causes of disease and try to improve health through lifestyle interventions. As we all know, we have a very needy, sick population in this country and we have various epidemics that are unfolding as we speak.   Ralph Lugo Certainly, diabetes would fall in the category Alzheimer's disease would fall under that category, and cardiovascular disease continues to be the number one killer worldwide and in the US, and of course, cancer as well. And all of these things absolutely need to be addressed. But there's not a lot of reimbursement opportunities to try to prevent disease and try to get at some of the root causes.   Ralph Lugo So that that has been an area that's been somewhat ignored over the years. So this organization was created to try to address root causes and lifestyle modifications. And lifestyle modifications are in many of the guidelines that currently exist for treating various diseases. But the problem is that when physicians say you need to change your diet or you need to change your lifestyle, that's as far as they go in many cases in terms of describing that.   Ralph Lugo And the patients don't necessarily know what that means. And if you ask ten patients what it means to change your diet, you're going to get 15 different answers. So so this organization is really about trying to prevent disease. So I really sort of latched on to that about ten years ago. And so I'm now working with a number of students, seven students actually to write four papers.   Ralph Lugo No, it's actually more than that. It's 8 or 9 students to write four papers on the pharmacist's role in lifestyle intervention, the community pharmacist in particular. So things like preventing dementia, things like preventing anxiety and depression, that's what we're writing on. We're writing on we're we're considering just writing on the pharmacist role in lifestyle modifications in the community pharmacy, trying to educate pharmacists and give them the tools necessary to be able to address these issues in their patients.   Ralph Lugo We have a captive audience here. We have patients coming to the pharmacy, and pharmacists are the most accessible health care workers. So there's a great opportunity for this intervention. But pharmacists need to be educated in this area of lifestyle medicine, and it's not currently in the curriculum. So I'm trying to champion more education about that. Part of the way I'm doing that is through scholarship, writing articles and engaging students.   Ralph Lugo I hope to develop an elective in this area in the near future, and I think a number of students would probably be very interested in that.   Michele Williams Definitely.   Ralph Lugo So I think if you just bring this back to your question, Doctor Williams, I, I think probably many students don't know that some faculty might know it, but not all faculty might know. And so I'd say that's that's an area that, that's probably at least known about me.   Michele Williams And they know it now. So yes, that's right. More requests for students to participate in that research. That's right. You're doing. Yeah.   Stephen Woodward What? And I know everybody knows about you that you're a huge fan of AI and that the rise of AI over the past few years is just it seems like it's taken over, not quite in like, Terminator style yet, but maybe we're getting close to that. Can you talk about how you got interested in artificial intelligence and what do you find most useful about.   Ralph Lugo Yeah, AI is is really interesting. I like to utilize technology as a tool, not just I, you know. Yeah, some of the faculty, they'll probably poke, poke fun at me because I'm always looking for a better app to do certain things. You know, whether it's project management and some faculty. I won't name any names, but some faculty may laugh at me in terms of, you know, the newest and the greatest project management tool, a doctor you logos using well, whether it's Trello or whether it's Clickup, which is which is what I'm using right now.   Ralph Lugo So there's a little bit of fun there that folks have with me. So I've always been very interested in utilizing technology to improve efficiency. I'm very much about maximizing efficiency, whether it's.   Ralph Lugo Driving a car that has good gas mileage or whether it's squeezing every dollar out of your budget or whether it's, trying to get the most work out of a work day. You know, that's just kind of like how I'm wired. And so technology has always been a part of that. So that got me interested. And then when I found out about I happened to be in a, I was in a, a faculty meeting on main campus, it was a it was a group of faculty members, that were addressing, it was actually a number of chairs that were meeting and we were addressing the charge to write a faculty handbook for new   Ralph Lugo chairs. This was about four years ago. And the, the, person that was leading this, this committee said I used ChatGPT to give me an outline of what a faculty handbook would look like. And he showed it and I was like, wow, that is amazing. Now, meanwhile, I had heard of ChatGPT. I wasn't quite sure exactly what it did or what it was, but I was amazed at the output.   Ralph Lugo So I started tinkering a little bit with it and then, you know, and then things began to snowball. And then we had a number of, faculty development sessions here at the college. I actually gave one of those sessions and, and we went to a number of national meetings where we had sessions on a all things I. So I learned a lot about it.   Ralph Lugo And now I would consider myself. I'm certainly not an expert at it, but I'm probably an early adopter and I'm very enthusiastic about its potential. I'm not completely ignorant about the downside of using AI. It certainly does have downsides and limitations and disadvantages, but I think a lot of things do, you know, and people say the internet has downsides.   Ralph Lugo Yeah. If you're in the wrong places at the wrong time, it can be very detrimental. Right? But it's got a huge upside to so it's just a matter of trying to balance that and learning when to best utilize and how to best utilize AI in order to help you in your productivity guardrails. So let me talk a little bit about guardrails with AI use, because that's what people will ask about is this like, how do we how do we put guardrails around its use so that it can be used wisely?   Ralph Lugo So I would say, first and foremost, we need as a foundational issue, we need transparency. It needs to be clear when AI is being used. It's a, it's a, some measure of academic honesty and, being genuine is to declare when AI is used in order to assist with certain things. And that's coming from a professional standpoint, but from a student standpoint, too, academic honesty really depends on disclosing when I was used.   Ralph Lugo And so we need to we need to set up guardrails about disclosure. And I think that needs to be in policies as we move forward. Things are changing so rapidly. Policies are being developed, guidelines are being developed. So I think those things will be important to include moving forward. The other part of guardrails is we need to be careful about not encouraging students to take shortcuts around critical thinking.   Ralph Lugo We are trying to teach critical thinking here at the College of Pharmacy. That is an important outcome, and there are certain exercises that require critical thinking. It's not necessarily we're trying to get the answer as quickly as possible. We're trying to put you through that exercise of critical thinking and synthesizing and taking all this information that you're learning over the years and coming up with a cohesive, cogent answer.   Ralph Lugo And that's the exercise. That's the benefit. You got to struggle a little bit with that. Well, we can assign that to AI and come up with an answer. And, a 10th of the time, perhaps, but the student will not have grown from that exercise of critical thinking, and they may not know how to critically think if they continue to take shortcuts.   Ralph Lugo So we need to have mechanisms in place to protect those critical thinking opportunities. Also, clinical reasoning students need to be able to reason through certain questions, and they need that practice. They need also to, demonstrate competencies. You know, our skills, we have these skills here in the in the college. They have certain things like oral exams or direct observations or practice labs where you have to display certain competencies.   Ralph Lugo You're able to do certain things. AI is not going to help you there. So so that's an important part of the guardrail as well. And then, faculty development from our faculty need to be, competent users themselves before they can be thoughtful regulators. So we as faculty need to create these guardrails. We need to create these policies.   Ralph Lugo But we also need to be able to utilize them, utilize AI ourselves so that we know where the pitfalls are, where the landmines are, and where students can get into trouble. So, we're in the process of, in AI and I say we I mean, college pharmacy, Etsu, the academy, the profession. You know, we're in the process of developing these things as we go along.   Ralph Lugo And in the meantime, we have people that are, like, totally embracing it. And we have people that are tepidly cautious. And then we have people that are naysayers. And so all the above, I, I'm, I'm enthusiastic, but not ignorantly, ignorantly. So in other words, I'm not just embracing everything. I, I think it needs to be within the context of guardrails.   Ralph Lugo Michele Williams I agree, I share some of your concerns about AI co-opting somebody's ability to think critically or to even just practice those skills of reasoning through a problem and problem solving. On their own. I know in the classroom they have opportunities to do that, but it, it does seem like it would be very tempting to get AI to do some of that.   Michele Williams So I think, yeah. What you talk about with, with guardrails and, and not only guardrails, but sort of offering rationales and helping students look further down the road to why is it that you need to be the person doing this sort of reasoning and thinking?   Ralph Lugo Yeah. And and how to use AI in the context of that reasoning? You know, I can be right. Appropriately, AI can be a tool in that reasoning process, maybe to provide them with some information as long as the information is double checked in terms of accuracy. But the reasoning is really important, and human judgment enters that reasoning very often.   Ralph Lugo So things like empathy, things like, context of patient care, you know, understanding Mrs. Jones social situation and the fact, whatever her limitations are socially, you know, she doesn't get out of the house or she limited mobility or all these things go into helping to make decisions for patients that I can't necessarily reason through. And you have ethical decisions as well that come up.   Ralph Lugo And I again, may not be able to help with that. I, we have to recognize that AI is trained on a data base that exists in the past. And so there may be some ethical situations that come up which are contemporary, which are not necessarily in the training data base that one needs to think through critically in order to come up with an answer to best fit that patient.   Ralph Lugo It's kind of like evidence based medicine in a way. We can have all of the objective clinical trial data on a drug. We can say very clearly, this is the most efficacious drug for this disease. State, but if Mrs. Jones is not going to take it, or if it's too expensive for Mrs. Jones, or if there's three other reasons why it's not going to work and Mrs. Jones, then it may not be the best drug for Mrs. Jones, even though it has the most compelling data.   Ralph Lugo So it's the same with I may gave you some very good objective information, but it needs to be contextualized so that you can determine what is best for this patient. That requires empathy, human reason, human judgment, contextualization and AI at this point doesn't do all of those things. Yeah.   Ralph Lugo You know, I might I might mention another thing. And I know Doctor Williams, this kind of resonates with you with regard to professional identity formation. I know that's an area of interest for you. But, you know, one of the things as we're trying to develop professionals here at the Gatton College of Pharmacy is we want students to be able to wrestle with difficult questions and sometimes failure, sometimes critique, sometimes not having the right answer, sometimes struggling and being corrected helps with that professional identity formation so that it helps them become a better professional.   Ralph Lugo And, you know, I can think we were just having a conversation just recently, another faculty member and I, about some of the students in the past that may have had some academic or behavioral challenges, shall we say. And I'm talking about the distant past. And I think in some cases, some of these some students may be young. They may they may not have that full maturity.    Ralph Lugo Certainly they're not fully matured professionally, that professional identity formation. But they've they went through a process that helped to correct them, to guide them, to corral them and shepherd them. And in that process, they came out on the other end and have created wonderful careers for themselves through that process. And sometimes a few hard knocks along the way will help people correct course, correct along the way, and help them become more successful.   Ralph Lugo So that's, you know, it's not always about having the right answer. That's true. And having all your eyes dotted and t's crossed, which I tends to do. Right. Great answer. I now let's put it in the context of training pharmacy students.   Michele Williams I agree, I agree.   Stephen Woodward It's got to be pretty satisfying to see a student from a long time ago struggle, but then come out on the other side and then go on to in a career.   Ralph Lugo Yeah. Very much succeed. Right. Yeah. And and you don't appreciate it or recognize it immediately until years down the road and you kind of look back and you say, wow, this person's really made a name for herself or himself. And and it's not always about making a name for yourself, but that making a name for yourself is usually because you're a great pharmacist and you take care of patients in a in a great way.   Ralph Lugo And, you do all the things necessary to be a wonderful practitioner. And so that's really what it's about, whether you make a name for yourself or not. Yeah.   Stephen Woodward Well, so you talked about you came to Gatton, I think you were hired in 2005, which was at the time of the founding 20 years ago. We're celebrating our 20th anniversary this academic year. Talk about the importance of our 20th anniversary here at Gatton, how far you've seen us come and where you think we're going in the future.   Ralph Lugo Yeah, that's a that's a great question. 20 years is a great milestone. So it's 25 and we'll probably have, you know, even a bigger celebration at 25. But it sort of represents similar milestones in some respects. And what I mean by that is that many of our founding faculty are still here, and we can look back at the early days and we can appreciate the struggles, and we can appreciate the challenges, and we can appreciate where we have come from and what we have built over the years.   Ralph Lugo So in many respects, 20 years, 25 years represents as somewhat of an inflection point where you have enough people here that were here in the beginning that recognize that the first 20 years was like maybe chapter one, or maybe it's, you know, maybe it's one with various sub chapters, but really it's it was when we started, it was we were getting things off the ground, and we achieved a number of wonderful things in those first 20 years in not only accreditation and re accreditation, of course, but we also achieved great academic, achievements nationally.   Ralph Lugo You know, winning a CCP clinical Challenge award twice, community service awards at the national level. Our operation study is an award winner. Now I think it's 12 years in a row, either national or regional. And it's just it's just amazing to think that a new school would achieve that level of national recognition and, national prowess, in the first two decades.   Ralph Lugo I think as we look forward, not only oh and I'll, I'll mention one more thing about those first 20 years is that we grounded ourselves in an amazing and outstanding culture. And that's where Gatton really shines in many respects. There are a lot of good schools academically. There are a lot of good schools that do community service.   Ralph Lugo When I tell applicants that that, applied to Gatton is you can get a pharm.d from many places where academically you're going to get a great education. What you're going to get here at Gatton is a great education, where you also have high impact opportunities and a wonderful culture, a community focused culture, a student centric culture with relatively small class sizes compared to many other schools, where you're going to know your professors and they're going to know you, and you're going to develop lifelong relationships with your colleagues, that doesn't always happen in all schools.   Ralph Lugo And so in the beginning, that was our aspiration to create that culture. That was the vision of Larry Calhoun, our founding dean. And he did that very well. And he articulated that to the faculty and the students and to the leadership team. And we just have propagated that forward over the last 20 years. And now, of course, Dean Debbie Byrd is in place for the last ten years.   Ralph Lugo And she of course, that's what she's about as well. So it was like we didn't even misstep when we changed deans. And so it's been this continuous progress of developing this amazing culture. Great place to work, great place to learn, student centric, people come first, you know, all bathed in academic excellence and, and community and student service.   Ralph Lugo Right. So that's a great three legged stool, right? Service. Community service, academic excellence and culture. Now in the next 20 years, we're going to have people retire. We're going to have people that maybe weren't here in the beginning. So there's going to be a little bit of a different flavor. But I'm fully anticipating that the culture is here to stay because we have foundationally set it in concrete and then the concrete is dry.   Ralph Lugo So I don't think it's going anywhere. And, you know, in the first three years or five years, maybe the concrete hadn't dried yet, but but now I think the concrete is dry. Everybody carries this culture, you know, inside of them. It's part of the fabric of who the faculty and students are. We talk about it a lot. We cultivated and and so I don't think it's going to change in the next 15, 20 years.   Ralph Lugo So that's going to continue. But now we've added some other things, you know, now we're we're working on streamlining our curriculum to become the most relevant, essential curriculum for training pharmacists. So that's what we just recently did in our curricular revision. And and also we're looking out towards our research and trying to improve our scholarship and our productivity from a research perspective so that we can become better known for our scholarly output and our research productivity, especially in the context of Etsu use research strategic plan and their, desire to improve scholarship as headed up by Nick Haggar.   Ralph Lugo Meyer, who's also one of us, here at the College of Pharmacy. So I think as we project out, it's a little bit of an inflection point. Just to summarize a little bit of an inflection point. And over the next 10 to 20 years, you're going to see people are not going to remember the beginning anymore. But I think we've wound this thing up sufficiently that there's enough momentum keeping it moving forward in the ways that are important, these high impact ways that it's not going to turn around anytime soon.   Ralph Lugo And we can just build on our successes and make it even a better place next decade, next two decades. Good to great is kind of our motto.   Stephen Woodward I love what you said about culture. I feel like, I mean, I've been here almost seven years. I don't think I realized how important culture is for just organizations in general. But hearing you articulated, kind of experiencing it here from a newer, newish organization like it's super important as the foundation and just helps lay the groundwork for everything else that is laid upon it as a like a good, solid structure.   Ralph Lugo You know, I think that's the reason why we've been so successful in, attracting students. I mean, every, every year we sit down with the PS1 students. The dean has a lunch with subgroups of the P-1 class, 8 to 10 at a time. And we ask them why they came here and what are the things that attracted them about Gatton College of Pharmacy?   Ralph Lugo And everybody talks about there are a number of things that attracted them. Of course, geographic location is always important, and there's a number of things that are important. But the culture and the receptivity and the warmth. Yeah. On their interview day is somewhat unmatched by other places. And so they felt at home here immediately, and that that's what attracts them.   Ralph Lugo Also, I think that's what keeps people here, both staff and faculty. Is that it? For that reason, it's a good place to work. You don't you don't have the, some of the, problems that other universities have with, disgruntled employees and backstabbing and competitiveness, and it just doesn't exist here. So it's just from that standpoint is just a wonderful place to work.   Ralph Lugo And I think we probably after a while, we probably take that for granted. And, you know, if you went to another school someplace else, you might say, oh, I think things a little bit differently. Yeah. So, you know, I've been to a number of schools around the country, and, things are different here again.   Michele Williams Yeah. And I, I think that culture is very intentional. That's not, it it doesn't just accidentally work like.   Ralph Lugo Yeah. That's right. Yeah. Yeah, it is definitely something you have to work at. It's got to it has to be something that's articulated from the leaders of the college initially. And, and it needs to be reinforced regularly. And it needs to not just be said you actually need to live the words walk the walk talk the talk.   Ralph Lugo You know, do all of those sayings. Right. And, and eventually people start to embrace it and it becomes clear when somebody is operating outside of those cultural boundaries. And I think there is just this natural pressure towards in a good way towards this is how we are. I get, you know, this is the Gatton way. You know, people have said that before, right, that this is not the Gatton way or this is the other way.   Ralph Lugo So it helps us and everybody knows what that means. You know, and probably I would say the students know what that means too. So it's something that that is cultivated, something that is repeated. And we even talk about it in our strategic plan, you know, in terms of environment. Yeah.   Michele Williams This has been such an interesting and sort of far reaching conversation. I've enjoyed every minute of it. Are there any other things that that you would like to talk about or that we haven't asked you about?   Ralph Lugo Well, you know, I think something just came to mind, that I think may be worth discussing and that's wellbeing and something that Gatton is all about to, and that's somewhat unique among colleges is we pay a lot of attention to the well-being of our students, the well-being of our faculty and staff. We're doing a survey this year for our staff, for wellbeing faculty and staff, for wellbeing.   Ralph Lugo And of course, we surveyed the students and we have for a number of years now. So we're able to track their well-being in all of the domains that Gallup would promote. And we track that over time, and we can see where students will drop in their wellbeing scores. And that's a great time for us as a college to intervene and try to promote wellbeing during that time.   Ralph Lugo So, with that as a background or a backdrop, I, the faculty advisor, one of the faculty advisors on the wellbeing Student Wellbeing committee. And one of the things that I'm working on with the research subcommittee of the Student Wellbeing Committee, that's a lot of work.   Stephen Woodward That and also loves its committees.   Ralph Lugo Yes. That's right. Yeah. Great committees. So that's the research subcommittee. We're working on ways that we can take the current research dealing with wellbeing and wellness and lifestyle medicine. As I mentioned earlier, this all fits together right. And yeah. And and draw on the research that is coming out relative to nutrition, relative to physical activity, relative to stress reduction, relative to social connection and, and encourage our students to promote their wellbeing through being aware of the research, adopting the research habits and patterns that are being developed.   Ralph Lugo So for example, we're just we're working on our first push out. I think that's a word. We're working on pushing out our first, I'll call it publication. Our first, information from this student wellbeing subcommittee, research subcommittee. And we're trying to do it in ways where students will appreciate the the presentation. So we're thinking about maybe infographics.   Ralph Lugo We're thinking about a short podcast of maybe, like 5 or 6 minutes with some graphics of a video podcast. We're thinking about a short written document. So just ways that we can encourage students to adopt some of the, contemporary research findings relative to wellbeing. And, and then at the same time, they learn about this to help their patients in the future.   Ralph Lugo So it's not just about them, it's about helping their patients as well. So we're going to be coming out with our first, stuff publication, here in the next few weeks. I had a meeting with them this week, and we've prepared some materials. Which I would actually meant to bring down so you all can look at it and see it.   Ralph Lugo I'd love to share that with you and get your thoughts on it before it gets pushed out. But, yeah, we're we're really excited about this aspect of, the Gatton culture, because that is really part of our culture too, is to try to enhance wellbeing.   Stephen Woodward Yeah. That's great. Thanks for sharing. I think that's a wrap. Thank you for being here. I appreciate your time.   Ralph Lugo Thank you for this podcast. And this podcast has been amazingly successful. So, kudos to both of you. And in creating this and keeping it going. And I think it does a great service to our students and faculty and staff, our community, and even across the country.   Stephen Woodward So we appreciate it. Thank you very much.   Michele Williams Thank you. All right.   Stephen Woodward I'll get it off. Thanks. Awesome. Thanks for listening to White Coat Radio. If you haven't already, be sure to subscribe and leave this review wherever you listen to podcasts. To learn more about East Tennessee State University Bill Gatton College of Pharmacy, visit us at etsy.com, slash pharmacy or follow us on social media at Etsy Pharmacy. We'll see you next time.   Ralph Lugo What you're going to get here at Gatton is a great education, where you also have high impact opportunities and a wonderful culture, a community focused culture, a student centric culture with relatively small class sizes compared to many other schools where you're going to know your professors and they're going to know you, and you're going to develop lifelong relationships with your colleagues.   That doesn't always happen in all schools.   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. I'm one of your hosts, Doctor Michele Williams, assistant professor and director of academic success.   Stephen Woodward And I'm Stephen Woodward, marketing and communications manager. On this episode, we talk with Doctor Ralph Lugo, senior associate dean and professor at ETSU Bill Gatton College of Pharmacy. He's been with the college since its founding, joining in 2006 as founding chair of the Department of Pharmacy Practice and serving in that role for 17 years before being promoted to Senior Associate Dean.   Stephen Woodward During this time, again, Doctor Lugo is primarily focused on administration, program development, and teaching. And before coming to Etsu, he served as vice chair of Pharmacotherapy at the University of Utah. Doctor Lugo‚Äôs practice experience and interest is in pediatrics, specifically in pediatric intensive care. His research interests include lifestyle medicine, pediatrics, neonatology, pediatric intensive care, analgesia, sedation, and his research has been supported by the National Institutes of Health.   Stephen Woodward Well, Doctor Lugo, thanks for coming to Waco Radio today.   Ralph Lugo Yeah. Thank you, Stephen, for having me. Doctor Williams, thank you for having me today. Look forward to our conversation.   Michele Williams We're happy to have you here.   Stephen Woodward So you came again as founding chair of the Department of Pharmacy Practice. Can you talk about your long history here and what roles you currently serve in?   Ralph Lugo Sure. I came to Gatton in 2006. I was hired in 2005, so I've been here 20 years now, which is just amazing to think that I've been here that long. And I was hired initially as the founding chair of the Department of Pharmacy Practice. As you all know, we have two academic departments Pharmaceutical Sciences and Practice. At the time, at the time, I was at the University of Utah as vice chair of Pharmacy practice and an associate professor in pediatrics.   Ralph Lugo I think most people know that my specialty area had been pediatrics in my up but in the air quotes. Former life as a as a clinician in the pediatric intensive care unit. And I had always wanted to come back to the East coast. Was born on the East Coast. I trained in North Carolina, worked in North Carolina. I really enjoyed the South East a lot.   Ralph Lugo So my wife and I, we started a family out in Utah, and we really had a desire to come back east and specifically the southeast. So I saw this position open up, and it was just a natural move for me to move from a vice chair position to a chair position. And I had been in academia long enough that 13 years at the time to be able to handle such a thing.   Ralph Lugo Of course, it's always very challenging, but really look forward to the opportunity. But there were some things in particular, I think, that really attracted me to Gatton. Number one, we were starting a college of pharmacy from scratch. There's not a lot of opportunities that come up in the country to start a pharmacy school from scratch, to no avail.   Ralph Lugo And and you know, there's as you go around the country and you train in different places, you realize that some things you know, I might do a little differently or the culture may not be as I would want it to be in certain places. And so here was this opportunity to start with a clean sheet of paper.   Ralph Lugo And I thought, what a wonderful professional opportunity that really doesn't come around very often. And and then I interviewed the for the position and was just overwhelmed by the community support for this for this college of pharmacy. Nothing I've really seen before coming from Salt Lake City. City of 1 million plus College of Pharmacy doesn't get much airtime or press.   Ralph Lugo And it seemed like here at the College of Pharmacy was in the newspaper towns, the city press constantly above the fold type of articles, on the news, on the marquees, on the bumper stickers. I mean, it was just all over and I was just amazed that the community support, so that really attracted me here, as well as meeting with Dean Calhoun at the time, really communicated a student centric focus to Gatton, which I really appreciated.   Ralph Lugo So between all of those things, the stars just aligned the right way from a career standpoint for me and Gatton seemed real attractive in a place that I wanted to live. And then, you know, the place sort of got pushed off into the background somewhat in front and center was there's a great opportunity here in Johnson City to establish something really unique, and I want to be a part of it.   Ralph Lugo So that's really what what got me here. And that's what's kept me here for 20 years.   Michele Williams That's great. So what is your favorite part about your job?   Ralph Lugo Well, I love working with students. I'm an administrator at least half my time, but I still teach a lot in the classroom. So depending on the semester, I may be teaching 30 or 40% of my time. In some semesters, I'm teaching 50% of my time. So I teach more than most administrators teach. And that's not something that I wish to give up.   Ralph Lugo I really enjoy being in the classroom. I really enjoy being around the students. That's not unique to being a founding chair of the department, but that's a part that I really wanted to hang on to and have hang on to, you know, because I could have given that up in various ways over the years, but I intentionally retain that, especially since I, I no longer practice, and I love practicing, too.   Ralph Lugo So I gave that up because there just wasn't enough time in the day to do all those things. So I gave that up, but did not want to give up teaching. So love teaching, love working with students, love working with the faculty. And that's the that was the hook for me about being a department chair is you really have an opportunity to work closely with the faculty and trying to create opportunities for faculty members, trying to promote them.   Ralph Lugo I don't mean promote the necessarily from assistant to associate, but promote them in their career development, to promote them in their daily practice and just just helping them come along as faculty members. That was something that was very attractive to me, and I've enjoyed that ever since. And that's the one thing I actually miss, in being in my current position right now, is I don't work as closely with the faculty members, but I still do work with them.   Ralph Lugo So, because I'm no longer department chair, I'm sure we'll get to that, soon, but, but those are the things I think that I really enjoy about my position.   Stephen Woodward Can you talk about your transition from department chair to senior associate dean now?   Ralph Lugo Right. So, so several years ago, after serving in that as a department chair for, for 17 years, Dean Byrd was, was provided with a wonderful opportunity to serve as interim dean of the College of nursing. And, in order to make that happen, we really needed to have somebody here that could assist, her to continue that leadership role.   Ralph Lugo And so she asked me to serve as it was at that point, it was called executive associate dean, which has since transitioned, entitled Who's Senior Associate dean. But essentially it functions in the same way. So, a few years ago, that transition occurred when she took over that, that interim role in the College of Nursing. And then she served in that role for a period of time and is now back full time here in the College of Pharmacy.   Ralph Lugo And I'm still in that position of senior associate dean. So that's how that transition occurred. That's what prompted that transition. I moved into the senior associate dean role, and then Sarah Thomas and moved into the department chair role. And it's been a wonderful transition, a wonderful new challenge for me as well. And I still do many of the same things I did before, even as a department chair, with the exception of working as closely with the faculty, as I mentioned earlier, earlier.   Michele Williams So, what is something that people at Gatton might not know about you?   Ralph Lugo I think.   Michele Williams Ralph Lugo I think many people, some people might know about my recent interests from a professional standpoint. As you all know, I trained in pediatrics, served in that capacity for a number of years, and still have an interest in that. But professionally, as the years went on, my interests sort of blossomed in other areas. And that particular area is lifestyle medicine.   Ralph Lugo And so about 25 years ago, an organization was formed called the American College of Lifestyle Medicine, and it was formed by a number of physicians. And the primary goal and mission of the American College of Lifestyle Medicine is to try to address the root causes of disease and try to improve health through lifestyle interventions. As we all know, we have a very needy, sick population in this country and we have various epidemics that are unfolding as we speak.   Ralph Lugo Certainly, diabetes would fall in the category Alzheimer's disease would fall under that category, and cardiovascular disease continues to be the number one killer worldwide and in the US, and of course, cancer as well. And all of these things absolutely need to be addressed. But there's not a lot of reimbursement opportunities to try to prevent disease and try to get at some of the root causes.   Ralph Lugo So that that has been an area that's been somewhat ignored over the years. So this organization was created to try to address root causes and lifestyle modifications. And lifestyle modifications are in many of the guidelines that currently exist for treating various diseases. But the problem is that when physicians say you need to change your diet or you need to change your lifestyle, that's as far as they go in many cases in terms of describing that.   Ralph Lugo And the patients don't necessarily know what that means. And if you ask ten patients what it means to change your diet, you're going to get 15 different answers. So so this organization is really about trying to prevent disease. So I really sort of latched on to that about ten years ago. And so I'm now working with a number of students, seven students actually to write four papers.   Ralph Lugo No, it's actually more than that. It's 8 or 9 students to write four papers on the pharmacist's role in lifestyle intervention, the community pharmacist in particular. So things like preventing dementia, things like preventing anxiety and depression, that's what we're writing on. We're writing on we're we're considering just writing on the pharmacist role in lifestyle modifications in the community pharmacy, trying to educate pharmacists and give them the tools necessary to be able to address these issues in their patients.   Ralph Lugo We have a captive audience here. We have patients coming to the pharmacy, and pharmacists are the most accessible health care workers. So there's a great opportunity for this intervention. But pharmacists need to be educated in this area of lifestyle medicine, and it's not currently in the curriculum. So I'm trying to champion more education about that. Part of the way I'm doing that is through scholarship, writing articles and engaging students.   Ralph Lugo I hope to develop an elective in this area in the near future, and I think a number of students would probably be very interested in that.   Michele Williams Definitely.   Ralph Lugo So I think if you just bring this back to your question, Doctor Williams, I, I think probably many students don't know that some faculty might know it, but not all faculty might know. And so I'd say that's that's an area that, that's probably at least known about me.   Michele Williams And they know it now. So yes, that's right. More requests for students to participate in that research. That's right. You're doing. Yeah.   Stephen Woodward What? And I know everybody knows about you that you're a huge fan of AI and that the rise of AI over the past few years is just it seems like it's taken over, not quite in like, Terminator style yet, but maybe we're getting close to that. Can you talk about how you got interested in artificial intelligence and what do you find most useful about.   Ralph Lugo Yeah, AI is is really interesting. I like to utilize technology as a tool, not just I, you know. Yeah, some of the faculty, they'll probably poke, poke fun at me because I'm always looking for a better app to do certain things. You know, whether it's project management and some faculty. I won't name any names, but some faculty may laugh at me in terms of, you know, the newest and the greatest project management tool, a doctor you logos using well, whether it's Trello or whether it's Clickup, which is which is what I'm using right now.   Ralph Lugo So there's a little bit of fun there that folks have with me. So I've always been very interested in utilizing technology to improve efficiency. I'm very much about maximizing efficiency, whether it's.   Ralph Lugo Driving a car that has good gas mileage or whether it's squeezing every dollar out of your budget or whether it's, trying to get the most work out of a work day. You know, that's just kind of like how I'm wired. And so technology has always been a part of that. So that got me interested. And then when I found out about I happened to be in a, I was in a, a faculty meeting on main campus, it was a it was a group of faculty members, that were addressing, it was actually a number of chairs that were meeting and we were addressing the charge to write a faculty handbook for new   Ralph Lugo chairs. This was about four years ago. And the, the, person that was leading this, this committee said I used ChatGPT to give me an outline of what a faculty handbook would look like. And he showed it and I was like, wow, that is amazing. Now, meanwhile, I had heard of ChatGPT. I wasn't quite sure exactly what it did or what it was, but I was amazed at the output.   Ralph Lugo So I started tinkering a little bit with it and then, you know, and then things began to snowball. And then we had a number of, faculty development sessions here at the college. I actually gave one of those sessions and, and we went to a number of national meetings where we had sessions on a all things I. So I learned a lot about it.   Ralph Lugo And now I would consider myself. I'm certainly not an expert at it, but I'm probably an early adopter and I'm very enthusiastic about its potential. I'm not completely ignorant about the downside of using AI. It certainly does have downsides and limitations and disadvantages, but I think a lot of things do, you know, and people say the internet has downsides.   Ralph Lugo Yeah. If you're in the wrong places at the wrong time, it can be very detrimental. Right? But it's got a huge upside to so it's just a matter of trying to balance that and learning when to best utilize and how to best utilize AI in order to help you in your productivity guardrails. So let me talk a little bit about guardrails with AI use, because that's what people will ask about is this like, how do we how do we put guardrails around its use so that it can be used wisely?   Ralph Lugo So I would say, first and foremost, we need as a foundational issue, we need transparency. It needs to be clear when AI is being used. It's a, it's a, some measure of academic honesty and, being genuine is to declare when AI is used in order to assist with certain things. And that's coming from a professional standpoint, but from a student standpoint, too, academic honesty really depends on disclosing when I was used.   Ralph Lugo And so we need to we need to set up guardrails about disclosure. And I think that needs to be in policies as we move forward. Things are changing so rapidly. Policies are being developed, guidelines are being developed. So I think those things will be important to include moving forward. The other part of guardrails is we need to be careful about not encouraging students to take shortcuts around critical thinking.   Ralph Lugo We are trying to teach critical thinking here at the College of Pharmacy. That is an important outcome, and there are certain exercises that require critical thinking. It's not necessarily we're trying to get the answer as quickly as possible. We're trying to put you through that exercise of critical thinking and synthesizing and taking all this information that you're learning over the years and coming up with a cohesive, cogent answer.   Ralph Lugo And that's the exercise. That's the benefit. You got to struggle a little bit with that. Well, we can assign that to AI and come up with an answer. And, a 10th of the time, perhaps, but the student will not have grown from that exercise of critical thinking, and they may not know how to critically think if they continue to take shortcuts.   Ralph Lugo So we need to have mechanisms in place to protect those critical thinking opportunities. Also, clinical reasoning students need to be able to reason through certain questions, and they need that practice. They need also to, demonstrate competencies. You know, our skills, we have these skills here in the in the college. They have certain things like oral exams or direct observations or practice labs where you have to display certain competencies.   Ralph Lugo You're able to do certain things. AI is not going to help you there. So so that's an important part of the guardrail as well. And then, faculty development from our faculty need to be, competent users themselves before they can be thoughtful regulators. So we as faculty need to create these guardrails. We need to create these policies.   Ralph Lugo But we also need to be able to utilize them, utilize AI ourselves so that we know where the pitfalls are, where the landmines are, and where students can get into trouble. So, we're in the process of, in AI and I say we I mean, college pharmacy, Etsu, the academy, the profession. You know, we're in the process of developing these things as we go along.   Ralph Lugo And in the meantime, we have people that are, like, totally embracing it. And we have people that are tepidly cautious. And then we have people that are naysayers. And so all the above, I, I'm, I'm enthusiastic, but not ignorantly, ignorantly. So in other words, I'm not just embracing everything. I, I think it needs to be within the context of guardrails.   Ralph Lugo Michele Williams I agree, I share some of your concerns about AI co-opting somebody's ability to think critically or to even just practice those skills of reasoning through a problem and problem solving. On their own. I know in the classroom they have opportunities to do that, but it, it does seem like it would be very tempting to get AI to do some of that.   Michele Williams So I think, yeah. What you talk about with, with guardrails and, and not only guardrails, but sort of offering rationales and helping students look further down the road to why is it that you need to be the person doing this sort of reasoning and thinking?   Ralph Lugo Yeah. And and how to use AI in the context of that reasoning? You know, I can be right. Appropriately, AI can be a tool in that reasoning process, maybe to provide them with some information as long as the information is double checked in terms of accuracy. But the reasoning is really important, and human judgment enters that reasoning very often.   Ralph Lugo So things like empathy, things like, context of patient care, you know, understanding Mrs. Jones social situation and the fact, whatever her limitations are socially, you know, she doesn't get out of the house or she limited mobility or all these things go into helping to make decisions for patients that I can't necessarily reason through. And you have ethical decisions as well that come up.   Ralph Lugo And I again, may not be able to help with that. I, we have to recognize that AI is trained on a data base that exists in the past. And so there may be some ethical situations that come up which are contemporary, which are not necessarily in the training data base that one needs to think through critically in order to come up with an answer to best fit that patient.   Ralph Lugo It's kind of like evidence based medicine in a way. We can have all of the objective clinical trial data on a drug. We can say very clearly, this is the most efficacious drug for this disease. State, but if Mrs. Jones is not going to take it, or if it's too expensive for Mrs. Jones, or if there's three other reasons why it's not going to work and Mrs. Jones, then it may not be the best drug for Mrs. Jones, even though it has the most compelling data.   Ralph Lugo So it's the same with I may gave you some very good objective information, but it needs to be contextualized so that you can determine what is best for this patient. That requires empathy, human reason, human judgment, contextualization and AI at this point doesn't do all of those things. Yeah.   Ralph Lugo You know, I might I might mention another thing. And I know Doctor Williams, this kind of resonates with you with regard to professional identity formation. I know that's an area of interest for you. But, you know, one of the things as we're trying to develop professionals here at the Gatton College of Pharmacy is we want students to be able to wrestle with difficult questions and sometimes failure, sometimes critique, sometimes not having the right answer, sometimes struggling and being corrected helps with that professional identity formation so that it helps them become a better professional.   Ralph Lugo And, you know, I can think we were just having a conversation just recently, another faculty member and I, about some of the students in the past that may have had some academic or behavioral challenges, shall we say. And I'm talking about the distant past. And I think in some cases, some of these some students may be young. They may they may not have that full maturity.    Ralph Lugo Certainly they're not fully matured professionally, that professional identity formation. But they've they went through a process that helped to correct them, to guide them, to corral them and shepherd them. And in that process, they came out on the other end and have created wonderful careers for themselves through that process. And sometimes a few hard knocks along the way will help people correct course, correct along the way, and help them become more successful.   Ralph Lugo So that's, you know, it's not always about having the right answer. That's true. And having all your eyes dotted and t's crossed, which I tends to do. Right. Great answer. I now let's put it in the context of training pharmacy students.   Michele Williams I agree, I agree.   Stephen Woodward It's got to be pretty satisfying to see a student from a long time ago struggle, but then come out on the other side and then go on to in a career.   Ralph Lugo Yeah. Very much succeed. Right. Yeah. And and you don't appreciate it or recognize it immediately until years down the road and you kind of look back and you say, wow, this person's really made a name for herself or himself. And and it's not always about making a name for yourself, but that making a name for yourself is usually because you're a great pharmacist and you take care of patients in a in a great way.   Ralph Lugo And, you do all the things necessary to be a wonderful practitioner. And so that's really what it's about, whether you make a name for yourself or not. Yeah.   Stephen Woodward Well, so you talked about you came to Gatton, I think you were hired in 2005, which was at the time of the founding 20 years ago. We're celebrating our 20th anniversary this academic year. Talk about the importance of our 20th anniversary here at Gatton, how far you've seen us come and where you think we're going in the future.   Ralph Lugo Yeah, that's a that's a great question. 20 years is a great milestone. So it's 25 and we'll probably have, you know, even a bigger celebration at 25. But it sort of represents similar milestones in some respects. And what I mean by that is that many of our founding faculty are still here, and we can look back at the early days and we can appreciate the struggles, and we can appreciate the challenges, and we can appreciate where we have come from and what we have built over the years.   Ralph Lugo So in many respects, 20 years, 25 years represents as somewhat of an inflection point where you have enough people here that were here in the beginning that recognize that the first 20 years was like maybe chapter one, or maybe it's, you know, maybe it's one with various sub chapters, but really it's it was when we started, it was we were getting things off the ground, and we achieved a number of wonderful things in those first 20 years in not only accreditation and re accreditation, of course, but we also achieved great academic, achievements nationally.   Ralph Lugo You know, winning a CCP clinical Challenge award twice, community service awards at the national level. Our operation study is an award winner. Now I think it's 12 years in a row, either national or regional. And it's just it's just amazing to think that a new school would achieve that level of national recognition and, national prowess, in the first two decades.   Ralph Lugo I think as we look forward, not only oh and I'll, I'll mention one more thing about those first 20 years is that we grounded ourselves in an amazing and outstanding culture. And that's where Gatton really shines in many respects. There are a lot of good schools academically. There are a lot of good schools that do community service.   Ralph Lugo When I tell applicants that that, applied to Gatton is you can get a pharm.d from many places where academically you're going to get a great education. What you're going to get here at Gatton is a great education, where you also have high impact opportunities and a wonderful culture, a community focused culture, a student centric culture with relatively small class sizes compared to many other schools, where you're going to know your professors and they're going to know you, and you're going to develop lifelong relationships with your colleagues, that doesn't always happen in all schools.   Ralph Lugo And so in the beginning, that was our aspiration to create that culture. That was the vision of Larry Calhoun, our founding dean. And he did that very well. And he articulated that to the faculty and the students and to the leadership team. And we just have propagated that forward over the last 20 years. And now, of course, Dean Debbie Byrd is in place for the last ten years.   Ralph Lugo And she of course, that's what she's about as well. So it was like we didn't even misstep when we changed deans. And so it's been this continuous progress of developing this amazing culture. Great place to work, great place to learn, student centric, people come first, you know, all bathed in academic excellence and, and community and student service.   Ralph Lugo Right. So that's a great three legged stool, right? Service. Community service, academic excellence and culture. Now in the next 20 years, we're going to have people retire. We're going to have people that maybe weren't here in the beginning. So there's going to be a little bit of a different flavor. But I'm fully anticipating that the culture is here to stay because we have foundationally set it in concrete and then the concrete is dry.   Ralph Lugo So I don't think it's going anywhere. And, you know, in the first three years or five years, maybe the concrete hadn't dried yet, but but now I think the concrete is dry. Everybody carries this culture, you know, inside of them. It's part of the fabric of who the faculty and students are. We talk about it a lot. We cultivated and and so I don't think it's going to change in the next 15, 20 years.   Ralph Lugo So that's going to continue. But now we've added some other things, you know, now we're we're working on streamlining our curriculum to become the most relevant, essential curriculum for training pharmacists. So that's what we just recently did in our curricular revision. And and also we're looking out towards our research and trying to improve our scholarship and our productivity from a research perspective so that we can become better known for our scholarly output and our research productivity, especially in the context of Etsu use research strategic plan and their, desire to improve scholarship as headed up by Nick Haggar.   Ralph Lugo Meyer, who's also one of us, here at the College of Pharmacy. So I think as we project out, it's a little bit of an inflection point. Just to summarize a little bit of an inflection point. And over the next 10 to 20 years, you're going to see people are not going to remember the beginning anymore. But I think we've wound this thing up sufficiently that there's enough momentum keeping it moving forward in the ways that are important, these high impact ways that it's not going to turn around anytime soon.   Ralph Lugo And we can just build on our successes and make it even a better place next decade, next two decades. Good to great is kind of our motto.   Stephen Woodward I love what you said about culture. I feel like, I mean, I've been here almost seven years. I don't think I realized how important culture is for just organizations in general. But hearing you articulated, kind of experiencing it here from a newer, newish organization like it's super important as the foundation and just helps lay the groundwork for everything else that is laid upon it as a like a good, solid structure.   Ralph Lugo You know, I think that's the reason why we've been so successful in, attracting students. I mean, every, every year we sit down with the PS1 students. The dean has a lunch with subgroups of the P-1 class, 8 to 10 at a time. And we ask them why they came here and what are the things that attracted them about Gatton College of Pharmacy?   Ralph Lugo And everybody talks about there are a number of things that attracted them. Of course, geographic location is always important, and there's a number of things that are important. But the culture and the receptivity and the warmth. Yeah. On their interview day is somewhat unmatched by other places. And so they felt at home here immediately, and that that's what attracts them.   Ralph Lugo Also, I think that's what keeps people here, both staff and faculty. Is that it? For that reason, it's a good place to work. You don't you don't have the, some of the, problems that other universities have with, disgruntled employees and backstabbing and competitiveness, and it just doesn't exist here. So it's just from that standpoint is just a wonderful place to work.   Ralph Lugo And I think we probably after a while, we probably take that for granted. And, you know, if you went to another school someplace else, you might say, oh, I think things a little bit differently. Yeah. So, you know, I've been to a number of schools around the country, and, things are different here again.   Michele Williams Yeah. And I, I think that culture is very intentional. That's not, it it doesn't just accidentally work like.   Ralph Lugo Yeah. That's right. Yeah. Yeah, it is definitely something you have to work at. It's got to it has to be something that's articulated from the leaders of the college initially. And, and it needs to be reinforced regularly. And it needs to not just be said you actually need to live the words walk the walk talk the talk.   Ralph Lugo You know, do all of those sayings. Right. And, and eventually people start to embrace it and it becomes clear when somebody is operating outside of those cultural boundaries. And I think there is just this natural pressure towards in a good way towards this is how we are. I get, you know, this is the Gatton way. You know, people have said that before, right, that this is not the Gatton way or this is the other way.   Ralph Lugo So it helps us and everybody knows what that means. You know, and probably I would say the students know what that means too. So it's something that that is cultivated, something that is repeated. And we even talk about it in our strategic plan, you know, in terms of environment. Yeah.   Michele Williams This has been such an interesting and sort of far reaching conversation. I've enjoyed every minute of it. Are there any other things that that you would like to talk about or that we haven't asked you about?   Ralph Lugo Well, you know, I think something just came to mind, that I think may be worth discussing and that's wellbeing and something that Gatton is all about to, and that's somewhat unique among colleges is we pay a lot of attention to the well-being of our students, the well-being of our faculty and staff. We're doing a survey this year for our staff, for wellbeing faculty and staff, for wellbeing.   Ralph Lugo And of course, we surveyed the students and we have for a number of years now. So we're able to track their well-being in all of the domains that Gallup would promote. And we track that over time, and we can see where students will drop in their wellbeing scores. And that's a great time for us as a college to intervene and try to promote wellbeing during that time.   Ralph Lugo So, with that as a background or a backdrop, I, the faculty advisor, one of the faculty advisors on the wellbeing Student Wellbeing committee. And one of the things that I'm working on with the research subcommittee of the Student Wellbeing Committee, that's a lot of work.   Stephen Woodward That and also loves its committees.   Ralph Lugo Yes. That's right. Yeah. Great committees. So that's the research subcommittee. We're working on ways that we can take the current research dealing with wellbeing and wellness and lifestyle medicine. As I mentioned earlier, this all fits together right. And yeah. And and draw on the research that is coming out relative to nutrition, relative to physical activity, relative to stress reduction, relative to social connection and, and encourage our students to promote their wellbeing through being aware of the research, adopting the research habits and patterns that are being developed.   Ralph Lugo So for example, we're just we're working on our first push out. I think that's a word. We're working on pushing out our first, I'll call it publication. Our first, information from this student wellbeing subcommittee, research subcommittee. And we're trying to do it in ways where students will appreciate the the presentation. So we're thinking about maybe infographics.   Ralph Lugo We're thinking about a short podcast of maybe, like 5 or 6 minutes with some graphics of a video podcast. We're thinking about a short written document. So just ways that we can encourage students to adopt some of the, contemporary research findings relative to wellbeing. And, and then at the same time, they learn about this to help their patients in the future.   Ralph Lugo So it's not just about them, it's about helping their patients as well. So we're going to be coming out with our first, stuff publication, here in the next few weeks. I had a meeting with them this week, and we've prepared some materials. Which I would actually meant to bring down so you all can look at it and see it.   Ralph Lugo I'd love to share that with you and get your thoughts on it before it gets pushed out. But, yeah, we're we're really excited about this aspect of, the Gatton culture, because that is really part of our culture too, is to try to enhance wellbeing.   Stephen Woodward Yeah. That's great. Thanks for sharing. I think that's a wrap. Thank you for being here. I appreciate your time.   Ralph Lugo Thank you for this podcast. And this podcast has been amazingly successful. So, kudos to both of you. And in creating this and keeping it going. And I think it does a great service to our students and faculty and staff, our community, and even across the country.   Stephen Woodward So we appreciate it. Thank you very much.   Michele Williams Thank you. All right.   Stephen Woodward I'll get it off. Thanks. Awesome. Thanks for listening to White Coat Radio. If you haven't already, be sure to subscribe and leave this review wherever you listen to podcasts. To learn more about East Tennessee State University Bill Gatton College of Pharmacy, visit us at etsy.com, slash pharmacy or follow us on social media at Etsy Pharmacy. We'll see you next time.  

In this episode we chat with first-year student pharmacist Maddie Stacey, who found confidence — and a community — through ETSU Gatton College of Pharmacy’s Early Admission Pathway. A native of Kingsport, Stacey learned about the college’s EAP program while in high school. For her, the program has made the adjustment to pharmacy school much easier.  Open to high school seniors and first-year ETSU students, the Early Admission Pathway enables students to earn both a Bachelor of Science and a Doctor of Pharmacy degree in just six years. EAP students also join the college’s Pre-Pharmacy Student Organization, designed to introduce them to different specialties in pharmacy and to foster connections with their classmates. Learn more at www.etsu.edu/RxEarlyAdmit.   Transcript Teaser Introduction Maddie Stacey I think some of the things that the early admissions pathway has made me as a student as confident. I would say that the transition pathway is very smooth. They again, they put everything in line for you. I mean, they give you your schedule, they tell you what you need to do. And so I think that it makes everything much more cohesive. Main Episode: 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. I'm one of your hosts, Doctor Michele Williams, assistant professor and director of academic success. Stephen Woodward And I'm Stephen Woodward, marketing and communications manager. First year student pharmacist Maddie Stacey from Kingsport, Tennessee, sat down for us to talk about her experience going through Gatton's early admission pathway opened high school seniors and first year ETSU students. The early admission pathway enables students to earn both a Bachelor of Science and the Doctor Pharmacy degree in just six years. Stephen Woodward The pathway offers students the assurance of a seat, mentoring, scholarships, research opportunities, and flexible start options for the pharmacy curriculum. For Stacey, the early admission pathway has made the adjustment to pharmacy school much easier and helped her to find confidence and a community. The deadline to apply is March 31st, 2026. Learn more at Etsu Edu slash. Early admit. Stephen Woodward Let's hear more about her experience now. Well, hi, Maddie, welcome to White Coat Radio. Start by telling us what got you interested in pursuing pharmacy. Maddie Stacey I'm interested in pursuing pharmacy because when I was younger, I realized how much one medication could do for one person. Right? And if it can just do so much to change a person's life, to make it more accessible, I want to know everything about how that drug was able to do that for that person. And what else can it do for another person? Maddie Stacey So I'm really interested in pursuing pharmacy because I want to know how all the drugs can help people be better and function in their lives and be able to enjoy their lives. And so I really love that about pharmacy. Stephen Woodward Well, what was it like going through our early admission pathway, which is for high school seniors attending ETSU and ETSU freshmen? Maddie Stacey I got really interested in pharmacy when I was in high school. And in high school they start to tell you about college options. And when you look at ETSU, you figure out that there are a lot of opportunities. So I was invited to a event for the Honors College and at the Honors College, they have a lot of the other colleges come and set up like Quillen and Gatton. Maddie Stacey And at that event, Becky Dunkelberger was there and she was there representing Gatton. And that's when I first got to figure out that there was a place here in Johnson City, really close to my hometown, Kingsport, that was offering a pharmacy program, which was very exciting. I was excited about that. And she told me there were a lot of opportunities. Maddie Stacey So the Early Admissions Pathway isn't just, you get here as soon as you can. It's a you create what you want to do. So there was a two years of undergraduate, and then you go in and you can start getting those requirements for your PharmD. Or if you want to get chemistry, biology, health sciences, any of those, you can do three years of undergraduate and then go in. Maddie Stacey And Becky explains all this very well. For me, I chose to go ahead and do the two years, and I also chose to get a Bachelors of Pharmacy studies, which is an option, and I chose to do that. It's just a few more requirements. But again, I never had to worry the school was with me along the way. Maddie Stacey So when you choose to be an Early Admissions Pathway student, you meet once a semester with either Steve Ellis or Becky, and they're like, okay, here's where you're at. Here's what you need to do. How does that sound? And you either are like, yeah, I can do that. Or, you know, this class is full. I don't think I can take this. Maddie Stacey And they help you every step of the way. If you can't do it, if you can do it. So, it sounds like a lot. Being like, oh, I need to do everything before I come to pharmacy school. But you do it one step at a time. And I love that. About the early admissions pathway. And I would do it again if I, if I was asked, I would definitely do it again. Maddie Stacey It's very smooth transition. Stephen Woodward Talk about your experience in the pre pharmacy student organization at Etsu. Also known as. So what was that like. Maddie Stacey So when you decide to become an early admissions pathway student Becky invites you to join pre pharmacy student organization which is so and so this organization works to invite pharmacists from the surrounding areas, from the faculty to come and speak about their specialties, their advice or their disciplines. And pharmacy. And it gives students like a wide range of options to see, oh wait, pharmacy is not just something that happens behind the counter at a Walgreens or a CVS. Maddie Stacey There's so much more to pharmacy and that's something I really loved about pre pharmacy student organization. So once you start going it's like once every other Wednesday night. And something great about pre pharmacy student organization is that as an early admissions pathway student it's a requirement. So obviously everybody there is also going to be in your program or a year behind you maybe a year ahead of you. Maddie Stacey But you're connected with all of these students that go to Etsu and are going to go with you to that program. So my class is 63 people, and of that 63 going in, I knew about 30 people, which is pretty incredible considering that, you know, they're students from out of state that didn't have that same opportunity. And that's just something that the early admission pathway offers. Maddie Stacey If you go to Etsu as well. And I loved getting to do that. And in addition to doing that, our faculty advisor is Doctor Thigpen. He's one of the pediatric pharmacists, and he's a faculty member. So, as president of the club, I got to talk to him a lot and make a relationship with him. And that was really great, because coming here, whenever they matched me up with an advisor, he actually ended up being my advisor to sorry, already had that relationship. Maddie Stacey And that's just like something that just falls into place. Something really great I can say about him is that when I was first starting with the requirements, you have the option of an elective, but my class was one of the first where physiology was a requirement, but, physics wasn't. And so I had a question. I was like, you know, is this still an option for an elective? Maddie Stacey Like. And it was like getting close to deadline. I was nervous, I was like, what if they just don't let me in because I didn't know there is an elective? And he was really fast to get back to me within, you know, a day he was like, yeah, that's all good. Get inside. That's okay. And it's like, I had that relationship with him. Maddie Stacey I was able to ask me that question, and I got my answer within a day because I knew him. And I think that connection was really great to have from that club to. Stephen Woodward So what advice would you give someone interested in applying for the early admission pathway? Again? Maddie Stacey Something that I think is a really big deal. Gatton is not just about having good grades or, you know, making the best grades. I think it's really important that you're going to be somebody that cares about your patients. And I think they care about seeing that in your essays. So I would say the essay portion is a big part of the admissions. Maddie Stacey And I would I would challenge, people who are interested in joining the program to ask themselves, what impact are you making right now, whether that be in an area and shared, say you help with child care. You do volunteering at a certain place. What impact are you making now? And, you know, I would ask, you know, how can you connect that in your essay to say, how does being a pharmacist help you make more of an impact in that area? Maddie Stacey What is being a pharmacist do to make an impact for you? And I think that's important because when you're connecting that, you're really showing how, you're not just interested in it for, you know, maybe the life, but you're interested in it for the way that you're going to impact patients. And getting is very patient centered. And I love that. Maddie Stacey That's why I chose, again, they love their patients and they love making people, the best they can be in that area. Stephen Woodward So as you know, getting offers a unique two week bridge program to help students transition into pharmacy school ... What was that experience like? Maddie Stacey Getting Ready is the first two weeks of your first year of pharmacy school. So in those two weeks you get introduced to all the classes. You will be taking, in the following semester. So you it's a little bit different from what your actual schedule will be like, but it encourages you to think about how you are going to balance and time manage the rest of the semester, which is the most important part that I feel like I got from getting ready. Maddie Stacey I think that it's nothing more challenging than you have done. I think that they prepare you in everything that is in the first two weeks you can do. It just feels like a lot because it kind of is. Everything is all at once in those first two weeks, and then, you know, after your first week, you have to prepare for your white coat ceremony, too. Maddie Stacey So it's just a lot of events at first, and I think that can be the most challenging. But as far as the transition, I would say that it got me prepared to think about what materials I wanted to use. You know, pharmacy school, there's a lot of notes, and I thought I was going to come in and do a lot of paper notes. Maddie Stacey But after that first two weeks, I was like, you know what? I think I'm actually gonna go digital for the first time. So I think those first two weeks really show you how the rest of your semester can go and what you want to do that works best for you. And I think that's what a lot of my peers would say, too. Maddie Stacey It's about learning about how you want your semester go and how you're going to attack your semester. So, you know, I'm really glad that I went digital. It helped me keep up in class. And a lot of people will tell you that, too. When you're just covering so much volume of material, it's faster when you're able to highlight the PowerPoints. Maddie Stacey And addition to that, you get to meet all of those advisors and all of those, professors in the first two weeks, which was really great. They were very helpful. They clearly outline how you can meet with them when you can meet with them. If you have questions where you can get those resources. So I really enjoyed that part. Maddie Stacey I think trying to think if there's anything else that I could say about, getting ready other than it's, it's not bad. I think I was, I was, I was intimidated, I was really scared. I was like, oh, they're trying to win me out here. This is where if I don't want to do it, they're trying to get me out. Maddie Stacey But it's not as scary as it sounds. So that's that's the comforting part. Stephen Woodward What? So what was the interview day process like for you as an early admission pathway student? Maddie Stacey So the interview process for me was during Covid. So unfortunately, I wasn't able to come on to campus and get to interview. I had my interview online and it was a set of two separate interviews in the same day. And once you one was with a small group and then one was individual with a mine was with a student instead of a faculty member. Maddie Stacey And it may have just been, Covid. I'm not sure how they do it now. And then once you get accepted, something that is very good about the early admissions pathway is that as long as you're on track, you have a seat reserved at the pharmacy school. So there's no second applications, there's no second essays, there's no second interviews. Maddie Stacey Once you're accepted, you have a shot at being here and you have that seat ready for you. When you're ready. Stephen Woodward You know, we hear from a lot of our students, alumni, faculty and staff that the culture and people are just highly valued at the college. How would you describe our culture here as a first year student pharmacist? Maddie Stacey I absolutely adore our staff so much. I can't tell you how much I adore them. You know, one thing I'd love to highlight as a pharmacy student and coming there are like obviously a million people for you to meet. Add on the professors, add on the the patients. Like there are just so many people for you to meet. Maddie Stacey I just want to give a shout out to Demers. She did so great. You know, introducing herself, making herself very approachable, you know, tells you about her career and something that I love you do as a pharmacy student. First year, you get to have lunch with the dean, which is so cool. So you have the small group, you come meet with the dean, she asks you these questions and like individually as you, it's not like, oh, I don't know your name. Maddie Stacey It's oh, she knows your name. She's already looked at your picture and the book. She knows who you are. How are you doing? Where are you at in this process? And that is so awesome. I don't know if other pharmacy schools do that, but we do here, and that's something I love. And then the one other thing I wanted to comment on was a time I was struggling and an advisor helped me, which was great because they're not even my personal advisor. Maddie Stacey They're just the professor of that class and offered to help me. I was really, really scared of vaccines. I was afraid of hurting somebody. I was afraid that I was going to make somebody really like. I was so afraid of hurting somebody, which I think is reasonable when you're starting to learn that. And when I started, after I got certified, the first thing I did when I gave vaccines was I would shake really bad because I was just so afraid of hurting people, you know? Maddie Stacey And it made me really upset. And I felt really disappointed in myself because I couldn't give a vaccine. And instead of, you know, just being quiet about it, letting that go on for four years, I reached I reached out to doctor J. Rob and Doctor Alexander. I was like, hey, I'm struggling, I'm not doing good and I'm okay. Maddie Stacey Admit that. Can you help me? And, doctor J. Rob. She was like, hey, come to my office at 8 a.m. and we can talk about it. And I thought we were just gonna be talking about it. And she had brought, syringes, needles. She brought saline, and she's like, we can get better today, and I will let you give me a shot in both my arms. Maddie Stacey And what what other school is going to have professors that offer up their arms? You know, when I say, hey, I'm struggling, I don't know how good I am. She's like, that's okay, you can do it on me. That's that's a pretty big ask. And then on top of that, she said, and down the hall, Doctor Dowling, you can give her two shots. Maddie Stacey Two after you give them to me. So she's just offering up everybody's arms. What other school are you going to get that that professors would be brave enough to be confident in me that, you know, I know you're struggling, but I know that you can. You're here because you can. So I think that's a really great, you know, a testament to how great the faculty is that they would be willing to give their arm for me to learn. Maddie Stacey So I love that. Stephen Woodward All right, well, tell us what you want to do when you graduate. Maddie Stacey So I think something to remember is, even if you're a first year student, you don't have to make plans as soon as you get here. You don't have to know what you want to do. As soon as you get here. Obviously, you're here because you're interested in pharmacy. In my case, though, I have a vision and I would love to see myself working at a pediatric hospital. Maddie Stacey I would love to see myself helping that population of patients. So right now, after I finish pharmacy school, I would absolutely love to go on to a residency that has a PGY1 and a PGY2, which, is focused in pediatrics. But something that I would really love is to be close to home. So the one that I'm looking at that I'd be very interested in is wake Forest. Maddie Stacey They have a pharmacy general, your first one, which means, you get to see all the disciplines within pharmacy and they have, I mean, a lot of different patients. I see a lot of different cases. And I think that would be a great learning opportunity. And, if I could get there my first year, I would love to apply to their pediatric program, which will be intensive. Maddie Stacey And that population of patients, how you work with them in those different areas. And I would absolutely love to continue to learn that. I love helping, children. And it's a lot of different dosing. They're not just little humans. They are they have different metabolism, different things they need. And I would love to learn more about that. Maddie Stacey So that's where I would love to see myself after Gatton. Stephen Woodward Was, you know, getting offers. A lot of student organizations and leadership opportunities. Tell us about what you're involved in and why that's important for students here. Maddie Stacey Okay, I'm in a few clubs and organizations here at Gatton. I am in the Pediatrics Pharmacy Association club, and what they do is they meet once a month and they go over some pharmacists or patient cases that pharmacists look at in their day, and they talk about how there's a range of cases and then you have volunteering opportunities in that club. Maddie Stacey And then I'm also in a residency based club. And what they do is they bring in, pharmacists that have either been through residency or, or who are very specialized in residency and, can help you a lot with looking at that. And that's a really great club to be in. I think if you are interested in residency, because it tells you early on what to expect, how can you make yourself competitive? Maddie Stacey And that one also meets about once a month. And the best part about clubs at Gatton is you have a free period. Usually in your day it's, lunch and then they call it common time. And most of the clubs meet during that day, so you don't have to commit extra time outside of school because it's within schools within those hours. Maddie Stacey So you have extra time to still work and, you know, have your work life balance. And that's something I think is really great about the clubs that you don't get an undergraduate. I would love to be a student ambassador. And that comes out at the end of the semester. You get to start to apply for those things, and it just gives you more opportunities to represent Gatton and get to look into the types of students that want to apply and get to talk to them and just encourage them about what's going on here. Stephen Woodward What impact do you think the early admission pathway had on you as you transition to Gatton? Now that you're going through your first semester? Maddie Stacey Yeah, I think some of the things that the early admissions pathway has made me as a student as confident, I would say that the transition pathway is very smooth. They again, they put everything in line for you. I mean, they give you your schedule, they tell you what you need to do. And so I think that it makes everything much more cohesive. Maddie Stacey Whereas if I was applying and for years I would be getting everything together myself, I would be applying to multiple things. I would be looking for all of these things. But the early missions pathway gives you everything in one place, and I think that's something really great. And that's something that has made me confident now, because again, I know those people coming in and I met a lot of advisors coming in and I know who to ask if I have questions. Maddie Stacey I think that's something the programs offered me. Stephen Woodward So of course, Gannon's mission is to train pharmacists who help serve rural and underserved patients. Service is really important here at the college. Talk about why that's important to you. Maddie Stacey Yeah. Something great about Gatton is how it aligns with what I want to do, whether that's in my values and morals. And I think that the college has done a great job. So something that we often talk about at Gatton is how important it is that we give back to our community, whether that's in the rural and underserved area or any of those areas around that we can do. Maddie Stacey And I think the school has really supported me and the ability to do that because they're consistent and constant volunteering opportunities in our area. And something that I think is really cool. We do, it's in combination. So Gatton and Quillen both work together. And this thing, it used to be called street medicine, but now it is under a different name and it helps to look at the people in our area, look at who is not getting enough healthcare, how can we help them? Maddie Stacey How can we bridge the gap and make sure that they're getting what they need? And, something great about Gatton again is that we're always considering those factors. So something they often tell you is, someone may need their insulin, but do they have a place to keep it? And, you know, we never want to make that patient feel bad just because they can't keep their insulin somewhere. Maddie Stacey And I love considering those things. I think it's so important that it's not just about helping people, but how can we make sure that the people were helping can stay healthy? Stephen Woodward Well, Maddie, we're really thankful that you would be part of this interview and be part of some of the publicity that we're rolling out as part of showcasing the early admission pathway and helping to educate students, in high school and at Etsu, about this pathway, as well as our other flexible admissions pathways. Can you kind of talk about your passion for Gatton, Etsu, and the early admission pathway? Stephen Woodward What is it about the university in the college that makes you just want to encourage others to to follow in the same path? Maddie Stacey That's a good question. I think something that Gatton does for me that makes me want to support them so much is the reason that they chose to support me. You know, when you apply to schools, you choose them. And it's at that point they have their opportunity to choose you. It's their turn. And you know, when Gatton chose me, they didn't just give me one opportunity. Maddie Stacey They have continuously given me opportunities. And you know, I have love how supported I felt here. And if I was to, tell our students about my experience, I'd want to be honest. I'd always be honest, and I don't have anything bad I can say about what they've done for me. You know, even more, I go further to say that if I did have something bad, I could tell them and they'd be like, okay, well, let's think about how we can fix it. Maddie Stacey I mean, and that's what, lunch with the Dean is like, as I was talking about, she wants to know what's going on. She wants to know how she can help us. And that's why I would constantly and consistently say that Gatton has made this a great experience for me. They will do whatever they can to make sure that I get the best education, and I feel like that's why I talk so well about them, because I want other students to get to experience what I have, and I don't want anybody miss out on that experience because it's really great. Stephen Woodward Well, Maddie, thank you so much for joining us today. Thanks for listening to White Coat Radio. If you haven't already, be sure to subscribe and leave this review wherever you listen to podcasts. To learn more about East Tennessee State University Bill Gatton College of Pharmacy, visit us at etsu.edu slash pharmacy or follow us on social media @ETSUPharmacy. We'll see you next time.    

The Student Success Coordinators at ETSU Bill Gatton College of Pharmacy are dedicated to supporting pharmacy students throughout their academic journey. Whether through connecting students with tutoring, setting up labs, or offering general support to students and faculty, the coordinators play a crucial role in fostering a positive and successful experience for all of pharmacy students. Hear from Justin White (P1 Coordinator), Kerstin Kromker (P2 Coordinator), and Lindsey Feltman (P3 Coordinator) in this episode.   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 will cover a wide range of topics about the pharmacy school experience and study tips to deep dives with faculty and student pharmacists. We're your hosts. I'm Doctor Michele Williams, director of academic success. Dan Vanzant And I'm Dan Vanzant, instructional design and IT manager. In this episode, we'll be talking with our new Student Success Coordinators at Gatton. These are brand new positions that the college has added to support faculty and students in the P1, P2, and P3 years. Michele Williams Yeah, we're really happy that you're here. And because this is such a new position again, we've gotten a lot of questions from faculty and staff, students. I'm sure you've heard some of these questions about what the student success coordinators do. So I'd like to take a minute just to kind of give a general overview of the job. And if you want to know more, there's going to be more information on Gatton’s Pharmacy Student Success page. You can find pictures of Justin, Kirsten, and Lindsey and list their responsibilities. Student Success Coordinators help faculty with things like grading and skills labs and the SIM lab experiences. They help with the space. They also help with things related to exams, and you may see them proctoring occasionally. They also can help students with information and resources. And beginning next year, they're going to start maintaining the class calendar of important events, which will be really helpful. And you'll be seeing them during that. And really, they help identify needs of students. So if you're a student and there's something that you have a question about or that you would like the administration to know a little bit about, you can let your student leadership know or talk directly to the student success coordinators, and that'll make its way up to the decision makers. Dan Vanzant So let's take a few minutes for each of you to introduce yourselves and tell us what professional year you are working with. And tell us a little bit about your backgrounds and what interested you in working with pharmacy students. Justin White Well, he's looking at you, Kirsten, so I feel like you should. Michele Williams Thank you. That's what we were going to go by. Yeah. Justin White Well, that would make sense. Well, my name is Justin White, and I am the Student Success Coordinator for the P1 students for the first year. And yeah, I've been on—what—since October. I guess it's been about six months now. And yeah, what was the question? Dan Vanzant Oh, just an introduction, which you just did, and then a little bit about your background and what interested you in working with pharmacy students. Justin White Yeah. Well, my background is a lot different than this. My background is actually more in public history. I majored in history as an undergrad and worked in several museums and historic sites in the area. I worked at the Reece Museum over on ETSU main campus. I most notably worked for Rocky Mount State Historic Site in Piney Flats for several years before COVID, and then moved over to the College of Nursing at ETSU. And then moved over here about six months ago. So yeah, I just—I really—I'm working on my master's right now. My passion is working with students. I want to work with students. And this job I feel like is a great opportunity to not only do that, but to make the role what I want it to be, because these are brand new positions that we're kind of—Doctor Williams used the term one time that I really like—building the road as we're walking it, and I like that. I like that we are—because we can ask, “What are student success coordinators doing? What is your day‑to‑day?” And the answer is: we're figuring that out really every day. So it's helping faculty, it's being there for students. And you know, that's what I really wanted was more of a one‑on‑one role where I would get to work directly with students, which is not something I was getting in my previous positions. Obviously not something I was doing a lot working in the public history sector. So awesome. Dan Vanzant Right? But we—the—our P2 Student Success Coordinator. Kirsten So I'm Kirsten. I work with the P2s. Background‑wise, my degrees are in translation. So I have a double major in German and Spanish translation. And I used to do a lot of interpreting. So I used to work a lot in hospitals and courthouses. And then, as a translator, most of my stuff actually used to be medical translating as well as military translating. So kind of familiar with that a little bit more. What drew me to work with the students is probably just because I have a wide range of interests, and I just like to learn more all the time. So I enjoy how much they kind of like—you focus on what they do. Lindsey So I'm Lindsey Feldman. I’m the P3 Student Success Coordinator. I’m the most recent addition, having just been hired in February of ’24. However, I do have a little bit of history with Gatton, starting in 2018 as a secretary in Bishop Hall, and then I transitioned into an Educational Coordinator role, which has some overlap with this new Student Success Coordinator role. I helped in the IDEAL Labs and facilitating all the moving parts with those and just other courses in the curriculum. So I stepped away to be a new mom in 2021, and when I found out that there was a new position that was more student‑focused, I was very excited to see that. And because my background is working with students—I was a high school English teacher—this role is actually a really good fit because I still get to work with students, do the things that I love to do in working with students and helping them succeed. Without the constantly‑in‑front‑of‑people component. You know—downtime. Yeah, yeah, it helps a lot. So yeah. Dan Vanzant Yeah, that's good. Well, now that we have that out of the way, we have some pressing questions and we have a speed round of questions. So I'm going to go around the room, I'm going to call your name, and ask you a question. And I expect you to respond as quickly as possible. So I'm going to start—let’s start with P3—with Lindsey. So first question: Is a hot dog a sandwich? Lindsey No, it's not. Dan Vanzant Oh, that was quick. Lindsey The bun—oh, next slide please. Dan Vanzant No, no, please go on about why it's not a sandwich. Lindsey The buns are on top and bottom, but on a hot dog it's the opposite—it’s on the sides. Dan Vanzant Would anybody else like to weigh in? Justin White I mean, I agree. I agree. I mean yes, it's meat between two pieces of bread, but that's where the similarities end. A hot dog’s a hot dog and a sandwich is a sandwich. Dan Vanzant It's meat with toppings sandwiched between two pieces of bread. Kirsten See, I'm going to agree with them. I don't think it is. I think it's a hot dog. I think that it has condiments. I don't think there’s anything else too much more involved. Justin White I can't imagine putting ketchup, mustard, chili on a sandwich. What kind of sandwich has—oh—I mean, a hamburger is a burger. Kirsten Right? And I can't imagine adding like cheese and tomatoes and—I don't know what else—to my hot dog. It's just weird. Dan Vanzant You ever had a barbecue sandwich with coleslaw on it? Justin White I don’t like coleslaw. Michele Williams I think it's the hinge. There's a— Justin White I agree. It's the hinge. The bun is one piece of bread that swings like a door. Michele Williams Yes. Justin White It's not two pieces of bread. Michele Williams Yeah. Okay. Yeah. Dan Vanzant Has anybody had a Five Guys hot dog? Michele Williams No. Dan Vanzant Okay. So they slice it down—okay, okay. Got it. I wasn't sure. They slice the hot dog down the middle. Justin White Yeah, I was—it was not that long ago. And if I had asked for, like, a Chicago‑style sandwich, I wouldn't have gotten a hot dog. I would have gotten an Italian beef sandwich. Dan Vanzant That's true. They might not have served you. Justin White Yeah, they probably would have. Dan Vanzant That's a good point. Chicago dogs are their own thing. Anyway—moving on. Again, going in reverse order. Kirsten: name five uses of a stapler without staples. Kirsten I can use it as a hammer—that’s one. I can use it to break your window. Dan Vanzant Okay… Kirsten Life‑saving measures… a doorstop… okay, let’s see… weapon? Justin White I guess I'm going to say weapon. Kirsten Yeah, I'm trying to keep it— Justin White I mean, if you're desperate enough. Kirsten That's true. I feel like I can use it to reach something—like the last one I need. Dan Vanzant As an extension. Okay. All right. That’s fine. Justin White Where the little staples go in—yeah. Kirsten Yes, right. Dan Vanzant Other acceptable answers… Michele Williams Supportive object. Justin White A paperweight. Dan Vanzant Or if it's a red stapler—a conversation piece. Michele Williams Yes. Movie memorabilia. Justin White That’s right. Movie memorabilia. If it's a red Swingline. Dan Vanzant All right. Excellent. Question three. Justin: What is the most recent song that you listened to on repeat? Justin White Oh gosh. Well actually, I've had a song on repeat today. It's recently come out. I don't want to sound too hipster, but I doubt anyone has heard of it. It’s a guy who makes music under the name Nourished By Time, and he has a new EP out, and the first song on that is called Hell of a Ride, and I've listened to that like 20 times today. It’s— Michele Williams Yeah? Justin White It’s kind of R&B. It's not hip‑hop, but it's—I would say more kind of R&B, kind of synth‑pop, kind of dancey. I'll play it for you. Dan Vanzant Okay, all right. I'm going to give you another chance, Justin. And then we'll go around the room the other direction. If you were a Microsoft Office program, which program would you be? Justin White Microsoft Office program… Can I say like, the old Windows PC games that used to come pre‑loaded? Like Chips Challenge and SkiFree and Minesweeper? Dan Vanzant Are those technically Microsoft Office programs? Justin White No. I guess those are just Microsoft. An Office program… I mean, it's not Excel because I'm not Excel. Absolutely not. I mean—maybe PowerPoint, because I like to think I’m a little creative, and I feel like you can get the most creative with that. Or with Publisher. Okay—PowerPoint or Publisher. Dan Vanzant Kirsten—same question. Kirsten Same question. I have a question for that then… you know the old Draw—like Draw— Justin White MS Paint? Kirsten Yes! MS Paint. There we go. Justin White Again, that's not Office though. Kirsten Oh darn it. That would be my choice. Dan Vanzant Maybe they incorporated that into the Whiteboard tools. Kirsten Yeah. Yeah. Dan Vanzant Okay, all right, we'll accept it. Michele Williams Okay. Dan Vanzant And Lindsey, same question. Lindsey Yeah, it makes me feel very boring, but Word is probably what I would pick just because I'm an English person. You know—the editor, that sort of thing. Justin White Yeah, when I was doing my history undergrad, I loved Word because of how easy it made creating bibliographies and citations and references. It made it so easy. Dan Vanzant It's only getting easier. Back in the day you used to be able to turn off spell check, right? Justin White Oh yeah. Dan Vanzant Now it's automatic. You can still—can you? As an English Word person, would you ever turn it off? Maybe for everybody. Justin White I don't see ever turning it off. As long as I have the option to ignore—like mark this as ignore—I don't see the point in turning it off. Lindsey I would turn off spell check because it's usually—not—I don't usually need it. But the grammar check is wrong sometimes. It is. Justin White It is. Oh yeah. Dan Vanzant Have any of you used Grammarly? Justin White Yeah. Kirsten Of course. Yeah. I actually use it a lot when translating because sometimes you just write too directly from one language to the other and I need a different perspective. Dan Vanzant Okay. Kirsten But I like it. Dan Vanzant Last speed round. Michele Williams Yeah. Justin White These speed rounds—we are getting through this—it's just mind‑blowing. It's like a NASCAR race. Kirsten As I said, the sloth is kind of my spirit animal. Dan Vanzant Okay. Last question. Kirsten: Cilantro—yes or no? Kirsten Yes. Lindsey Yes. Michele Williams Yes. Justin White Yes. Dan Vanzant I didn't ask me—I'm going again. I have gone back and forth. Actually, sometimes there are periods in my life where I feel like my taste changed a little. I couldn't eat it—it tasted like rubber soap or something. I think there's some cilantro that's fresher, that's stronger, whereas you can get more mild cilantro. Justin White I'll even get pico that has cilantro in it and then add some extra cilantro. Dan Vanzant Wow. Okay, I'm doubling down on cilantro. Justin White I'm on board. Dan Vanzant Yeah, okay. All right. Excellent. Well, that concludes the speed round. Michele Williams And so finally, how can students find you if they have a question or if they'd just like to say hello? Justin White Well, we're all in the same office, so that makes it super convenient no matter what year you are. We are in Bishop Hall on the first floor, basically on your left as soon as you walk in the building. We are in room 112—the Student Success and Research Coordinator office. That's where you can find us. Also, you can make an appointment with us on EAB Navigate. We recently got that set up, so hopefully we'll be using that a lot more in the future. Of course you can shoot us an email any time. My email is [email protected]. Feldmanl1… Kirsten …and [email protected]. And you also have the phone. Justin White What is the number to that phone? Michele Williams 439‑6401. Dan Vanzant All right. Well, thank you all for joining us today. Nice to get to know you guys a little bit more—I think good for the students as well. Thank you. Michele, do you have anything to add? Michele Williams Again, we're really glad you're here. Justin White I'm glad we're here too. Michele Williams Thank you guys. Justin White Yeah. Thank you.    

In this episode we chat with Steve Ellis, Assistant Dean of Student Affairs at ETSU Bill Gatton College of Pharmacy. After Gatton was founded in 2005, Ellis played a key role in the college’s early development, officially joining in 2008 to lead the Office of Student Affairs. This office supports students throughout their entire journey—from recruitment efforts starting as early as high school, to current student services, and even alumni engagement after graduation. Ellis also serves on the college’s Executive Committee and has held leadership roles at the university level. Steve recently celebrated his 30th anniversary working at ETSU and was honored with a special scholarship in his name to support students. You can support this scholarship by visiting our Gatton donor page: Under Designation, select "Write In Your Choice," and type in "Steve Ellis Scholarship."   Transcript Introduction Teaser: Steve Ellis There's nothing that brings me greater joy than than watching them grow and be successful and know that they're going to go out in the world and and make such a difference, you know, in people's lives. Full Episode: 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. I'm one of your hosts, Doctor Michele Williams, assistant professor and director of academic success. Stephen Woodward And I'm Stephen Woodward, marketing and communications manager. In this episode, we chat with Steve Ellis, assistant dean of student affairs at ETSU Gatton College of Pharmacy. Steve recently celebrated his 30th anniversary working at ETSU and he was honored with a special scholarship in his name to support students. You can learn more about that in the show notes for this episode. Stephen Woodward Steve has extensive experience serving students, starting his career at Texas A&M University, his alma mater, and Louisiana State University before coming to ETSU Quillen College of Medicine, where he served as assistant dean for student affairs and director of student support services and outreach programs. After Gatton was founded in 2005, Steve played a key role in the college's early development. Stephen Woodward Officially joining in 2008 to lead the Office of Student Affairs, this office supports students throughout their entire journey, from recruitment efforts starting as early as high school to current student services and even alumni engagement after graduation. Steve also serves on the college's executive committee and has held leadership roles at the university level. Well, Steve, thank you for coming to White Coat Radio. Stephen Woodward It's good to have you. Steve Ellis Well you're welcome. Thank you for the invitation. Stephen Woodward So you recently celebrated 30 years of service at ETSU. So how many years of those have been at Gatton? Steve Ellis Well, I guess it depends exactly how you want to count that. Gatton is celebrating, you know, as many people know, 20 years from its founding in 2005, and I've seen all 20 of those years. However, from an absolutely official capacity, it's 16 that I became the assistant dean for student affairs in 2009. Steve Ellis During the years prior to that, I had been at first unofficially involved helping the founding dean, Larry Calhoun, with some things. He, you know, we shared some office space, if you will. So I would help him with some stuff related to student affairs. And then that morphed a little bit into a formal relationship where I was splitting time 50/50, if you will, between the College of Medicine and the College of Pharmacy. Steve Ellis And for anybody who thinks that sounds great, 50/50 really is 100/100. Steve Ellis Okay. Steve Ellis So don’t ever be misled. Steve Ellis With that… Steve Ellis Idea there. We got about 50% of your time. Michele Williams Don't agree to that. Yeah. Steve Ellis Absolutely. So, and of course, I've enjoyed all my time here at ETSU, but in particular, I've enjoyed my time here with the College of Pharmacy. Yeah. Michele Williams So how did you wind up coming to Gatton full time? Not 50/50. Can you tell us a story about that? Steve Ellis Sure, sure. You know, I can tell lots of stories, but I'm actually reminded of this story a little bit in terms of how I came to Gatton. Every week on interview days, we interview applicants for pharmacy school on Mondays, and we show them a brief video of our history so they can have some understanding of how we got founded and that sort of thing. Steve Ellis And in the video, of course, the founding dean is speaking. And in his little blurb where he talks about the beginning of the college, he says, “Well, the first thing that Ron Franks asked me on that very first day—besides ‘Larry, I hope you can find an office’—is ‘I hope you can do this. Good luck.’” And it always reminds me of how I came to Gatton because that is how Larry and I met. Steve Ellis At the time, I was the acting student affairs dean for the College of Medicine. And the weekend before Larry Calhoun was to start as the founding dean, Ron Franks and I—Ron was the dean of medicine at the time—were coming back from a meeting and were on the same flight. While we were waiting for our connecting flight, he said, “Hey, Steve. Larry’s going to be starting on Monday, and he doesn’t have an office. You think you can help him?” And it just so happened we had an extra office within student affairs in the College of Medicine at the time. Steve Ellis So I volunteered that space. And as they say, that was the beginning of a relationship. That’s how I became initially involved with pharmacy, and I continued, as I said a moment ago, in a part-time relationship helping to run admissions in particular at that time because staffing was somewhat limited. Steve Ellis And I had a lot of experience with medicine, you know, in the admissions processes. And then when the student affairs dean position opened here in the College of Pharmacy, Larry asked if I would take it on an interim basis. That was in 2008. And then of course that morphed finally in 2009 to be officially the student affairs dean in the College of Pharmacy. Steve Ellis So, a little bit of a serendipitous type of initial meeting between he and I that has led to what’s become, I guess, a lifelong kind of love affair—in terms of me and the College of Pharmacy. Yeah. Stephen Woodward I feel like now, you know, 20 years—we’re celebrating our 20th anniversary now—and, you know, the college has raked in all these awards, we’re nationally recognized and have a great reputation across the country. But there had to be a lot of fear coming in to a brand new school then. I imagine things were a lot different. Can you kind of talk about that and maybe some of the apprehension you might have felt or challenges that were there in the early times? Steve Ellis Yeah, absolutely. As you can imagine, there was a lot of fear. I mean, you’re doing things on faith and hope and all of those sorts of things. And I think in particular about our inaugural class of students, but even the first few years of students, because unless you understand the accreditation process, the program does not become fully accredited until you graduate your first class of students. Steve Ellis So there’s a four-year period of time that in theory everybody’s taking a chance—and especially your students. So I oftentimes thought about what type of apprehension the applicants and those who signed on as students were feeling because we actually had them sign a disclaimer at the time they were being accepted that in effect said, “I understand where the college is in terms of accreditation,” and essentially, “we’re going to do everything we’re supposed to do and fully expect to gain accreditation—but at the same time, this could go south, and you can’t really blame us.” Steve Ellis Not too long ago I came across some of those signed forms, so it brought back memories. And in a way you can think the same thing with all the faculty and staff, you know, many of whom truly uprooted. For me, my uprooting was to cross the sidewalk, but at the same time you were stepping out on faith. Steve Ellis But it was such an exciting endeavor. The people of this region—those familiar with the history of the college’s founding—were just so, so supportive of the college getting started, not only with money but really with whatever it took. Pharmacists came forward to serve as preceptors, and people volunteered in whatever capacity they could. Steve Ellis So while you were taking a chance, deep down you knew this was going to work. But when you think about the awards and recognitions, as you mentioned a few moments ago, obviously none of that was in our minds. Our mind was: “Hey, let’s get this college off the ground, make it a quality thing, and produce pharmacists,” because at that time there was a huge shortage nationally and in the region. Basically, we wanted to serve this region and overcome that shortage. Steve Ellis Right. And obviously we did a good job with that over the years. But I think, to your question of what's changed over the years—in many ways nothing has changed in terms of that culture. We've always emphasized the importance of culture here in terms of the workplace. Steve Ellis You know, that it's a good place to work and a good place for students to learn and have an overall quality experience. But what you were not prepared for—as you grow over the years—is growth. In the early years, we used to comment, “We’re like a rowboat. If you're going in one direction and you realize it isn’t working, you just turn and go in a different direction.” You could do that quickly and meaningfully. Steve Ellis Whereas when you grow—bureaucracy hits and structure and processes develop—it becomes not more challenging necessarily, but a very different process to make changes quickly. Steve Ellis I liken it to an individual who decides to open a business because they love what they do: baking, painting, whatever it may be. But then all of a sudden it becomes a business, and the dynamics change. Steve Ellis But at the same time, that's exciting because of the growth that's going on and watching things change. And along with that came the awards and excitement associated with those kinds of things. Steve Ellis One of the biggest memories I’ll always have was the first time our students won the American College of Clinical Pharmacy clinical skills challenge. Streaming was still kind of new at that time. I can vividly see us all huddled around one computer in a cubicle. Stephen Woodward I've seen the photo. Steve Ellis Yes, yes. And cheering like we were at a baseball game or something. It was really something special. I'll never forget that moment in time for sure. Michele Williams Well that's really so interesting. I didn't know all that about the early days of Gatton. And so your position here at the college—you’re the assistant dean for student affairs and you're a member of the executive committee. Can you tell us a little bit about some of the things you're responsible for? Michele Williams Keeping in mind that we have a time limit, but it's going to take you a huge amount of time to say all the things. I'm just kidding. But maybe talk a little bit about your job and the day-to-day of your job. Steve Ellis Yeah, sure. Be glad to share some of that. Student affairs is a big animal because it affects so much with students. Almost anything associated with students that’s not directly academics can fall in that bucket. And sometimes I feel that way—if the word “student” gets used, oftentimes they're like, “Oh, Steve and his staff, you all handle this.” But it's always a wonderful thing because of the students. Steve Ellis A lot of what student affairs does is provide student services and support—just helping them be successful. They have enough to do as students. Going to pharmacy school is their job, and that's a full-time job. So we try to make the other stuff as easy as possible—for example, getting through financial aid processes. Steve Ellis We try to provide services so they can get the things they need. Financial aid—we do those things in-house. Registrar’s services—course registration—so they're not thinking, “Oh gosh, I forgot to turn in a form.” Steve Ellis We oversee admissions and recruiting processes, and that has changed a lot over the years. In the early years of the college, there was no shortage of applicants because it was the new kid on the block and nationally there were a lot of opportunities. But things change, the field self-corrects, and the need for recruiting has changed a lot. Steve Ellis So the admissions staff, student affairs as a whole, and the college collectively spend a lot of time educating people about what pharmacists do as a career. Steve Ellis Pharmacy has always been, in my opinion, the invisible profession. Unless you have a need—an interaction with a local pharmacist—many people think of them only as the corner drugstore. They have no idea what pharmacists really do or their role in the health care system. Steve Ellis Pharmacists are truly the drug experts. And these are things I've come to learn over the years. I often laugh when watching commercials where they say, “Ask your physician.” And I always think, “No, ask your pharmacist,” because that’s truly the drug expert. Steve Ellis So we spend a lot of time helping people understand what pharmacists do and using that platform from a recruiting and admission perspective. And I think it's a nice service we provide to the community, not just to get students but to help people navigate the health care system better. Steve Ellis But to get back to the question: In student affairs—and in my job as the leader of that—we focus on trying to make the student experience as fulfilling as it can be, especially outside the classroom, and to support them when they have struggles. Life doesn’t hit the pause button when you're in school. Steve Ellis So we try to help ameliorate some of that and really do all we can to help them have a quality experience while they're here. Michele Williams I have to agree with you 100%. And I also want to give a little shout-out to your amazing staff. The people that work in student affairs are really, really student-oriented. You create an environment where people really want to help students, and I’m always surprised at all the things student affairs does to support students. Steve Ellis Yeah. Well, I appreciate that. And truly, I think it's a real love for the staff. If you look at the student affairs staff, most of us have been here for a good period of time. I mean, I've been 30 years at ETSU, 20 in fact with the College of Pharmacy. Steve Ellis But in addition, there's an individual who's been here for 17 years in student affairs, another individual at 17 years. So it's really a nice situation. They are so invested in students’ well-being. And it just makes it nice. And I think our students know that. Steve Ellis They know they can count on people in student affairs. And we're talking about student affairs because that’s my area, but it's the college. People know they can count on everybody in the college to be in their corner. It’s easy to be in someone’s corner when times are going good. Steve Ellis But I think the students realize that we’re all in their corner—maybe even more so when times are tough—to help them meet challenges and still be successful. Stephen Woodward Well, one thing student affairs is known for—maybe famously or infamously—is Halloween celebrations. And I don't know, this will come out probably after Halloween, but tomorrow we're celebrating Halloween here. Can you talk about your favorite Halloween performances you've… Stephen Woodward …done in classrooms? Stephen Woodward Performed or spent? Yeah. College dance party. Steve Ellis Yeah yeah yeah yeah yeah yeah yeah yeah. Steve Ellis You're right. There have been a lot of wild things over the years. All good fun. All good fun, of course. Steve Ellis Yeah. Steve Ellis I think my favorite one—and I can't specifically remember the year, but somewhere around 2014—was when we did a performance to a song that was one of those one-hit wonders that came out that year. And the song was “What Does the Fox Say?” Steve Ellis It was by this Canadian duo—don’t even ask me what their names were. And it was just such a fun thing. We spoofed it up to entertain the students. And of course, as always, I seem to be the guy that either has to make the fun or get made fun of. Steve Ellis So I was the senior dancer, if you will, for that event. And it was just a really, really fun time. The class had a ball. I had fun. And let me be sure PETA people are not mad at me—I had a faux fox tail I was wearing. Steve Ellis Just, you know… It was just really a fun time. And that whole Halloween celebration that happens every year was one of those things that happened by accident. Steve Ellis It was like, “Oh, we should just do something for the students.” So we decided to do a costume contest and trick-or-treating, and the student affairs staff dressed up as the Village People. Steve Ellis And someone got the idea: “We should go downstairs and see what’s going on with the class.” Steve Ellis And we did. And the next thing you know, students start expecting that every year: “What are you all going to do?” So it's just been a lot of great laughs over the years. Michele Williams Yeah, it is a lot of fun. Yeah. Stephen Woodward I'm curious how you've seen ETSU change in your time here—at the university as a whole. Gatton started as a private college within a public institution. I think it was the only one in the country at that time. It was a very unique situation. Steve Ellis It was definitely unique. And we were—at least in terms of pharmacy—the only one in the country. So that was unheard of. And I think even here, maybe people surprised themselves. Steve Ellis Not that it became successful, but just the idea. For your state institution, for so many years people had been going to the state appealing to establish a college of pharmacy. In large part because of the history of the medical school being started in the mid‑70s and the impact that had on the overall quality of life in this region. Steve Ellis And I think someone said—tongue in cheek—“Why do we have to have the state's money?” Everyone laughed. But then it was like, “Wait… why do we have to have the state's money?” Steve Ellis So that idea took root. That’s the East Tennessee spirit—don’t tell us we can’t do something. Just watch us. Steve Ellis It was a big endeavor for the university, though. ETSU was—and still is—a regional school. But maybe even regional in its thinking at that time. “We’re going to be in our designated world and do the things we do.” Steve Ellis But over time the university—especially under the leadership of the current president for more than a decade—began to think bigger. Yes, we might be regional in founding and history, but we are a world‑class university in terms of the educational experience. We attract students from all over. Steve Ellis That’s something I've seen change—the mindset of people in the region and at the university. And that’s been a good thing. We’ve attracted students from across the country and internationally. We've enrolled international students in the College of Pharmacy. Steve Ellis We’ve been able to attract faculty and staff and make a name for ourselves in this little corner of Tennessee—one that has impacted the world. So that’s a big change for me. Stephen Woodward Yeah, that’s well said. Flash forward from when it started without state funding—of course, a few years ago we received some state funding for the college. And we've also established the early admission pathway program, which has become a huge part of Gatton. Can you tell our audience what the early admission pathway is and why it's important? Steve Ellis Absolutely. And just to comment on the state support—we do receive some state dollars now. We're not fully private as we were. And it's important—it wasn’t about chasing state dollars because we needed money. Steve Ellis It was part of our commitment to students—to lower tuition. And we've done that and continue to do that. Pharmacy education, especially in southern/central Appalachia, needs to be accessible. Many students come from rural areas, might be first‑generation students. The idea of becoming a health professional might feel far‑fetched. Steve Ellis So we want to do all we can, including with tuition. And under the leadership of our current dean, Dr. Byrd, we’ve been able to do some of that and continue forward. Steve Ellis That also helped feed into the EAP program—the Early Admission Pathway. As we've changed recruiting, we're spending time educating students in high school and even middle school about what pharmacists do and what the pathway looks like. Steve Ellis Through the EAP program, students are able—as early as high school—to be, air quotes, “admitted” into pharmacy school coming out of high school. It removes the pressure of “I have to make all A’s,” and the feeling that classmates are competitors for a limited number of spots. Steve Ellis It removes that pressure because they know they have a spot. They still have to perform academically, but because they're in the pathway, we see them from day one as our students, even while completing undergraduate coursework. Steve Ellis And we support them—Dr. Williams assists with academics, we help them grow professionally, and we provide some scholarship money. Steve Ellis The program has grown. The first cohort in 2020 was 12 students—only four ultimately started the PharmD program, which is expected due to attrition and young people making life decisions. Steve Ellis But our most recent PharmD cohort from the program was 20 students. And the newest incoming EAP cohort of freshmen at ETSU is 50. Steve Ellis So it has really grown. Students are seeing what the pathway can offer and what a career in pharmacy can offer. We love working with those students. Stephen Woodward Yeah, it’s been great seeing them at the tailgates this football season. Steve Ellis Yeah, it has been. And I think they appreciate that because even though they know, “Hey, I’m in pharmacy school as a freshman,” they still have trepidation. But then to come to a tailgate and the dean is there to welcome them, the faculty are there and know who they are—not just “Hi, who are you?” but “Hi Megan, glad to see you today”—that goes a long way. Steve Ellis And our current students talk with them and put an arm around them and see them as part of the group. That helps them feel at home and know we are here to support them fully through the journey. Michele Williams That's great. Tell us a little bit about the Steve Ellis Scholarship. Steve Ellis Well, the Steve Ellis Scholarship was a real surprise to Steve Ellis. A lot of scholarships are started by someone or a family. But this one—which makes it so special—was created by you all, my colleagues here, in appreciation and recognition of my time at ETSU. Steve Ellis We’re still working through details, but the scholarship will support students from that overall student‑support perspective. It’s not for the student who makes the best grades but to help students who need support or want to take advantage of certain types of experiences—things aligned with student affairs. Steve Ellis They're currently emphasizing collecting donations because we want it endowed—not something that’s spent and gone—but something lasting. Steve Ellis I was blown away and surprised when the college presented it to me. I generally try to be even‑keeled, but I was about to cry. I was so moved. Steve Ellis I’m excited to see what the scholarship can do to help students grow and develop as pharmacy students. Stephen Woodward Yeah. That’s awesome. We'll put a link in the show notes for folks who want to donate and help it reach endowment. Steve Ellis Yes, yes. Same type of thing as how the school got started—no amount is too small, and people have a heart for things that directly impact students. Stephen Woodward And if people want to see the look on Steve's face at the surprise party when the dean presented it, you can go back on social media and find the photos. Steve Ellis Yes, absolutely. I was definitely surprised. Michele Williams That's great. Well, I was really looking forward to this because I knew it would be a fun conversation. And you did not disappoint me. Is there anything we haven’t asked that you wish we had? Steve Ellis No, I think you asked great questions—some good thought‑provoking ones, and some that brought back great memories. I think perhaps students, faculty, staff, administrators—they don't always know us as people. They see our roles but not us. Steve Ellis I try to help students know I'm just a regular guy like they are. We all have struggles. But truly, I’m going to be here for them—whatever it takes to help them be successful. I want to be in their corner. Steve Ellis There's nothing that brings me greater joy than watching them grow and be successful and know they're going to go out in the world and make such a difference in people’s lives. Stephen Woodward Well said. Okay. Thank you for being on the podcast. Steve Ellis Well thank you. I've enjoyed this opportunity, and hopefully somebody out there might appreciate something we talked about today, and who knows—might make a difference in their life. Stephen Woodward We'll have you back on in your 60‑year. Steve Ellis Okay. Okay. Steve Ellis Well, yeah, you know—I need to stay on because at the celebration you do get gifts the longer you’re here. Steve Ellis You know, there's that rocking chair that looms out there. But I’ve got to put in a lot more years to get the rocking chair. You get one of those nice… I can say that. Steve Ellis All right. Well thank you all. I really appreciate this and enjoyed it. Michele Williams It's great, you know. Stephen Woodward Thanks for listening to White Coat Radio. If you haven't already, be sure to subscribe and leave us a review wherever you listen to podcasts. To learn more about East Tennessee State University Bill Gatton College of Pharmacy, visit us at etsu.com/pharmacy or follow us on social media @ETSUPharmacy. We'll see you next time.  

In honor of American Pharmacists Month, we sat down with Dr. Anthony Pudlo, Chief Executive Officer of the Tennessee Pharmacists Association (TPA). Dr. Pudlo leads an organization that advances, protects, and promotes high-quality, pharmacist-provided patient care in the state of Tennessee. In this interview he talks about the importance of TPA, the state of the profession, and advice for students. Learn more about TPA on their website, tnpharm.org, or on social media. Transcript Introduction Teaser: Anthony Pudlo Happy American Pharmacists Month or whatever day you might be listening. It could be Pharmacy Technician Day, Women in Pharmacy Day. There's a lot of great points that we try to celebrate the profession this month. So, thank you to everybody out there listening for what you do each and every day for the profession and the patients you serve. Full Episode: 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. I'm one of your hosts, Doctor Michele Williams, assistant professor and director of academic success. Stephen Woodward And I'm Stephen Woodward, marketing and communications manager. Today we're joined by Doctor Anthony Pudlo, chief executive officer of the Tennessee Pharmacists Association. In this role, he leads an organization that advances, protects and promotes high‑quality pharmacist‑provided patient care in the state of Tennessee. You can learn more about TPA on their website, TNPharm.org or on social media. Stephen Woodward We'll put links in the description. Doctor Pudlo, we appreciate you coming today. Welcome to White Coat Radio. Anthony Pudlo Thank you so much for having me. Really appreciate being here. Stephen Woodward So talk about what brings you to Gatton this week. Anthony Pudlo Oh, goodness. When am I not at Gatton, right? No. A lot of the visit this week has really stemmed from an outbound effort from the association to meet and collaborate with our local district pharmacy associations around the state. So actually, later this evening we'll be hosting a great dinner program with our colleagues at the First District Pharmacists Association. Anthony Pudlo And yeah, anytime you come out to Johnson City, you’ve got to make sure you visit some pharmacies and visit some members, talk to the students. So it has been a jam‑packed week already. I've been enjoying it. Michele Williams It's really great to have you here. And for some of our students who may not have gotten the message yet, can you talk a little bit about the role of the Tennessee Pharmacists Association? Anthony Pudlo Yeah, it's a great question. And I do think students should know a few different things. First and foremost, there are a whole lot of different organizations out there, and we encourage people to get involved in as many of them as they want to. But at the state level, the Tennessee Pharmacists Association—plain and simple—we are a membership‑based professional society that represents the practice of pharmacy. Anthony Pudlo Our members are pharmacists, pharmacy technicians and students of the profession. Wherever you see them practice—large health‑system practices, small critical‑access hospitals, large national chains, regional chains, independently owned community pharmacies, long‑term care, home infusion, nuclear pharmacy, managed care, academia. And so we bring those voices together. Very uniquely in Tennessee, we're able to be one voice for all those pharmacists and technicians and students to advocate for the profession and help make sure we're promoting the profession in the right way to policymakers and other stakeholders—educating the profession, whether it's formal continuing education or just helping people stay up with the times on what's going on in practice. Anthony Pudlo And I would also say helping advance the profession as well. So we do that through a lot of different mechanisms. Some of that is really wielded through the work of our foundation. But in the end, our members tell us—tell me—what to do. Anthony Pudlo We're a membership‑based organization, and we stay focused on the state of Tennessee. But as I was saying earlier, we work very closely with all those national pharmacy associations too. We are either direct or indirect affiliates with our colleagues at the American Pharmacists Association, American Society of Health‑System Pharmacists, National Community Pharmacists Association, AMCP, AACP—you go down the list. Anthony Pudlo We work very closely. As many people can imagine, there’s a lot going on in the world of pharmacy, and we try to collaborate and coordinate as best we can across all facets of the industry. Michele Williams That's wonderful. And what are some of the member benefits for students? Anthony Pudlo For students, for sure—there's a whole lot. And I even think back to my days as a student and what professional involvement means. But plain and simple, I always tell students that depending on what year you're in school, there's different things that TPA probably means to you. Maybe as a first‑year student, you're just trying to learn the acronyms, learn what's going on in the world of pharmacy—and that's fine. That's perfect; you should be. Anthony Pudlo So I tell people we have a weekly communication called our “10 for 10” newsletter that comes out, and we try to spotlight the ten most important things that happened in the world of pharmacy in the last week—some national‑level issues, some state practice issues, whatever it might be. Anthony Pudlo And plain and simple, as a P1 that’s probably perfect, right? They just want to learn and understand, and these things help augment what they're learning in the classroom. But as they get older in the curriculum—as a P2, P3—I think we offer a whole host of engagement opportunities, whether through our conferences, networking events, or opportunities to meet pharmacists doing unique, cool things in practice. Anthony Pudlo We also have an executive summer internship program. We offer a practice site for fourth‑year students. We offer scholarships through our foundation. And then probably the biggest thing I encourage students on is helping them hone and find their voice for the patients out there—through advocacy. Anthony Pudlo We want to make sure students are attending our Pharmacy Day on the Hill every year at the end of February. Later today I’ll be meeting with some student groups to talk about advocacy efforts and how you find that voice. Anthony Pudlo This week on Friday we host a big residency showcase where residency programs from across the region come to Nashville and students interested in post‑graduate training can meet them—making it easier than having to travel to wherever ASHP Midyear is that year. Anthony Pudlo There’s a little bit of everything. But plain and simple, we are a network—a network of pharmacy professionals to help a student learn the profession and how we operate. Anthony Pudlo Even if students don’t plan to practice in Tennessee, I think we're doing some cool, great things in our state. Take that knowledge and apply it wherever you go. And yes—the college would probably love to see alumni come back someday and apply that knowledge here, because it makes us all stronger together. Michele Williams That's awesome. It sounds like there's something for everybody. Anthony Pudlo Yeah, very much so. Stephen Woodward Can you tell us what the CEO does and give us a day in the life of what you do? Anthony Pudlo Well, let's throw this week out the door because it's a little bit unique—but maybe not. In a nutshell, it's important to realize how we operate to know what I do. Like I said earlier, TPA is run by the members. But even more specifically, TPA is still organized in a way—probably one of about 15 or 20 states—that still has a House of Delegates. Anthony Pudlo They are our policymaking body. They meet at our winter and summer conferences. Students can observe or speak. That’s our legislative branch. They decide our stance on medical cannabis, artificial intelligence, telepharmacy—you name it. Anthony Pudlo Those statements drive decisions of our board of directors and committees. Our board is essentially our executive branch. They approve our budget and strategic plan. Anthony Pudlo They also employ me. So they hand me the strategic plan and budget, and I figure out how we get the work done. Anthony Pudlo I manage our small but mighty team—five full‑time staff, a few part‑time. I manage committees. And I make sure we accomplish what the profession needs from us within budget constraints. Anthony Pudlo A big part of my role is legislative work. During session I’d be running around the Capitol a couple days a week working with our contract lobbyists, advocating for the profession, helping legislators understand our pain points. Anthony Pudlo Even outside session, I meet with legislative leadership to prepare for the next year. Anthony Pudlo Yesterday was the end of the month, so I worked with our finance team and auditors on closing the audit. There's a little bit of everything. Anthony Pudlo I also spend a lot of time coordinating with counterparts in other states and national organizations—learning from each other, identifying strategies, amplifying messages, troubleshooting issues. Anthony Pudlo Any bigger‑level strategic issues—those are on my plate. Stephen Woodward Okay. Thank you. So I know today is October 1st—we're recording at the beginning of American Pharmacists Month. We want to ask you: what's the state of the profession of pharmacy, and what is the importance of pharmacists in today's day and age? Anthony Pudlo Yeah, great question. And thanks for the reminder—it is October 1st. We have a lot we're planning to push out. So yes, to all our listeners—Happy American Pharmacists Month, or whatever day you're listening. It could be Pharmacy Technician Day, Women in Pharmacy Day. We celebrate the profession in many ways this month. Thank you to everyone for what you do. Anthony Pudlo But to your question, Stephen—it's an interesting time. I've been meeting with pharmacists the last couple days. We see a lot of challenges in the profession—undue influence from outside groups. But also opportunities. Anthony Pudlo Maybe I'm a glass‑half‑full person. People tell me it feels like the early days of the pandemic—big decisions being made, ripple effects on how we live and care for patients. There's ongoing advocacy work to amplify our voice to decision makers. Anthony Pudlo Some decisions may have undertones of things the profession has asked for a long time—proper regulations around influencers on the profession. Anthony Pudlo But finances are challenging. Community pharmacy closures. A big long‑term care group recently filed bankruptcy. Health systems struggling with 340B, reimbursement, etc. There’s a lot of challenge. Anthony Pudlo But pharmacists are problem‑solvers—detectives. We navigate difficult issues. We bring solutions. Tennessee has had success—PBM reform, scope expansion recognizing pharmacists can independently provide care and be paid for it. Not across every payer yet, but opportunities exist. Anthony Pudlo There are challenges, but people are not alone. People are working hard to overcome them. And there’s opportunity when we use our voice together. Michele Williams It sounds like there are so many important facets to your job. When you think back to pharmacy school, were there experiences that led you to where you are now? Anthony Pudlo We could go down a long path about choosing pharmacy, but in a nutshell—I didn't come from a family of pharmacists. Pharmacy somewhat fell into my lap. My older sister went into physical therapy; I chose pharmacy. Anthony Pudlo Because I didn’t have direct exposure to the profession, I soaked up everything I could. I got involved in different organizations almost every semester—independent ownership, managed care, hospital practice—you name it. Anthony Pudlo I wanted to be a sponge, to make the right choice for my career. Looking back, I learned a little of everything. And now, in my role, I see medications as the common thread across all health care. Anthony Pudlo That broad exposure helps me understand what different pharmacists deal with. My job isn't to know everything—but to know who to call. Anthony Pudlo I learned early to communicate, understand people's passions and issues, and amplify their needs in the right way. That helps when talking to the Governor’s office, legislative leaders, members of Congress—you need real examples to illustrate why change is needed. Michele Williams That's amazing. Thank you for sharing that. Stephen Woodward You were reflecting on pharmacy school. Looking back, what advice would you have for a current P1 or someone just starting their career? Anthony Pudlo Doesn’t matter if you're a first‑year or fourth‑year—be a sponge. Learn every facet of the profession. The PharmD degree offers so much flexibility. You can work anywhere. Anthony Pudlo But learn your passions. Learn your clinical interests. Yes, you have to be a jack‑of‑all‑trades to pass boards, but also learn what you really care about. Anthony Pudlo Know the clinical areas you love—become the expert. Learn the trials, the guidelines. And also learn your colleagues’ passions. You won’t know everything. You need to know who to call. Anthony Pudlo There’s mutual respect when you know your limits and rely on colleagues. Be a resource to each other. Not only in school, but when you're alumni caring for patients. Stephen Woodward Great. That's great advice. Anthony Pudlo Thank you. Michele Williams That's awesome. Are there any other things you'd like to talk about that we haven't touched on yet? Anthony Pudlo How much time do we have? It's important for people to realize—sitting in this chair as CEO of TPA for years now—there are a lot of positive things the association is doing externally that people may or may not see. Anthony Pudlo But there's also a lot internally—revamping communications, new website, new emails, better social media. If you don’t tell your story, others make their own narrative. My leadership has been clear—we need to peel back the curtain and showcase what TPA does. Anthony Pudlo We've revamped advocacy strategies. We've revamped financial processes—being efficient with the membership dollar. Anthony Pudlo For anyone who hasn't considered what TPA is or what it means to you, I encourage you to take a look at our website, www.TNPharm.org. Anthony Pudlo I'd appreciate advice, too. I'm still soaking up information—ways we can be better, more relevant to pharmacists and technicians who need our help. There’s more to come. Some exciting things on the horizon. Michele Williams That's awesome. Stephen Woodward We'll put a link to your website in the episode description, and we hope this episode helps you tell your story and more about TPA. We really appreciate you joining us today. Anthony Pudlo Thank you both. Really appreciate it. And I guess it’s time to go talk to more students in person. Stephen Woodward That's great. All right, that's a wrap. Thank you very much. Thanks for listening to White Coat Radio. If you haven't already, be sure to subscribe and leave us a review wherever you listen to podcasts. To learn more about East Tennessee State University Bill Gatton College of Pharmacy, visit us at etsu.com/pharmacy or follow us on social media @ETSUPharmacy. Stephen Woodward We'll see you next time.  

In this interview with Dr. Jim Thigpen, Associate Professor of Pharmacy Practice at East Tennessee State University Bill Gatton College of Pharmacy, we discuss his pharmacotherapy course and how to succeed, leadership in pharmacy, and Dr. Thigpen's favorite pastime: fly fishing!   Transcript: Introduction Teaser Jim Thigpen You're in too big of a hurry fishing, you're not going to do well. And if you're in too big of a hurry as a pharmacist, you're going to make mistakes. And that's dangerous. And so learning to be patient and taking your time is important. Main Episode 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. I'm one of your hosts, Doctor Michele Williams, assistant professor and director of academic success. Stephen Woodward And I'm Stephen Woodward, marketing and communications manager. Today we're joined by Doctor Jim Thigpen, associate professor of pharmacy practice, a pediatric pharmacist by trade whose practice site is Ballad Health’s Niswonger Children’s Hospital, which is located right next to the college. Doctor Thigpen has been with the college essentially from the beginning, starting in 2008 after working as a clinical pharmacist for nearly 15 years. Stephen Woodward He is originally from Charleston, South Carolina, and attended Clemson University before going on to pharmacy school at the Medical University of South Carolina. He moved to Johnson City in 1993. Doctor Thigpen coordinates Pharmacy Practice V and Pharmacotherapy III, as well as an Advanced Pediatrics elective course. We hope you enjoy today’s interview. Michele Williams What would you like students to know about being successful with your material that you wish they knew—something maybe you don't say out loud in class? Jim Thigpen Don't be intimidated by it. You know, don't think that it's that different than what you've learned. About 70% of all the children in the U.S. are cared for by pharmacists that are not pediatric specialists. There are 200 children's hospitals in the United States, and I’d ballpark maybe 2,000 pediatric specialists who work in those hospitals. Jim Thigpen But here there’s four in East Tennessee. And so the vast majority of children are going to be seen by pharmacists that are not pediatric‑trained. They all have to have some level of comfort taking care of a child and recognizing the bad things—when they need to go to the ER right now, or when it's something they don’t need to worry about at that moment. Jim Thigpen I hope by being exposed to pediatrics through the program, they develop a comfort level so they can say, “Yes, you need to call your doctor,” or “You need to make an appointment,” or “Yes, you need to go to the emergency room,” or “No, we can treat that with Tylenol.” Jim Thigpen And just develop a level of comfort with children because you will be somebody’s pharmacist, and somebody will call you at 4:00 in the morning and say, “My son has a fever. What should we do?” And you need to know what to do. Stephen Woodward What are the steps that a student right here at Gatton would need to take in order to become a pediatric pharmacist? Jim Thigpen You need to get involved with the national organization. If you're serious about pursuing residency in pediatrics, join pediatric pharmacy groups such as the Pediatric Pharmacy Association. They love students—they welcome them at national meetings. Meet people and figure out if that’s what you want. Jim Thigpen Pediatrics is limited. Tennessee has children’s hospitals in Johnson City, Knoxville, Chattanooga, Nashville, Memphis. That’s it. You can't be a pediatric pharmacist anywhere—you have to live in a city with a children’s hospital. Jim Thigpen Thirty years ago we were in high demand—and still are—but you may have to move. Jim Thigpen If you want to do pediatrics, talk to me and talk to preceptors like Robin Modern. Pharmacy is a small world; pediatrics is even smaller. People know each other. It’s about connections and making a good impression. Jim Thigpen Residency often means moving. I was going to leave Charleston for a residency at VCU, but we found out we were having a baby, and I didn’t want to take my eight‑months‑pregnant wife to a strange city. That’s the only reason I stayed. I recommend going elsewhere for residency—it’s a good learning opportunity. Michele Williams We were talking just a minute ago about the pharmacotherapy series. That’s where your course content primarily lives, right? During the P3 year? Jim Thigpen Yes, historically. Michele Williams If I were a student about to start the spring P3 year, what advice would you give me to be successful with your course content? Jim Thigpen Don’t worry about it. There are probably only three or four drugs that are exclusive to pediatrics. The rest are used in adults and then used in children. About 25% of drugs are FDA‑approved for children; the rest aren’t, but we still use them. Jim Thigpen There are only a handful of drugs you’ll need to learn that you don’t already know. Jim Thigpen People think pediatrics is so different—it’s really not. A lot of diseases are the same; the drugs are the same. It’s just a little different for children. Jim Thigpen You need to develop comfort with acute issues in kids—things you need to be able to recognize. I will drill that into you. If someone calls you in the middle of the night about their kid, you need to know what to tell them—and say it in a way that doesn’t terrify them. Jim Thigpen You need to talk to parents—help them give medicine effectively, or explain the importance of managing something like type 1 diabetes. You need to communicate clearly. Jim Thigpen Some parents are afraid of vaccines. You need to understand the facts and communicate them without offending them. Jim Thigpen Outside of those differences, pediatrics isn’t that different. I highlight the key differences. Don’t be intimidated—but I’ve been doing this for 40 years, so of course I say that. Stephen Woodward A few months ago I had the privilege to shadow you in the hospital. I think we often think of pharmacists in the background, but you were in more of a leadership role. Nurses, medical students—they were looking to you for answers. Can you talk about that leadership role? Jim Thigpen Well, not trying to be funny, but I'm probably older than everybody there. So it's natural to look up to the old man. Jim Thigpen But anyone who’s known me would not say I'm the smartest person in the room. They would say that if they needed help, I’d give it. Brian O’Toole and I worked together for years, and we always tried to help people and make their job easier. Jim Thigpen People know I’m someone you can ask without feeling stupid. Medical students especially—they get far less pharmacology than our students do. Some pharmacists make them feel bad for not knowing something. I try very hard not to do that. Jim Thigpen I want them to understand the details and feel like they can ask me anything. I try to break the ice—ask where they're from, talk about baseball or fishing or Clemson football—so they don’t see me as “the guy in the white coat.” Jim Thigpen For all pharmacists: you're part of the team. You develop a reputation. Students, nurses, doctors—they know whether you’re approachable. Jim Thigpen Almost every time I take a student into the NICU, one of the doctors walks up and says, “I’m so glad you’re here—I’ve got a question for you.” It's not scripted—it just happens. They know I’ll help. Jim Thigpen It’s not leadership; it’s reputation. If you're nice, people want to ask you questions. If you're not, they'll avoid you. Jim Thigpen Don’t ever treat providers condescendingly. They will avoid you forever. Even if they're really messing up, don’t make them feel like they’re messing up. We’ll teach you those skills. Jim Thigpen I’ve never thought I was smarter than anybody. I’m usually the dumbest person in the room—but at least I'm willing to help. Michele Williams Were you Mr. O’Toole’s specialty? Jim Thigpen He was internal medicine. But he was a special person. If you knew him, you loved him. Jim Thigpen I better stop before I get emotional. Stephen Woodward Well, that’s a great transition to fly fishing. Jim Thigpen Yeah, gives me a chance to clear my throat. Stephen Woodward Everyone knows you love fly fishing. What is it about fly fishing that pulls you? Jim Thigpen I always liked fishing—bluegills and catfish as a kid. I never fly‑fished until I moved to Tennessee. A pharmacist I worked with took me in 1993. First time out, we fished for a while with no luck, and then suddenly the fish went nuts. I caught six in 15 minutes and said, “I’m done, I need to buy a fly rod.” It was magical. Jim Thigpen Fly fishing is technical. It’s rhythmic—like in A River Runs Through It. It’s comforting. And trout live in beautiful places—the Watauga, the South Holston, Beaver Dam Creek. It’s just pretty. Jim Thigpen There have been days I've caught more fish than I can count—and days I’ve caught one or two, and felt just as rewarded. Catching fish is gravy. Michele Williams It sounds like you’d recommend fly fishing. What could a student pharmacist learn from fly fishing that applies to the profession? Jim Thigpen Attention to detail. That’s important for pharmacists. Fly fishing requires the right size, the right color, matching the insect. You need patience. If you're in too big of a hurry fishing, you won’t do well. If you're in too big a hurry as a pharmacist, you'll make mistakes—and that's dangerous. Jim Thigpen You need to pay attention. Sometimes I wasn’t catching anything and realized I wasn’t paying attention to which insects were around. I kept using the wrong fly. Then I switched and suddenly caught fish. Jim Thigpen Attention to detail and taking your time—both are important as a pharmacist. Michele Williams When you talked about matching the fly to the insect, it made me think about pharmacists finding “just the right” answer. Jim Thigpen Yes. In a perfect world you always use the best option—but the world’s not perfect. Sometimes the patient can’t afford the best medicine. You have to figure out what will get the job done. It’s problem-solving. Jim Thigpen We want students to develop critical thinking. Same with fishing—you use something similar if you don't have the perfect fly. Sometimes you choose something that isn’t your first choice but fits the situation. Stephen Woodward You should use that with pre‑pharmacy students. Can you talk about advice you give students interested in pharmacy? Jim Thigpen I've had this conversation hundreds of times. I never sugarcoat the profession. You don’t have to be a chemistry expert. I made two Cs in organic chemistry and was glad to get them. You do need problem‑solving skills. Jim Thigpen Most importantly, you need to communicate. Patients, parents—you must explain what you're thinking in a way they understand and feel heard. Jim Thigpen Talk to as many people as you can about the profession. See what you're getting into. Maybe get a job in a pharmacy. There are many paths—you don’t have to work retail. I never did. I worked in hospital pharmacy. Jim Thigpen But healthcare carries responsibility. If my son messes up at his job and loses the company half a million dollars, he might get fired—but he didn’t kill anyone. Healthcare is different. The stakes are higher. Jim Thigpen The most rewarding parts of my career: seeing parents relax because I'm helping their doctors make good decisions, and seeing students or residents understand something better because of my teaching. Being part of the team for 35 years—that’s rewarding. Jim Thigpen I enjoy interacting with the doctors, nurses, everyone. We all help each other and support each other when bad things happen. Stephen Woodward That really came across when I shadowed you. It was incredible to watch. Jim Thigpen Experience helps. I’ve been there a long time. Only one pharmacist at the medical center has been there longer than me. I've been here 32 or 33 years. I don’t know how it happened. Michele Williams It really comes across—you still have enthusiasm and passion. Students love working with you. Jim Thigpen I try to have fun along the way. Serious business, but jokes and cutting up with people make difficult days more tolerable. I encourage students to get to know the team—it makes everything more rewarding. Stephen Woodward Were you an inaugural faculty member? Jim Thigpen Not the first group. They started July of ’07. I started March of ’08. Stephen Woodward The college is celebrating its 20th anniversary. Can you talk about how you came to Gatton? Jim Thigpen I moved to Johnson City in ’93. I’d been doing the same job for almost 15 years and knew I didn’t want to be an administrator. I didn’t have anywhere else to go in that position. Jim Thigpen Larry Calhoun is the reason I came to Johnson City. I thought it’d be fun to work with him again. Maybe they’d need a pediatric specialist. I had taught some at the College of Nursing and College of Medicine, so I felt comfortable teaching. Jim Thigpen It was a transition from full‑time clinical to full‑time academia with clinical work. It wasn’t a big change—but it was a good opportunity. People said, “You just wanted to work with Brian O’Toole again.” That was a bonus. Jim Thigpen If the College of Pharmacy hadn’t opened, I’d still be at the med center. I never would have left—because we love living here. Coming to Gatton was probably the second-best decision of my life. The first was moving to Johnson City. Stephen Woodward Well, Doctor Thigpen, we really appreciate you coming. Jim Thigpen Certainly. It’s good to be here. Michele Williams It’s a great conversation—no surprise at all. Jim Thigpen Everybody says, “Do you have a story for every drug?” And I say, pretty much. If you've done it long enough, you have an experience for everything. Michele Williams And a good story too, I’m sure. Stephen Woodward Thanks for listening to White Coat Radio. If you haven't already, be sure to subscribe and leave us a review wherever you listen to podcasts. To learn more about East Tennessee State University Bill Gatton College of Pharmacy, visit us at etsu.com/pharmacy or follow us on social media @ETSUPharmacy. We'll see you next time.  

Check out Part 2 of our interview with Dr. KariLynn Dowling-McClay, Assistant Professor of Pharmacy Practice at East Tennessee State University Bill Gatton College of Pharmacy. Dr. Dowling-McClay discusses some of the exciting research opportunities for student pharmacists.   Transcript Teaser Introduction: KariLynn Dowling-McClay They're better than TV sometimes. Like, I would just go out and spend time just standing around with my chickens and just watching at. Full Episode: 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. I'm one of your hosts, Doctor Michele Williams, assistant professor and director of academic success. Stephen Woodward And I'm Stephen Woodward, marketing and communications manager. Today we are talking to Doctor KariLynn Dowling-McClay, assistant professor of pharmacy practice again. Her interests include women's health, substance use disorders, and public health. Michele Williams Welcome back to White Coat Radio, Doctor Dowling-McClay. KariLynn Dowling-McClay Thank you. I'm excited to be back. Michele Williams So I believe that you might be unique among our faculty members in that you do both quantitative and qualitative research. Can you tell us a little bit about what qualitative research is, and then also about the areas in which you research? KariLynn Dowling-McClay Yes. So qualitative research is such a fun area, and I didn't honestly think about it much at first when I was going through my training and building out my skills in research. First and foremost, I'm a big data nerd. I really like looking at numbers, working with spreadsheets, doing statistical tests. So qualitative research is everything outside of that. KariLynn Dowling-McClay And so I wasn't naturally drawn to it until I got some exposure to it. That really started when I was doing my postgraduate training. I went through the Master of Public Health program here at ETSU when I first came here as a pharmacy fellow. Michele Williams That's kind of data nerd paradise. KariLynn Dowling-McClay It is. I mean, it gives you all the time you want to really dig into those interests. But what I learned through my mentors and instructors in that program is that you can't form a whole story through research that is just numbers‑driven or quantitative data‑driven. Qualitative is a really important piece of the puzzle. KariLynn Dowling-McClay So how I look at research now: it’s numbers and it’s stories. And qualitative is the story side of research. With qualitative, you can do a deep dive into a topic—maybe a challenge that a community or population is having—and you can find things you wouldn’t have found just by crunching numbers. KariLynn Dowling-McClay An example: I have an ongoing project investigating pharmacist prescribing of contraceptives—something pharmacists can do in Tennessee and several surrounding states. But in practice, it's not happening much, even though the state authorizes it. KariLynn Dowling-McClay This is a multi‑pronged research project involving many students over the years. One piece was interviewing community pharmacists to find out what they think about the state law, why they may not participate, and what would help them participate. Generally, they think it's a good idea—but where is the disconnect? KariLynn Dowling-McClay To answer that, we needed to talk to the people in the group—community pharmacists. We recruited them, brought them in person or on Zoom, turned on a recorder, asked a bunch of questions, and recorded everything again and again and again. KariLynn Dowling-McClay Qualitative research is rigorous—even though it’s not number‑based. You ask the same questions repeatedly until you keep getting the same answers. That's data saturation. Then you analyze the recordings for common themes. KariLynn Dowling-McClay By doing that first, we could then better design a survey for a larger group, diving deeper into the questions. I see qualitative and quantitative research working together for full‑perspective research. Michele Williams That sounds really interesting. Stephen Woodward So you teach a research elective at the college. What can students expect in that class? KariLynn Dowling-McClay Yes. I may be biased, but I think it's a lot of fun. They get to do research with me outside the classroom. I offer the Pharmacy Practice Research elective series. KariLynn Dowling-McClay What's unique is that pharmacy practice research is research, but it may be totally different from what students picture. We don’t have a lab or animals or cell lines or fancy equipment. We're out in the community doing research with people and pharmacy systems. KariLynn Dowling-McClay There’s a lot of human interaction, but also a lot of independent work. I always tell students—as long as they have an internet connection, they can do most of our research from anywhere. KariLynn Dowling-McClay Once oriented, we meet every other week, and between meetings they work toward goals to push the project forward. It’s flexible, independent, and hands‑on. Michele Williams I can understand why that's such a popular elective. If a student is interested in doing research with a particular professor who doesn’t teach a research elective, is it still possible to do research with that professor? KariLynn Dowling-McClay Great question. Yes—there is more research happening than what shows up in the elective menu. Every faculty member has different duties and different amounts of research time. KariLynn Dowling-McClay I offer a lot because my job is 50% research. But others may only have 5–10% research time, so they might not advertise opportunities. KariLynn Dowling-McClay I always tell students: there’s no harm in asking. And you won’t know unless you ask. Reach out with a professional email, explain your interest and how it aligns with their research, and ask if opportunities exist now or in the future. KariLynn Dowling-McClay You’re also building rapport. A professor may think of you later when a new project starts. Michele Williams So that's great advice. If a student does that, can they get any sort of academic credit? KariLynn Dowling-McClay Yes, absolutely. Students can still register for research elective credit. It’s almost like a hidden option—no guarantees, but when available, students receive credit for the work. Michele Williams Okay, a little inside info there first. KariLynn Dowling-McClay Yes! It’s like the hidden menu at a coffee shop—you just have to ask. Michele Williams Like the veggie burger at some restaurant. Yes. KariLynn Dowling-McClay Exactly—they don’t advertise it, but it may be available. Michele Williams That's great. And on a personal note, I happen to know that you're really fond of chickens. Not eating chickens—you don’t want to be eating chickens—but as pets. Can you tell me the story behind your fondness for chickens? KariLynn Dowling-McClay Yes! Chickens just make me so happy, and I probably talk about them too much. I grew up in a small town in Montana where animals were a big part of life. We had horses, dogs, sheep, goats—lots of animals. KariLynn Dowling-McClay I was fascinated by birds, and some neighbors had chickens. I loved observing them: they all looked different, acted differently, had distinct personalities. I begged for chickens, and my parents made me study, plan, and save for a year before letting me get them. KariLynn Dowling-McClay When I finally did, I was so proud. I raised them through middle and high school, took them to the county fair, did all the chores. Chickens are more entertaining than people realize. They have different intelligence levels—you have smart troublemakers and simple ones who get stuck in corners. Stephen Woodward Those would be my favorite. KariLynn Dowling-McClay Honestly, they're better than TV sometimes. I'd just stand outside watching my chickens—that was my entertainment. Stephen Woodward Are they loud? If you live in a small neighborhood, would they cause problems? KariLynn Dowling-McClay They can. My neighbors have some secret chickens that I think aren't allowed where we live. I personally love it—it makes me feel at home. But yes, chickens are noisy. Not just roosters—they all make lots of noises. Michele Williams Having a pet bird, I know there's a lot of flapping and screeching. KariLynn Dowling-McClay Yes—that translates completely to chickens. Michele Williams That’s how they communicate they are not pleased with something. KariLynn Dowling-McClay Yes. Michele Williams Doctor Dowling-McClay, thank you for joining us today. It was a pleasure speaking with you and learning more about you. Stephen Woodward Thanks for listening to White Coat Radio. If you haven't already, be sure to subscribe and leave us a review wherever you listen to podcasts. To learn more about East Tennessee State University Bill Gatton College of Pharmacy, visit us at etsu.edu/pharmacy or follow us on social media @ETSUPharmacy. We'll see you next time.  

Check out Part 1 of our interview with Dr. KariLynn Dowling-McClay, Assistant Professor of Pharmacy Practice at East Tennessee State University Bill Gatton College of Pharmacy. Dr. Dowling-McClay explains professional identity formation, imposter phenomenon, and the role those play in the lives of student pharmacists. She also shares her own journey to becoming a professional pharmacist.  Transcript Introduction Teaser: KariLynn Dowling-McClay Doing that job, I had never felt more connected to the community and a sense of responsibility for the well-being of the community. Main Episode: 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. I'm one of your hosts, Doctor Michele Williams, assistant professor and director of academic success. Stephen Woodward And I'm Stephen Woodward, marketing and communications manager. Today we are talking to Doctor KariLynn Dowling-McClay, assistant professor of pharmacy practice again. Her interests include women's health, substance use disorders, and public health. Welcome to White Coat Radio, Doctor Dowling-McClay. KariLynn Dowling-McClay Thank you. I'm excited to be here to talk with you all. Michele Williams I've learned so much from you. One of the things that I think is a favorite topic of yours is professional identity. And so I thought maybe we could talk about that a bit today. And just kind of in general, what is professional identity and what role does it play for student pharmacists? KariLynn Dowling-McClay Sure. I think it's a really interesting topic. And you're correct—it's something I've enjoyed bringing into the classroom. And honestly, I'm still learning about it. So every year when I first come to the topic again, I have more to add, I have some new perspectives, so it's one of those fun ones where it just keeps evolving. But it is a concept that really exists for any profession that's out there. KariLynn Dowling-McClay So that includes pharmacy, other health professions, and even things outside of health care, like lawyers—really any group that is united by the career they do or something they have in common. And so the process of professional identity formation for student pharmacists is going through this internalization of thinking, acting, and feeling like a pharmacist. KariLynn Dowling-McClay So it's really the idea that they start out as a student. They want to become a pharmacist. But what is this process that they go through to actually be a pharmacist by the time that they graduate and go out into their career? And so I think for a lot of students—and it would be myself included when I went to pharmacy school—I knew I was going through this four‑year curriculum, working really hard, but I kind of felt like I was just a student. And then at graduation or the day after, I would be a pharmacist, like I was just flipping a switch. KariLynn Dowling-McClay Which is, yes, flipping a switch—but actually there’s evidence that shows it’s a continual process that really starts from the moment someone is welcomed into a profession. Michele Williams Wow. KariLynn Dowling-McClay So yes—and it could even be earlier for students who have worked in pharmacy environments or had exposure before school. It may start at different times for different students, but definitely by the time they come here for orientation, they're all on that journey together. And like I said, it’s an internalizing process. KariLynn Dowling-McClay Everything they're doing is contributing to how they will use thought processes to solve problems like a pharmacist. It's their sense of belonging—feeling like they're a member of the profession. In recent years, we’ve tried to bring that to the forefront to help students be aware this process is happening. That awareness can also help in times they might struggle with belonging or feel discouraged. Michele Williams That makes so much sense. And I imagine there are times when a person really starts to feel like a pharmacist or really feels like they're thinking like a pharmacist—and then times when they don’t feel like that, or feel like they’re pretending to be a pharmacist… like imposter phenomenon. KariLynn Dowling-McClay Yes, yes. And unfortunately, I think that is a pretty universal experience. It will hit at different times for every person going through this process. But part of that process is going through those feelings of doubt and coming out the other side and realizing that you do belong in that profession—that you actually are a member of that profession and you're not just portraying that. Michele Williams Not fooling people. KariLynn Dowling-McClay Right. You actually are. And this has been studied some in pharmacy and a whole lot in medicine and nursing. The scientific field is still learning more about it, but it seems to be a common experience or a common way of understanding how students reach that endpoint of being a member of the profession. Michele Williams Yeah, it's good that that's being studied now, because I'm guessing that for a long time people thought they were the only one who felt like they were pulling something off. KariLynn Dowling-McClay Yes. Those feelings of imposter phenomenon or feeling like you don’t belong can lead to a lot of doubt—and it can be very isolating. Something we try to do in the program is help students realize they’re not alone when they struggle with those feelings. Guaranteed, there are other people in the room who are or have or will feel the same way. Stephen Woodward That's really interesting. So what got you interested in that topic to begin with? KariLynn Dowling-McClay Honestly, it wasn’t something I had ever heard about as a pharmacy student. Looking back, I know I went through the process, but I didn’t know there was a term for it or that it was a formal concept. It really wasn’t until I became a faculty member and started interacting not just with pharmacists but with educators. KariLynn Dowling-McClay Through pharmacy education conferences I started hearing these buzzwords—PIF, professional identity formation. Once I heard it again and again, I felt like, okay, there must be something here I need to know about. KariLynn Dowling-McClay I dug into it, went to talks, looked up resources. The more I read, the more it clicked that it is something always happening for our students, whether we acknowledge it or not. KariLynn Dowling-McClay I like to lift the hood on the car for students—not keep everything behind the scenes. So just like we talk about educational outcomes, I like to talk about PIF and help students acknowledge the process while they’re experiencing it. Stephen Woodward What do you think causes that imposter syndrome for health care professionals? KariLynn Dowling-McClay I think part of it is a disconnect. When you're brand new to something, you don't know what you don't know. Then as you gain more experience, you learn some things—but you also become aware of all the things you haven’t mastered yet. KariLynn Dowling-McClay When there's that imbalance, it weaves into imposter feelings. People think, “I can’t think like this, I can’t solve these problems,” when really they’re just learning. That’s part of becoming the professional—they’re still growing toward that endpoint. Michele Williams Do you think comparing themselves to others fosters that feeling? Thinking someone else knows all the answers, or their parents are pharmacists, or they’ve worked in a pharmacy for five years… What am I doing here? KariLynn Dowling-McClay I think that's actually a huge part of it. Our society and educational system prime young people to measure themselves against others constantly. Many things students must do to get into pharmacy school involve measuring up. KariLynn Dowling-McClay You can’t just turn that off. You have to reframe how you see yourself, and not always be in competitive mode. KariLynn Dowling-McClay And students are surrounded by people they want to emulate—faculty, preceptors. They’re fully developed pharmacists. But students may not realize those role models had steppingstones too. They struggled in school too. Michele Williams That's great. Thank you so much for sharing that. In addition to the PD course that you and I co-coordinate, what are some of the other courses in which you teach? KariLynn Dowling-McClay I think I have a really fun job because I get to pop up in some unexpected places throughout the curriculum. I love working with P1s in the PD series. But I also get to teach women’s health topics—early on in self-care in P1 spring, and later in pharmacotherapy. KariLynn Dowling-McClay I usually work with groups in the communications course or the APP program. And I take fourth-year students on an academia rotation. They spend a month with me at the college—not as students, but seeing behind the curtain how we do our jobs as educators. Michele Williams That's great. Stephen Woodward Recently you spoke to incoming P1 students and asked them to reflect on the question, “Why are you here?” What is the why that led you to become a pharmacist? KariLynn Dowling-McClay This is a fun exercise. I wish someone had advised me to do this when I started pharmacy school. Honestly, maybe someone did—I just didn’t listen. KariLynn Dowling-McClay Sometimes it's hard to put into exact words, which is why writing it down helps. For me, my “why” comes from a deep sense of caring for the community and wanting to find my role in making the community as healthy as possible. KariLynn Dowling-McClay Before this conversation, I pulled out my pharmacy school application essay. I wanted to see what I wrote back then. To my relief, I used very similar terminology. KariLynn Dowling-McClay At the time, I had started working in a community pharmacy to make sure that’s what I wanted to do. I wrote about how doing that job, I had never felt more connected to the community and felt a responsibility for the well-being of the community. That thread has carried through my entire career. Stephen Woodward Okay. Thank you for sharing. Michele Williams Thanks. What do you think inspired that desire to be of service to the community? KariLynn Dowling-McClay For me, it’s rooted in my upbringing. My dad is a pharmacist—he’s retired now—but he worked in community pharmacy in our hometown for close to 40 years. KariLynn Dowling-McClay Growing up, everywhere we went—dinner, shopping—he’d run into someone who knew him as their pharmacist. Most conversations weren’t health related. He was just well known, well liked, held in high esteem because of his care. KariLynn Dowling-McClay I grew up in a small Montana town where community mindedness was baked in—what do we do for each other because we all know each other? KariLynn Dowling-McClay I probably didn’t realize it at the time, but those experiences made me see that if I wanted to do something meaningful for my community, pharmacy was a powerful way to do it. Michele Williams Wow. That's great. Doctor Dowling-McClay, thank you for joining us today. It was a pleasure speaking with you and learning more about you. Stephen Woodward Thanks for listening to White Coat Radio. If you haven't already, be sure to subscribe and leave us a review wherever you listen to podcasts. To learn more about East Tennessee State University Bill Gatton College of Pharmacy, visit us at etsu.edu/pharmacy or follow us on social media @ETSUPharmacy. We'll see you next time.  

Interview with Dr. David Roane.

We continue our conversation with Dr. Jessica Burchette, Associate Professor of Pharmacy Practice at East Tennessee State University Bill Gatton College of Pharmacy, and dig deeper into the pharmacotherapy and patient care course. She is a clinical pharmacist who helped lead the recent curriculum changes at the college. 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. I'm one of your hosts, Doctor Michele Williams, Director of Academic Success, and my co-host is Stephen Woodward, our Communications and Marketing Manager. Michele Williams Hi, Stephen. Stephen Woodward Hey, Doctor Williams. Joining us today is Doctor Jessica Burchette. Doctor Burchette is an Associate Professor of Pharmacy Practice, and she was selected as the Distinguished Faculty in Teaching at ETSU in 2023. She was also the keynote speaker at ETSU commencement in December of 2023. Doctor Burchette coordinates the Pharmacotherapy and Patient Care course that takes place during the fall of the second professional year. Doctor Burchette, welcome to White Coat Radio. Jessica Burchette Thank you so much for having me. I'm excited to be here, Stephen. Stephen Woodward Well, can you start by telling us a little bit about the Pharmacotherapy and Patient Care course? Jessica Burchette Yes, absolutely. This is one of the courses that I'm most excited about with our new curriculum. It is a four-course series that starts in the fall of the second professional year, as you mentioned in your introduction. The goal of this course is to start out with very common diseases that our patients have — things like high blood pressure, diabetes, coronary artery disease, influenza, GERD, even heartburn. We're starting students out in a stepwise approach, and we're trying to really wade them into the water of being a clinical pharmacist and thinking through patient issues clinically. Starting out with a single disease state and then beginning to layer those disease states with each other so that we're not teaching in a silo — we're not learning about one disease state and then forgetting about that and moving to the next disease state. Everything continues to build. So our students started out this year with very basic topics that I actually taught — allergic rhinitis, which is just seasonal allergies — and then moved into things like heartburn. Then they started talking about lipids, cholesterol, and hypertension. Now they're talking about coronary artery disease, which is impacted by people who have hypertension and lipid problems. You can see how we're continually growing and building that repertoire and moving things forward. The goal is that by the end of the four-course series, students can rattle off any information they need to take care of a patient with those basic core disease states, and then begin implementing more complex patients as we move through. The series actually ends with patients who have cancer or other types of oncologic issues. So taking care of a patient that has a very acute disease state — but they still have high blood pressure, they still have heartburn — and making sure that you can look at all those medications safely and decide what's best for a patient. Michele Williams So you mentioned that this course is part of a four-part series. What can students expect from the series beyond just getting more complex as it goes along? Jessica Burchette Right. I think that's a great question. Our goal in this series is that we slowly provide students with more opportunity for self-growth. We're starting out teaching students how to read medical literature and where to find guidelines. As we move through, students will be able to take that information and interpret it on their own without the faculty member picking out the most important pieces. We're really trying to teach students how to teach themselves — slowly removing some of those guardrails and allowing more free thought and self-expression. By the end, students should feel like they have the power, authority, and autonomy to look at a patient and very confidently say, “I feel like there's something here that I can contribute to this patient based on my own thought processes.” Stephen Woodward What should students do to be successful in the course? Jessica Burchette This entire course series is built around team learning — taking small teams of students and giving them patient scenarios or complex questions to think through as a group. The first thing students can do is really lean into that. Ask good questions. Participate with your group. I always tell students that thinking out loud in learning is like going to the gym and paying someone to teach you how to properly lift weights. They have to see you do it in order to correct your form or encourage the direction you're moving in. As faculty, we really view ourselves as personal trainers of how you're going to think through problems. The only way we can help you with that is if you speak and really engage in the process. Participate in class. Participate with your small groups during case discussions and facilitated exercises. And do the pre-reading. That is a big difference in this course compared to what we've done in the past — asking students to do a small amount of pre-work prior to coming to class so they're ready to engage. It allows us to maximize class time while also giving students practice in digesting material for themselves. It may not be comfortable at first, but so far, the students are doing a great job. It really shows in their performance and the way they're able to engage with us in the classroom. Michele Williams Prior to the new curriculum, students were taking the Integrated Series, which was comprised of discrete courses like pulmonary, renal, and cardio. How has the focus shifted from those separate courses into this integrated series? Jessica Burchette That's a great question. The Integrated Series became very compressed and very classroom-heavy. Students might have only three weeks to cover everything related to the renal system — pharmacology, medicinal chemistry, and therapy — all at once. It was a sprint. Courses never overlapped, and there was never a passing of the baton from one course to the next so information could build. We also determined that spaced retrieval of information is so important to learning. In the previous model, students would learn pharmacology one day and therapy the next without time to digest. When you understand how a drug works and how the body works, it makes sense why we use certain drugs — but they didn't have time to process that. Now we've separated pharmacology and medicinal chemistry into a three-semester core series. Then students move into pharmacotherapy, where they apply that information to treating patients. We've also reduced classroom seat time. We realized we can't expect students to prepare effectively after sitting in class for eight hours. No one has that kind of mental capacity after being mentally fatigued all day. Previously, we as faculty sometimes defaulted to saying, “I know you didn't have time to read, so here's what you need to know.” We were feeding information rather than allowing students to interact with it. With the new curriculum — and with Doctor Williams’ help — we've been more intentional about balancing seat time with independent learning. Students now have less classroom time, more time to digest information, and more time to engage with the community through flu clinics, blood pressure checks, and senior center activities. That experiential learning is just as important as classroom learning. Michele Williams One of the things I noticed when sitting in on the class is how it facilitates students making connections across disease states and gives them time to reflect and build memory and retrieval skills. Jessica Burchette You've been instrumental in that. Faculty are often faculty because we love school — we're nerds. But not every student thrives in the same way. Doctor Williams has helped us see things from a student perspective and identify where what we intended didn't always match how students experienced it. The pharmacotherapy faculty meet every three weeks to discuss how the class is going, what issues we're seeing, and whether it's working the way we expected. That has been instrumental in continuing to grow the quality of the course. Stephen Woodward Is there anything else you'd like to add today? Jessica Burchette I've been really impressed with the way faculty have jumped in and gone the extra mile. I've also been impressed with the students and the quality feedback they've provided. We know it won’t be perfect the first time. Student feedback is so important. I've also been really pleased with the support from the Executive Committee, the Dean, Doctor Lugo, Department Chairs Doctor Stacy Brown and Doctor Sarah Thomason, and Doctor David Stewart over Academic Affairs. Everyone has stepped back and said, “We’re ready to do what we need to do to make the best graduate for our community and for the pharmacy profession as a whole.” It’s been humbling to watch everyone rally around this and build something special. We're already hearing great feedback from introductory pharmacy practice preceptors about how engaged and professional students are, and how they come in on day one with real skills. I can’t wait to see them move into their advanced pharmacy practice experiences and hear that continued feedback. It’s going to be amazing. Stephen Woodward Great. Michele Williams That’s fantastic. We did an earlier episode with Doctor Burchette about the curriculum, and this course really illustrates that curriculum in a microcosm. You’ve done such an amazing job leading the curriculum change and this course. We're very excited about the future and grateful you joined us today. Jessica Burchette Thank you for your support and your kind words. I appreciate the chance to share these thoughts with you and with your listeners.

Check out Part 1 of our interview with Dr. Jessica Burchette, Associate Professor of Pharmacy Practice at East Tennessee State University Bill Gatton College of Pharmacy. She is a clinical pharmacist who helped lead the recent curriculum changes at the college.    Transcript: Stephen Woodward: Welcome to White Coat Radio, a podcast from East Tennessee State University Bill Gatton College of Pharmacy in Johnson City, Tennessee. Every 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, Doctor Michele Williams, Director of Academic Success, and my co-host is Stephen Woodward, our Communications and Marketing Manager. Stephen Woodward: Hi, Stephen. Michele Williams: Hey, Doctor Williams. Stephen Woodward: Joining us today is Doctor Jessica Burchette. Our listeners may know Doctor Burchette as an Associate Professor of Pharmacy Practice, but they may not know that she’s a Gatton alum and was a graduate of the inaugural class at Gatton. She was also selected as the Distinguished Faculty in Teaching at East Tennessee State University in 2023. One of her many roles at Gatton is Chair of the Curriculum Steering Committee. So when we began implementing our new curriculum, she led those efforts, and that’s what we’re here to talk about today. Doctor Burchette, welcome to White Coat Radio. Jessica Burchette: Thank you, Doctor Williams. I’m so excited to be here with you both today. Michele Williams: So we’ll start with the basics. Tell us, what is a curriculum, and what does it mean to change it? Jessica Burchette: That is a great question. I think of a curriculum as one of two things. One is a roadmap. We have a goal in mind that all of our graduates will be excellent pharmacists who take care of the public and serve their communities, and so we need a roadmap to make sure they get there efficiently, in the right order. The other thing a curriculum is, to me, is like packing a suitcase. If you're going on a trip, you need the right proportion of the right things in order to be successful at your destination. And so when we’re thinking about a curriculum in terms of education, it’s both the science skills — understanding how the body works and how drugs work — and also understanding how to implement those and communicate those to patients, how to communicate with other health care professionals, and how to make good decisions financially and with the resources that patients might have. And so there’s a lot of different aspects to a curriculum, and our job is to make sure we have all those placed at the right time, in the right order, and in the right proportion to give our students the launch that they need to move into their careers. Stephen Woodward: So when did Gatton decide to change its curriculum, and why? Jessica Burchette: That’s a great question. I think a curriculum should always be dynamic. It should never be stagnant, because as new things change and as we learn new things about medications and how to best treat people, our curriculum should change as well. However, what we’re talking about today is a big change, because we revised our curriculum to have a totally different outlook and mindset compared to what we’re calling our legacy curriculum. I would say this began around COVID. That’s a marker that everyone remembers. We were starting to see in our graduates maybe some places where our curriculum was not meeting their needs as quickly as it could. So we sat down as a faculty and asked, what is our goal? What are we trying to create? What can we be really good at? Here at Gatton, we can be really good at creating pharmacists who can impact their communities the day they graduate. They should not need extra training to be practice-ready. While many of our students choose to pursue additional training and have great success, we want to make sure that when our students leave here, they are ready to impact their communities immediately. And so we asked, what are the key things a pharmacist should know at graduation? And that question really drove our curricular change. The other driver is that things are always changing in medicine. We’re always learning, and so we need to teach our students how to teach themselves once they graduate, because the information we teach them will be out of date quickly. They need the tools and the skills to go out, learn new information, and digest it as it becomes available. So those were really the two main drivers of changing our curriculum. Michele Williams: Curriculum change sounds like an enormous task. Can you walk us through the mechanics of how you changed it? Jessica Burchette: That is a great question. I’m fortunate to lead a Curriculum Steering Committee made up of faculty who truly want to put students first. That was instrumental in making such an enormous change possible. We started by going back to our mission and vision. What is Gatton here to do? What makes us unique? And how do we lean into that? Then we mapped out what we believed to be the most important competencies and outcomes for our graduates. Once we had that big picture, we worked backward. We asked, what foundational knowledge needs to happen first? What skills need to be layered in? Where do we need repetition? Where do we need integration? It was not a quick process. It involved a lot of meetings, a lot of discussion, and honestly, a lot of humility — because sometimes we had to admit that something we had done for a long time might not be the best approach anymore. We also gathered feedback from alumni, preceptors, and students. We asked them where they felt strong and where they felt less prepared. That external feedback was really important in shaping the direction we took. Then came the work of restructuring courses — deciding what to move, what to combine, what to expand, and what to remove. And that part required collaboration across departments, because no one course stands alone. So mechanically, it was a lot of mapping, revising, presenting proposals, getting approval, revising again — and continuing to refine as we implemented. Stephen Woodward: That sounds like a huge lift. Jessica Burchette: It was. It was. But I will say that it was energizing, too. When you get a group of people together who all care deeply about student success and the future of the profession, it’s motivating. And we’ve continued to adjust as we go. Curriculum change is not something you do once and then walk away from. It’s something you continue to evaluate and refine.

Hear from Dr. Shelby Brooks, one of the newest editions to faculty in the Department of Pharmacy Practice at East Tennessee State University Bill Gatton College of Pharmacy, and learn about her clinical interests as well as her obsession with Harry Potter!   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. I'm one of your hosts, Doctor Michele Williams, and I'm joined today by one of my co-hosts, Stephen Woodward, our Marketing and Communications Manager. Hi, Stephen. Stephen Woodward: Hey, Michele. Michele Williams: In this episode, we'll be talking with Doctor Shelby Brooks, one of the newest additions to the faculty in the Department of Pharmacy Practice here at Gatton. Doctor Brooks, welcome to White Coat Radio. Shelby Brooks: Hi. Thank you so much for having me. I'm excited to be here this morning. Stephen Woodward: Doctor Brooks, can you start by telling us what brought you to Gatton and a little bit about your background? Shelby Brooks: Absolutely, yes. So before I moved to Johnson City, I lived in Shreveport, Louisiana, and I was also an Assistant Professor at University of Louisiana Monroe on their Shreveport campus. So I've been in academia for about three years now. Really enjoy it. Teaching is definitely one of my passions. And then moving to Johnson City, I really wanted to get back closer to family. So my family is from the Asheville, North Carolina area, and they live in Marshall, North Carolina now, so it's only about 45 minutes away. So I had been thinking about wanting to move closer to the area, and I saw this job posted, and so it seemed to be a really good fit with working with family medicine and getting back to an area that I really loved. I also lived in Knoxville for six years to finish up pharmacy school and to do residency. So I was really excited to get back to the area. Once I had my interview here, it really solidified it for me. Everybody was so welcoming, and I felt pretty much part of the faculty even on my interview day. So it worked out really well, and I'm excited to be here and to get started again. Stephen Woodward: That's good to hear. Thank you. Michele Williams: So in what courses can students expect to see you? Shelby Brooks: Yeah, we are still working that out a little bit, but as of right now I will be in the new pharmacotherapy series. So I'll be in Pharmacotherapy One with the P2s this fall, and I'll be teaching coronary artery disease. So they'll get to have me for about two weeks in the classroom. And then in the spring I'm also teaching Pharmacotherapy Two, and I'll teach ischemic stroke in that series as well. So again, with the P2s. I get to interact with the P1s a little bit. I'll be an IPPE One facilitator for that. And then I will also be a facilitator for the communications course that's starting in a couple of weeks. Michele Williams: Oh that's great. Yeah. Stephen Woodward: So you're also a practicing pharmacist. Can you tell us about that side of your working life? Shelby Brooks: Absolutely. Since residency, I have practiced with inpatient family medicine. That is absolutely my passion. I love working with the family medicine team. So when I was in Shreveport at my previous academic position, I also worked with an inpatient family medicine team. And then now that I'm here at Gatton, I'll also be working with inpatient family medicine, both at Johnson City Medical Center and at Holston Valley Medical Center. So working in the hospital, working with my team is definitely a huge passion of mine. I love being able to show that with the students and show them the type of pharmacy that I practice, and showing them that you can practice at the top of your license. We see any and all disease states. So family medicine patients tend to be some of the sicker patients in the hospital, besides critical care type of patients. They just have a lot of disease states, and they tend to be a bit of an underserved population, so not as much access to healthcare as maybe a traditional type of patient. So we really get to dive into all different kinds of disease states with a family medicine team, and that's what I love about it. It keeps me busy. I don't get bored. There's always something new going on. Stephen Woodward: If I can ask a follow-up question to that, to speak maybe to the prospective student to Gatton who's weighing different career paths in health sciences, what would you tell them about the importance of pharmacy and the different career paths available to them? Shelby Brooks: Yeah, I think pharmacy in general as a career, just as a career path, and the different things that you can go into in pharmacy, really the basis of that is being the medication expert. And so I'm sure that the new students and students that are enrolled here hear that all the time, and prospective students will too. But that's a really important thing when you look at other professions. So like physicians that you're working with, nurses, any kind of other health profession, they really only get a semester or two of pharmacology. It's not even like pharmacotherapy. So it's really important for us to be able to come into an interdisciplinary team and use that medication expertise to provide the best care possible to our patients. It seems like a small thing when you're talking about it, but it's really not. And when you get into an interprofessional team and they've not worked with a pharmacist before, it tends to be a bit of a mind-blowing thing for them to have access to us. So it's really important, and I would say definitely take pride in what you do as a pharmacist, because a lot of other health professions really appreciate what we do. Michele Williams: Cool. Thank you. Yeah. Sounds like they rely on the pharmacists. Shelby Brooks: Absolutely. Yes. There are definitely things like when they are working with a pharmacist, a lot of the times they don't think about what the blood sugars are looking like. They don't think about what the blood pressures are looking like either. A lot of that stuff can kind of fall on us as the pharmacist, and we can make those recommendations to the team, and they really appreciate it. Michele Williams: It's great. So during our Getting Ready transition weeks, which we just finished at this point in the year, you gave a great piece of advice to our incoming P1s, which was to not be afraid to say hello to someone. And you emphasized the importance of networking. Can you talk a little bit more about networking when you were in pharmacy school and beyond, and how that can benefit you when you're a student pharmacist or a newly minted pharmacist? Shelby Brooks: Yeah, absolutely. I know that networking can be a scary word, so please don't be afraid of it. Really, all that networking is, and it's why I put this piece of advice, it's just saying hello to someone. It is the easiest way to learn about different people in your profession, learn about different people that you're working with that maybe aren't a pharmacist, but they're still going to be in your work circle. And so that's really important. When I was a student, I started networking by getting involved in my student organizations. So I was in a pharmaceutical fraternity, and then I also was heavily involved in APhA when I was a student. I pursued leadership positions within those organizations. I wouldn't say that you have to pursue those types of positions, but go to the meetings. Go to the annual meetings. Go to the Grand Councils, all kinds of different things. For APhA, go to those meetings. And be willing to just go and say hi to someone, whether it's another student in a different chapter, whether it's another professor, it really doesn't matter. And the cool thing about professional meetings, if you are able to go as a student, is that people want you to talk to them. Professors want to talk to you about what they're doing in their pharmacy practice. Other students want to tell you what's going on with their chapter, with whatever particular organization's meeting that you're at. They want to tell you these things. And the more that you're willing to just go and talk to someone, the more connections that you can make, and you absolutely never know what those connections are going to help you do later in your career. So as an example, I got involved with ACCP when I was a student. I was involved with ACCP as a resident as well, and I joined some of the committees and different divisions. Within one of the committees that I was in, I actually got a job offer initially when I was coming out of residency. I had worked with her on a couple of projects for the committee. She knew how I practiced, and she knew the type of residency that I was in. And when the position at her institution became available, she emailed me personally and was like, I think this would be a good fit for you. Please consider applying. So you never know what's going to happen. Definitely say hi to someone. Network, and then stay in touch with them as well. Stephen Woodward: It's great advice. Michele Williams: Yeah, that does sound like really good advice. And something that you're clearly good at. So just as a side note, you and I met when you came for your interview, and I can remember thinking that you're so easy to talk to and very engaging. And that has an impact when you're looking for a job, that sort of ability to connect with people and talk with them. And I get the feeling that maybe because you put yourself out there and you've practiced a little bit over the years, kind of figured out what feels comfortable for you. And I think that's probably true of anybody, that you have to find what your style is and what you're comfortable with, and then just like you said, say hello. Shelby Brooks: So yeah. And like I, I'm definitely, I consider myself an extroverted person. So I love being around people. I get very energized being around people. But you don't have to be an extrovert to network well. And that is definitely a point that I want to emphasize. You don't have to be extroverted. And I did practice when I was a student. I had my little elevator speech for the different residency showcases that I went to and all that stuff. So if you put a little time into it, a little bit of practice, practice within your friend group, you're going to become really good at networking and being able to go up and talk to those people and make connections. Michele Williams: Awesome. Stephen Woodward: So what are you most excited about in teaching again? Shelby Brooks: I am really excited to get into the pharmacotherapy series. Pharmacotherapy in general and teaching that type of stuff is really what I'm passionate about. I did a pharmacotherapy residency for two years, so anytime I can get into the therapy and all those things, I really enjoy that. I also eventually want to develop an elective. That's something that's kind of on the page over the next few years, kind of determining that. I'll be very honest, I have no idea what it's going to look like right now. Probably something inpatient-focused, but just not really sure the direction. But it definitely is part of my goals here in the next few years while I'm here at Gatton. Michele Williams: Yeah. Are there any other things that you would like for our listeners, and especially our Gatton students, to know about you or to share with them before we finish up today that we haven't talked about yet? Shelby Brooks: Absolutely. I'll get a little nerdy here so you can learn about me as a person and not just a pharmacist for a minute. I'm a huge animal lover. I'm also a huge Harry Potter fan. Since I was a child, I used to go to the midnight book premieres. So I'm aging myself a little bit, but it was the best thing when I was growing up. So my pet names. I have two dogs. One of them is named Neville, like Neville Longbottom. One is Rowena, like Rowena Ravenclaw. And then I have my cat. Her name is Minerva, like Minerva McGonagall. So obviously very obsessed with Harry Potter. Huge animal lover. So if you ever want to talk about those things, please feel free to stop by my office. I'm always happy to nerd out and to geek out, really, about books in general. So anybody who's a reader, please come and talk about it. Stephen Woodward: Or if you're into Harry Potter, did you know about the House program? The in the wellbeing program? Shelby Brooks: I did. I found out about that. I am not shy about my Harry Potter fanaticism. And so when I was interviewing, I heard about the Harry Potter — like the Potter houses and the sorting and stuff like that. So I'm very excited to learn more about it. And I know there's a sorting ceremony this week, right? It's Friday. Yeah, very excited to hear about it. Michele Williams: You really fit right in here. Absolutely. Well, Doctor Brooks, thank you so much for joining us today. This has been a great conversation. Shelby Brooks: Yeah. Thank you so much for having me. Stephen Woodward: It's great chat. Yeah.  

Listen to this interview with Class of 2022 alumna Dr. Kaitlyn North, who returns to her beloved East Tennessee State University Bill Gatton College of Pharmacy not to visit but as one of the newest editions to faculty in the Department of Pharmacy Practice. Transcript: Stephen Woodward: 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. I'm one of your hosts, Doctor Michele Williams, and I'm joined today by one of my co-hosts, Stephen Woodward, our Marketing and Communications Manager. Hi, Stephen. Michele Williams: Hey, Doctor Williams. Stephen Woodward: In this episode, we'll be talking with Doctor Kaitlyn North, one of the newest additions to the faculty in the Department of Pharmacy Practice here at Gatton. Well, she's a new addition to the faculty. She's not at all new to Gatton. She graduated from the Bill Gatton College of Pharmacy in 2022. Doctor North, welcome to White Coat Radio. Kaitlyn North: Thank you so much. Michele Williams: So this probably feels like homecoming, I imagine. Talk about your journey from student pharmacist now coming back as faculty. Kaitlyn North: It definitely feels like a homecoming to be back here. I'm very thankful to be back here. When I was a student pharmacist, I was really into peds. I thought, I'm going to be a pediatric pharmacist. And then as I progressed in the curriculum, I started liking the adult disease states more. So during my P4 year, I really solidified that I wanted to go into ambulatory care. So I matched to my outpatient-focused PGY1 residency in South Carolina. That was a rural program. So I thought my skills that I learned and our mission really helped me there. I practiced at a federally qualified health center, which is like the Johnson City Community Health Center across the street. But I kind of describe it like a fancy health department. We didn't turn anyone away for inability to pay, anything like that. We did sliding scale fees, things like that. So that really helped me sharpen my rural health skills and definitely helped my ambulatory care skills, being savvy with medication cost, things like that. And then I did a PGY2 in ambulatory care at the University of Tennessee Medical Center in Knoxville. I think that also helped me with Indigenous populations. We had a lot of people come from all the surrounding rural areas to Knoxville because that is our academic medical center, and towards Middle Tennessee. So I saw people from Kentucky, Virginia, North Carolina. That was a really good opportunity for me to also sharpen my ambulatory care skills with some of the more niche clinics like cystic fibrosis and specialty clinics like rheumatology and advanced lipid management, things like that. But I was definitely ready to come home to Gatton. I feel like I'm ready to apply the skills I've learned elsewhere back here. Stephen Woodward: Thank you for sharing. Yeah. So for our current students who may be interested in teaching, what advice would you give them regarding preparing for a teaching career now while they're in pharmacy school? Kaitlyn North: I would definitely recommend taking the academia APPE. No matter who you get, you're going to get to go to faculty meetings. I know Doctor Alexander always says it's like pulling the curtain back and seeing how Disney works. I think that's true. I enjoyed that. Another thing that's really important that I feel helped me sharpen some skills is in residency. Almost every program has a teaching and learning certificate. They call it different things, like Pharmacy Educator Academy, but it's basically your teaching certificate. They do teach you foundational things like how to write exam questions. A lot of them go over how to be a good preceptor, which is something we obviously don't have any experience with. So I think getting plugged in in those little ways, and then also a lot of times your residencies will let you be a guest lecturer. I know our residents at Gatton definitely get that. A lot of residents will give you as much as you want. Every college of pharmacy. I loved that. I was volunteering myself to help them. Faculty members typically don't have as much free time on their hands to help grade OSCEs and things like that. So I really think that volunteering myself for those extra things, both of my residencies were associated with colleges of pharmacy, so making those connections in this world. I know students roll their eyes, but pharmacy really is such a small world. So I think all those connections really helped me. Continuing education, things like that. I'll do extra CE and then attend meetings, things like that. So I think showing your interest and getting plugged in where you can makes a big difference, especially if you don't have that experience like I did not when I was applying for this job. Stephen Woodward: And it sounds like also that if you think you might be interested in teaching, those experiences might help you decide if that's what you'd like to do — an academic APPE would also let you know something that doesn't really interest you so much, or doing a certificate or something. So it might even be good if someone's trying to decide if that's what they want to do. Kaitlyn North: Absolutely. I had co-residents who were like, yep, this is not for me. And I think a part of academia that you might not realize until you're in residency is that medical residencies that are training physicians will also hire a pharmacist. And pharmacy students versus medical residents are very different audiences to teach. So I've seen some of my friends really enjoy teaching medical residents. My co-resident from UT that was in ambulatory care actually works for the internal medicine program at UT now. So she doesn't teach at the pharmacy school, not affiliated with them at all. But she's very academic because she's working with the medical residents and teaches them their didactics and things like that. So there might even be more avenues than you think if you're interested in teaching. Stephen Woodward: Oh, wow. I didn't realize that. Yeah, that's really interesting. Kaitlyn North: I do a little bit of didactic teaching for my residents in the family medicine clinic in Kingsport, as do Doctor Smith and Doctor Doll as well. Stephen Woodward: Great. Michele Williams: So in addition to teaching, you're also a practicing pharmacist. Can you tell us more about that side of your working life? And in addition to that, can you give us kind of the 10,000-foot view for prospective students about the different kinds of pharmacy practice that they might encounter? Kaitlyn North: I definitely thought I was either going into a hospital or a Walgreens when I graduated, and that is not the case. And that's perfectly fine if that's where you want to be. But yes, I love being a pharmacist. I love practicing. The majority of my time is spent in that clinic in Kingsport with family medicine. So a lot of my role is consultative. So a resident comes to me and they say, my patient's A1C is out of control. What medicines should I consider? I do a lot of counseling on things like that. The bread-and-butter disease states that I see and help with every day: smoking cessation, COPD, diabetes, high blood pressure. You know, I've had a heart attack. Now what do we do? That kind of thing. So I love being a jack of all trades with ambulatory care. I don't see myself as a specialist. I see myself as a generalist just in a clinic, which I love because it's something new every day. But a lot of specialized clinical pharmacists do find that niche, like ID, cardiology, something like that. Critical care. I think we're exposed well to the different career areas. It's kind of intimidating your P1 year, I think. We show you what is available as you go through more and more. Like I said, the more I learned, the more I shifted away from pediatrics. I'm sorry, Doctor Thigpen. My advice would be never too early to consider residencies. They all have websites. Kind of see if that's something you'd be interested in. You get the advice a lot that it's a year of your life, but it unlocks a lot of doors for you. There's a lot of cool positions. One of the girls I graduated with is a medical writer. So she works for a drug company and writes their literature and their key documents and things like that. So you would not think a pharmacist would be in that role. But I have some friends in industry that represent drugs and act kind of like a medical science liaison. There are a lot of interesting jobs out there. But yeah, the backbone is definitely community pharmacy. So if that's where you want to go, then I completely support that too. Michele Williams: If I can ask a follow-up to that along the same path, for prospective students who are weighing pharmacy against other health professions — medicine, physician assistant, those kinds of career paths — why should they look more closely at pharmacy, do you think? Kaitlyn North: That's a great question. I think if you're considering pharmacy, something to think about is it's really easy to shadow in the pharmacy. I worked as a pharmacy tech when I was an undergrad, and I really enjoyed that. I think pharmacists are — well, of course I'm going to say they're the backbone of the health system because I am one — but truly, we're the most accessible. You can walk into any independent or chain pharmacy and get medical advice right there. No copays, anything. I take joy in the fact that I help make decisions. I am responsible for them. But we don't have a lot of the strife that physicians do in terms of how many patients are you seeing in a day and things like that. I enjoy being someone that physicians lean on instead of someone that needs someone to lean on, if that makes sense. Stephen Woodward: Does make sense. Kaitlyn North: Thank you. Stephen Woodward: So we were talking a little bit about teaching and how you came to Gatton in an academic position. In what courses can students expect to see you? Kaitlyn North: That's a great question, especially because we just blew up and reconstructed our curriculum. My first year, I'm helping with skills labs with things you would see in ambulatory care, like smoking cessation devices, the inhalers, more hands-on labs. I'll be in the CGM, or continuous glucose monitor like Dexcom, that lab for students. In the spring, I'll be teaching the SOAP note writing portion for outpatient practice in the skills labs. After that next year, I don't know. That's the fun of being a generalist, right? I might teach gout. I might teach who knows what. But I probably will be popping in and out of the pharmacotherapy courses as they need me to. Stephen Woodward: That's great. Michele Williams: So talk about how you'd like to grow in this new position. What types of things would you like to do in the future? Kaitlyn North: That's something I've started doing is piling my goal list and my aspiration list. I really would like to start an ACCP, or American College of Clinical Pharmacy, student chapter here. That is the organization I've plugged into really meaningfully. They have an ambulatory care section, so I'm with like-minded people in there. We do interact with that organization through our Clinical Pharmacy Challenge, but I feel like I would have really blossomed in that as a student. So that's something in my five-year plan. I have probably groups and coworkers helping me with that. I'm definitely excited to continue with research endeavors with the rural population that I serve in Kingsport. Most of my patients, I believe, are on TennCare, which is our Medicaid, or Medicare. So we definitely have a population that is underserved. So I'm excited to have some projects brewing in my mind. I'd like to start at my clinic, but I need some time to get that going and get more settled. I really do want to be an integral part of our faculty and give back because I'm a very proud alumna. I would go to Gatton again in a heartbeat if I could. And I think that's because of the faculty that are now my colleagues. So I really want to give back in the ways they have. Michele Williams: Awesome. Stephen Woodward: That's great. And we're extremely excited to have you back here again and in this new role. And it sounds like lots of exciting things ahead for you. So that's terrific. And thank you for joining us today. It's been great getting to chat with you and learning a little bit more about you. Kaitlyn North: Yes. Thank you for having me. Also excited to get this invitation. Stephen Woodward: To this. Great.        

In this episode, we talk with Dr. Alex Surbaugh, one of the newest editions to faculty in the Department of Pharmacy Practice at East Tennessee State University Bill Gatton College of Pharmacy.   Transcript: Stephen Woodward 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. I'm one of your hosts, Stephen Woodward, the Marketing and Communications Manager at Gatton. And joining us is Doctor Michele Williams, Assistant Professor of Pharmacy Practice and Director of Academic Success. Welcome, Doctor Williams. Michele Williams Thanks, Stephen. Stephen Woodward In this episode, we'll be talking with Doctor Alex Surbaugh, one of the newest additions to the faculty in the Department of Pharmacy Practice here at Gatton. Doctor Surbaugh, welcome to White Coat Radio. Alex Surbaugh Thank you. Good to be here. Michele Williams So we're really excited to have you here as our guest. And I understand that your specialty is in psychiatry. Is that right? Alex Surbaugh That is, yes. Psychiatry. Michele Williams And can you tell us a little bit about your practice? Alex Surbaugh Yeah. So I'm just kind of getting started. For anyone that's worked with Doctor Thompson, I'm kind of taking over and doing a lot of what she does, but kind of expanding in terms of—we've added a new clinic. So Kingsport Internal Medicine, and then also I’ll be in Johnson City Internal Medicine. So I split two days in Kingsport, two days in Johnson City. Day to day, I’m kind of seeing patients and working with them on their psychiatric medication. So really kind of talking with them, getting to know what their symptoms are, working with their diagnoses, and then figuring out with the patient what the best medication plan moving forward is, and then kind of following up with them as needed and making sure that we're really doing our best to get care into all settings, especially for our psychiatric patients that may not be able to get in with a psychiatrist. And so really excited to kind of get started with that patient population and make a difference, hopefully, here in East Tennessee. Michele Williams That sounds great. Good. Stephen Woodward So what courses can students expect to see you in so far? Alex Surbaugh The neuroscience course—I will be teaching this fall—the bipolar lecture. So that'll be kind of my first big lecture to teach. And then also kind of helping in some of the skills labs, communications, interprofessional education, things like that. But hopefully we'll continue to kind of ramp up as time goes on. Michele Williams So what are you most excited about with regard to working at Gatton? Alex Surbaugh That's a really great question. I first came up to East Tennessee and Gatton in February for my interview. And so when I was here, the one thing that was really apparent was just how much of a family atmosphere is promoted here among the faculty, but also with the faculty in regards to the students as well. I love that people know students’ names, because I was a student on a distant campus, so I had a smaller subset of faculty that I really got to know, and that really impacted my journey as a student pharmacist. And so I would say that's one of the things I'm most excited about here at Gatton, is being a part of that family atmosphere and being able to build those connections with students as well. I know mentorship is so important, and having those people you can ask for advice on next steps. I'm like the first pharmacist on my side of the family, so I had no idea what really to be looking for or what was coming and what to expect. And having those mentors was great, and the faculty that I could reach out to. So really excited to get to know the students and work with them and build those relationships. Michele Williams Oh, that sounds great. Yeah. Stephen Woodward Well, tell us a little bit about your backstory. Where are you from originally, and where did you work prior to starting at Gatton? Alex Surbaugh I am from the Nashville area, so about 30 minutes south—born and raised in Franklin, Tennessee. Lived there all my life, and then went off to undergrad at the University of Mississippi. So I am a diehard Ole Miss fan. Football season is obviously coming up, so for me it’s an exciting time of year. But I spent four years in Oxford, enjoyed it, majored in chemistry, and knew that I wanted to do some sort of medicine. And so that led me to apply to the College of Pharmacy at the University of Tennessee so that I could start to make my way back home. So I spent a year in Memphis and then three years in Nashville on our distant campus. Once I finished pharmacy school, I knew I wanted to get out. I think it's really important—and it was really cool to me—to see practice somewhere different. And so I moved out to Kansas City and lived in Missouri but worked in Kansas at the University of Kansas Health System. So I did my general PGY1 training there—just very generalized—and then specialized. So I really committed, stayed, and did my PGY2 year in psychiatry at the University of Kansas as well. So now I'm kind of making my way back to Tennessee, and that was always the plan. So here we are, back in East Tennessee now. Stephen Woodward Thank you. Michele Williams That's great. So it sounds like you considered Tennessee home. And what drew you to Gatton in particular? Alex Surbaugh Well, I will say, like I said, we knew we wanted to come to Tennessee. We knew we wanted to get back home. And then I would say the family atmosphere and how apparent it was on interview day. I feel like I didn't meet a stranger, which is really hard to do when you're coming in completely blind to someplace and you've never met anyone there in person. But from my first interaction with Doctor Thomas over Zoom as a pre-interview to my actual time here, Johnson City and East Tennessee just really felt like home—somewhere I could see us putting down roots and building our own family and getting connected in the community, but then also within the college and with the students. And I love the atmosphere and the culture that's promoted here. And so that's really what drew me in. And so far, I've been really pleasantly surprised with just how true that picture that is always portrayed really is, and just how reflective that is of my time here so far. Everyone's been great. Michele Williams That's terrific. Good to hear, too. Alex Surbaugh Yeah. Stephen Woodward Well, for the prospective students out there considering a career in health sciences, what do you think is special about pharmacy? And why did you want to become a pharmacist? Alex Surbaugh Pharmacy is one of those fields that I think is continuing to grow. When I first started pharmacy school—it sounds really silly because I obviously was going into pharmacy and committing my life to it—I just knew about the pharmacists that worked in the retail setting. I didn't realize that there were pharmacists in the hospital. I know it sounds silly to say now, but I remember the first day when we talked about residencies and specialty pharmacists that can specialize in different areas—psychiatry, cardiology, family medicine, any of that. I mean, it's just so expansive. Now we're also seeing people in industry that are doing pharmaceutical sales, that are working on the research side of things. So I think that's what makes pharmacy so unique, is that we are such an expansive field that continues to grow, continues to expand. And I think the second part of that is how accessible we can be to our patients. Medications are, I think to a lot of people, very scary. You read one warning label—someone always told me if you read the warning label, you'd never take the med. But I think we are in a great position to really work with patients on why these medications can be beneficial to them, what they should be watching for risk-wise, what the realistic risk-benefit is, and helping them to make educated decisions and being that kind of frontline person that has that conversation. So I do think we bridge a lot of gaps for patients when it comes to their medical team care as well. And so that's something I love about my job as a pharmacist, is being that person that advocates for the patient and kind of making sure that their questions are answered and that they feel comfortable with what they're doing, while also advocating for them with the team. Stephen Woodward Great. Thank you. Michele Williams And what do you like to do in your spare time? Alex Surbaugh I am just now getting back some spare time post-residency. I think everyone always says residency is a busy time in your life, but especially when you uproot and move to a completely new city and then you're doing two years, it is a big time commitment. Very well worth it. But I'm a big reader, so that's something—especially in the evenings—I love to just pick up a good book. I'm not really super specific on my genre, so historical fiction, thriller, mystery, anything like that—that's kind of how I unwind. I do have a dog, so she is a Maltipoo, and we've really enjoyed taking her for walks. Michele Williams I bet she's cute. Alex Surbaugh She is. She's really little. She's about eight pounds, and I think she's a lot more ferocious than she really is. So we've enjoyed exploring the area, going for walks in the evenings, cooking. And then, like I said, college football season is coming up, so my Saturdays will be spent on the couch watching Ole Miss play. And my husband-to-be is a Bama grad, so unfortunately the Tide too. But—well. Stephen Woodward Is there anything else you'd like to mention? Alex Surbaugh Everything's been great so far up here. I'm really looking forward to getting started and really getting to know the students and working with all of the students here at Gatton. If I can ever be a resource or help to anyone, I hope they know that my door is always open. So there’s my email—feel free to email me or stop by my office and just say hello so that I can get to know everyone. But thank you all for having me. It's been wonderful. Michele Williams Well, thank you so much for joining us. This has been terrific. And thanks for giving us a chance to get to know you a little better. Stephen Woodward Yes. Great. Thank you very much.

In this special bonus episode, we hear an inspirational speech from alumna Dr. Melissa McCall, who graduated from the inaugural Class of 2010 and recently spoke to the Class of 2028 at their White Coat Ceremony in August 2024. Dr. McCall serves as the Pharmacy Professional Services Manager at Food City/KVAT Foods and oversees daily operations for 31 Food City Pharmacy locations.     In addition, she completed her undergraduate pre-pharmacy coursework at ETSU and holds a Master’s Degree in Business Administration from Milligan University. In 2018, former Gov. Bill Haslam appointed her to one of the highest pharmacy positions in Tennessee— serving on the Tennessee Board of Pharmacy.   

In this episode, we talk with Carolina Davis, a third-year student pharmacist at ETSU Bill Gatton College of Pharmacy who recently served as the inaugural Executive Intern at the Tennessee Pharmacists Association (TPA). TPA is a membership organization serving all pharmacy professionals, student pharmacists, and pharmacy technicians in Tennessee and advances, protects, and promotes high-quality pharmacist-provided patient care in the state. Our student pharmacists frequently have opportunities to attend TPA meetings throughout the year, which are important for professional and leadership development. 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. I'm one of your hosts, Doctor Michele Williams, and joining me today is my co-host, Stephen Woodward, our Marketing and Communications Manager. Stephen Woodward Hi, Stephen. Carolina Davis Hey. Good morning. In this episode, we'll be talking with Carolina Davis, a P3 at Gatton who recently served as the inaugural Executive Intern at the Tennessee Pharmacists Association. TPA is a membership organization serving all pharmacy professionals, student pharmacists, and pharmacy technicians in Tennessee and advances, protects, and promotes high-quality pharmacist-provided patient care in the state. While at the college, Gatton students frequently have opportunities to attend TPA meetings throughout the year, which are important for professional and leadership development. Carolina, welcome to White Coat Radio. Stephen Woodward Hi. Thanks for having me. Michele Williams So TPA sounds like a great place to be. Tell us a little bit about the Executive Intern position that you had. And you were the first one, right? Stephen Woodward Yes. I was the inaugural intern, so there were really no expectations for me when I was going in. And I tried to keep a really open mind. And they sure hit me with a bunch of stuff. My first two days, I felt like I was in a tornado, just learning all of the things that they needed me to do. But I had the most amazing experience. So one of my biggest projects that I was able to complete while I was there is I drafted the Fellows of TPA program. So it's a program for practicing pharmacists to become a Fellow of the association. So they’re just very committed to the association and kind of the mission of the association. So I was able to draft all of that, and it’s to be presented to the Board of Directors in September, hopefully for approval to kick off the first class of Fellows this year. Michele Williams Wow, that sounds really exciting. Stephen Woodward Yeah, that was great. Michele Williams How did you wind up in this particular role? How did that experience come about? Stephen Woodward So I've been a member of TSSP, so it's a student society within TPA, since I started at Gatton. I've loved it since I started. I have been a member-at-large for two years, so I've been helping kind of plan all of the meetings and all the student programming from the day I actually started. And so that was really awesome. And while I was at the Winter Meeting this past year in Nashville, the staff approached me and were like, okay, we think you could do this. You should do it. And I was like, oh, I don't know. That’s a lot. Michele Williams You’d have to move and, like— Stephen Woodward I don’t know. But like, is it paid? I got all of the information, and I applied, and I talked to my mentors about it. What do you think? Do you think this is a good opportunity? Is it really what I want to do long term? But what do you think? Can you do it? And they said never say no to an opportunity like that. And I’m so glad I didn’t. I’m so glad I said yes and went. So I interviewed, applied, and got the position. Michele Williams That’s great. Carolina Davis How long did it last? And kind of walk us through what the day-to-day looked like. Stephen Woodward Yeah. So I was there for two months, but moving forward it’s going to be a 12-week program. But I had my rotations already planned and scheduled for May, so I wasn’t able to start until the first week of June and stay to the end of July. Day to day is not the same when you walk in. So at the beginning, it was very much just getting my bearings, learning kind of how TPA operates. We learned a lot of the differences between TPA as the association and CPRS, which is the Community Pharmacy Research and Education Foundation, which is their 501(c)(3). So anything legislatively, money that goes into the foundation—that’s where all the grants go through. I was able to learn all of that kind of in the first few weeks that I was there—the history of TPA, who all was there at the beginning making those foundational steps. And I met a lot of people my first two weeks. Really sat down and met with the team and some of her colleagues. I met some pharmacists from across the board. I met with John Cerasuolo, PBM Director at the Department of Commerce and Insurance. So I was able to meet with a lot of people. Michele Williams And what is PBM? Stephen Woodward That is Pharmacy Benefit Managers—whose job is to regulate pharmacy benefit managers within the state agency. Michele Williams Wow. Stephen Woodward Yeah. So that’s really great moving forward with the practice of pharmacy. So hopefully we’ll get some more things straightened out through legislation. But later on, I started helping plan the Summer Meeting. So I was able to make PowerPoints, review slides, review scripts, all of that stuff. So a lot of just baby tasks moving forward. I was working on that Fellows program in the background, trying to get all that done. I had three presentations while I was there—very short ones, just to kind of get some more presentations under my belt, which were really fun. But yeah, a lot of fun laughs in the office. It was very laid back the whole time. Michele Williams Oh, that’s great. Cool. And so what did you learn? What really were the takeaways from this experience for you? Stephen Woodward Yeah. So I got really great project management skills and kind of like moving in time blocks and not just looking at something for 17 hours and hopefully getting it done. I really solidified that, like, you have two hours to work on it today. If it doesn’t get done, work on it the next day. So I was good at spacing that time out and learned how to do that quickly. But I also really took away the power of networking and helping people. I think that is such a big, important factor of the profession, because everybody helps everybody in some way, shape, or form. So yeah, being able to network was really important. And I also really understood how important advocacy is. I always knew that it was important, but I really got into it this time around and saw what all goes into planning for the legislative year and how impactful it is to pharmacists and pharmacy and even patients. So I really enjoyed that kind of knowledge and what to do about it. Carolina Davis That sounds really cool. We’ll talk a little bit about why you want to be a pharmacist and what your goals are now after graduation. Stephen Woodward Yeah. So I wanted to be a pharmacist when I was like ten years old. My mom has epilepsy, so I have been involved in her care since I was very young. You see all the things that she’s had to go through and how many medicines she has to take. And so since I was little, I was like, oh, that’s crazy. To figure out how that works—I’m curious how that happens and why is this happening to her, and why can’t she just be fixed? You know, like all of those things. So that was one of the biggest reasons that I wanted to go into pharmacy. And those goals—how to get there—changed along the way. I kind of started with pharmaceutical research to the brain that way, and then I was like, no, I don’t really like the lab work. And I really like patient care and advocacy that way. Also, my aunt—she was really heavily involved with the opioid epidemic and things like that. So seeing how that played into her life and her children’s lives and then my family as a whole—those things, and just the things that Appalachia has to deal with—have really pushed me into the pharmacy profession. And I’ve accepted it fully. I love it. So moving forward, I’m working to keep as many doors open as I possibly can to see where the world puts me. But I’m really interested now in ambulatory care, family medicine, and just being a constant in a patient’s life and not having to jump in and out—really helping to find a regimen that works for them and advocating for the patient. So that’s what I’m looking at now, kind of family medicine areas. I’m also really interested in still being involved with TPA and working—not maybe as a staff member—but definitely as a volunteer leader within TPA. I’d really like to get involved there, hopefully more on the political affairs side and seeing how we can interact with legislators. You know, they’re not scary people. They just have a lot to do. Michele Williams Well, I know whatever it is that you decide to do, you’re going to be awesome at it. And what has been your favorite part of pharmacy school so far? Stephen Woodward That’s such a hard question. I love it all. Even if I say that I’m tired and want to go to bed, I really have loved it. Honestly, I think just meeting the people in my class and getting to know those people who have been such an impact for me. Seeing all the different walks of life we come from—that’s been something that I’ve really enjoyed, past all of the pharmacy things, I guess. It’s just getting to be really close friends with my classmates. That’s something that I’ve really enjoyed about the journey. Michele Williams That’s awesome. We really do have some great students. Stephen Woodward Yes, I agree. And the faculty and staff, too. I think just getting to know them and being close and in-person support from faculty and staff is really cool. Carolina Davis What was it that brought you to Gatton? Stephen Woodward Well, I did my undergrad here and played softball there, so I had been here for a hot minute. And I actually met with Julie Hurley when I was 15. She kind of got me into the Gatton loop, and I have loved it ever since. When I came to interview, the second I stepped over here into Gatton, I felt like people really care about you here. They don’t treat you like a number. They want to know who you are. So that’s why I fell in love with Gatton. It’s just the family aspect and the family atmosphere that’s here within the walls. It feels like home when you walk in—for me. Michele Williams Awesome. Carolina Davis Where’s your hometown, and where do you hope to go after you graduate? Stephen Woodward Yeah. So I’m from Englewood, Tennessee. It’s about an hour south of Knoxville. Really small town, foothills of Appalachia. Tellico Plains is the biggest touristy area around, but it’s not very big at all. So born and raised in Englewood. I’d love to go back there one day, but residency and things like that—I think I want to get out for a little bit, maybe get some highlights and then come back and serve the people of Appalachia. Ultimately, I want to end up back in the place where I was raised to help the people that raised me. Michele Williams That’s great. That’s terrific. And so, as you know, our P1s have just started. What advice would you give a P1 who’s just starting here at Gatton? Stephen Woodward I have so much to say in a few months, and I tell them every time I see them. But I think the biggest piece of advice that I would have for anyone coming into any pharmacy school ever is to do things that get you out of that normal pharmacy student silo. So take opportunities. Be involved in extracurriculars. Do things that would set you apart from just your normal pharmacy student. Because everybody can do that. Everybody here has gotten accepted. Everybody can be a pharmacy student once they’re here. It’s what sets you apart from those people. And I think, like I said, getting out of the pharmacy silo is something that’s really important—taking those opportunities when they come. Michele Williams That’s some amazing advice. I think that’s great advice. And I hope our P1s listen to this and take that to heart. That makes so much sense. Carolina Davis An opportunity like going to TPA and being the inaugural Executive Intern. Stephen Woodward Yeah, I know. That is one that’s on my résumé forever. Carolina Davis That’s pretty cool. Stephen Woodward I definitely think that that’s such a great opportunity, and it’s going to be there for a long time. So in your P1 summer or P2 summer, it’s an open opportunity to any of the six pharmacy schools across the state. So anybody can apply for the position. Michele Williams Well, you’ve got it off to a great start. Stephen Woodward I hope so. Michele Williams Thanks so much for joining us today and for sharing your experience with us. It’s been terrific. Stephen Woodward Yeah. Thanks for having me. I really appreciate it.      

In this episode, we talk with Mary Little, Director of Disability Services at East Tennessee State University. Little is the point of contact and a vital resource for our students and faculty when determining student eligibility for accommodations at ETSU Bill Gatton College of Pharmacy.   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. I'm one of your hosts, Doctor Michele Williams, and I'm joined today by a new co-host. Michele Williams Our regular co-host, Dan Vanzant, will be working remotely for the next year or so. Stephen Woodward, our marketing and communications manager, has agreed to co-host with me during Dan’s absence. Welcome, Stephen. Stephen Woodward Thank you. It's good to be here. Michele Williams So in this episode, we'll be talking with Mary Little, director of disability services at ETSU. Mary Little is a point of contact and a vital resource for our students and faculty with regard to determining student eligibility for accommodations here at Gatton. So she's our go‑to person. If someone needs an accommodation, Mary, welcome to White Coat Radio. Mary Little Thank you. Thank you for inviting me. Stephen Woodward So your full title is Director of Disability Services and ADA/504 Coordinator. Can you just tell us a little bit more about what your office does? Michele Williams Sure. Mary Little Our primary responsibility is to provide accommodations to students with disabilities. The ADA coordinator piece of my job is also to provide accommodations to faculty and staff with disabilities, and also to interact with facilities on our physical campus. But the biggest thing we are doing is providing accommodations for students across campus. Michele Williams That's great. Mary Little And that's all students—graduate students, undergraduates, medical school students, pharmacy students. Michele Williams So we've used the word "accommodation" a lot. What exactly is an accommodation? And if I'm a student—a pharmacy student—how do I know that I need an accommodation while I'm in pharmacy school? Mary Little Okay. What's an accommodation? In a perfect world, everything would be completely accessible. Nobody would have a hard time getting in the door or upstairs or accessing online materials. But there are many things that are not accessible. And where access is not, an accommodation is needed to make that bridge so that the person with a disability can access it as well. Mary Little So that's what an accommodation is in the short version. If you have had—if you have any kind of disability, or if you are a student and perhaps you had some assistance going through K through 12 and high school, it's really worth it to reach out to our office and talk that through. You may be eligible for an accommodation. Mary Little And we can help you with that. So if you have any kind of disability—we’re serving all kinds of disabilities. People often think disability means people in wheelchairs. It does, but it also means all kinds of disabilities. We have a huge number of students with medical disabilities. I'm always surprised by that, I guess, by the number of students who have chronic medical issues. But no, there's mental health, there's learning disabilities, autism, all kinds of ADHD. Mary Little So it's a wide range of disabilities. So if you have any of those things and you think that it might be impacting you in any way in your academics, it's worth it to talk to us. Michele Williams Okay. Okay. Stephen Woodward Just to play devil's advocate for a moment—would asking for an accommodation be a way just to get an advantage on an exam? Mary Little No, I'm glad you asked that question, but it's absolutely not that. And an example I would say is—we all wear glasses and we don't think a thing about it. We wouldn't think to take an exam without our glasses, because we wouldn't be able to access that. We can put our glasses on and we can. So the accommodations are simply that—they're leveling the playing field for the person with the disability. Stephen Woodward So what is an invisible disability? Mary Little So invisible disabilities are the ones that are not readily obvious. If you see a person in a wheelchair, you know they have a disability. A deaf student may have an interpreter with them. A blind student often uses a cane. So the invisible disabilities—which is actually the vast majority of students with disabilities—it's all the chronic medical, mental health, the learning disabilities, the things that would not be obvious in just seeing a person or talking with them. Stephen Woodward Thank you. Michele Williams So if a student thinks they might have a disability that could be accommodated, do they need to wait until they start making failing grades—or non‑passing grades as we say in parentheses—before they look into getting an accommodation? Mary Little Yeah, that's a great question. And the answer is no. Don't wait. Come and see us. Really, when you begin school, it's a good time to just talk about it. I encourage students who have disabilities—and a lot of freshmen think they want to come and try it without—but I encourage them to establish the safety net. Mary Little You don't have to use accommodations even if you have been made eligible for them. So it's important for a student to have the safety net. And I would recommend they use them as they get their feet under them, because if you're not eligible for them, there's nothing I can do for you after you've failed the test. Mary Little But if you are eligible for extended time on an exam, for instance, and you don't use it, nobody may understand. So I would say absolutely don't do that. I don't understand the math in this, but a bad grade hurts you more than a good grade does you good. Michele Williams So yeah. And in pharmacy school, there's not a huge amount of time to correct—to correct the problem. So being prepared, and if you think you might have a disability, it sounds like it's a good idea to get in touch with your office to make sure. Mary Little Absolutely. Michele Williams And if I'm a student who has an accommodation, do I have to tell my professor I have a disability? And will my fellow students know I have a disability? Mary Little So when you request accommodations, you're establishing the idea that you have a disability. When I communicate the accommodations to your faculty, that's what I communicate—the accommodations. Michele Williams Okay. Mary Little So there's no disclosure from me or my office about what the disability is or why that's needed. It's just—that’s sort of what we're tasked with, being the clearinghouse for the documentation and having read it and knowing that it means this. And then I can just tell faculty this is what we need to do. Mary Little So they're going to know there is a disability, but they're not going to know the specifics. And your peers are not going to know that either. Michele Williams Okay. Good to know. And if I think I might need an accommodation for pharmacy school, how do I get in touch with you? What's the easiest way? Do I call your office? Do I go to the Disability Services website at ETSU, or how do I do that? Mary Little You can do any of those. Michele Williams Okay. Mary Little We are located on the third floor of the Culp Center, and you are welcome to drop by. Our phone number is (423) 439‑8346. And you can absolutely give us a call. You can email [email protected]. You can go to our webpage and do the application, and then we'll contact you. So really any of those things work, and we respond to all of them. Michele Williams Great. One other tip—you can also go see Doctor Williams at the College of Pharmacy, and she'll give you Mary Little’s card. And then you'll have it there. Mary Little Yeah. Stephen Woodward What's your favorite thing about your job? Mary Little Oh wow. I would say my favorite thing is the creativity of it. It is not a job where one size fits all. There's no two people that are the same. Two people can have the same disability—it’s not going to be the same. They're not in the same program. And there's never a shortage of things we've not heard of before, a need we've not done before, or a new disability we've not heard of before or worked with before. Mary Little So I love that you have to think on your feet. And you need to like doing that piece, which I do. Stephen Woodward On the flip side of that, what's the biggest challenge that you face on a daily basis? Mary Little Gosh, you know… so the disabilities in and of themselves are not so much the issue. I think we're at a really interesting time as a country and as a university where things are really changing. You know, we talk about equity and things like that, and disability is a piece of that. And so moving from a place of compliance to true accessibility—I think we're on that path. Mary Little And so it's a challenge and it's an exciting thing both. Michele Williams And you were talking about that one of your favorite things is being creative. And I know from my interactions with you that you're a really good problem solver. And one thing that's come up recently that I hadn't really thought about before—that you and I have worked on, that you and Doctor Alexander have worked on—are accommodations for students who are going on clinical rotations, particularly the advanced experiences, the APPEs. Michele Williams So can you talk a little bit about what students should do if they feel like the accommodations that they’re getting in the classroom—they may need some other version of that out in the field, in a clinic, or in that sort of environment? Mary Little Yeah, I think it's really important—really for maybe any student who is receiving academic accommodations—to maybe touch base with you, to touch base with me, and say: we're getting ready to go into these clinical experiences; how is this going to translate? And is there something we need to do? So the academic accommodations are under Title II of the ADA, and then workplace accommodations are under Title I of ADA. Michele Williams Makes sense, yeah. Mary Little So the process is the same—it's just a different law and a different way of navigating it. But there may be things that you didn't need in the classroom that you will need in the work world, or vice versa. So I would almost say anybody who is getting ready to do those rotations—APPEs—that's getting accommodations, it would be worth touching base with you and me to talk that through. Michele Williams That's good to know, because I think students get very focused on the academic accommodations. They want to make sure they have what they need for exam time and those kinds of things, but they don't think ahead to—especially students maybe with medical accommodations—that when they get into a clinical setting, some of that may translate into that setting, but that requires a greater degree of preparation. Michele Williams It seems like, than extra time on a test or something like that. Mary Little Yeah. I guess, you know, the different pharmacies are set up differently. And working with Doctor Alexander has been a great experience for me. She knows the different ones and what they have and what they are strong in. And you can select them based on what you're trying to accommodate. A person might be best served in one setting over another. Mary Little So—and I think the other piece of that is equipping the students for knowing how to advocate once they are in the work world, and how to ask for accommodations, and to know that as a person with a disability, you have certain rights. You're not asking for a favor or anything like that. But knowing how to do that with confidence and respect—you know, sometimes just counseling on that is helpful. Michele Williams Yeah. And so talking to you about that can be really helpful, too, so that they're sort of equipped when they get out into the working world. It almost seems like preparing in that way for an IPPE or definitely an APPE gets you ready for moving into your career and making sure you have what you need to be successful. Mary Little Yeah, absolutely. That's great. Stephen Woodward Do our alumni have access to your services after they graduate? Mary Little I have talked to people—not at the same level as a student one—but I think the university is always a resource to alumni, if I'm not mistaken. Stephen Woodward We can cut that out. Mary Little Yeah, you might want to cut that out. Stephen Woodward All right, Dan, cut that out. Mary Little I also might want to cut out when I said "equity" there on our school anyway. Michele Williams Might. Yeah. Yeah. Stephen Woodward So okay. Michele Williams And so I'm going to pause for a minute and then may ask you a question about assistive technology. So what if I need some assistive technology in the classroom? What kinds of technology are available to students with disabilities? And how does that work? Mary Little So it's such a broad landscape, you know, of disability, and therefore what technology would be helpful. But I'll talk about the things that are kind of really cool. So a lot of students will have trouble note‑taking, which is a complicated process, right? If you're listening, distilling, writing, all at the same time. And if you're a person with a disability or something like that, it can really slow you down. Mary Little So we offer note‑taking software. Michele Williams What is a print disability? Like dyslexia? Mary Little Anything, you know, where you are not processing printed word as quickly. Yeah. So we offer note‑taking software to a lot of people, but there's also the LiveScribe pens, which just look like a pen. They're the coolest thing, right? They just look like a pen, but it interfaces with the internet. And you're taking notes and you know it's recording, and then you— Michele Williams Sync it with your computer? Mary Little —in Evernote, which is where it works perfectly. And you hear the professor lecturing and your handwriting is magically appearing on the computer screen. And it's "Oh, here we go to that glitch where I zoned out for a minute," and I can fill that in because I'm hearing it again. You upload it and it's there. That's very cool too. Mary Little You know, that does sound cool. Michele Williams Yeah, I think other students might be interested in that too. Stephen Woodward I'd like to get one of those. Michele Williams Yeah. Yeah. Mary Little I have an attorney friend who uses it for all kinds of stuff. But I mean, you know, yeah—buy him one. But the other thing we got recently is a reader pen. So again, students who have difficulty learning disabilities—previously the accommodation might be a reader as needed on an exam. So this is a person who's reading in our office. Mary Little We do like to encourage technology largely because you're not going to want to ask a person to read things on your job. So the more tools you have and the more you know how to use them—the more independent you are. Makes sense, right? So the reader pen looks kind of like a highlighter, and you can go over printed material and it will read it out loud. Mary Little That is cool. Michele Williams And do you have that equipment over at Disability Services? Mary Little We do. In fact, you can take a picture of it, translate it to another language, and then have it read it to you. Michele Williams Interesting. Mary Little Yeah. Wow. Traveling—you might want one. But I mean, a lot of students might have use for something like that. Michele Williams Well, that's great. Is there anything else about getting an accommodation or advocating for yourself as a student, or anything else about the kinds of things that your office does, that you would like for our students to know? Mary Little I guess the biggest thing I would like students to know is, again, you're not asking for a favor. You're just asking for the thing that makes it level—just like using a step ladder or glasses. And it's no more than that. So I would love for students to assimilate that and feel comfortable with themselves and with that. Mary Little Other than that, I would say, if you think you need help, please come see us early and let's work together to put in place what you need. If you need documentation, you know, we can explain what would be needed because it's going to depend on—if it's a medical disability, it'll be a doctor's letter, or if it's a mental health disorder, maybe your therapist is writing your letter. Mary Little Or maybe you've had an evaluation at the Behavioral Health and Wellness Clinic on main campus. So it would depend. And the earlier you talk to us, the earlier we can get everything into the pipeline. Michele Williams So you help give students advice on what it is that they need and how to do that. Mary Little Yes. Michele Williams How to do that. That's great. Well, Mary, thank you so much for joining us today. This has been really, really helpful. And hopefully students will take the step and reach out to your office and make sure they get those accommodations when they need them. Mary Little Well, thank you very much for having me. It's great to work with the pharmacy school. Thank you.  

In this episode, we talk with Dr. Stacy Brown, Professor of Pharmaceutical Sciences at East Tennessee State University Bill Gatton College of Pharmacy about the Process Oriented Guided Inquiry or "POGIL" teaching strategy.  In addition to being a POGIL expert, Dr. Brown is an award-winning educator and researcher.  She teaches Medical Biochemistry and Medicinal Chemistry and serves as the Interim Chair of the Department of Pharmaceutical Sciences at Gatton.   Transcript: Dan VanZant Welcome to White Coat Radio, a podcast from East Tennessee State University Bill Gatton College of Pharmacy in Johnson City, Tennessee. Each episode will 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, Dan VanZant. Michele Williams And I'm Doctor Michele Williams, director of academic success. In this episode, we'll be talking with Doctor Stacy Brown, professor of pharmaceutical sciences at Bill Gatton College of Pharmacy. Doctor Brown teaches medical biochemistry and medicinal chemistry and serves as the interim chair of pharmaceutical sciences. She's also an award‑winning educator and researcher. Welcome to White Coat Radio, Doctor Brown. Michele Williams Thank you very much. So we all know you as the coordinator for the chemistry courses in the P1 year, but you are also our resident expert on teaching with an instructional model known as POGIL. Can you tell us a little bit about what POGIL is and why you use it? Stacey Brown Okay. So POGIL—the acronym stands for Process Oriented Guided Inquiry Learning. And so this is a student‑centered, group learning teaching strategy. It was developed back in the 1990s by some chemists at a smaller university, intended to help students learn chemistry. So that's the framework where it originated. But now it’s expanded to all different— all kinds of different fields. And in a POGIL classroom, the students are working in small teams, and the instructor is the facilitator. So there's not a lot of lecturing, not a lot of slides and things like that. What they're working on are very specifically designed exercises that take them through the learning cycle. And so you give them data of some sort—a figure. I use chemical structures all the time. Sometimes there's a table, and you use guided questions to help them look at that model or that information. So we would call this just the exploration phase. They’re looking at the model. They're answering questions. And sometimes the questions look super easy. But the whole point is to make them look at it and say, what kind of information can I get out of this? I mean, even as simple as—if it’s a graph—what are the axes? You know, what is this graph of? So they explore the model and then eventually they go to a phase called concept invention, where they try to see some trends in the information and then come up with some sort of hypothesis. So the idea is that you've followed kind of the scientific method with this. So they come up with a hypothesis to explain the model, maybe generalize what they're seeing. This is the concept that we're trying to get at. And then finally they're going to apply that concept. So now we have our idea, and I'm going to throw some new information at you in an application question, and you're going to see how the concept works. So that’s what the classroom looks like. The process part is a little bit harder to quantify and to assess, but there are tools for that. And those processes are very intentional. They include oral and written communication, teamwork, time management, problem solving, critical thinking, and assessment work—both self‑assessment and metacognition. And so there are rubrics from the POGIL project, which maintains all of the resources for this strategy, to assess each of these things. If you have an activity that's really focused on critical thinking, there's a rubric to go along with that so you can see how well your students are doing. But as far as why I use this—I started teaching in a chemistry department at another university. It was a military college, and that will be important later. But when I first started teaching, I just did exactly what I had seen as a student. And I was a good student and did fine. So whatever that was, I thought, well, this must be the perfect way. But my students were really doing poorly, and they were the lowest cohort of Gen Chem students in the department among six or seven instructors. Mine were like a full standard deviation below everybody else. And so I thought, okay, maybe I should quit my job because I'm awful at this. And my chair talked me out of it and said, no—you’re not awful. You just don’t know how to do it yet. And so she sent me to some training at an American Chemical Society meeting. And I learned about POGIL there. And I just signed up for something random. I didn’t—I was like, okay, well, you sent me. Let me do something while I'm here. And it was sort of a transformative moment because I said, oh my gosh—first of all, sorry, but all the teachers I had before were not doing a good job. Because I stood at the chalkboard, you know, and wrote things. Or stood at an overhead projector and wrote things. And so I came back to my job and I said, okay, I'm going to do this totally different. It's going to be awesome. And it—it was. Wow. It was really good. But I had a lot of pushback from the students, like, whoa, what are you doing? And even from some of the other faculty because they thought I had gone off the deep end with my ideas. But it was working really well for my students. They kind of turned their ship around. And then when I came here, I said, I'm going to bring this strategy with me because it worked really well. And I was the only person—the first person—to ever teach a class. So there was no precedent. I could do whatever I wanted, and it was all mine. So slowly I developed activities to go with medicinal chemistry. And then now I'm working on biochemistry. Michele Williams So have you gotten any pushback from students here—either when you first started using it or at the beginning of a new semester? Do students get a little freaked out about this model? Or are you experienced enough with it now that you sort of take care of that before it starts? Stacey Brown Initially in a few—it would—the pushback would only come in the form of evaluations at the end of the semester. Like, “I'm not paying all this money to teach myself.” Like—okay, well, that’s fine. That’s not what happened, but that’s okay. And so now I just sort of preface everything in the first class. I just tell them, like, look, I want everybody to succeed. I don't have a preconceived notion of, “We're going to give out this many A’s and this many B’s.” I want you all to know this stuff. And this is the way that I've learned—and research supports it. And if you like reading research papers, I can provide those. That helps you. And then, you know, I often have individual groups in each classroom that don’t like to sort of coalesce together and work together. And I just try to encourage them a little bit more—like learning is a community thing. And it's so much easier if you have that community to support you. So let this be your little community while you're in here. And maybe you don't study with these people later. That's okay. But while you're working through this stuff— So I don't get a lot of pushback anymore. But initially I did, and I really did when I first started. But I also think I startled them. Michele Williams By—like, that's a big change. Stacey Brown Yeah, it was a huge change. Yeah. Dan VanZant So it seems like you make chemistry less daunting. And you have a very high reputation amongst your students. So how do you achieve that? How do you do that? Stacey Brown Yeah. Well, I don't know that I help them love it, but my goal is to build their confidence with it. Because—I took medicinal chemistry with the pharmacy students at the University of Georgia. So I was a PhD student, but in that program PhD students and pharmacy students are on the same track for the first year, and then they diverge. In my med chem class, all we did was memorize structures. That is—we drew them and we identified them by the way they looked. And that is all we ever did. And I thought—that is a waste of time. And we're not going to do that in my med chem class. So I’ve thought a lot over the years about what information you can get from a chemical structure that would help you understand that drug. Because they're going to see new drugs in their career. And I want them to be able to use all the information about it—not just the clinical trials, not just maybe the kinetics and the package insert—but even look at the structure and say, oh gosh, I understand why we have to give this IV. Or I understand why you only get this once every six months. Or whatever it is—you can find those data in the structures. So that's what I set out to build their confidence in. You're not going to memorize stuff for the sake of memorizing it. It's all about learning a handful of tools and then just applying them to new situations. So building their confidence that they can use information in the chemical structures—and then keeping their morale high. And this is what I learned teaching in a military college—that if their morale is low, and they're scared and nervous about the content, and they're nervous about their ability to do it—that is a huge roadblock to success. So despite how high‑achieving they might be—if their morale is low about that ability—they won’t be as successful. So learning the value of morale is another thing that’s applicable to any class. But it really helps with the chemistry stuff because many students do come in with a lot of trepidation about it. Michele Williams You know, you're saying that really makes a lot of sense to me in the context of talking to students individually. Because they talk about their past struggles with chemistry and so forth. But when they get into your class—after they've been in there for a little while—I don't really hear that from them anymore. And it can be incredibly discouraging if you don't do well on an exam—particularly for pharmacy students. They come to pharmacy school having been good students, and they are not accustomed to getting failing grades or non‑passing grades. And for any of us, it puts a big dent in your confidence. So it makes a lot of sense to hear you say that you work on their morale and confidence, because that does seem to be part of the transformation they make when they get into your class. They seem less discouraged, which I think is huge. The motivation—if you don't, first of all, have a need to know—which it sounds like in your description of understanding the structures versus memorizing them—built into that is a need to know. Why do pharmacists need to know chemical structures? And that's why. But also the idea of: you can do this, you should be confident in your ability to do it. And just listening to you talk to students actually makes me a little jealous because I'm thinking—I wish Dr. Brown had taught me chemistry. I would have felt a lot more confident in my abilities. But when you talk to students—that’s why I encourage them to come see you—because that can be transformational. Just to have that conversation with the expert and understand, “Oh—I can do this. I think I can do this.” So yeah, that makes so much sense. Now you're in that room with them the whole time. Dan VanZant Yeah, I can relate to that too. With my chemistry class—or several classes—you have a topic that's known to be difficult, and then you mix that with a professor that doesn't seem to care about your morale or give you the “can‑do” attitude. And it really makes a difference in being able to learn the material. And then also the application piece is huge. Every time I've had a professor who has gone the extra mile and shown how it fits into this broader picture—it really is helpful and meaningful. Stacey Brown And I can't do much of the application stuff in the first year just because I don't have the clinical background yet. But then, through the other courses—where we teach along with the therapy and pharmacology—I’m always in touch with the clinical instructors to help me identify some good application things. For example, in infectious disease, they might talk about which antibiotics you're going to give orally and which are IV only. And I can do that in the med chem portion of it. So we can learn to look at the structures and decode that. Then they're not just memorizing the list—they say, “Oh, okay, I remember that chemical feature that made this one restricted to IV only versus oral.” So I'm always trying to weave those real applications in. Because I'm not a pharmacist. But I happen to know a few. And they help me figure out how to get the chemistry in there. Michele Williams Okay. Great. Dan VanZant Also—thinking about the structures. When I was taking some of these classes—nobody had an iPhone in their pocket. And as I recall, we did have the little model kits that we'd have to put together and look at structures that way. We were just getting into having computers where we could kind of look at some of those—if you were fortunate enough to have one in your dorm. But now that we have all this technology—have you found any apps or do you use any apps in class that help students visualize structures? Stacey Brown I personally don't use a lot of that kind of thing. I provide all of those resources—figures and things like that—but I don't have any apps that necessarily help them. What you're talking about is more like in organic chemistry—you would look at the three‑dimensional space that a molecule fills. And I guess you can still do that—and you could probably find those images pretty easily now, where before you would have had to physically build them. But they probably are more aware, honestly, of different apps than I am. I just self‑generate what they experience. Michele Williams So you mentioned that you teach further into the curriculum. The students will see you again in various classes. And you mentioned infectious diseases. What other classes do you teach in, as well as those first‑year classes? Stacey Brown So I'm in every semester now. Infectious diseases and pulmonary for the P2s in the fall. And then for the P3s in the fall—the endocrine and men’s and women’s health course, neuro psych, and GI—which is actually P2 now. I'm a little discombobulated about where they fit. Then for the spring P2s—I have cardiovascular. And for the P3s in the spring—I see them in the oncology course and in critical care. And if I'm missing one, I apologize. Michele Williams Those sounds like a lot. Stacey Brown But it's really fun to see that progression through the curriculum. Because especially starting in med chem with P1s—we’re working on very fundamental things: functional groups, what's an acid and a base. And then I see them in spring P3 and I'm not—and I give almost zero instruction at that point. There's no preface. They just come in and start working. And they’re sitting there debating in that critical care activity I have—it’s a toxicology one. They’re debating, like: “Okay, which antidote is better for this type of cyanide poisoning?” Or “Is Narcan the best choice, or is there something else?” It’s just fun to hear them having these conversations. And it's all predicated on their understanding of the chemistry. But I didn't tell them anything about it. They're just coming up with it because they have the background. So it's really awesome to watch them grow. And I always compliment them. I'm like, “You're so smart. Look at you having all these smart conversations. And two years ago you were trying to figure out what's a carboxylic acid.” Michele Williams That's the astonishing thing about pharmacy school—the development of a person’s expertise over such a short period of time. They just transform into pharmacists. It's pretty cool. Stacey Brown Yeah. And teaching every semester—I get to witness that happening. It’s awesome. I love it. Michele Williams So if we think about the P1s for a minute—if you were giving advice to a P1 about what they need to be successful in medical biochemistry or medicinal chemistry, what bits of advice would you have? Stacey Brown Well, I do—on the syllabus—for each class—I have pre‑work. And it's usually just…the idea is that you preview the content. You don't turn anything in. I just want you to look at it and start to generate a little bit of action in your brain about it. So: preview the content a few minutes before class. Just look at it. And then when you come to class—in the P1 courses—I do preface the activities with some lecture. So I'm like, “Okay, here's the terms we're going to use. Here's some framework for you to build on.” And then I—wean them off of that over time. But because they need some foundation, I give them some content. Then for the group activities—my advice is to come to participate. You have the time set aside. You’re paying for that time. It is for learning. So use it. Use your classmates. Use me. Don’t squander it by shopping on Amazon or whatever distraction. Use the time because you will learn during that time—and it will be easier than trying to learn later in your apartment on your own. Michele Williams Amen. Stacey Brown I always liken it to going to the gym. You've paid a personal trainer. You go to the gym. And you're just standing off to the side watching, not doing anything. What a waste. And we talk even on the first day of biochemistry about skill‑building: Who plays a sport? Who plays an instrument? Who does technical crafts? And getting them to think about how they learned those things: by doing them. Not by reading about them. Same applies here. You can’t just read the book and get the same level of understanding that you would get if you actually do the work. Michele Williams Yeah. That makes so much sense. And I concur with you. Students underestimate sometimes the value in previewing the work before class. They are saving so much time and getting so much more out of class by priming their brain. Trying to learn the same amount later at home isn’t the same—and it won’t stick as well. Stacey Brown Yeah. It just feels better to know what’s going on. It feels terrible to walk into a room where everyone else seems to know what’s happening and you don’t. You can prevent that feeling. Michele Williams It’s like one of those bad dreams where you show up not wearing shoes or something. Stacey Brown Right. And you're the only one. You’re not ready. Dan VanZant Is this exam day one? Michele Williams Yeah. Well, thank you so much. This has been a great conversation, and we really appreciate your time today. Thanks so much for joining us. Stacey Brown All right. Thank you.    

On this episode, Dan and Michele talk with Dr. David Cluck, Associate Professor in the Department of Pharmacy Practice at ETSU Gatton College of Pharmacy.  He specializes in Infectious Diseases Pharmacotherapy, and is the course coordinator for the Infectious Diseases course in the Integrated Series  Dr. Cluck shares his advice for success in this challenging course!  Transcript: Dan Vanzant Welcome to White Coat Radio, a podcast from East Tennessee State University 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 to pharmacists. We're your hosts, Dan Vanzant, and I'm— Michele Williams Doctor Michele Williams. Today we'll be talking with Doctor David Cluck, associate professor in the Department of Pharmacy Practice. He specializes in infectious diseases pharmacotherapy and is the course coordinator for the ID course in the integrated series here at Gatton, which students take in fall of their P2 year. Doctor Cluck maintains a clinical pharmacy practice with the Infectious Diseases Consult Service at Johnson City Medical Center. In this episode, we'll talk with Doctor Cluck about his course and get some advice on how students can get the most out of it. Welcome to White Coat Radio, Doctor Cluck. David Cluck Thank you. Thank you for having me. Michele Williams So let's talk about your course a little. Some students can be a bit intimidated by ID. What makes this content so challenging? David Cluck I think that it's challenging for a number of reasons. I think that the transition from the P1 to P2 year, which we're going to talk about, is pretty staggering for a lot of students. You sort of delve into clinical‑based scenarios. The clinical questions—I think that alone probably intimidates students the most—is the questions and just not being familiar with how to approach those types of questions. Michele Williams The dreaded case‑based question. David Cluck The case‑based questions, yeah. And then I think the material in and of itself is just difficult. I think it's not something that—most students have seen Medical Micro, but that may have been some time ago. And then to look at it through a clinical lens, I think, makes it all the more difficult. And then I tell students in the course, usually in the first week, it's a lot of volume. It's a lot of volume, especially in the first exam. You need to spend a lot of time with it. It's a lot of memorization. So dividing up your studying and having good study habits—that’s revisiting over time leading up to the exam. But I think all those things kind of collapse into one and make it a really challenging, challenging content, challenging course. I don't know—I think every student's different. I think every student probably looks at it differently. Some students might not have the same fear about case‑based questions. They may be good test takers. But the content again in and of itself is still a challenge for a lot of people. Michele Williams It’s a course—from my experience working with students—where it's a bad idea to get behind. David Cluck I would agree. Yeah, I would agree. I try to tell students as well, don’t wait until a couple of days before the exam. I think this is a course that—so many students find out their study habits leading up to ID and then subsequent integrated series courses—you can't do the same things and get away with studying for 2 or 3 days really hard and skipping class and that be sufficient. So yeah, I agree it's a challenge. Dan Vanzant Yeah. So, what P1 course or courses are most connected to ID? David Cluck So I think the P1 course for me that's probably the most connected is probably not the one that's the most obvious. And I would say UTC. And the reason I think it's UTC is because I think that is the introduction where you start to see case‑based questions. Students have to reason through why selecting this therapy over other available therapies listed, and why it's correct and what's most correct. I think that's kind of a sneak peek as to what you get when you begin the integrated series. I do think immunology does kind of come back, but it's not realized until probably the P3 year when you get into HIV and some of the concepts in the IHOP course. Michele Williams So it sounds like that memorization—the fundamental facts you learn at the very beginning of the course—does factor into being able to answer case‑based questions, because you have to apply what you know to a case. David Cluck I think so. I think that UTC, again, is kind of the first introduction into case‑based questions. Then you get into ID and you see really a lot of case‑based questions. And I often say—tell students—that once you make it through my course, prepare yourself for all subsequent courses because you're going to see case‑based questions in every other course moving forward. So I do think, yeah, there is application that they carry with them. Whether they fully appreciate that, I don't know. I do have students that come back to me—more so in the P4 year, not after the P3 year. In the P4 year, they appreciate what was talked about in ID. They say, “I’ve been on rotation and all those things we talked about in class—it’s been a little while—but it's kind of come full circle.” Michele Williams Well, you offered a really great segue to the next question, which is: What courses in the curriculum does ID prepare students for? So in the spring of P2 and then into the P3 year and P4. David Cluck I think the answer is all of them, at least in the integrated series. Because ID is essentially in every integrated series course. It presents itself in every course—to my knowledge. It might not be taught by me, but it is in every other course. And I think a few years back I remember hearing some students say that for IHOP in particular—don't neglect ID. It kind of represents itself. And if you've slept on it, well, it does present itself in the curriculum in our courses. But it's only in sort of bite‑size amounts. So I think some students might say, “Well, 7 to 10 questions versus 20 questions on neuro psych,” and so it's easy to say, “This is not my priority.” But I do think remembering concepts from ID is important through the didactic portion and especially important for rotations. One of the things I tell learners—I just told this to students recently—ID will find you. It doesn't matter where you go. You can avoid my rotation and go with Dr. Chair or Dr. Covert and I guarantee you'll see plenty of ID. So ID is important right at the beginning because it represents itself over and over again—even beyond the classroom. Michele Williams And I really liked what you touched on just a minute ago—counting up the number of questions represented by a subject. I think that can be a recipe for disaster. Saying “There are only five ID questions, so I'll focus on the others.” Well, ID will find you, as you just said. But also, that’s a grade‑based orientation versus a learning‑based orientation. You have to learn everything to be a competent pharmacist. So I’m glad you touched on that—because a lot of students use that strategy and then wind up coming to see me because they're not doing well in certain subjects. Michele Williams So, thank you for bringing that up. What are some things that you see students doing in class where you think, “Yes, that student is doing well,” and that bodes well for their grade? Are there things you see students doing that are a recipe for success? David Cluck I think the answer here is—I’m not really 100% sure. And I say that because there's so much heterogeneity. Everybody’s different—how people process things. Students come see me and say, “This is not sticking—what can I do?” So we walk through strategies. For some students it’s making note cards. But I usually say be wary of note cards—you can spend all your time making them and then have one day to use them. Not a great use of time. What I usually tell students—and it’s not their favorite answer—is: put it into your own system. If that means making study guides, rewriting notes, highlighting them—do what works for you. I had a student years ago with at least ten colors of highlighter. Everything highlighted. She’d come into my office and say, “Pink means this, blue means this…” If it works—great. But I can't say, “If you do this one thing, you'll be successful.” I don't have that. David Cluck Some students seek additional resources—bug‑drug guides, cheat sheets online. I would say that’s helpful for some, but be cautious. As a student, you don’t know what's good and what’s validated. Something may not line up with what’s in my notes—and then you're frustrated. I've seen that happen. I’m always happy to validate something and say, “Yes, use that,” or “No, don’t use that.” But ID sits in this tricky space—lots of info online, but not all of it is good. So my best answer is: it depends on the student. Michele Williams I agree—it depends on whether you're someone who processes by talking or by writing. Some students need time alone before joining a study group. Some jump right in. You have to know that about yourself. And yes—students can always come see me if they want help learning their learning style. We can talk through what’s worked before and adapt it. And I also agree about Quizlet. Using someone else's cards can be risky. They might match the notes—or they might reflect someone who made a D in the course. ID is one of those courses where if you don't know yourself as a learner, it’s time to figure that out fast. David Cluck Yeah. When I was a student, I didn’t really get the benefit of group learning until maybe P3. And I realized—I missed out. But you can’t come into a group having studied nothing. You won’t contribute—you’ll panic. I see that sometimes in review sessions—a day or two before the exam. Panic rising because there’s an area they didn’t spend time on. I endorse group learning—but you need to know where you are before engaging. Michele Williams It can have a counter‑effect otherwise. David Cluck It will not be good. Dan Vanzant Yeah—you can't ask other people during the test what they know. You’re by yourself. Michele Williams Right. Dan Vanzant So if I may—since I'm the ID person (instructional design, not infectious disease!)—do you have any tools that are your go‑to if you need to refresh your memory? Maybe something from when you were a student that stuck with you? David Cluck It’s a tricky question because the temptation for students is to download the Sanford Guide. And that’s just… too much. We live in a world where everything is an app now. When I was a student—this will make me sound old—we didn’t have all this. Smartphones existed, but the app ecosystem wasn’t what it is now. I carried the Sanford Guide around. But Sanford is too much for a P2 student. I would NOT purchase it yet. There are things out there that are good—Quizlet, ID Stewardship, bug‑drug charts online. But I don’t have one source I point to as “the thing.” And honestly—reach out to me. Email, Teams—whatever. Sometimes it's just better to come talk to me. Email can become a novella. It’s easier in person. Last year I had structured hours where students could come in. I’ll do that again. I also hold review sessions before most exams. And students who’ve been through ID will tell you: go to the review session. I’m always mystified that it’s not the whole class. But people have jobs and obligations, so it’s recorded. Still—you miss the chance to privately message questions. And that is something students love—anonymity. No one sees the question but me. And if one student has the question—ten others do too. Michele Williams I love that. Students really do struggle to ask a question when they think they’re the only one. The private message option is brilliant. And you're right—when several people ask the same question, that tells the instructor something. It helps us see where the gap is. Students don’t always realize that their questions help us teach better. David Cluck Yeah. I can usually tell in person from body language. Zoom made that harder. But in class—I can see on their faces when something isn't landing. Dan Vanzant Shifting in the seat, yeah. David Cluck Yes. Michele Williams Do you have any other questions, Dan? Dan Vanzant Nope, I'm good. Michele Williams Well, thank you so much for joining us today, Doctor Cluck. This has been great. And I learned some things about ID that I’m filing away for future reference. And thanks so much—we’ll see you next time. David Cluck Sounds good. Thanks for having me.  

Bienvenidos al White Coat Radio! a podcast from East Tennessee State University Bill Gatton College of Pharmacy, in Johnson City, Tennessee. In this episode, Dan and Michele talk with Gatton student pharmacists from the beautiful island of Puerto Rico to learn more about why they chose Gatton.  Transcript: Dan Vanzant Bienvenidos al White Coat Radio 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. I'm one of your hosts, Dan Vanzant. Michele Williams And I'm Doctor Michele Williams. And today we'll be talking with Gatton student pharmacists Gilary Cortes Oliveras, Yareliz Pellot Soto, and Janer Torres Ramirez, and all of them come from sunny and beautiful Puerto Rico. So welcome, everybody. Hillary Thank you. Yareliz Thank you. Janer Thank you for having us. Dan Vanzant All right. So let's get started by each of you just telling us a little something about yourself. Janer Well, as was said, my name is Luis Janer, pharmacy student, as you know. But I come from a rural area in Puerto Rico, in the mountains—private farm, privately owned farm. And so even though I feel like I'm pretty extroverted, I was raised in an introverted environment, I guess. But I like to do other stuff. I like drawing, I like to work on cars, and to play the guitar—a lot of instruments. I used to be in a musical group when I was back in my college in Puerto Rico, at the University of Puerto Rico Río Piedras campus. And that taught me a lot, not only in the area of music but in discipline. And so, yeah—that's part of why I'm here too. But that's a long story. Michele Williams Well, thank you. Yareliz Well, that's hard to follow. Dan Vanzant laughs Yareliz So I'm Yareliz. I'm from the west coast of Puerto Rico. I love the beach. I am shy, but I love—I'm a people person. I really enjoy talking to everyone. Janer You're also with all the organizations, right? Yareliz Yeah. I love to be in all the organizations—well, most of them. I'm in a fraternity, part of the leadership committee. I belong to SNAPhA, to CPFI—that’s the Christian organization—the fraternity PDC, and I'm part of the directive committee. Michele Williams Nice. Yareliz It's me. Dan Vanzant And if you wouldn't mind—what year is each of you in the program? Are you all in the same year? Janer Well, I'm P1. Yareliz I'm in my second year. Gilary Hi. My name is Gilary. I'm the last one. I'm P2. I'm also from Puerto Rico. Of course. I was born and raised in Manatí. I have almost all my family there, so that's kind of hard for me. Normally I am introverted, but I always put myself out there even if it's uncomfortable for me. And I love to talk with people, so probably you'll see me normally quiet, but when you know me, I cannot stop talking. I'm also, like, the realest—I’m in most of the organizations. And I'm part of Phi Delta Chi too. I love to spend time with my family, friends, and read. I love to read as many books as I can, but I don't have a lot of time now. Michele Williams I was gonna ask—if you've been doing a lot of reading for pleasure lately. Gilary Like, yeah—now we read papers. Dan Vanzant And we do. Yareliz And we love traveling. Gilary Oh yeah, that is probably the most important thing. I love to travel. I met Yari one year ago—one year and a half—and I have traveled with her more than I’ve traveled with any other person, so I'm happy with that. Michele Williams That's nice. Well, thanks so much for those introductions. And let's talk a little bit about pharmacy school and what has been your favorite course so far in pharmacy school. And Gilary, we'll start with you—tell us what you enjoy about it. Gilary Okay. So when I was thinking about this—because this is like a normal question that people ask and I'm always struggling, like, what will it be? But I say like the first one… and the one that made me choose Gatton probably. Or one of the reasons that I chose Gatton was for the interprofessional careers that we have here. I really enjoy meeting people from other— disciplines. Michele Williams Disciplines. Gilary Disciplines—like med school, nursing, or even I have, personally, my small group that is speech therapy. So it's very good for me to learn about these other disciplines and now know how to work with them. So I really liked that. And I will say that is my favorite. Michele Williams How about you, Yareliz? Yareliz Well, this is hard for me because I found so many classes so interesting. I loved all the interprofessional classes we have. But like—one of the reasons I chose pharmacy school was because you're an accessible health care provider. So one of the classes that I enjoyed the most was the OTC class. I was able to learn—for example, everyone takes Tylenol, everyone takes Advil, but you never read the instructions because it's something everyone takes. But then you can instruct people: “Oh, you shouldn’t take more than this,” or “If you have this, you should not take it.” I thought it was very interesting in applying and helping others. Michele Williams So it sounds like you learn a lot about everyday products that people take for granted, but there's a lot more to it. Exactly right. We might need to talk later. Dan Vanzant Yeah, yeah. Michele Williams How about you, Janer? Janer Well, in my limited experience here in Gatton—only being in one semester and half of the spring semester—I can safely say that my favorite class by far has been anatomy. I just love understanding how the body works and all the systems, how they work together to form this working body. To me, that's very interesting, very amazing. Before coming here, I knew I loved anatomy. And I've been told by some doctors I know that I should have gone to be a physician. Yes. So I really like anatomy. But I also kind of like the physical pharmacy class, or what they call DDS. But that was probably mainly because it was Dr. Digavalli doing the class, and I found it absolutely wonderful—the way he taught, the tutoring he did. It was just wonderful. And I really enjoyed that class as well. And obviously, like I said, I like anatomy—but then Dr. Pond… you combine anatomy with Dr. Pond and she’s going to make a great class. And I really enjoyed that one. That’s my favorite. Michele Williams Yeah, it does sound great. Makes me want to sit in on those classes more. Dan Vanzant Yeah, yeah. See what Dr. Digavalli is doing in the class. Michele Williams Yeah. Dan Vanzant So you all have mentioned inside the class what your favorite classes are. What's been a good experience you've had outside of the classroom? Yareliz For me, I haven't been able to do a lot because we don't have a lot of free time. But all the hiking trails nearby—I’ve been able to do, I think, three. A professor recommended a whole list of trails and things I should know about Johnson City or nearby. So it's definitely not the same as Puerto Rico, but Johnson City has its own thing. And it's been nice—at least the trails. Gilary I will say the same, because we are like a package. When I see Yari, I'm behind. Yareliz So yesterday, a professor told us, “Oh, it's funny because when I see one, I see the other.” Dan Vanzant Really? laughs Gilary So I will say the same. But also—I love to cook. So every time we have an exam or something, I go to Yari’s house and I cook for them. That is something good to do outside the classroom without any stress—or at least having a break from the stress. I just like to be here. I find Johnson City very close to my home in Puerto Rico. I live in a place called Monte Bello, which translates to “beautiful mountains,” and in Johnson City we have a lot. So I feel like home on that side. Janer Especially in the summer. Summer looks a lot like Puerto Rico. Gilary Oh yeah. Janer Well, in my case, I've done so many things, I can't even start to list them here. But just to name a few—we actually went outdoor laser tagging with the girls and the fraternity. We did mini golf. I've gone to the trampoline park. I've done axe throwing. I went to Gatlinburg and saw WonderWorks, and went through… what was that? Gilary Anakeesta? Janer Anakeesta! I went to Anakeesta—I love it. Yareliz You didn't see bears. Janer I didn't see bears, but I wish I had. It's just very fun to go there. And the area around Johnson City— the reason I picked Johnson City intentionally before coming here is because of the access to all the things it has. It's big enough to have everything you want, but small enough for people to be kind and for there not to be high crime rates or anything. I really, really like the city. And who knows—maybe I’ll end up staying here after I finish the degree. So yeah—I actually really like it here. Michele Williams Nice. So as all of you know, Gatton has the PEER‑E2 program funded by the Tennessee Board of Regents. PEER‑E2 stands for Promoting Engagement, Excellence and Retention for students whose first or best language is not English. Funds from the program have allowed us to travel to Puerto Rico to recruit students. And Gilary and Yareliz have been members of the recruitment team, and Janer is one of the students we had the good fortune to recruit. So let's start with the students who have traveled to Puerto Rico as part of the recruitment team. Tell us what that has been like. Gilary For me, it has been a very beautiful and excellent experience. I've been to Puerto Rico with the recruitment trip twice, and every time is a different experience. The first time we went with Rochelly—she’s a P4—and we had an amazing experience. We had the opportunity to visit not only schools but also specialty pharmacies in Puerto Rico. And that was a very cool experience. Before going on that first trip, I didn’t know we had so many specialty pharmacies close to San Juan. That changed me—I’m now looking at that pathway, maybe when I finish my PharmD. The second time was amazing too. We visited more schools. You have a unique opportunity to talk about your experiences to other students who maybe only think about Puerto Rico and don’t think about the other opportunities we have in the States. It’s very cool to talk with them and see the interest in their eyes. Yareliz For me, it was my first time going this year, and the experience was awesome. Going back to my alma mater and talking with undergrads—and remembering when I was there too. Even though I hate the spotlight and it’s way out of my comfort zone, it felt so good talking about the school and my experience. Michele Williams And remind us again—what is your alma mater? Yareliz Inter American University of Puerto Rico. Michele Williams Okay. Yareliz Tigers! Dan Vanzant Yeah! Yareliz The students were so engaged. They asked so many questions. They wanted to know much more. Because in Puerto Rico we only have two options for pharmacy school, and they’re both in the capital area. So you don’t really consider going outside of Puerto Rico. We're very family‑oriented, and being far from family is scary. We don’t consider outside, mostly. But they wanted to know more— “How have you been doing?” “What did you do to get here?” Because usually you think graduate school is so hard it’s impossible. Then they realize it’s not impossible. And they can relate to us. Janer She said a lot of things I wanted to say. Even though I've never been on a recruitment trip, I’ve had experience recruiting. I have two friends—one still applying, one recently accepted and already doing the paperwork to get here next year. Gatton made it easier because the things this college offers are so different from my experience—so different from other colleges I applied to—it’s easy to convince people to come here. Not just because of the college, but the area and the staff. Everyone here is so wonderful and welcoming. In Puerto Rico, we think entering pharmacy school is extremely hard because there are only two schools, and both are in the top ten hardest to enter in the U.S. So we think that’s what pharmacy school is everywhere. And since we're family‑oriented, we don’t want to leave. But once I tell them how possible it is—and how accepting the staff is—they’re blown away. They try it for themselves and end up liking it. I hope one day I can make the trip too. That would be awesome. Michele Williams Yeah, that would be awesome. So tell us a little bit about what your P1 year has been like. It's coming to an end before you know it. Janer Well… the P1 year has been—and I don't want anyone to misinterpret this—way easier than I expected. And the reason is that when I was at the University of Puerto Rico Río Piedras campus—the biggest campus—I actually had a harder time getting through my bachelor’s. Not because the classes were hard, but because of everything going on. Puerto Rico was going through riots, earthquakes, hurricanes Irma and Maria… the governor was thrown out. There was always something happening. And I still had to study on top of that. One thing I wanted when picking schools was a place that would limit distractions. And that alone made it so much easier to focus on what I needed to focus on—studying. That’s why it’s been easier in my P1 year. Michele Williams That makes so much sense. A lot of students don’t realize that studying and class rigor is just the beginning—life is still happening. You still have things to manage while you're in pharmacy school. So that’s a very interesting perspective. Thank you for sharing that. Janer That's why I feel like most Puerto Ricans are probably prepared to deal with the things they have to deal with here. We've already gone through so much, and we still had to study on top of it—and keep up with homework and grades. A lot of them—if they've done a science degree—they're probably prepared to deal with a pharmacy degree. Michele Williams Are there any other things you'd like to share about your experience at Gatton? So I talked a little bit with Kwaku before this—he’s our graduate assistant—and he gave me some good advice about questions to ask. He said to ask you all: What information do you need to know coming to pharmacy school, and what information is just good to know? Gilary I will probably say one of the most important things—at least for me, and I’m still working on that—is finding the best way to study. That made me struggle. I'm still learning what the best way to study is, because not all classes are going to be the same way. And you have to adjust that for each class. So probably if you find the best way to study the first year, the first semester, that will be great. Michele Williams Great. Thank you. I can help with that too. Yareliz Yeah. So absolutely—I'm still struggling on how to study because every professor is different. In one class, we can have multiple professors, and one study way is not going to be the same for another class or professor. So you need to get comfortable with change, I guess. Michele Williams That’s a good point. Janer Well, in my case—again, I only went through one semester, so I don't have too much experience. But I can say the earlier you get used to the methods the professor uses to teach, the better it will be in the long run. Don't wait too long to get used to how the professor teaches and how you're supposed to study for the class. Be quick about getting there. And when you do get there, it will feel much more consistent. Gilary Probably—don’t be nervous or shy about asking for help. Here, I learned a lot of things, and one of the things I’m very grateful for is the faculty. They have given me a lot of things to get better. Even when I was in Puerto Rico, I never had a person who was like, “Hey, are you doing good?” or “Do you need help?” So for me it was very difficult to say, “Hey, I need help. This is happening, and I don't know how to deal.” So probably—if you come here with an open mind, saying, “Okay, this is not going well, I need to ask for help”—please do it. Because they have the tools to help you. And they will help you. Michele Williams Great. That’s all really good advice. Dan Vanzant Could you give examples of the different teaching styles—how you've had to pivot from one class or professor to another? Gilary I would say for us—now that we are in P2—cardio has a lot of professors. So sometimes the way they ask the questions is kind of hard. Also in renal, we have like three different professors. And sometimes when we do something like, “Okay, this is not that good,” we go to the professor to ask what's happening. And they say, “You did good in these questions from this professor, but this professor is the one where you’re not doing well.” So my biggest thing is—some professors are more superficial, some are more specific. So you have to know which specifics you need to deal with. Dan Vanzant Okay. Yareliz For me—for example—we try everything. Teach someone else, or have someone else teach the class. Take notes, don’t take notes. Do a study guide, do flashcards. Everyone learns differently. In cardio, with some professors, it’s me and Gilary—we study our material apart, then we come together and say, “Did you understand this?” If I understand it, I explain it to her. If she understands, she explains it to me. In undergrad, I studied by myself because I didn’t have classes with the same people and I was shy. But at the beginning of P1, that didn’t work. Then we started studying together—and that helps the most. Also, for renal—I bought a whiteboard bigger than I expected for my home. Writing things down and doing diagrams helped me a lot. For other classes, I do a study guide in Word so I can make things prettier. So it all depends on each individual and each professor. Michele Williams Thank you. Janer Yeah. Like they said—we have professors that like to teach in a broad spectrum, and others who like very narrow, specific teaching. You have to be fast at recognizing what type of professor you're dealing with and what type of questions they will give. One thing I like about Gatton is—they give out a lot of quizzes. They’re meant for practice. Yes, they’re graded, but they help you understand the professor’s question format. When the test comes, you already know what to expect. The hardest classes are the ones that don’t do quizzes—only lectures. When the test comes, you don’t know what to expect. So if a class doesn’t have quizzes, be careful. Those tend to be perceived as harder. Dan Vanzant Interesting. Thanks. Michele Williams Well, this has been great. Thank you so much for sharing your experiences and advice for future students. And thank you so much for coming today. Janer Thank you for having us. Yareliz Thank you for having us today. And now that you mentioned advice, I just thought of something. Sorry! So like, in general—not in regard to classes—I would advise everyone thinking about pharmacy school to not let fear dictate your decisions. I’m not saying don’t be scared… the best decisions of my life, I've made them dead scared. Even if it's scary—if it's what you want—at least try it. Michele Williams Yeah. That’s really good advice. Janer I think we should say adios then. Like, together. Dan Vanzant Yeah. Michele Williams Do you have something you'd like to say in Spanish? Janer Oh, yeah. Dan Vanzant Maybe Michele can translate it later. laughs Michele Williams That's right. Janer Sigue tus sueños. Follow your dreams. Gilary Yeah… I don’t know. I will say, like— Michele Williams Say it to your friends and family. Gilary Muchas veces se nos hace difícil tomar decisiones por el miedo, como dijo Yareliz, pero si empiezas y tomas el primer paso, después de que estás aquí, todo se hace un poco más sencillo, y en el camino encuentras personas que van a hacer que tu camino sea mucho mejor, así que no tengas miedo. (ENG: A lot of times we find it difficult to make decisions because of fear, like Yareliz said, but if you start and take the first step, then after you are here, everything becomes simpler, and on the way you will find people who will make your path much better, so don’t be afraid.) Dan Vanzant Just beautiful. Yeah. Michele Williams Awesome. Yareliz The only thing that comes to mind… Donde Dios guía, Él provee. Where God guides, He provides. Janer So it sounds like it even rhymes in English. Dan Vanzant That's good. Dan Vanzant That’s awesome. Michele Williams Well done, y’all. Dan Vanzant Yeah. Janer Adios, on three. All ¡Adios!  

This episode features Dr. Lori Mills, a clinical psychologist who is an expert on mood and anxiety disorders, as well as positive psychology. In addition, she provides counseling services to our student pharmacists at ETSU Bill Gatton College of Pharmacy. Dr. Mills shares valuable advice on how to manage stress and anxiety in order to thrive in pharmacy school. 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. I'm your host, Doctor Michele Williams. In this episode, we'll be talking with Doctor Lori Mills, a licensed clinical psychologist in the state of Tennessee. Michele Williams She's an expert on mood and anxiety disorders, positive psychology, and counseling. She's a professor at Milligan University. And fortunately for us, Doctor Mills provides counseling services to our student pharmacists here at Gatton. Doctor Mills, welcome to White Coat Radio. Lori Mills Thank you very much. I'm glad to be here. Michele Williams Well, I'm really glad we have this chance to talk to you today because you are an amazing resource for our students. But you and I rarely have a chance to chat this way, and so there are a lot of things I've always wanted to ask you. So before we begin talking about students, can you tell us a little bit about your background and what led you to a career as a psychologist? Lori Mills Sure. I am probably one of those rare people who decided in high school that I wanted to be a psychologist. And I'm from a very small town in Illinois, very small high school. So I never had a psychology class in high school, but I went to Milligan University—actually was where I did my undergrad—and I was a psychology major from day one. Never changed my major, never veered off of that. And then as I prepared to go to graduate school, I didn't know whether I wanted to be a licensed clinical social worker, like a professional counselor, marriage and family therapist, whatever. But one of my professors just kind of steered me towards clinical psychology, and that's where it went. And I think sometimes I say I had a friend who had a very traumatic accident the summer before my senior year, and that kind of solidified my senior year in high school. That kind of solidified that I can be around people going through really difficult things and enjoy—maybe the wrong word—but giving support in that kind of situation. So that sort of solidified, I think, my interest in psychology and doing therapy in particular. Michele Williams So you had that sense that you had that skill, that ability in you to support people in that way. Well that's awesome. I'm really glad that you do. How long have you worked with pharmacy students again? Lori Mills So it has been about six years. I was thinking about this. It's been since the spring of 2016. Michele Williams Okay. And what has that been like? Lori Mills It's been very fulfilling. I have really enjoyed it. I'm like a lot of other people who go into clinical psychology. I thought, oh, I'm going to have my own private practice. That's what everyone thinks they're going to do. And then you realize how tough that is to build your own client base and all that kind of thing. So anyway, I fell in love with teaching undergraduate psychology, and that really has been the bulk of my career. But later in my life, I really think I've gotten better at doing therapy. I had to kind of get comfortable in my own skin and I think more confident and self‑assured. And I think I'm a better therapist than when I was a younger person. Michele Williams You never think about that with therapists. I don't think that they have a learning trajectory too. And they have to get comfortable as well. So being accepted into pharmacy school is a huge achievement, obviously, but it comes with stressors and responsibilities and demands that are not always easy to cope with. If I'm a student pharmacist who's starting to feel pressure in pharmacy school, how do I know it's time to reach out to you? Lori Mills Well, I think the first thing I would want to say is any time is a good time to reach out to me. I'm always happy to meet with any students. But more to the point of your question, I guess this question made me think of a common theme that runs through mental health and mental illness: when something becomes a problem is when it causes impairment or distress. And so how I would say that is impairment is if this thing that you're dealing with is interfering with your life or interfering with your academic performance, interfering with your relationships, interfering with getting out of bed in the morning. So that would be the impairment piece. And then the distress piece is just, you know, like, I'm feeling really sad. I'm feeling really anxious. I'm feeling irritable all the time. I'm having trouble controlling my anger. Those kinds of things would be the distress. So when either of those—you feel like, yeah, this isn't just something that's been going on for a couple of days, this is lingering and it's causing me problems—that would be a time that I think you say, okay, now's the time to reach out. Michele Williams That makes so much sense. So to just sort of use that as a kind of measure of, you know, how long has it been going on, and is it interfering? Lori Mills Yeah. And I think, for example—and I know we'll get into things like test anxiety probably later—but maybe a typical situation would be that someone might feel like, wow, I get anxious at test time. Well, most people do, okay? I mean, there's some degree. Yeah. So you are going to feel anxious around tests. But if it's: I can't sleep at all the night before I have a test, I vomit every morning when I have a test, and I have isolated myself from all my social contacts… okay, those are things that are saying this is not sustainable. This is taking away from the quality of your life. Like those kinds of things would be indicators that yes, this has gone beyond what you want to keep happening and something that you might want help with. Michele Williams So beyond just wanting to do really well, and I'm nervous. Lori Mills Right. Because I think the vast majority of people have some of that. Michele Williams Yeah. And what can a student expect when they make that first appointment with you? What is that going to be like? Lori Mills Okay. So generally they would have contacted me—and you go straight to me. You generally call me and let me know that you'd like to meet. And I work with you to make an appointment that works for you and for me. And then ETSU owns a house that is probably maybe a mile from the pharmacy school, and it's just in a neighborhood. And so I give you the address of that house, and you come there and meet me. And we meet for 45 or 50 minutes, something like that. That first appointment I generally ask more questions than I would at any other time, just trying to get to know students, asking them what brings you in, tell me a little bit about your family. I ask specific symptom questions to know sort of what they're dealing with. And by the end of the session I get around to, okay, let's try to narrow this down: what are your goals, what do you hope to get out of meeting with me? And then we talk about, okay, yes, that's definitely something we can work on. Because it's one thing to sort of go and pour out a lot of information, but then it's like, well, okay, we have to get some kind of focus to what we're doing and see how we can proceed from there. Michele Williams And so the goal setting, that's where you sort of figure out what the plan is—what you're going to do. Lori Mills Yeah. Michele Williams So one area of expertise—and you alluded to this just a minute ago—is anxiety. And just in the most general sense, what is anxiety? I mean, you hear people say I have anxiety, or test anxiety, or just, you know, I feel anxious. But actually, from your point of view, from an expert point of view, what is anxiety? Lori Mills I think the closest maybe synonym or word that we use interchangeably with anxiety would be worry. And I would call this anxiety excessive worry. It's funny because we use the word anxiety, or we say anxious, but then there's diagnosable anxiety that rises to the level of disorder. So anxiety—I think a certain amount of it is okay and actually preferable. If you had zero anxiety about starting pharmacy school or zero anxiety about starting your rotations or zero anxiety about a test, you're not going to prepare, you're not going to study, you're not going to perform at the level you need to. But that's not what most of us are dealing with. Most of us are dealing with: my anxiety has gone too far. It's too much. So that's when we sort of say, okay, what can we do to take the edge off of this? We're not trying to remove anxiety. Therapy is just not that magical to do that anyway. But that's not even what we're trying to get to. We're trying to bring it down to a manageable level—a level that's appropriate to the situation. So excessive worry about maybe a specific situation that then takes on these different physical symptoms—shortness of breath, muscle tension, fatigue—and then also cognitive and emotional symptoms like difficulty concentrating, irritability. When it starts to gather in those other kinds of symptoms, I think that's when it becomes more anxiety that's problematic, not just “I feel a little worried about my test.” Michele Williams Right. That makes sense. And just based on your experiences working with pharmacy students, what role do you see anxiety playing in the lives of pharmacy students? Lori Mills So I think for some people who maybe again, it's not super problematic, it plays the role of pushing them to work hard. So that's when anxiety is manageable and in check. Michele Williams It seems almost to me like conscientiousness. You know, if someone is conscientious, they worry what the professor thinks of them or how they're going to perform on an exam, and it seems to just come with the territory of someone who's a conscientious student. Lori Mills Well, even to put this in another context—if you think about, for example, a school teacher. A lot of people would say a school teacher should have anxiety their first day of school every year. And if they don’t, maybe it’s time to retire or something. If it’s the first day of school and you don't even worry—you just say, oh, I'll just take out my lecture from last year—you might not be invested. So I think yes, that level of anxiety: most people don’t need to worry about having enough. But you’re right, it’s more conscientiousness. But anxiety also unfortunately plays a very different role for some students. It causes difficulty studying, causes them to be preoccupied with negative thoughts, causes them to underperform, to second‑guess themselves on tests. Even more broadly, thoughts like: should I even be doing this, am I smart enough, do I belong here? So unfortunately I think it plays that role for some students. Michele Williams And it’s interesting you say that. Because when I talk with students and they're having difficulty performing on an exam or on a clinical rotation, I often hear them say, “I just drew a blank,” or, “I froze,” or, “I knew the answer but I couldn't say it.” And then after the exam they remember it. I sometimes suspect that might be anxiety. Lori Mills I think so too. For sure. Michele Williams Okay. And why do you think it's so common? Working with many different types of students over the years, I feel like anxiety is a pretty large part of some pharmacy students' lives. Lori Mills Yes. Let me say something about pharmacy students in particular, and then something broader. Pharmacy school involves high‑stakes testing. Other types of educational programs may spread grades across papers, presentations, projects—but pharmacy school is very heavily weighted toward tests. And you know you have to get a certain score to pass. Even licensing exams add to that pressure. Financial pressure also lingers in the background. Then on a broader level, I think our culture feeds anxiety. We live in an “age of anxiety.” We hear about every bad thing happening in the world and feel powerless. The 24‑hour news cycle has been widely discussed as harmful for mental health. And culturally, we're told we should be happy—and if we’re not, something’s wrong. If we just bought the right product, used the right planner, ate the right diet, decluttered the right things—we’d be happy. This pressure to be perfect contributes to anxiety. Michele Williams Yes, you're right. We feel pressure for everything to be going great, and life doesn't always work like that. Lori Mills I think we have—this is going off‑script—a cultural narrative that says we should work ourselves to exhaustion so that “one day” we can finally enjoy life. Like the story of the Mexican fisherman. He already had the life he wanted—simple, meaningful—but the Harvard MBA tried to convince him to build an empire so that someday he could retire and do exactly what he was already doing. That’s so much like American thinking. And it's unfortunate. Michele Williams It is. And it's easy to fall into that pattern, especially in pharmacy school. Lori Mills Yes. Michele Williams So we talked about anxiety in general—but what is test anxiety? And what tips do you have for helping with it? Lori Mills Test anxiety is extreme distress in testing situations that interferes with performance. There is a very high correlation between procrastination and test anxiety. It becomes a chicken‑and‑egg situation. If you procrastinate, you will feel unprepared, which leads to anxiety, which makes you feel overwhelmed, which leads to more procrastination. Sometimes underperformance gets labeled as test anxiety when lack of preparation is the real issue. I like to think of it like pain medication: doctors say “we have to get ahead of the pain.” You need to get ahead of the anxiety by preparing early. Michele Williams That is a great analogy. And you had some tips? Lori Mills Yes. The first is preparing a sufficient amount and studying over time rather than cramming. Spreading out studying reduces anxiety. Studying effectively is also important—Michelle helps students with that. Not just studying more hours, but studying in ways that actually work. Self‑care is crucial—sleep, nutrition, exercise, relationships, doing enjoyable things. This is a marathon, not a sprint. You can't deny yourself all self‑care for four years. Something I found recently that I like is a calming worksheet. On one sheet, you list meaningful quotes, reminders like “breathe deeply,” your goals, your supporters’ names—things that ground you. Deep breathing helps. Even taking one minute before a test to breathe in through your nose and out through your mouth slows you down. And refuting negative thoughts. When you’re really anxious, you're probably telling yourself extreme things like “I'm going to fail” or “I can’t do this.” These thoughts are not helpful. You need to have prepared statements like “I can do this,” “I’m prepared,” “I know this material.” You’re not trying to wipe out all negative thoughts or pretend everything is perfect—just nudging yourself away from the negative extremes. Michele Williams I love that. Being ready to respond to those thoughts makes so much sense. Lori Mills Right. I come from a cognitive‑behavioral perspective. A lot of people get anxious about having negative thoughts, which makes it worse. Sometimes you can just say, “I'll think about that later. Right now I need to look at this question.” Or, “That thought isn’t true because I’ve passed every other test.” Or, “Another way of seeing this is I won’t know every question, but I will know a lot of them.” Michele Williams That makes so much sense. So what advice would you give pharmacy students with regard to taking care of their psychological well‑being? Lori Mills One thing is: not everything should be about pharmacy school or the career of pharmacy. You need interests outside of that. You need friends outside of that. If your whole life is pharmacy school, everything will feel catastrophic when something goes wrong. Another thing is stepping back and taking a long‑range perspective. Yes, this is hard. It’s supposed to be hard. But you can get through it. Another important thing is seeking other people's feedback. Students get locked into their own narrative. They’re often afraid to talk to professors because they think the professor will judge them. But professors genuinely care. They want to help. So does Michelle, and so do many others. Don’t lose connections to people outside pharmacy school. Those relationships remind you who you are beyond grades. Michele Williams Yes. I think students don't always realize how many of us are willing listeners. If they see an open door, they can come talk to us. Ninety‑nine percent of the time, we'd be happy to talk. Lori Mills Students are more than their grades and test scores. One of my own students once implied that professors only liked the top performers best, and I thought, that's simply not true. Reaching out—even when it's scary—is important. Michele Williams Doctor Mills, thank you so much for the conversation today. It's been terrific—really helpful. A lot of things I don't think students realize about the resources they have here. Are there any other things you'd like to add? Lori Mills I would just add—doing things outside of school, like volunteering, is incredibly healthy. One of the most consistent findings in psychology is that helping others makes us feel better. Getting outside, participating in something bigger than yourself, doing life‑giving things… whatever those look like for you. Identify the activities that energize you and make sure you keep doing them throughout pharmacy school. Michele Williams I think that's great advice. And thank you so much for talking to us today and giving us great tips on maintaining good mental health, and what to do when the pressure is on and we may need a little extra help. Thank you so much for chatting with us. Lori Mills Appreciate you asking.    

Michele and Dan continue the conversation with Dr. David Stewart, Interim Associate Dean of Academic Affairs and Institutional Excellence and Professor of Pharmacy, about his role as the head of Academic Affairs at ETSU Bill Gatton College of Pharmacy. In this episode, we discuss services the department provides including insights into academic progression and student course evaluations.  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. I'm one of your hosts, Doctor Michele Williams. Dan Vanzant And I'm Dan Vanzant. 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. In this episode, we'll talk about Doctor Stewart's role as associate dean and learn more about how academic affairs serves the college and most importantly, our students. In particular, we're going to learn more about those course evaluations that students are asked to complete at the midterm and at the end of the semester—where they go and how they are used. Dan Vanzant Doctor Stewart, welcome to White Coat Radio. David Stewart Thank you, Dan. It's good to be here. Michele Williams So, Doctor Stewart, all three of us work in the Office of Academic Affairs—you as dean, Dan as our instructional design and technology manager, and I'm the academic specialist—but I'm not sure our listeners really know all that Academic Affairs does within Gatton College of Pharmacy. Can you tell us a little bit about that? David Stewart Yeah. So, you mentioned that I'm the interim associate dean, and I've been doing this role for about a year now. I have to admit, a year ago I don't think I knew all that Academic Affairs had within the College of Pharmacy. I was really fortunate to have some great folks in the office, and as you mentioned, everyone on the podcast here today is part of that office. We also have a director of assessment and institutional excellence, and an office coordinator. So it's a five‑person team. I would say the two biggest buckets based on the title would be: Academic Affairs covers things like curriculum, and then we have the assessment component. Assessment is really important for our accreditation efforts and also guides a lot of what we do here at the college—curricular design and improvements, etc. Other things we do include student success, academic progression, instructional design issues for the college, and housing office duties. So those are probably the big buckets. Dan Vanzant Great. So as I mentioned in the introduction, Academic Affairs is responsible for distributing the midterm and end‑of‑semester course evaluations—formative and summative evaluations. We always encourage students to complete those. But what happens with those evaluations behind the scenes? How are they created? And then what happens when students fill them out? David Stewart Yeah, that’s a great question. And I get the same questions from students about how these things are used. Oftentimes it's not even a question—it may be more of a comment: “Why would I fill these out? Nobody ever reads them. I don't think they ever use them. I never see anything change.” So I think from a student’s perspective, I can see why they would feel that way. What I really try to encourage students to understand—and what I tell them upfront—is how they are used, because I don't think we do a very good job of telling students what we do with the data they provide. When a student receives a course evaluation—the technical name is a student assessment of instruction (SAI)—we’re asking them about two things: the course and the faculty. There are specific questions for each faculty member and for the course as a whole. So who gets them? I get a copy in Academic Affairs. The faculty member gets a copy. And the department chair for the faculty member also gets a copy. Our faculty are in one of two departments: the Department of Pharmaceutical Sciences or the Department of Pharmacy Practice. Each department has a chair, and the chair is responsible for reviewing evaluations with faculty each year during annual evaluations. So these evaluations are used not only by faculty for feedback but also as part of their performance evaluation regarding teaching effectiveness. As a faculty member myself in Pharmacy Practice, our chair asks us to identify things we plan to change and to provide a written plan for improvements based on student feedback. I find this very helpful because students often point things out I may not appreciate or didn’t realize were happening. Students are often hesitant to complete evaluations because we ask for them before finals are due, but they are completely de‑identified and anonymous unless a student includes identifying info. The system anonymizes them immediately—we only get the responses. Dan Vanzant Okay. And did you mention this? Do any of those get added to accreditation documents? David Stewart Yes. Accreditation is one of those things—like in healthcare, where the Joint Commission accredits hospitals. If a hospital isn’t accredited, they can’t bill Medicare, and they’ll fail financially. Likewise, if a College of Pharmacy is not accredited, students cannot sit for the national board exams. So accreditation is essential. Our accreditors ask us to report on quality improvement and how we use assessment data. We have latitude in how we use our data, but we must always have ongoing quality assurance processes. Evaluations help us show how we collect and use assessment data, including examples of where students suggested things and we implemented changes—or where we developed alternative solutions aimed at curricular effectiveness. Students often feel like nothing changes because they typically won’t see the changes themselves. It's usually at least a full year before those changes happen—long after they’ve moved on and forgotten about the course. And sometimes changes are iterative; we might refine something over two or three years. Students may think “They’re still doing that!” when in fact we’re improving it each cycle. Michele Williams And they just haven't seen that evolution as it took place. David Stewart Right. By the time the final version comes out, they’ve graduated and are working. Dan Vanzant Do you think that’s true of formative evaluations too? That faculty often don’t make changes mid‑semester, even though the intent is to? David Stewart Great question—and yes, that may contribute to student frustration. Formative assessments—open‑ended feedback about what’s going well or not going well—are meant to allow short‑term changes. We usually try to do these around six weeks into the semester. Block courses complicate timing because they’re so short. If we don’t have good systems in place, we might miss the window. This year we asked faculty for the optimal timing for formative evals so feedback would be meaningful. That worked well. Best practice is for faculty to close the loop: tell students, “Here’s what I heard, here’s what I can change now, here’s what I may change in the future, and here’s what I can’t change and why.” Students need to feel heard, even if everything can’t change immediately. Summative evaluations are easier to analyze—Likert scales, trends, comments. We can identify consistent areas for improvement more clearly. But again, students themselves rarely see the results of their feedback because changes occur in the next offering or several offerings later. Dan Vanzant Feels like putting a message in a bottle and throwing it into the sea. Michele Williams But there is somebody who finds that bottle. Dan Vanzant That's right—future classmates behind you. Michele Williams Yes. Students may not see the benefit of their feedback, but they benefit from the feedback of those who came before them. David Stewart Absolutely. They are reaping the benefits of previous students’ suggestions, and future classes will benefit from theirs. Michele Williams And some students give great feedback, it must be said. Dan Vanzant As a faculty member, what types of feedback do you find most helpful? David Stewart Generalizations are helpful, but specific examples are even more helpful. If a student says, “Dr. Stewart could present information more clearly,” I don’t know what that means. But if they say, “For example, when he explains things with a picture on a slide it’s helpful, but when it’s just words, I struggle,” that’s actionable. If a student says expectations are unreasonable, that’s vague. But if they say, “There was too much pre‑reading—it took me this long—and the assignments took this long,” now I understand. Michele Williams So when students give open‑ended feedback, it helps if they include rich detail and an example. David Stewart Exactly. Michele Williams You also mentioned Academic Affairs oversees academic progression. Could you talk about that? David Stewart Academic progression can sound intimidating. But all students are monitored throughout their entire pharmacy education. Each semester, a committee reviews student grades and votes on progression. If a student earns a non‑passing grade, the committee evaluates what’s needed. You can’t be a pharmacist if you don’t master the content, so we must ensure competency. For some students, if they earn a D in one course, they may complete expedited remediation over the summer. Others may need to repeat the course. Students doing very poorly may be dismissed. The committee advises the dean. Academic Affairs oversees the administrative side—tracking, documentation, ensuring students are treated fairly and consistently. Our goal is to help students progress. Student success is part of our office. Your role, Dr. Williams, involves supporting students through tutoring, success plans, mentoring, and resources. Students are often hesitant to seek help, but once they do, they often say, “Why didn’t I do that sooner?” Michele Williams Yes. Many students don’t realize how much support exists and how invested we are in their success. Pharmacy school is very different from undergrad—but Gatton especially is a supportive environment. Dan Vanzant Their success is a measure of our success. David Stewart Exactly. And if a large number of students consistently struggle, that reflects on us too. Education is always changing. Students today are different from students 20 years ago. Society has changed, K–12 changes, undergraduate differences… we must constantly adapt how we teach. It’s a never‑ending refinement process. Michele Williams Yes. That’s part of what makes higher education interesting—it never stays the same. David Stewart The one thing that stays the same is that it’s always changing. Michele Williams Definitely. Do you have any other questions, Dan? Dan Vanzant No, I’m good. Michele Williams Well, Doctor Stewart, thank you so much for talking to us today about the role of Academic Affairs and all the different things our department does at Gatton. We appreciate it very much. David Stewart It was a pleasure being your guest. Thank you. Dan Vanzant Doctor Williams.    

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—    

On this episode of White Coat Radio, we learn the steps to better sleep for pharmacy students. Dr. Sarah Melton, a board certified psychiatric and ambulatory care pharmacist, and Dr. Jeff Gray, who specializes in the care of advanced age patients with acute and chronic conditions are both professors in the Department of Pharmacy Practice at East Tennessee State University Bill Gatton College of Pharmacy in Johnson City, Tennessee. They offer insights into the effects of poor sleep hygiene on learning and performance, as well as practical advice for sleeping well.  Note: This episode discusses medication and health conditions and is for informational purposes only. Proper diagnosis and treatment of health conditions depends on a number of factors. Your doctor or other licensed health care provider is the best person to address your individual health care needs.   Transcript: Dan Vanzant Welcome to White Coat Radio, a podcast from East Tennessee State University 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. I'm one of your hosts, Dan VanZant. Michele Williams And I'm Michele Williams. In this episode, we'll be talking about sleeping well as a pharmacy student with Doctor Sarah Melton and Doctor Jeffrey Gray. Doctor Melton is a professor of pharmacy practice at Gatton. She's a board‑certified psychiatric and ambulatory care pharmacist. Doctor Jeffrey Gray is an associate professor, also in the Department of Pharmacy Practice here at Gatton, and an adjunct professor in the Department of Community and Behavioral Health at the ETSU College of Public Health. Michele Williams He specializes in care of advanced‑age patients with chronic and acute conditions. Doctor Melton and Doctor Gray, welcome to White Coat Radio. Sarah Melton Thanks for having us. Jeff Gray It's good to be here. Thank you. Michele Williams Doctor Melton, you're an expert in psychiatric and neurological conditions, and Doctor Gray, you have a wealth of knowledge in patient care and wellness. And both of you have many years of experience working with students. So what interests you about the topic of sleep, particularly with students? Sarah Melton Well, I’ve been in academia probably for 20 years now and worked with hundreds of students during that time who come to me with difficulty sleeping and asking for advice, or they’ve come with anxiety and depression and we link it back to not sleeping well. So it’s really been an interest of mine because I know with better sleep there’s better performance. Sarah Melton And I think it's our goal to provide information so that everybody does sleep the best so they can perform the best. Jeff Gray Yes. And for me, I teach a class during the P2 year, and I'm always amazed on an annual basis how many students—when I put them into a project where they investigate a topic they're not necessarily familiar with—choose sleep deprivation or insomnia or something related to the quality of their sleep, because they recognize it impacts potentially their performance and other things they desire to do. Jeff Gray And so I know there's a desire among students to learn more about this topic. Michele Williams Yeah. I talk with students a lot about sleep deprivation, especially with regard to studying for exams. So I'm really excited about this topic and looking forward to learning more from both of you. And it's tempting for students, I think, to forgo sleeping—especially the night before an exam—just so they can get those few more hours of studying in. Michele Williams And also because it's difficult to sleep when they're worried. What types of things can result from depriving yourself of sleep? Sarah Melton Well, we know that students aged 19 to 25 need at least 7 to 9 hours of sleep a night—so on average, eight hours. In the third year, I have our students do a two‑week sleep diary, which is very interesting. What I’ve noticed is that most of our students get much less than eight hours. And before exams, maybe they’re getting 2 to 3 hours, and sometimes some students don’t go to bed at all. Sarah Melton And when they're deprived, we see dramatic decreases in cognitive function. Some studies have shown it’s like you're drinking alcohol. And who wants to take an exam when you're under the influence, right? So that's one big thing we notice for sure. Jeff Gray Yes. I personally witnessed a student last week—this student had been involved in an engineering camp. They had minimal sleep during the week but probably enough to manage. But on Friday night, the last night of the camp, they decided to stay up all night socializing. The final camp day was Saturday, and I watched this individual all day long—knowing they’d had hardly any sleep. Their performance was way off, compared to earlier in the week. They were not as engaged. Had they had an exam that day, I’m certain they wouldn’t have performed well. Jeff Gray But your question also touches on chronic deprivation. Chronic lack of sleep increases risks of cardiovascular disease, hypertension, stroke—much higher risks than individuals with adequate sleep. And with athletes, inadequate sleep increases risk of accidents and injuries. Sometimes students find that motivating. Michele Williams Yeah, and what their needs are to strive for better sleep. Sarah Melton Well, another thing we frequently see with chronic sleep deprivation is increased anxiety and depression. And if you're anxious or depressed, you're not going to be productive or perform well. We also see a link with obesity and weight gain, which many people don’t realize. Michele Williams I notice when students come to me after an exam they didn’t do well on saying, “I don’t know what happened—I was so prepared, and then I just went blank,” I always ask, “How much did you sleep the night before?” Often the answer is none or just a couple hours. They don’t connect the dots that they would perform better if they slept more and studied less that last night. Sarah Melton I totally agree. It’s super important to ask. Jeff Gray Yes, there's often a disconnect. Students want consistent sleep but don’t realize how it affects exam performance, athletic events, or other activities. Michele Williams Pharmacy school can really cause students to feel they don’t have enough hours in the day. They feel like sleep is a luxury. So what are some realistic things busy pharmacy students can do to improve the quality of their sleep? Sarah Melton We call this sleep hygiene. Just like brushing your teeth every day, these are daily habits for better sleep. Number one: Go to bed and get up at the same time every day. The brain likes patterns. Students often sleep less during the week and try to catch up on weekends—our brains don't work that way. Number two: No caffeine after 3 or 4 PM. Students laugh at this, but caffeine disrupts sleep. Energy drinks are especially harmful. Jeff Gray I don’t think students realize how much caffeine they’re consuming—many drinks today have several days' worth of caffeine in one serving. Sarah Melton We once had a student drinking 28 Mountain Dews a day! They were referred for anxiety and insomnia—they didn’t need medication; they needed a caffeine taper. Sarah Melton Alcohol: binge drinking on weekends severely disrupts sleep. Some drink alcohol to help fall asleep, but chronically this harms sleep patterns. Jeff Gray Over‑the‑counter products can also interfere with sleep—pseudoephedrine, decongestants, antihistamines taken at the wrong time can be stimulating. Michele Williams So students should ask: What am I ingesting? How much caffeine? Any allergy meds? Alcohol? It’s not always just stress. Sarah Melton Exactly. Also, avoid exercising right before bed—it increases alertness. Avoid TV and screens before bed. If you can’t fall asleep, don’t stare at the clock—turn it away. Your room should be cool, dark, quiet—some like white noise. Jeff Gray Where we’re recording now would be a great sleep environment—dim lighting, quiet, gentle HVAC noise. Sarah Melton But naps? Not always a good idea. Napping late makes it harder to sleep at night. Consolidated nighttime sleep is best. Jeff Gray Yes—sleep hygiene is an all‑day process, not just what happens before bed. Dan Vanzant As a parent, I’ve seen more people recommending melatonin. Have you seen an uptick in students using melatonin or self‑medicating? Jeff Gray Students definitely self‑medicate. Hopefully they're informed. I work with older adults—many use melatonin. I rarely recommend it for anyone over 40 unless there’s a schedule disruption, like jet lag. Sarah Melton Evidence shows melatonin is only effective in a few populations: intellectual disabilities, developmental delays, blindness, jet lag. Otherwise, it’s not very effective—though some swear by it. Other OTC sleep aids like diphenhydramine or doxylamine cause next‑day hangover and cognitive impairment. Not ideal for exam days. Jeff Gray Best practice: Don’t try new medications the night before an exam. Follow the same routine you used while studying. Michele Williams That makes so much sense. Dan Vanzant Doctor Melton, you mentioned blue light. People say not to use devices before bed. Any thoughts? Sarah Melton We recommend no phone, computer, iPad, or TV for one hour before bed. Light is activating. Create a calming routine instead—bath, pajamas, brushing teeth, reading. Blue‑light‑filter glasses can help too. Jeff Gray Students still need electronics to study, but that 30–60 minute window helps. Dan Vanzant What about fitness trackers and tech that monitors sleep? Sarah Melton Fitness trackers are helpful—especially for seeing how long it takes to fall asleep (we want 15–20 min), number of awakenings, hours slept. Jeff Gray My mattress even tracks my sleep! It was eye‑opening to see how restless nights matched how I felt the next day. Tracking patterns can reveal how alcohol, cold medicine, or activities affect sleep. Sarah Melton There’s a great free app: CBT‑I Coach (Cognitive Behavioral Therapy for Insomnia). It guides sleep diaries and teaches cognitive strategies for sleep. No ads. I recommend it often. Dan Vanzant That’s great. We’ll link it in the notes. Michele Williams This has been fascinating. Dan Vanzant Doctor Gray and Doctor Melton, thank you so much. This has been great information for students about sleep and sleep hygiene. Sarah Melton Thanks for having us. Jeff Gray My pleasure.        

In Part 2, Dr. Katelyn Alexander, Director of Experiential Education at ETSU Bill Gatton College of Pharmacy in Johnson City, Tennessee, goes deep into the context and purpose of experiential education and offers insights and perspective from the preceptor’s point of view. 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. I'm your host, doctor Michelle Williams. In part two of this two part episode, we'll be talking about experiential education with Doctor Katelyn Alexander, associate professor of pharmacy practice and currently serving as Director of Experiential Education. Michele Williams If you missed our last episode, we covered the basics of experiential education and clinical rotations. So if you're new to pharmacy school, you really want to check that out. So welcome back to White Coat Radio. Katelyn Alexander Doctor Alexander, I'm excited for this one. Michele Williams Me too. Michele Williams So in this segment we're going to take a deeper dive into experiential education at Gatton. And I'm excited about this episode because there's so much to learn. And I recently found out in our last episode that, experiential education is responsible for one third of the pharmacy school curriculum, and that's amazing. Katelyn Alexander Yeah, there's been all sorts of cool things about experiential at that. I've learned since moving into this office and, and that the relationship between experiential education and students like career planning, between, the kind of career exploration, there's just a lot of things that relate. So, yeah, it's a it's, it's a complex and complex office with a lot going on. Michele Williams Yes, definitely. And, so, so I'm so glad that we're we're doing a deeper dive into experiential education with this episode. And, so, so I have some, some more specific questions. So. Yeah. So let's say I'm a student pharmacist and I'm getting ready for my first immersive rotation. That would be an eye eye PPE and introductory. Michele Williams Yep. Pharmacy practice experience. Yep. When we're where I'll be at the practice site all day for several days in a row, it's my understanding it's an immersive rotation. Katelyn Alexander Yeah. So most of the time students will spend between 8 and 12 hour per day. Usually, subsequent days over the course of about two weeks. So our blocks are two weeks. But, you know, sometimes the the length of time can vary minimum of 80 hours for those initial rotations. Michele Williams Okay. And so, so I know that this learning experience is going to be different from sitting in a classroom listening to a professor, you know, engaging in the classroom setting. So, so what can I do to shift into that experiential mindset? Because it's it's been my experience as someone who who works with students on developing, learning strategies and becoming more aware of their thinking processes and their learning processes, that that sometimes when there is that shift to an experiential setting, students take with them that classroom mindset of, you know, I'm used to being in the classroom. Michele Williams I'm really good at listening to lectures and or participating in small groups. So so what can students do to get into a more experiential mindset? Katelyn Alexander So I think that is true. It's a it's a much different type of, delivery of information. It's a much different type of assessment of what students know. So I think the first thing is, for the IPS, we specifically provide a workbook to help kind of guide students to give them a little bit of that academic structure. Katelyn Alexander Rotations in your fourth year or AP rotations do not have that same rotation or workbooks that goes with the rotation, but for IB is to kind of bridge them from the classroom to the practice environment. We provide this workbook to help kind of get them thinking and asking the right questions. So, you know, we usually tell students to kind of look that over to look over information about the rotation just so they sort of know what they may be participating in. Katelyn Alexander But the biggest thing I think that's different about experiential coursework versus didactic coursework is you also get to be somewhat in charge of your learning. So students have to be reflective about, okay, what am I comfortable doing or what have I had experience with? What am I maybe nervous about that I would like to learn more about? Katelyn Alexander Or what do I what haven't I seen? What don't I understand that I feel like I really need to gain confidence in. So you can approach rotations from lots of different ways. You can seek out opportunities to practice things that you are comfortable with, but want to gain more exposure to. You can use it to fill in gaps of things that you're not comfortable with. Katelyn Alexander Preceptors can can accommodate lots of different requests, but you have to tell them what it is that you're hoping to gain out of the experience. So it also takes a little bit of introspection to figure out, well, what do I want to get out of the experience and how will I go about doing that potentially. Michele Williams So you have to be a little bit more active in understanding what your goals and what your needs are, as opposed to in a classroom where the faculty, the professor, is going to have a sense of what your needs are as a learner, you're you're a little bit more behind the wheel in an experiential setting. It sounds like where you're you need to have thought about those things ahead of time and, and verbalize those to if there's something that that you're wanting from the experience. Katelyn Alexander Absolutely. Because people can adjust it versus the classroom. You know, I have to make it fit every learner in the room because everybody is receiving the same delivery of that lecture content, but with a rotation, most of these placements, you're 1 to 1 with your preceptor. Maybe there's two students to one preceptor. So the ratios are much smaller, which means even though the preceptor is still doing their full time job, being a pharmacist in whatever setting you're in, there can still create learning opportunities for you. Katelyn Alexander And it also helps them know, okay, where am I going to have to really provide a lot of guidance to a student on. Or where am I going to have to maybe identify some additional learning opportunities versus if they're comfortable and confident, I can maybe watch them a few times, can model, but then I can really give them autonomy very quickly because they're comfortable with that. Katelyn Alexander And then I can kind of let them go and fly, because I think an experiential where students learn the best is when they just get to do things autonomously, when they get to do it on their own. So having a having a preceptor be aware of what you think your strengths and weaknesses are, things you want to work on really helps them model that rotation. Katelyn Alexander And every site's going to be different. I mean, certain sites maybe have different opportunities available. So for example, if you recognize that maybe you're not that comfortable giving immunizations, some sites are going to be and depending on the time of year, some sites will have lots of vaccines that they give and some sites that may not be as much of a part of what they do or maybe just wouldn't be available. Katelyn Alexander So they can try to prioritize it based on what they know you want to work on to to an extent. And, and that's where we come into play. We usually will help coach students, as well with their rankings. If I know that you have this kind of goal, I can help you pre identify the sites where you're most likely to achieve that. Katelyn Alexander Oh, okay. So we even go about it before you even step out on to rotation. Our office, when we help students plan their schedule or rank their preferences, we provide some coaching about the types of sites that will accomplish the goals that they have. Michele Williams So students really need to be thinking about what they want and what what their needs are, even before the first day of rotation. Katelyn Alexander Yeah. So the earlier you can kind of start doing that all along, I think. I think that helps out a lot. Michele Williams Okay. So it sounds like, like being a very active and sort of engaged student when you're on rotation is is really beneficial. Yeah. What if I'm a little more, on the, on the introverted or reserved side of things? I'm not super comfortable, you know, being really chatty or. I feel a little intimidated. What what would you suggest that a student could do to to have a good experience, even though they're not, very, very extroverted. Katelyn Alexander Yeah. Or comfortable. So we probably get a lot of questions from students to that first rotation that they go out on. That might be the most time they've ever spent in a pharmacy. And so they're very nervous about I don't really know how things run. I don't want to I don't want to get in the way. Yeah. So the first thing is rotation. Katelyn Alexander Just because you have a preceptor or an instructor doesn't mean that's the only person you're going to work with. Okay. So look for lots of people who can help you, technicians who are, sort of support staff in the pharmacy. Other students, they may be, more able to assist. You are more, more approachable, but they may just have more flexibility with time, because of their responsibilities. Katelyn Alexander So don't always assume that just your preceptor can help you. I think there's lots of different people you can learn from on rotations. I think students sometimes feel like there's an expectation that they know how to use the computer system right away, or that they know very quickly how to jump into the workflow. And we just tell them we're we're not looking for perfection. Katelyn Alexander I just want you to try, and maybe do things that you are comfortable with. So you may not know how to put how to answer the call, but if the phone's ringing, listen a couple times to figure out how people answer the phone. You can answer in the next call and maybe talk to the tech ahead to figure out how you put them on hold after the fact. Katelyn Alexander But, you know, just kind of jumping in honestly will help you feel more comfortable because, because it gains confidence. And the thing that sometimes I think hold students back who are worried about messing up is that they never get the practice. They never dip their toe in enough to to feel confident about anything. So you have to be a little uncomfortable to grow. Katelyn Alexander And this is the perfect time because we're just looking for you to show progress. Michele Williams So take a little bit of a risk. Katelyn Alexander You take you take some little risks. And if and if you're not sure and want some guidance still about what risks to take. Find a friendly technician and maybe say, how can I help? And they will be happy to tell you a million ways, whether it's helping them pull, restock bottles, maybe it's helping them answer the phone, maybe it's helping with check out like they will find little ways to get you, incorporate into the workflow. Katelyn Alexander And they're happy to answer questions. There are no dumb questions when you're on rotation. Michele Williams That's good to know. And and I from from what you're saying, it's it's a good idea to, to take a risk because then once you realize you can do it, that confidence builds on itself and and you get better and better. Katelyn Alexander Yeah. And sometimes students, I think, worry about, well, what's what's my role as a student versus, oh, I shouldn't do that because that's a I don't want to step on someone else's toes. Or maybe that that role is not beneath me, but it's it's meant for a different type of staff member. And I would say like, everybody kind of jumps in and does everything and most pharmacy setting. Katelyn Alexander So it's okay. However you start to just just start. That's the biggest thing. Like we all have to be willing to take out the trash. So most pharmacists will tell you at the end of the day, you know, if, if, if the phone is ringing or something needs done, they have to know every aspect of what happens in their work setting. Katelyn Alexander So, so by a student jumping in, there's no wrong place to get started. Michele Williams Great. And, so, so it sounds like that, that kind of taking action and, and getting engaged and stepping outside of your comfort zone, those are things that are that are expected and and are good to do. And, and can you talk a little bit about some of the other expectations that, that are different from a classroom expectation? Michele Williams Sometimes it's difficult to, to bridge that gap. So when you're in a new environment, it can be difficult to know, what are they expecting of me? Like you said, am I in the way? I don't want to be in the way. I don't want to be an impediment to them getting their work done. So. So how do you, find out what those expectations are? Katelyn Alexander So on for a good rotation? All of that happens on day one or happens ahead of the start. So we'll coach students to reach out to their preceptors roughly two weeks before the start of the rotation via email, they usually ask a couple of questions. You know, where do I show up? What do I wear? What time do you want me there? Katelyn Alexander All those things? Do I pack a lunch? And then on the first day, most preceptors, unless something goes catastrophically wrong and they have to adjust, they'll do a quick orientation with the student of here's, here's maybe where we'll have you start different kind of get you oriented to the workflow, get you introduced to people. And that just kind of shows you, I think, where you might be involved, but rotations, IB rotations specifically their pass fail. Katelyn Alexander So the elements of the grade for the rotation are a guided by the workbook. So they're things that because of where you are in the curriculum, we know you can do and we can apply and this real world setting. And then the other part is just do you show up? Do you act like a professional. So I think as long as you're making an attempt to be involved, as long as you're, you know, putting your best foot forward and really trying to be engaged and and staying, participating in the elements of, what's going on around you? Katelyn Alexander That's that's really what we're looking for in a past. The things that sometimes students, I think, misinterpret. It's not a good it's you're not really doing what you're supposed to do if you're simply just hanging out, standing against the back wall, letting things fly by. Michele Williams You. Katelyn Alexander Okay, you're not just there to observe. You're there to participate because you're not going to learn as much as you can if you're simply watching. You really learn by doing so, you have. Michele Williams To build on it. Katelyn Alexander Yeah, okay. And you can do things that you feel comfortable with. So throughout the first year curriculum, we will prepare you through lab and through several courses. There will be skills that you learn that you can use communication skills with patients. You'll have a lot of the foundational things that you can start using when you go out. Katelyn Alexander So you have to be responsible for the knowledge that you have received, and you have to be willing to provide that. But as far as things that are unique to the site, maybe the computer system or specifics with the workflow, there's no way we can teach every every student, every individual pharmacy or health systems way of doing things. Katelyn Alexander Yeah. So there are some on the job that you'll have to kind of pick up on. And there's a learning curve there, but we're not expecting you to be an expert after two weeks, especially if this is your first time working in that setting a pharmacy. Michele Williams Okay. Katelyn Alexander But you have to be willing to just do it's not just observational, okay? And then you have to really, I think still be able to dig back within what you've learned in the curriculum and be able to apply it. So an example of that might be, let's say a patient comes up to the counter seeking a recommendation for an over-the-counter product. Katelyn Alexander Maybe they have seasonal allergies or cold or something. You've had that in the curriculum as a P1. So when the pharmacist says, hey, would you mind counseling them on this. And I histamine that they picked up or this allergy medicine that they picked up. Yeah. You know that you can do that. Yep. You're up and, and probably the first time I mean most preceptors, they'll kind of feel the student out to to figure out what you're comfortable with. Katelyn Alexander Like we talked about previously, you know, you have to also be aware of what you're good at and what you're not comfortable with. Right. But generally, you know, after maybe observing one, the preceptor watching you, for one, you know, then they'll sort of turn you loose when they feel like you're ready. So, you know, the expectation is that you do are responsible for what, you know, however, from there, it's really just are you kind of participating? Katelyn Alexander That's really the expectation. Michele Williams Okay. And, let's say that that I get the sense that, I don't have a good communication with the preceptor, because people are people, and human beings don't always have a great fit with each other. Yeah. What are some things that, if I'm a student pharmacist, that I can do to to work on that communication because you you're you may encounter that at the point where, where, you wish the communication were better with the preceptor. Katelyn Alexander Yeah. And that that can be for lots of different reasons. Like you said, it can be a mismatch between kind of people's personalities. Sometimes preceptors have personal things going on. Pharmacies are really busy places, and so it can be easy to get lost. The one thing that sometimes I notice where students can sometimes fall into a can, they can they can, I want to say it, they can create communication barriers for themselves is by picking the wrong time. Katelyn Alexander So you may have to kind of step back and think, okay, if I'm asked, do I have to ask my preceptor this question? Like, maybe it's a question about the computer function or, where do I find this thing? Do I have to ask my preceptor and then be, if it's a question about like, philosophical things, tell me about how did you get to this career? Katelyn Alexander What do you really like about this type of pharmacy is right now the best time to ask them that question. So sometimes students won't have the awareness of this is a super busy time and I'm peppering my pharmacist with questions. Maybe I need to wait until there's a little more of a lull, because preceptors love having those conversations with students, of course. Katelyn Alexander But sometimes communication breakdown happens just because the timing is off. And, and sometimes preceptors because they're, they're taking you on in addition to their, their full time job. You know, they may not be able to be the only person you go to with every question. So that's where getting comfortable with the rest of the staff is really important. Katelyn Alexander Because if you're on a rotation with me and you have a question about something related to the operations of our office, I may not be the best person to tell you. It's probably one of my staff members. So, so using the rest of the team essentially can can be helpful. But if those things aren't really what's at the crux of the problem? Katelyn Alexander I mean, openness is the best kind of communication. And sometimes you may have to pull your preceptor aside an opportune time and and sort of say, I feel like we're not on the same page. Can you clarify this? And you may have to kind of work through whatever that communication is. Just so you have some clarity, or if that really isn't working, either, you can always reach out to our office and we'd be happy to work with you. Katelyn Alexander But most of the time, I think it's just a matter of, you know, who are you asking? Are you asking the right person the right question? And then also, timing. Michele Williams So it's it's probably a good idea if you get a little bit of a short response from the pharmacist to think back on, when was I asking this question? And and maybe it wasn't the question or it wasn't me. It was that I should have picked a better time to ask the question. And and then was there someone else that I could have asked? Katelyn Alexander Yeah, a lot of. Michele Williams Pharmacists or people. Right. And they get busy and just like everybody else, if you if you ask the person when they're really busy and distracted by some important task that they're doing, you may not get. Katelyn Alexander You're not going to get their full attention and you might not get the type of response you want. And students, I think it is a big shift. If you're in a classroom and you have a question, you're the only person you turn to is the instructors, the faculty member. And since the preceptor is the faculty or instructor or equivalent of the rotation, a lot of students feel like, well, I should only be asking that person. Katelyn Alexander But we even tell students, you may not even exclusively be working with that person. They may work a schedule that's different to yours. So you might work with other pharmacists at the company. You'll definitely work with other staff members. And that's a good thing, because in the real world, you're going to be working with all those people to like, you need to kind of to, you know, get comfortable with lots of different folks. Michele Williams So, so the whole environment and all the people in that environment are part of that learning. Katelyn Alexander Yes. Michele Williams It's not just a 1 to 1 with that preceptor. Katelyn Alexander Yeah. You're not you're not like side by side with them across the entirety of the experience. You're not glued to their side. You you definitely kind of float around with everybody working in that, that team. Michele Williams And they can still, if a student is having, a challenge and they need a little bit of advice on isolating it, they can they can contact you. Yeah. They could contact me, actually, if they wanted to talk about just straight up communication skills, not the clinical piece. Katelyn Alexander But. Michele Williams The communications. One other thing that I would suggest if, if someone is having, if they're a little more on the reserve side, a little more introverted and, and you're, you're trying to break through a kind of communication barrier or something that I think can be helpful. It's also helpful if you have if you're more extroverted, too, but especially if you have a little more introversion is to write down what you're going to say. Katelyn Alexander So yep. Michele Williams If if things didn't go well to kind of process it, once you're out of the fray, once you're home and think about what how you'd like to articulate, you know, the express yourself and and make a connection with that preceptors, there's nothing wrong with writing it down and sort of thinking about what you're going to say first. Don't don't read it to the preceptor. Michele Williams But but that act of writing, it helps you to kind of articulate what it is you, the point you want to make and get the information across, especially if something a little, less than optimal happened in the communication. That can really be helpful. And and the other thing that I think is so important about experiential ed is that it's, it's in those, those tough situations or tougher situations that we learn the most. Michele Williams Oh yeah. Working with other people. Working through communication, misunderstandings and things like that. That's you don't learn how to deal with misunderstandings unless you have a misunderstanding. Katelyn Alexander Yeah. And and our office is happy to coach you. But a lot of times we do tell students, okay, take our advice. And now you have to go do it for exactly that reason. Because this is a perfect learning opportunity to to build a skill set that, that a lot of students don't have. And that's really important for your future job. Katelyn Alexander So, yeah, absolutely. And, both Jolina and I's Angelina, is the assistant director for experiential ed. Her background is in, career counseling, so she actually has a lot of good insight, too, about just how to how to talk with other people in the workplace, as well as kind of giving advice for placements as it relates to, like, ultimate career goals. Katelyn Alexander So, so. Michele Williams Lots of good resources. Katelyn Alexander For. Michele Williams Experience all at. Katelyn Alexander Yeah. And we're we're happy to help navigate that and we'll, we'll intervene with preceptors if we have to. But most of the time it's usually just, a timing issue or difference of expectations. I think sometimes too is like the real problem. But yeah, we're happy to help students navigate that. Michele Williams So you mentioned, sort of career readiness. Yeah. Some of these skills that you're learning are really not just the the clinical skills that you're learning, but also the communication skills, the interpersonal skills workplace skills, those are all things that are happening while you're on rotation. And they really start from the very first IPA. Yeah. So can you talk a little bit more about that? Michele Williams The the relationship of that, that, IPA and AP experience to the larger kind of career plan that. Katelyn Alexander Yeah. So IPA is because they're introductory, they're more just kind of exploration. But a lot of students, what we have found with IPA is, is it's a good opportunity to find, paid employment. So students will go, let's say, to maybe a retail chain, they're really impressed. And that preceptor has a network of folks above them. And they might say, well, we're we know a store close by is looking to hire an intern. Katelyn Alexander And it's amazing how quickly then that student usually is called up of, hey, I heard from your preceptor, or they're encouraged by the preceptor to apply because they're just did a really great job. So that's usually one kind of career route. A lot of students, find that their IP rotations will influence their AP rotations. So maybe they go to on their clinical IP after their second year. Katelyn Alexander Maybe they go with a at an ambulatory care site. So outpatient, outpatient clinic where a pharmacist is working alongside physicians and nurse practitioners. And I don't know how many times we hear, man, I definitely want that rotation. Maybe we even have that same preceptor. On my app is. And on the flip side, sometimes students will say, I know that's not the career for me. Katelyn Alexander And I, I'm going to change my rotation selections to kind of go in a different direction. So that I think definitely helps kind of guide APS in general. A lot of students will come in, well, both ways, since they're come in still not knowing exactly what they want to do post-graduation. Or sometimes students come in with a very clear idea of what they want to do, and we provide coaching to all students about selection, both on IPS and APS. Katelyn Alexander But, a lot of times we hear back from students, particularly in the fourth year and every I don't know how many students I've heard say, every month. Oh, this was my favorite. Oh, no, this one was my favorite. So it's really fun to see how the rotation experiences change their career path. And open their minds to different opportunities. Katelyn Alexander And, and ultimately result in job. So on the fourth year there you're there for four weeks and four weeks is an awfully long interview. So I don't know that students always appreciate that the rotations really can set them up for future job opportunities simply because, you know, if ever there's a position opening, a lot of times pharmacies will go back and hospitals will go back and say, well, who did we have on our rotation? Katelyn Alexander Oh yeah, I love that person. Let's see if I wonder if they're still around here. I wonder if they're available. They also, employers will reach out to our office, sometimes to inquire about students that they've had. Or just if we know anybody who is job searching. So it's said a lot. The field of pharmacy is really small, but it's really true. Katelyn Alexander If you have a good experience, whether it's an IPA, two week rotation or an AP four week rotation, that really can create a lot of opportunity for you. Just because people really value and recognize good work and a good fit with the rest of the team at a site. So, yeah, there's a lot of things that grow out of a lot of opportunities that grow out of rotations that students may not always think about. Michele Williams I was kind of wondering that to our students, where you use the word interview when you were talking about rotations. And so it sounds a bit like a rotation is like an extended interview in some cases, because your specialty, if you're interested in and working in that particular area. Katelyn Alexander Yeah. Because, because it, it if you're exposed as a preceptor, if I'm exposed to a student and I get to watch firsthand what they do, you know. Michele Williams Quality of their. Katelyn Alexander Work, the quality of their work, their, their behavior, their, yeah, their, you know, their attitudes, all of that, their knowledge. I can't help but apply that to a future interview. And, you know, interviews are pretty brief. So if you have that rapport with somebody because of that placement, yeah, it can definitely change the way you're perceived. Katelyn Alexander In an during an interview process, really. Michele Williams Gets your foot in the door. It sounds like. Katelyn Alexander Yeah, for both jobs and for residency. So we'll coach students, you know, if you're interested in, residency placements as well, consider doing a rotation. I don't know that I would do all my rotations at a single site, but consider maybe at least one month because you know that that will make an impression. And that will get back to, the, the director of the program at that site. Katelyn Alexander So it's a really great way of and it's a good way for the student to kind of feel out, both from a, in a residency seeking process and a job seeking process. Is this a good fit for me? Yeah. So I think it it definitely works. Both ways, but yeah, it's, it's an important element and similarly, a good work. Katelyn Alexander The news travels fast, but, you know, bad news travels fast as well. So sometimes what we'll hear from preceptors is, maybe the student is interested and has a clear direction for career goals. So again, on our our fourth year, there's four core rotations that every student has to take. They cover a lot of variety of practice settings. Katelyn Alexander So let's say you're going to you really want to work in a community pharmacy, but, you're on rotation in a hospital or more clinical environment up on the floor. And preceptor could really tell that you weren't that interested or you didn't give very good effort. Well, I don't know how many times we've heard that, you know, that preceptor and that employer, through various channels probably know each other or know someone else. Katelyn Alexander And so sometimes we're we've heard, well, a student maybe didn't get an opportunity because, you know, they kind of melded in on an experience. So their. Michele Williams Lack of enthusiasm. Katelyn Alexander Kind of showed. Yeah. So you can never take for granted that even rotations that maybe aren't what you really want to do, still can make a big impression because you're how you represent yourself is, is your identity. And that will travel with you whether you intend for it to or not. So yeah. So it's really we always coach students like you have to be interested. Katelyn Alexander You have to be dedicated and be enthusiastic whether it's what you want to do or not. Michele Williams That makes sense. And I think it's it's a really good thing to know ahead of time to realize, that that those skills that you're, that you're learning and that you're employing, they're being noticed, they're worthwhile to develop. You want the preceptor to see you developing those skills. And it sounds like the, the expectation is not that you've got everything all sorted out and, and that you do things perfectly, but that you're, that you're engaged and you're really working to, to do your best and, and to improve areas that you might be weekend. Katelyn Alexander Yeah. In particular in the AVP. So in your advanced pharmacy practice experience, the the ante is up a little bit. The stakes are a little higher because you've been through the whole curriculum. There is a little bit more, of an expectation that you can apply the knowledge and you may not get the, the preceptors question, or you may not get the answer to every patient scenario. Katelyn Alexander Right. Every time. But if you have a learning opportunity and rotation, the other expectation is that you learn from it and you can take that and apply it moving forward. So you're really responsible for building on that knowledge and you want to see a progression. So everybody's going to have different starting points. And your starting point is going to look very different when you first start on rotations. Katelyn Alexander In the summer of your P4 year versus the spring of your P4 year, when you're months away from getting licensed. So preceptors expectations kind of have to shift because of the amount of experiences that you've had. But I think as long as you're showing growth and as, as long as your, applying knowledge that are things that you've learned and kind of consistently then can apply them over time, that's going to make you successful. Katelyn Alexander We had a faculty member one time laugh that a student was upset that they didn't get an A for A rotation. Students. I showed up on time, I dress professionally, I communicated well, and the preceptor said, yeah, that's the expectation at baseline. That's the foundation. I need you to kind of continue moving. Because kind of like we talked in the past, sometimes you have to be a little uncomfortable in order to grow. Katelyn Alexander If if I'm just if I'm meeting where you where you are and you're constantly comfortable, then I didn't really do my job because I didn't get you to do something. I didn't push you. So preceptors are not going to. They're not going to have things that are completely un, unreasonable as far as expectations. Yeah, but they are going to try to get you to move forward so that you can grow. Katelyn Alexander Yeah. Because that's the whole point of that fourth year, and. Michele Williams It's all in service of, helping someone to become a really good pharmacist. Katelyn Alexander Right. Michele Williams Which which we all want to have happen. Katelyn Alexander Right. We want you to be successful in your career. We want you to be successfully licensed. We want you to take care of our patients, too. I mean, we're going to share patients across the the continuum. And so, yeah, it's all out of a place of I, just looking out for you. And that's sometimes tricky for students, too. Katelyn Alexander I think the feedback that you get on rotations is a little different than how it's delivered in the classroom. So sometimes students really struggle feeling like it's, either personal or feeling like they can't do anything. Right. And that's not that's not the goal of it at all. The goal is, again, kind of making you aware, if you aren't already, what you're good at and what you are and where to focus attention and, and how to kind of continue to grow and move forward. Katelyn Alexander So maybe that's where you have to study a little bit more. Maybe that's where you need to find out where you can get more practice. But, you're going to get a lot more feedback and it's all going to be verbal versus in the classroom. The ways we assess your knowledge is much different. Michele Williams Yeah, that's a good point. And it I think it's probably a little a little more challenging to get verbal feedback about your performance versus getting this sort of grade that pops up on your, on your computer that you can look at. But to have a interaction with somebody where they're telling you something, I think that's and that's actually much more like the real world. Katelyn Alexander Yeah, absolutely, absolutely. Michele Williams So yeah. All of this is, is, I think, so important for students to understand because, some of it is not, not necessarily written in a manual or workbook. Katelyn Alexander No, it's not there. Michele Williams But they're things that are really important to know about the, about experiential education, what the expectations are and how they're different from, from being in the classroom. Are there any other things that, that you can think of or sort of parting words about, experiential education that. Katelyn Alexander Yeah. So we, I mean, this isn't the only time students will hear about experiential ed. So we orient everybody, to the courses in the fall. We do lots of orientations when they get to provide their rankings. We're actually going to start meeting with every single student to kind of coach them through their ranking process. We do a very extensive onboarding. Katelyn Alexander So there's a lot of touch points that students will hear information. Michele Williams So the ranking process is where they prioritize their first choice, second choice, etcetera. For the rotations. That's what you mean right okay. Katelyn Alexander And they can also prioritize time when they don't want to be on rotation. So like if a student is going on a vacation that they know about, if they're getting married, they can also tell us and priority or through their other rankings, they can kind of avoid certain timing and we'll look at that. But yeah, students, and a lot of students don't really know, you know, what they, what they want to do or what the difference is. Katelyn Alexander And some of the placements are. So that's why we meet with them to really talk through. Okay, here's the read between the lines. Because similarly, just seeing a preceptor name who you don't know, a store that you're not aware of, the differences between the Walgreens on the corner of State of Franklin, that's just around the corner, and West Town Pharmacy, they couldn't be any different. Katelyn Alexander And they're a stone's throw away from each other. So, and that's really where our office can kind of help students decide. There's just so many cool opportunities. And I think, experiential ed is a really place where students can do some exploration. So we have rotations. I think I mentioned maybe in the past episode, we have different zones for rotations so students can complete rotations out of our area, or they can elect to do everything within kind of 90 miles of the college. Katelyn Alexander We do have some rotations that students can apply for. So we have rotations with the Tennessee Pharmacists Association. We partner with the FDA, the CDC, with multiple professional associations at the national level like Pharmacy Quality Alliance, the American Pharmacists Association, various other different associations that students can do rotations there. Michele Williams Katelyn Alexander We have rotations, across the country so students can request to do rotations with the Indian Health Service. And we have sites in partnership with the IHS, all the way from Juneau, Alaska to, sites in New Mexico and Arizona, and then close by here and Cherokee, North Carolina, just serving different tribes and different populations of, of Native Americans. Katelyn Alexander And that stuff that, you know, you may never those types of experiences are things that you might never get to do in your future career. We have rotations. Nuclear pharmacy is where you get to see, radioactive materials. You can do a rotation with the veterinary pharmacy to figure out, how they prepare meds for animals. Katelyn Alexander We have opportunities with research. I mentioned academia. I think the last, episode, you can do management at a hospital or, a retail pharmacy setting. In a pet pharmacy ownership, like, the possibilities are just endless. And that's what's so cool of helping students figure out there's a lot of different ways that they can prepare themselves for a future career. Katelyn Alexander And it's fun to be able to help. Help coach them, to figure out how to make that work. And, you know, there's always some, some quirky things. Our office motto is your schedule isn't final until you graduate. Because since we're we're working with all these external folks, you know, some things are always up in the air and a little bit out of our control, but we always guarantee that, you know, students, we will work as hard as we can to provide students with the best experience possible. Katelyn Alexander It just may be adjusted over time. Michele Williams For various. Katelyn Alexander Factors, but, yeah, we have over shoot over 300 preceptors that we work with. Wow. And countless sites. So yeah, lots of different opportunities and, just really exciting to be able to help students find that career that's perfect for them in pharmacy. Michele Williams That's amazing. And, and I think that, all this information is so incredibly important, experiential. That is such a huge part of pharmacy school. So I really thank you for, for sharing this information with us. And, Doctor Alexander and, Angelina Piano, who works in the Office of Experiential Education. Both great resources. If you have follow up questions. Katelyn Alexander Come up and see us. We'd be happy to help you. And Sandra Telford, our office coordinator, can you can also point in the right direction. So, we know it's it's sometimes can be a little complicated with, with all the different sites and terminology. So help us help you. Yeah. Don't be a stranger. Alright. Michele Williams Well, thank you so much, Doctor Alexander. Katelyn Alexander Thanks for having me. It was fun. Michele Williams Till next time, thanks for joining us on White Coat Radio.    

In this two-part episode, we hear from Dr. Katelyn Alexander, Associate Professor of Pharmacy Practice, who serves as Director of Experiential Education at the ETSU Bill Gatton College of Pharmacy in Johnson City, Tennessee. In Part 1, Dr. Alexander gives us a comprehensive introduction to Experiential Education and what students need to know to get the most out of all of their IPPE’s and APPE’s. Transcript: Michele Williams Welcome to White Coat Radio, a podcast from East Tennessee State University at 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. I'm your host, Doctor Michele Williams. In this two part episode, we'll be talking about experiential education with Doctor Katelyn Alexander, associate professor of pharmacy practice and currently serving as the Director of Experiential Education. Michele Williams Welcome to White Coat Radio, Doctor Alexander, thanks. Katelyn Alexander So much for having me. Michele Williams We're really happy to have you here. This is going to be part one of our two part episode on experiential Education. In this segment, we're going to talk about the basics of experiential ed at Gatton. Are you ready to get started? Katelyn Alexander Yeah, absolutely. Just go for it. Terrific. Michele Williams So I'm going to be very basic with my first question. What exactly is experiential education? Katelyn Alexander Yeah. So for students who have not been in a professional program before or in a health science major, it probably isn't something they're familiar with. So experiential education is experience driven. You may have heard of it as more along the lines of an internship, a clinical, sometimes called just place it. But it's basically things that happen outside of the classroom. Michele Williams Okay. Okay. So I sometimes hear of clinical rotations referred to as IPAs and APIs, or APIs and APIs. I've heard that. Katelyn Alexander Before. Yep. Depending depending on on who you're talking to. Those are the same. Yep. Michele Williams So, let's start with IPAs. What are those? Exactly. Katelyn Alexander So, just for some definition, IPA is introductory pharmacy practice experience. Okay. So these are more foundational. They're more skills driven. They're more to give students kind of an awareness of different areas in pharmacy practice. They're they're definitely more, I wouldn't say solely observational, but it's, I think the expectation are that you, you sort of show up and participate and become more aware of that type of pharmacy practice. Katelyn Alexander Environment. Okay. And then APIs or APIs are advanced pharmacy practice experiences. APIs occur throughout the entirety of the fourth year. Michele Williams So, okay, so you don't really start APIs until you're a fourth year pharmacy. Katelyn Alexander Yeah. So the IP is in the first through third year of the program. And once you clear the IP as you move on to APIs and those advanced practice, experiences, advanced pharmacy practice experiences, really run the entire fourth year. So students are out of the building. They're out in different pharmacy practice environments, for nine months out of that final fourth year of our program. Katelyn Alexander Okay. Yeah. So there's, there's a lot more variety when it comes to APIs. They differ in terms of expectations in terms of time. So there are some pretty big differences. They're both pharmacy practice driven. But they fall at different times in the program. And the links are much different. Michele Williams So they're truly more advanced. Katelyn Alexander Yeah, absolutely. Absolutely. Michele Williams When do student pharmacists, let's say I'm I'm a new student pharmacist. I'm just starting a program. When can I expect to start going on rotations? Katelyn Alexander So you'll participate in the introductory IPAs from the moment you walk into the door. Okay. So you'll have some things that occur during the calendar year. So during the semester, there are certain experiences that students have that fit in alongside their classwork. And that's true throughout the first three years. And those might be things like going to abundant Christian living community and working with a group of students to meet with a resident and talk about, their health history, maybe to talk about, some of their experiences. Michele Williams That a senior living. Katelyn Alexander It is. Yeah. So the patients are our older adults, and, students are given kind of guiding questions and the experiences crafted around a longitudinal, relationship with that person over the course of several years. So it's really fun. And and fulfilling for a lot of people, like adopting a grandparent. Really. Other things that students get to do during the actual, didactic year include, service hours. Katelyn Alexander So we have students self-select different, learning opportunities based on what's interest, of interest to them. And then, a lot of the other activities that fall within IPA are skills driven. And they all set up the summer rotations. So the first time you really get to go out on rotation for more of a, immersion rotation, that's what I would call it, where you're in the pharmacy setting for extended hours per day for several subsequent days or in the summers. Katelyn Alexander So after the first year, the way our curriculum is structured, students go out and spend time in a community pharmacy for two weeks and on rotation, and then in the week or in the year after the summer, after the, second year of the program, they spend two rotations, one in a hospital and one in a clinical setting, usually ambulatory care or an outpatient pharmacy setting. Katelyn Alexander And in a inpatient setting. More on rounds up in the in the floors at the hospital. Michele Williams Okay. And and you mentioned, a minute ago, the, the students get to select some of their learning experiences. So do students get to, to pick where they go on rotation or some rotations. And how does that work? Katelyn Alexander Yeah. So to a degree. So for the community rotation for example, obviously you have to do go to a community pharmacy. And we provide students with lots of different options as far as location, both local and in some of our kind of particular zoned areas where we know we have a lot of student interest and good preceptor sites, and you get to rank preferences, you rank preferences based on site, preceptor and time. Katelyn Alexander And usually we're able to accommodate most students requests. Michele Williams Oh, nice. Katelyn Alexander Yeah. So the only thing that usually we can't place students at is a place where they're employed, because we want students to have a diverse experience. So we wouldn't want someone who works, for example, at CVS to do a rotation there as well. We'd want them to see the way another community pharmacy would operate. Michele Williams Okay, that makes sense. And, you mentioned some of the places that students go on rotation and community pharmacies. What are some of the other rotation sites that students can go to? Katelyn Alexander Sure. So for IP is then after the second year, students got to health systems and spend a two week placement. Michele Williams Health systems are hospital. Katelyn Alexander Hospitals, right? So they'll be, in the central dispensing area or the main pharmacy of a of a hospital. And we primarily partner with Ballard Health Facilities here in the Tri-Cities. So we have rotations at the majority of Ballard facilities all the way from Greenville, Tennessee, up to Abingdon, Virginia, down to Elizabethton and Sycamore Shoals Hospital, which is they are. Katelyn Alexander And also here at JCM, which is right across the parking lot. Students sometimes also can go to hospitals in some of our main zoned areas. So we have pockets of rotations that are available in Southwest Virginia and Chattanooga and in, Knoxville area. And so we have health system partners in those places as well. Michele Williams Great. Katelyn Alexander So pretty regional. And then the clinical IBP, which also happens in the summer after the second year. That one's pretty diverse. We have pharmacists that are embedded in primary care clinics throughout the region. For more outpatient based care, we have, clinical specialists who round up in the floors in interdisciplinary teams in a hospital. And we have community pharmacies that offer advanced patient care services. Katelyn Alexander The the element of the clinical rotation, I think that's unique is it's all kind of a team based care, environment. So you're going to see not just what a pharmacist does, but how a pharmacist and the rest of the health care team, impact that patient's health outcomes. That's. Yeah. Michele Williams So sounds like an important part of it. Katelyn Alexander Yeah. And it's it's so nice to get to see that that regardless of what area of practice you're in, whether it's in the hospital or out of the hospital, those teams still exist in different ways. So that's a kind of a unique thing about the clinical IP. Michele Williams Okay. Katelyn Alexander The APIs though, they are even more diverse. So we talked about practice experiences. There are similar to the IPAs. There are some rotations that every student has to do. Michele Williams Okay. So they're required. Katelyn Alexander Yeah. And they're for four of them. Okay. That's dictated by the, body that oversees our, our the design of our curriculum, our accreditation standards. So every student will go on a rotation in their fourth year at a community pharmacy within the main pharmacy in the hospital. In an ambulatory care outpatient pharmacy. And then in some sort of acute care, or inpatient medicine setting. Katelyn Alexander So again, that kind of rounding on the floor, okay, of, of a hospital environment and then the remaining five rotations. Our elective. So students get to pick and they get to give input on those. So have to be involving patient care. So they might be things like disease state areas. Maybe it's pediatrics or oncology or cardiology or diabetes. Katelyn Alexander And that can be in the inpatient or the outpatient setting. Some of them are driven by settings. So maybe you're going to a specialty pharmacy to see patient care there or seeing advanced services that are in a community pharmacy. And then some are not patient care focused. So electives that are, focus maybe on research, on management, on academia. Katelyn Alexander They want to spend a month with me. And then we have all sorts of other unusual ones, which I think we probably get into in the next episode, some of those really unique experiences. But yeah, the fourth year is fun because students can really kind of personalize it. They have a ton of choice. Michele Williams So an academic AP, that's the I love those because I get to see the students again back on campus. Katelyn Alexander That's right. Michele Williams Who what what, is the interest there? So a student that goes on an academic AP, are they interested in teaching or, presenting or. Katelyn Alexander I think with a lot of the electives, it's just branching out and seeing areas of pharmacy that maybe you're not familiar with. So from an academia rotation, a student might pick it because I always tell students when they come with me, it's like seeing the magic behind Disney. Because you see what you see in the classroom. Katelyn Alexander But there's so much stuff that goes into why that experience that you have as a learner is the way it is. Michele Williams Yeah. Katelyn Alexander So they get to spend some time just figuring out how do we write, exam questions. How do we evaluate exam questions? What goes into researching a lecture? And that's only a fraction of my job. Right. So, service opportunities and research and and now administrative. So students get to see all of that and kind of how we spend our time. Katelyn Alexander And most students have a very different expectation what they think going in versus what they find out coming out of the rotation. So I think that's true of a lot of the electives in the fourth year. Students will sometimes pick them because, well, maybe it's the only time you're ever going to see that kind of pharmacy practice. Or maybe you're still undecided about a career and just want to kind of explore what your options are. Katelyn Alexander So, yeah, I think it can be for lots of different reasons that people rank rank different, rotation types. Michele Williams Okay. Well, that that sounds really interesting, actually. And I, there there are a lot of things that that when you hear experiential education, you don't realize how much goes into it. I, I was surprised when you told me we were talking about this. How much of the curriculum, what's the percentage of the curriculum of pharmacy school comes under? Michele Williams Experiential education. Katelyn Alexander It's roughly a third as well. So students spend time in the classroom. But yeah, roughly a third of their overall time spend is with an experiential. So if you think about it, you have these experiential rotations longitudinally throughout the semesters. You have the immersion rotations in the summers. And those all run about two weeks. And there are about 40, about 80 hours total. Michele Williams Okay. Katelyn Alexander So then that can differ. So we we schedule students in two week blocks, but the amount of time can vary that they're on site. So they do that over three different immersion rotations across two summers. And then the entire fourth year is really rotation driven where they spend month long blocks, across nine different rotations. Michele Williams Really tells you the importance of that practical experience and really being in a place and, having those having those educational opportunities. Katelyn Alexander Yeah. Because what a lot of students will say is I learned it in a classroom, but I, I didn't really understand what that meant or I didn't really I didn't have any practical experience to tie that dizzy state or that concept to. So the really awesome thing about rotations is that students get to go out and see real people and real clinicians problem solving and figuring out solutions to improve the outcomes of those people that they serve. Katelyn Alexander And also get to apply skills that you can do in a classroom. But it's so much different to do it in a real world environment. So it's sort of stepping you towards being a practitioner yourself, having that autonomy and being ready to make those decisions on your own. And having the skills and confidence to be able to do it. Michele Williams So, so students get lots of opportunities to practice skills. Yes. And improve and develop as they go through the curriculum. Katelyn Alexander Sounds like. Yeah. And that's I think why you have the division between the IPS and the AP. So the IP are very they are introductory, the expectations are lower. They are very much practice. We grade them as pass fail. So as long as students kind of show up, they act in a way that's representative of a professional and they do what they're supposed to do. Katelyn Alexander And they they kind of play along, you know, and they absorb as much as they can. That's really what we're looking for. We're just looking for progress, not perfection. And then the AP is, you know, there are a little more stakes because ideally you can do more because you've been through three years of the curriculum. So you know more, you have more skills. Katelyn Alexander And now to get you to that place of being an independent practitioner, the stakes are a little higher to ensure that you do have the competency to do it. Michele Williams That's great. Yeah. So this is all been really helpful and interesting. I hope our listeners find it, informative. And, and so the, the last part of, of this segment of the podcast, I'd like to, to ask you some questions that we're going to call, either fake frequently asked questions or MythBusters. Okay. Come up. So and you've kind of alluded to the answers to some. Michele Williams Okay. But, this is something that the, I think probably comes up a lot, which is that the terminology, there's a lot of terminology for experiential expectation. So what is the difference between a clinical rotation and an internship and a practicum? Katelyn Alexander I mean, they're they kind of all get to the same thing, which is a placement outside of, the primary institution where you sit for your classes, like it's something out that is a continuation of what you've learned within the program. I think it just depends on what type of degree you're earning. So maybe an internship is, and I don't, I don't know, I'm thinking, like, business, I think of internships. Katelyn Alexander But because this is all in clinical settings, we just call them call them rotations or clinical rotations. Other thing that you might think of differently is who the instructor is for the experience. Being a pharmacist, I've actually never gone through practicums or internships, but I'm not sure what their instructors would be called. Maybe they're just instructors, but the instructors for our clinical rotations, we call preceptors. Katelyn Alexander Okay. So they're the people who, oversee the experience. They might, they're the ones who provide the evaluation and ultimately grade the student at the end. Michele Williams And this is a pharmacist, right? Katelyn Alexander Most of them are pharmacists for AP irritations. We do have some non pharmacists that serve as preceptors, but the majority of them are not faculty. So they're not necessarily people that work at the college or that you'll see throughout the rest of the program. There are people who are employed by hospitals and pharmacies in the area and etc., etc., but they volunteer to take students because they want to give back. Katelyn Alexander As a way of helping the next generation. So, the preceptor is essentially your instructor for that rotation. Michele Williams Okay. And and you alluded to this, but if I already work in a pharmacy, you said I can't go on rotation in that pharmacy, and it makes sense because you need a new experience. This is time to learn. But the other question is, and is related to that, do can I get paid for being on rotation? Michele Williams I mean, I'm working right in some cases. Katelyn Alexander So there are two questions we usually get from students. Can I get paid and also can I test out? So I don't know if that was going to be on your list or not, but so as far as getting paid, the answer is unfortunately no, because it's a rotation. Also you get course credit for so because you're getting a grade it's part of the curriculum. Katelyn Alexander It would really be a conflict of interest if they were also going to compensate you. So so no, unfortunately because of the rules of our accreditation standards, you cannot be compensated. Because it is a learning environment. It's not it's it's not a hard position. However, we'll talk about, I think, in our next segment that a lot of these opportunities do turn into paid employment down the line. Katelyn Alexander So even though that two week rotation or four week rotation isn't paid, there's sometimes are opportunities that come out of it. Michele Williams And then you mentioned, can I, can I test out of a rotation? That was going to be my next question. Katelyn Alexander Yeah. And a lot of students will ask that because we have we probably have a split. Some probably 50% of our students come in with some form of experience and probably about. Michele Williams For pharmacy technician. Yeah. Like that. Katelyn Alexander And some of them it's shadowing, but some of them have been pharmacy technicians, either in a hospital or in community pharmacy for a long, long time. And they'll say, well, if I've worked in a hospital, do I really have to spend this introductory experience for two weeks? And again, the answer is unfortunately, yes, because it's a course within the program. Katelyn Alexander Our accreditation standards dictate that students have to, over the course of the entirety of the program, achieve so many hours in placement. And our curriculum is designed to give you that many hours for IEPs. It's a minimum of 300 hours. We provide a little bit of buffer, but if you test out of that, I have to find something else equivalent for you to do. Katelyn Alexander And everything kind of sequentially builds. So our thought is, no, we really need students to do the experiences. You can select, type of practice setting that maybe is different. So maybe you are in a community hospital where you work. Let's go. So maybe a level one trauma center, so much bigger hospital that's seeing much more acute patients. Katelyn Alexander Maybe you worked at a retail chain pharmacy in the community. Well, let's see what practice would look like in an independently owned pharmacy. So we try to find diversity within that experience so that even though you kind of know the role, you're still getting some new learning opportunities just because of the diversity, of, of pharmacy practice available, available sites. Michele Williams So it keeps it interesting. Yeah. Adds to a person's knowledge base. It sounds like. Katelyn Alexander Yeah. And sometimes just because you learn something one way through your work experience doesn't necessarily mean it's the right way or the best way to do something. So it also helps just to make sure that everybody kind of has the same foundational experience and then kind of progresses together. Michele Williams That makes so much sense. And then if I this is a tough question. If I transfer from another college of pharmacy, let's say I come to get in as P2. Okay. And I had my first year of pharmacy school at another pharmacy, another college pharmacy. Do my or P3 even do my clinical rotations from the other college transfer to Gatton. Katelyn Alexander So it is a tough question. And the answer is it depends. Okay. So unlike well, not even unlike the didactic curriculums depending on the College of Pharmacy, they go to, they are varied in terms of what's what's in them, what year in the program things happen, how the curriculum is delivered. An experiential is the same. So different schools have different rotations, at different times. Katelyn Alexander So essentially what we would do is kind of look at what, what experiential learning environment or learning opportunities have you had? Does it line up with our curriculum? Are we going to meet those required number of total hours? And also does the curriculum that you have in the experiences that you have set you up for success in our so our curriculum is designed so that certain things kind of build. Katelyn Alexander And so we might have you repeat some rotations or some, experiential learning opportunities just to make sure that you're prepared for kind of what comes next. Michele Williams So if they're not able to, to use those past experiences, it's really in their it's to their benefit. Katelyn Alexander Absolutely. Yeah. Because we wouldn't want you to go somewhere with expectations that you weren't ready to meet because you hadn't really seen, that type of practice setting or had some skill practice with wherever you're headed. So, yeah, it would it would be for the students benefit. Michele Williams Okay. Well, thank you so much, for for answering all these questions and for giving us some really basic information about experiential education. I'm, I appreciate it so much. And I'm looking forward to part two of of this particular topic where we do a deeper dive into experiential ad. So until then, thanks so much for joining me. Michele Williams And, we'll talk to you again soon. Katelyn Alexander Yeah. Thanks for having me.  

On this “Pondcast,” Dan and Michele interview Dr. Brooks Pond, Professor of Pharmaceutical Sciences at ETSU Bill Gatton College of Pharmacy and recipient of ETSU’s Distinguished Faculty Award. Dr. Pond talks with us about her fascinating research into the effects of psychostimulant use on the brain, as well as tips for being successful in her Human Physiology course. Transcript: Dan Vanzant Welcome to White Coat Radio 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 and deep dives with faculty and student premises. We are your hosts, Dan Vanzant. Michele Williams And I'm Doctor Michele Williams, the Gatton academic success specialist. In this episode, we'll be talking with Doctor Brooks Pond, Professor of Pharmaceutical Sciences at the Bill Gatton College of Pharmacy. Doctor Pond teaches human physiology and conducts research into the consequences of psychostimulant use on the brain. She was also the recipient of ETSU’s Distinguished Faculty Award for Teaching in 2020. Michele Williams Welcome to White Coat Radio, Doctor Pond. Thank you. I guess we should call this episode the pondcast. And you think so? Michele Williams It works. You're very well known around Gatton as the professor who coordinates human physiology. But your PhD is in pharmacology, particularly neuropharmacology. Can you tell us a little bit about that? Sure. Brooks Pond So I always loved the biological sciences, and I was actually a biochemistry and molecular biology major in college. And while I was in college, I did undergraduate research with a professor, at my undergraduate institution, at Center in Danville, Kentucky. And it was neuro research. And so I loved neuroscience. Knew that I had an interest in teaching, ultimately. Brooks Pond And I applied to programs in cell and molecular biology, that would enable me to essentially rotate through multiple different labs. But give me a good broad base of, teaching expertise. And, I ended up at Duke University in that cell and molecular biology program, and I rotated through all neuro labs. But the lab that I chose to ultimately do my thesis work in was a neuropharmacology lab. Brooks Pond And so my primary, appointment was actually in pharmacology. And so I joined the Department of Pharmacology after my first year, and it was fortuitous because I loved physiology. And to me, pharmacology just really applied physiology. So using their physiological concepts to understand drug action. And so I really enjoyed that, kind of move that it was just serendipitous really. Michele Williams Yeah. And lucky for us too. So, human physiology that that we mentioned, you you coordinate at Gatton is really an essential and foundational course in the pharmacy school curriculum. If a student wants to be successful in your course, what kinds of things would you recommend that they do? Brooks Pond So the biggest thing is that we just cover a lot of content in one semester. And I think that the biggest challenge for students and so the biggest piece of advice I have for success is staying on top of your studies and literally adopting a daily study approach as opposed to studying for exams. And so if you go home every night and spend, you know, at least half the time that you're in class that evening and going over what we did in class, I think by the time it comes test time, it's largely going to be review. Brooks Pond So that's the biggest, piece of advice I have. The other thing is to utilize the worksheet that I provide, as well as the in-class activities that we do to self test. So, you know, you can do those, do the worksheets while we're going through class and enable you to take notes that also utilize those before a test and see if you can fill it in without looking at your notes. Brooks Pond And you can do the same thing with the in class activities that are designed to be group work, where we're looking at models and answering questions based on the model. But ideally, come test time, students should be able to answer the questions without looking at the model and without engaging with others. Michele Williams That that makes so much sense. And I, I love that you do that, that you give students a worksheet that actually helps them prioritize what's important during the lecture. So what they should really tune into, because I think especially students who are new to pharmacy school, it can feel like a lot of information is coming at them at the same time. Michele Williams And so to have that resource to focus your attention and help you to register, oh, she's talking about that thing that's on the worksheet. I think that's terrific. Yeah. So students will see you again later in the curriculum. And what other courses will you be teaching. Brooks Pond So in the second year I teach a little bit in the renal integrated series. And then I also teach a well, an elective course called Non medicinal Drug Use in the second year. So of course not every student would have that, but some may choose to sign up for that. It's a fun class, and I coordinate that and teach a majority of the content for that class. Brooks Pond And then I teach quite a bit in the third year, in particular in the third year fall. So I teach in the neuro psych and then also in the endocrine, men's and women's health. That's, recently two classes that merged. Michele Williams That's great. And and it helps it helps to sort of remind students that the things they're learning in their P1 year, they'll, they'll be hearing about again and they'll be seeing you again. And, there's that continuity throughout the curriculum. I think that's great. Brooks Pond Yes. In fact, a lot of times I'll use like the exact slides from physiology and my repeats and pharmacology, like remember this. And then we're going to talk about the drugs. Michele Williams Yeah. So that's terrific. Dan Vanzant Are there any apps or programs that you recommend students using or that you use in the class that that maybe they wouldn't experience in other classes or that they would find useful? Brooks Pond Yes. So our book, comes with McGraw Hill Connect, and that is an awesome resource. There's an e-book that you can walk through. There's also exercises with practice questions. There's interactive, figures that you can walk through, and it provides you immediate feedback. So if you mess something up, it'll tell you and explain why that's the wrong answer. Brooks Pond And you know why the correct answer is correct. And so that's a great resource. So I encourage students to utilize that. I've already assigned, a Gen Cam and Gen bio kind of review, to all students because some students struggled on certain concepts on the pre-assessment that we did on the second day of getting ready. And so hopefully students are already looking at that, some that they have it for all the chapters. Dan Vanzant So yeah. Okay. And is that the McGraw Hill content. Is that all available through tool or can they go directly to McGraw Hill. Brooks Pond And so you. Michele Williams Can. Brooks Pond You set up a connect and then just bookmark it. But there's a link to connect through our D2L site. Michele Williams So it's easy to get to. Yes. That's great. Dan Vanzant That's great. Yeah. So you've done research looking at the long term effects of psychostimulants like Ritalin. Can you tell us more about that? Brooks Pond Yes. I love talking about this. So, so yes, I have, been at Gatton for 15 years and have been working on a project involving Ritalin for a majority of my time here. So when I was a postdoc, I worked with a guy who was traditionally a Parkinson's researcher, and he became interested. And the link between that long term, spike of stimulant use and, neurodegenerative disease and particular Parkinson's disease. Brooks Pond And the reason that there may be a link at all is because with, psychostimulants, they all increase their levels of dopamine in the brain. And never mean does a lot of good things is a feel good chemical in the brain. But it can be oxidized to, quinone and actually lead to oxidative stress and neurotoxicity. Brooks Pond So caused brain cells to die. And, so the thought was that, okay, if we're providing a long term like stimulant that's consistently elevating our dopamine levels, we may be providing this kind of long term oxidative stress that may sensitize those brain cells, to becoming vulnerable, to other insults. And so in his lab, he used a MPC, TP model. Brooks Pond So MTB as a really super long chemical name one methyl for fennel, 1236 tetra Hydra pyridine. That thankfully we can. Dan Vanzant See it's at now. Michele Williams Brooks Pond So, but it has a really interesting, sad, but interesting history. It was discovered first actually in humans. So back in the early 80s, there were seven cases of, essentially people developing Parkinson's overnight when they injected themselves with what they thought was going to be like a parodying. So they were trying to, synthesize a synthetic opioid like my parodying, and they sped the reaction and ended up with like 95% in PTB, and they injected themselves with it and killed the same neurons that we see die in Parkinson's disease and had the same symptoms, like severe motor symptoms, like, you know, they were called the frozen addicts. Brooks Pond And so basically we've used that tragedy. Now we have an animal model that uses that same chemical. And, we use that as a Parkinson's model. And so he used that and essentially he found that there were several different strains of mice had different vulnerability to that toxin. So certain strains exhibited a significant loss of brain cells in the area of the brain that's affected by Parkinson's disease, which is called the substantia nigra. Brooks Pond And then certain mice strange did not show a loss. And so basically, what, when I worked with him, I found that you could take a psycho stimulant, provide the mouse with a psycho stimulant long term, and it would cause the not vulnerable mouse to become vulnerable. So where once they didn't have a cell loss, they would lose cells. Brooks Pond And so since then, we've collaborated with him some. But we've also done some independent work in terms of trying to figure out why. And is basically, I think what we thought, which is that you're elevating dopamine. We measured that. We saw increased dopamine quinones, with our psycho stimulant exposure. And, there's a natural and eye oxidant that we have in our bodies, and it's in our brain called glutathione. Brooks Pond And that can be kind of added to the quinone or conjugated to the quinone to try to protect cells from that, damaging molecule. But you can deplete it. And so we have found that the long term psycho stimulant use depletes glutathione. And so we basically increase this oxidative stress there. And we deplete the thing that's going to protect against it. Brooks Pond And so ultimately it causes this vulnerability. Well and so yeah, so we have done, done some work with that. So it's been cool stuff. Michele Williams And it seems like really important research given that Ritalin isn't very common. Brooks Pond Yes it is. You know, they they estimate like 8 to 10% of school age children, are treated with some kind of psycho stimulant for ADHD. And in fact, like in adolescence, methylphenidate is the number one prescribed drug in adolescents. Yeah. Michele Williams So it's a lot of food for thought. Yeah, yeah. So. Dan Vanzant So you also study this, pharmacokinetics of vape substances, like, nicotine. What have you found so far with that research? Brooks Pond So. Yes. So we've been collaborating with a researcher from the University of Wisconsin, and he has, little rodent vaping chambers. So essentially the mouse, gets put in this chamber and it's like the whole cage goes in there and it, causes, you know, nicotine vapor in the environment. And it's a very controlled manner. So it's a way of like delivering the drug in the way that humans would take the drug, in a very controlled manner. Brooks Pond And he really wanted to measure the nicotine content in the brain and plasma of these rodents exposed to nicotine vapor. Well, a lot of the methods by which you, measure nicotine are kind of more geared towards measuring nicotine in the vape itself, like, in the fluid. And so you have to have quite a bit higher concentration for those methods to detect the nicotine. Brooks Pond And so if we're going to detect it in a biological matrix like, plasma or our brain, and we need to get down to the nanogram per mil range, they're pretty low concentration. And so we developed methods that we could do that using our LC‑MS machine over in building 178. And we have developed that and we did we're able to detect our nicotine and, rodents exposed to the nicotine vapor, but we haven't actually conducted any studies yet. Michele Williams Which is interesting. What is LC‑MS? Dan. Sorry. Brooks Pond Liquid chromatography, mass spectrometry. Michele Williams Okay. Brooks Pond Yes. Yes. Michele Williams So, I. Brooks Pond I it's a little bit hard to say. Michele Williams Yeah. It's just they use that too in those crime shows like. Brooks Pond Yes. That's right, that's right. Dan Vanzant I understand that pharmacy students can assist with your very interesting research you've been telling us about. What can students expect from that experience? Brooks Pond Yes. So I love working with students in the lab. It's a lot of fun to kind of get to know them outside of the classroom. For one, and all of the students that have been through the lab have multiple opportunities to present their research, either locally at the Appalachian Student Research Forum that's held at ETSU each year, as well as national or even international meetings, depending on their interest. Brooks Pond So I've had a lot of students, present at pharmacy related meetings, like the mid-year meeting is a big one that a lot of students will present, particular when they're thinking residency and want to kind of, mingle, with preceptors in that environment. And then also, I've had students who actually accompany me on my meeting, which I'm a member of a pharmacology society. Brooks Pond And we, our annual meeting. Sometimes I've gone and presented at that meeting as well. And then I've had, you know, pretty much most people that go through the lab get a publication by the time they graduate, if they do their research concentration in the lab. And in fact, have had a couple students, had two publications by the time they've graduated. Michele Williams So that's awesome. Yeah. Yeah. Great opportunity. Brooks Pond Yeah. So. Michele Williams Well, Doctor Pond, thank you so much for for participating in our podcast today. And, and I look forward to, to learning more about your research and, and I'm sure students are, going to have a lot of great opportunities working with you. So thank you so much for talking to us today. Yeah. Sure thing. Dan Vanzant All right. Thank you.  

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.      

Dr. Ashana Puri, Assistant Professor of Pharmaceutical Sciences at ETSU Bill Gatton College of Pharmacy, talks with Dan and Michele about her fascinating research into transdermal drug delivery systems and keys to success in her Pharmacy Calculations course. 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. And in this episode, we'll be talking with Doctor Ashana Puri, assistant professor of pharmaceutical sciences at the Bill Gatton College of Pharmacy. Doctor Puri teaches pharmacy calculations and conducts research involving topical and transdermal drug delivery systems. Welcome to White Coat Radio, Doctor Puri. Ashana Puri Thank you. Michele, and Dan. Dan Vanzant To start us off, could you share a little of your background with us? How did you come to be interested in the pharmaceutical sciences? Ashana Puri Sure. So I am originally from India. I did my bachelor's and master's in pharmacy from India. I always wanted to stay connected to the healthcare field. I came to know about pharmacy, and I was pretty interested in that. And when I was doing my master's, I was working on a project where I had developed a product, a topical product, and I was testing the anti-cancer activity of that, drug. And when I saw that the product that I had developed was actually able to, prove the progression of skin cancer, I was like, wow, this is rewarding. And that made me fall in love with the research. And that's when I came to the US to do my PhD in pharmaceutical sciences. Particularly in topical and transdermal systems. That's where my educational background ended. And after that, I worked as an associate scientist for one year at Teva Pharmaceuticals. But I always wanted to end up in academics because I love teaching and research. And that's how I came to the Gatton College of Pharmacy. Michele Williams That's great. And it's very lucky for us, too. Ashana Puri Thank you. Michele Williams You're the course coordinator and instructor of pharmacy calculations, which is an incredibly important course in the pharmacy school curriculum. Why is having a strong mastery of pharmacy calculation so important? Ashana Puri Yes, Michele. That's absolutely right. Pharmacy calculations is a very important and integral part of the pharmacy profession. So, I would say no matter where the students end up, you know, working. Be it as, be it a compounding pharmacy where they are supposed to compound prescriptions, they would have to do calculations to, you know, make the recipe as per the prescription. Or if they end up, you know, working in the community pharmacy where they have to fill capsules and take care of the dose that needs to be dispensed, or the more critically, you know, important environment of a hospital where they're dealing with patients and they have to take into consideration, let's say, just the body weight of the patient or other pharmacokinetic parameters. It's it's really important for them to, you know, be able to do the right calculations and give the right dose. And as I, as you would imagine, with math, if, you know, one decimal goes here and there, what is going to happen? We all know that. So if it's going to be ten fold less, it's going to be under dosing. And you might not see the effect of the drug if it's ten times higher. It's overdosing. And as you can imagine it can be so fatal. Michele Williams Yeah. Ashana Puri So that's where we want all the pharmacists to understand their importance in calculations. Miscalculation can actually result in medication errors. And that can be very, very fatal. And so that's that's you know pretty much it like how calculations are so, so important. Just to add a little bit, let's say you're working in the kitchen. You have a recipe you're trying to make. And cook something. What happens if you miss something or you don't end up, you know, adding the salt as per what was required. It's just going to ruin your dinner or your taste buds are not going to like it. But what if you're preparing a formulation and you mess up the ingredients in a medicine that can be very, very fatal. So, we need to understand the importance of calculations there. And that's where we would emphasize on all these aspects. Teaching the students what they really need to do the calculations correctly. And, and that's that's pretty much it. Calculations is really, really important. Michele Williams Absolutely. It sounds like it's literally a matter of life and death. If you get the you need to get those calculations correct. Exactly. That's that's amazing. If a student wants to be successful in your course, and I'm assuming all students who start your course want to be successful in your course, what kinds of things do they need to do? Ashana Puri Sure. So since I'm talking about calculations, as you all know, math is all about practice. So of course I'm going to be there to give them instruction, but it really depends on the students to practice. So the first key to success is going to be practice. The course has been structured in a way where they will be given instruction. They will be, asked to participate actively in the class. They'll be given a lot of questions through quizzes, practice quizzes. They'll be allowed to like, work on questions in my presence and of course, outside class as well. So the second thing is to follow the structure as closely as possible. What I have set for them is it's possible for them to practice regularly, because that's the key to success if they solve questions every day. That is going to result in their success. Also, I know that students love to study in a group. You know, they love to be with people when they're practicing. But one thing that I've noticed is that students should develop the habit of being able to solve a question independently, all by themselves. Oh yeah. Even though the group helps you to kind of solve the question and understand the concept. My advice to students is always to develop the capability of solving the question independently when no one is around you, because that is going to determine your success in an assessment, in an exam. And if you can solve questions with an open book or with a friend at your side, just make sure you can solve questions with closed book and no friend at your side as well, because that is something that I've seen has impacted the success of students. So, practice, follow the structure and be able to solve questions independently. And don't be shy and never hesitate to reach out to me or the student tutors for help. That's you're going to be really successful if you do all these things. Michele Williams That's great. That sounds like great advice. Dan Vanzant And so you touched on this a little bit, but could you tell us more about, what students can expect regarding the expectations or structure of your course in the classroom, in the classroom, and outside of the classroom? Ashana Puri Sure. So, for this coming semester, what I'm planning is students will have an opportunity to review the material before class. So it's not going to be a lot. It's going to be like a 30 minute review where you just go through the concept that, you know, doctor is going to talk about this in the class. So I'll just take a look at it and come to class. In the class you will be given instruction by me. We're going to solve some questions together. And I'm going to use quizzes for gaming in the class. So I'm going to have questions through the quiz that they have to answer. And they will get a participation credit for that as well. So that's going to be the instruction mostly on Tuesdays. When I have a lecture or a two hour lecture. They'll go back home, they'll have a quiz to work on, which is going to be a graded quiz. So, they'll have three days to complete the quiz based on the questions that we have discussed in the class. When they come back to class on Friday, they're going to have a low stakes in-class quiz. In my presence, it's going to be open book. They can get help from friends. They can get help from me. All I want for them is to actively solve questions in my presence. Determine their weaknesses and know the areas where they have to work. They go back home. They have additional questions to practice, but they're not going to be graded. So like I said, the course has been structured in a way where you get a lot of practice in class and you go back home and you get a lot of practice as well. So my expectation from students is to actively participate in the class and also sincerely work on their homework each day, every day. And that's going to determine their success. Michele Williams That so there's there's doesn't sound like there's any magic to it. It's really a matter of completing the practice that you have built into the course. They don't have to find their own material to practice with. They can use what you've given them. And another thing I really like about what you just said is that it sort of disrupts what's called the forgetting curve. So, within hours after the first, you know, exposure to material, you already start forgetting that material. So if you have the opportunity right after class or as soon as you can after class to go over that material again, or to do it within a day's time, it's going to further encode that material into your long term memory. And, and I think what a lot of students miss is that opportunity to practice in that frequent exposure that they'll get if they engage in the materials in your course, it's going to make the time they spend studying for an exam, not as intensive, so they don't have to drop everything in their lives and only do calculations for hours at a time right before the exam, because they've been studying steadily all along. And, I think it's great that your course gives them that opportunity to do that. So, I hope students will take advantage of that, because it does sound like the really the key to success in calculations. Ashana Puri Yeah, I hope so too. And, I would just like to add that, you know, the assessment of the exams, they're all going to be cumulative because the material and calculations build upon what is taught each week. So, I want to challenge students to connect the dots and, you know, question me. How are the two chapters related? You know, how am I going to apply all this? So we start with the basics, and students will discover how they're going to actually apply those basics and all the clinical calculations that get along the way in the in the further chapters. So it's all cumulative. They will not have a chance to forget anything. And that's why the course has been structured in a way that they get practice in. Like you, you mentioned retention is so, so important. So that was actually my goal when I, you know, decided how to structure this course. Michele Williams Yeah, it sounds very intentional. And they're going to be thanking you later when they take the NAPLEX. And they remember all those calculations. Ashana Puri I hope so. Michele Williams So, if a student doesn't consider themselves a math person, can they still be successful in in your class? And what would you recommend those students do? Ashana Puri Absolutely. So, the good thing is that we are not doing any high level math here. Okay, so it's not calculus or anything that should scare students. So what the students themselves will discover in the way is pharmacy calculations is more about word problems. For them to be able to read the question properly. Most of the times the question is going to be like seven lines or eight lines or a paragraph, and you know, that should not scare them off. So the first thing is that the students should know how to read the question and interpret it correctly. So if you understand that situation, you're able to understand what the question is exactly asking you. Then it should not be a problem. So that's the first thing they should know how to do. The second thing is the kind of calculations that we do is very basic algebra. So if you know how to cross multiply, if you know how to set up a ratio and proportion, if you know how to do dimensional analysis. Trust me, those students are going to do well and they're going to love the course. You know, if they develop the habit of reading the question. Right, and just applying the basic, you know, those math concepts, like I said, it's not really calculus. However, if the student, you know, feels that they're weak in math and that is something that scares them off. I would say early on in the course, they should just work on the basics and kind of strengthen just just the ones like I mentioned. And once they do that, they should be fine all throughout. And of course they're going to be formulas and equations and those are not too bad. It's all about memorization and just applying the concept correctly. So and also, you know, like in the second, third year, they actually see these situations and they apply these calculations. So definitely it's going to just help them reinforce and they, they're going to be fine. And they can always reach out to me for help. Michele Williams That's good to know. Dan Vanzant Okay. Are there are there any apps or programs that you would recommend for those students who need extra help or want to practice outside of class? Apps that you know, you recommend for students in your class or that you're going to use in class on regular basis. Ashana Puri So I do not really have an additional app as such or program. Like I said, in the class, we're going to do, a quizzes kind of a game. Rest of it is just going to be the D2L platform for all the quizzes. So the additional practice that they would want to do, I would recommend to, you know, use the book that I'm going to refer to for additional practice. But other than that, I don't really have an app or a program that I would ask them to use for this course. Dan Vanzant So we've talked a little bit about, what students can expect in the classroom. Can you tell us more about your research? What do topical and transdermal delivery systems involve? Ashana Puri Sure. So, like I said, I do research. I have a research background with, topical and transdermal drug delivery systems. And I do have an independent lab now, working in the same area. Having one PhD student and then some pharmacy students working with me. So basically, I develop the products that can be applied on skin for a local effect of the drug on skin. Or it could be the drug actually going into the body transdermal. So also my research is all about skin, and I work with therapeutics and drugs, of course, but I do work on cosmetics as well. So, if there's a project that involves the use of natural products that have, let's say, anti-cancer activity on the skin or something, I would love to develop a product for those kind of, phytochemical, products as well. So, topicals and was, let's say formulation of gels or creams or ointments or some of those fancy nanoparticles, micro emulsions and those kind of systems. If someone is familiar about this field, they would have heard about these terms. Transdermal. I work on transdermal patches, as you would see in a pharmacy. And also I work on some fancy active technologies like micro needles or kind of devices, which is like using electric current to push the drug through the skin. Or using lasers for drug delivery. So, so like I said, transdermal, it's more of pushing the drug into the system, into the blood. To help, you know, cure any of the diseases in the body. So, so that is that is mostly what I do in the lab. And students get to actually develop these products and then test them on, skin. And just, you know, kind of work on those kind of projects. Michele Williams So when you say, a transdermal patch, for example, with micro needles on it to, to someone who doesn't have a background in, in pharmaceuticals, that sounds terrifying. So can you, can you tell us a little bit more about what that involves? A micro needle on a on a transdermal patch, and what kind of medication might be delivered in that in that form? Ashana Puri Sure. I totally understand how micro needles might sound to someone who doesn't know about it, but let me tell you that micro needles are actually available on Amazon as well. They are, they're more for cosmetic tools, so they're actually used for wrinkle rejuvenation. And so you so if you check like, you know, the services offered by a cosmetic clinic, you're going to see Microneedling there as well. So it's a cosmetic tool which is now being, heavily involved for drug delivery. And that's what we do. What I do in the lab. So, while there are needles, there are micron size needles. So they are, like, really tiny needles. And let's say there's a patch that has 100 micron sized needles on it. So it's very tiny. It's not going to not going to reach your nerve endings. That means you're not going to feel the pain, but they are actually going to help make pores on the skin. So, you know, the difficult drugs that cannot cross the skin will get a channel to cross the skin. So that's why we use micro needles mostly for like puncturing the skin deliberately to get our drugs across the skin. So that's, that's how I use it for drug delivery, but it depends on the length of the needle if you're going to experience pain or not. But usually we don't go with the long needles that can make someone experience pain. So, yeah. So because it's cosmetic and people use it at home as well. So trust me, it's not painful. Michele Williams So, when, when pharmacy students work with you on your research, what can they expect from that experience? Ashana Puri Sure. So, like I mentioned, all the delivery systems that I work on be topical or transdermal. The students would get an experience formulating and developing those products by themselves, so they would get an understanding of how to make the product what is in the product, how would they select the ingredients and that specific composition. So understanding the development of those products will actually help them, you know, when it comes to the pharmacy in their dispensing a product that gives them a better understanding of the ingredients, their role, and you know how they can better counsel the patients? So let's say if they're making the transdermal patch and, you know, they ask the patient to not cut the patch, but when they actually make the patch, they would understand how cutting a patch can actually result in overdosing and could be harmful for a patient. So, you know, just getting more details about how the product is formulated is going to give them a better idea of how it works. And then, they can be better at patient counseling. So that's one part of product development. Like I said, we would test these products on skin to see how the drug will move. So they will have an opportunity to actually work with pig ears because pig ears are ears. Michele Williams Yeah. Interesting. Ashana Puri Yeah, they are, very close stimulator of human skin. So the skin barrier that we have resembles, the pigs’ as well. So in the lab, we have these special cells that we work with. So we mount the pig skin on it, and we can test, the permeation of our drugs across the skin, and we can make predictions about how it's going to actually behave in humans as well. So they get experience working with pig ears, testing their formulation for drug permeation. Pretty much I do more of like, in‑vitro stuff. So they don't actually test it in animals or humans. They would start from like those basic cells and skin studies. And, they will get an idea of how their formulation is going to behave in the body. Other than the students who have worked in my lab so far, they have all, received an opportunity to be co‑authors on a publication. They have presented several posters. So be it regional conferences or national. I try my best to send them out so that they can present as well. And, you know, they can add a lot of value to their CV, and get some good experience from my lab. Michele Williams So you have a student who will be presenting at AACP, in the coming week? Ashana Puri Yes, yes. Yeah. So Dakshita Ban, she's, before now, she has worked with me ever since, I think, the one year, really, where she volunteered for research with me and, she's been part of a very important project in my lab where I am developing microneedle for naloxone delivery. For opioid overdose treatment. Well, we've had some interesting data that she's going to go out and present at the AACP. And she did at the regional conference. And she won a prize as well. So I'm I'm really, really proud of her. Michele Williams Yeah, I bet you are. That's terrific. Ashana Puri Yes. Michele Williams And it sounds like really fascinating research and a great opportunity for a student to learn more about a particular topic. And I'm, I'm guessing also, looks great on on someone's CV when they're going out, once they're ready to, to look for jobs. That's terrific. That's so interesting. Well, Doctor Puri, thank you so much for for joining us today. Michele Williams We really appreciate it. And for talking about calculations and about your research. Ashana Puri You're. Oh, my pleasure. Thank you. Michele, and Dan.    

Our inaugural episode of “White Coat Radio” welcomes the Class of 2026 to ETSU Bill Gatton College of Pharmacy with advice, encouragement, and inside info.   Transcript: Michele Williams Welcome to White Coat Radio. Michele Williams Your resource for all things related to the pharmacy school experience. Where your. Michelle Williams, academic success specialist for the College of Pharmacy at East Tennessee State University. Dan Vanzant And I'm Dan Vance, instructional design and technology manager. Michele Williams So this is our first episode of White Coat Radio. And we thought it would be great to begin again with the show for our incoming P1s, also known as the class of 2026. So with us today, we have Michelle Gray Graybeal, the student life coordinator here again, and Reagan Bell, a student in the class of 2023 and former president of the student Wellbeing Committee. Michele Williams So Reagan and Michelle, welcome. Michele Graybeal Thank you. Thanks for having us. Michele Williams Well, thanks for being here. So we'll start with you, Michelle Graybill. There's so many things that students need to know before they start pharmacy school. If there were one thing that you could tell them, what would that be? Michele Graybeal I actually have two things. Michele Williams Okay. Michele Graybeal So the first one is, just we are here for you. So at any point, if you feel like you don't know what you're doing or supposed to do, please reach out, because we truly are here for you and we will help you through the process. No matter where you are in pharmacy school. And the second thing would be something that my, one of my professors at Etsu said when I was in college, he would always tell us, be responsible for what you're responsible for, which is pretty simple if you think about it. So, that would break down to read your emails, follow instructions. Keep us updated if any changes, and if something isn't clear, please reach out to us. Because while we try to make everything clear, sometimes it doesn't come through that way to a student. So, please don't be shy about reaching out and asking a question. Michele Williams Great. Thank you so much for that. Raegan, it's been a while since you were an incoming P1. It probably feels like a very long time ago at this point. But what do you wish someone had told you before you started pharmacy school? Reagan Bell I got a lot of really great advice coming in to pharmacy school. I had the fortunate opportunity, to get to speak to some students before I came. But the two pieces of advice that I gave students coming in whenever I get the chance to talk to them is one. Get involved. I've probably been way over involved in my time here. But then my other piece of advice would be, just give yourself some grace. This is a big learning adjustment for everyone. It's an adjustment for our faculty and staff to get to know you. And as adjustment for you just learning how to be a graduate student. There's going to be more material. There's going to be more obstacles and give yourself some grace. If you get that one bad test grade or something just doesn't work the way you think, that it should. So that has to be my two pieces of advice. Michele Williams When? When you started pharmacy school. Outside of. Of course, the academic coursework is rigorous. It's it's not not easy. But what what did you find most challenging about the transition between being an undergrad and being a pharmacy student? Reagan Bell I think for me, the most challenging thing was just the material that we were learning. And I always tell people this too it's not necessarily any harder than what I was learning in undergrad. It's just a lot more material in a shorter amount of time. And so for me, up until I got to pharmacy school, I truly don't think I've ever had to study a lot. Which sounds crazy, but it's true. I just I would study the day before, and I would be fine. And so when I got here, I had to really adjust the way that I learned and the way that I studied. And so I had a few bad exam scores. And honestly, that's why I say, like, it's important to give yourself some grace because I was so stressed out about it, so nervous about it. I think I met with you about it. But my professors were reaching out to make sure that I was okay if something was out of the ordinary. And I think that helped a lot to, just kind of ace that stress. To allow me to take the time to study is because I knew that my professors knew what I was struggling with and, like, wanted to give me time to fix it. So yeah, I think that was my biggest adjustment. Michele Williams That that's so important I think to, to talk about with students because you don't get into pharmacy school by being a bad undergraduate student. Right. By being a poor student. And so you have this image of yourself, as always, doing well. And then you get to pharmacy school and I think one of the reasons we reach out so frequently is because it happens so frequently, because the courses are, you know, the level of material and the courses are challenging. And so, can you talk a little bit about how you sort of regain that sense of yourself as a student, and what did you do to to sort of feel like I'm okay? I, you know, I had this problem. You said something about giving yourself a bit of grace, but what does that look like? Reagan Bell For me, I've always been somewhat of a perfectionist. And so when I say giving myself grace, I mean truly anything less than a it was a struggle for me. So the first time I truly did poorly on an exam, was like, I'm never going to make it. I don't know what I'm going to do. And so I have gotten my fair share of poor grades over my time here. But for me, Grace just looks like, you know, stepping back and saying. What happened in the time that I studied. Was there something else going on during that time? Did I just not study like I should? And so one year I sat down and studied, differently for the first few exams just to see which one stuck better for me. I figured out that if I wrote steps down several times, that was important that I knew I needed to remember. That helped. I started studying with a group after I would study about myself. And it took a little bit of time before I truly started to see my grades reflecting what, what I would envision for myself to be acceptable. And even though that might not be a true reality. But yeah, for me, Grace is just giving myself time to figure out what happened when something doesn't go the way that I wanted it to. And the same has gone for organizations that I've been in leadership roles in. When something doesn't work out, just stepping back and figuring out what happened and asking for help if you need it. I think that's one of the things that as a pharmacy student, you know, up until this point, you've never really had to ask for help as often as you probably should now. And so I encourage everyone, like if you need help, there's someone who can help you. So just like reach out and they'll connect you with whoever it is, that you need help with or that can help you with the thing that you need help with. Michele Williams So that's great. And and there that that sounds like great advice. And, considering the fact that that you are just a year away from being finished with pharmacy school, I would say that's a pretty good formula for kind of getting back on track when you need to. That's great. Thank you so much for sharing that. And Michelle, what advice do you have for students when they, when they get here in terms of, getting connected and getting involved and, managing all the different things that you want to do along with responsibilities and school. Michele Graybeal Well, I would say to definitely take advantage of a lot of the, organization meetings that will be happening during the first month of, classes. The student organizations here are amazing. They do wonderful things, and they connect you, to your profession in a way that, I don't think you fully get without them. They're obviously not required participation, but we've heard from students throughout the years that the more involved you get, the more you actually see what is going to interest you in the profession. The more connected you you get with professionals and other student pharmacists around the country. And, it actually helps kind of codify what you're doing in the classroom, what you're learning in the classroom with the reality of what pharmacy is. So I highly encourage students to get involved in at least one organization. And you can kind of get your feet wet with one, you know, when you first get here and if that's not the one for you, it's okay. You can always switch to a different one or you can add one the next year. Our student organization leaders are really good about, reaching out on a regular basis and giving those opportunities for involvement. Plus, you get to go out into the community and, do some good things in the community. Michele Williams Yeah, I'm always hearing about the terrific things student hearts do. It makes me really proud to to work again when I read about this. It does. Michele Graybeal And a lot of times they will feed you. So just got some meetings and I end up with some free food. Michele Williams So there's an event that's going to be happening during getting ready. That's kind of an interesting way to learn more about the student organizations. Can you tell us a little bit about that what that's going to be like? Michele Graybeal So we call it the Student Organizations Fair, where we invite, representatives from each of our pharmacy student organizations to come and meet with you. So, we're going to split up the P1 class into small groups, and you get to travel around the building and actually visit with those leaders, kind of more of a one on one situation where you really get the to know what each organization is about and what might interest you. You're not making any kind of commitment at that point. It's really just, kind of speed dating for student organizations. And it's nice because the upperclassmen who are here get to know some of the new students, too, and I think they enjoy doing that as well. Michele Williams That's terrific. Sounds like a good way to sort of get get to know people who are not in your particular class and get some advice from upperclassmen and, maybe even find a friend or study buddy or something like that. Michele Graybeal Yeah, I think it's key to have some connections with some of the upperclassmen as well. That's great. Michele Williams The incoming students web page that we have is really, really useful, but there are a lot of items on there and it can be a little bit overwhelming. What what is your suggestion for how students might prioritize the items on that page? Michele Graybeal Yes. I think the overwhelming part is mostly when you see all the deadlines on there. And as we're recording this, the June 5th deadline for most of those requirements has passed. But I don't want anybody to panic. If there's some reason that you weren't able to submit something, then we will work with you on a timeline. As long as you're making reasonable progress on those things. So I don't want you to give up on that. Or we will work with you. But beyond the immunizations, basically, you just need to read through the instructions. And if you have trouble again, like we keep saying, reach out. If you go beyond that, it just talk about getting ready and your white coat ceremony, which is kind of your welcome to the profession of pharmacy, the official welcome. And getting ready is considered the start of the semester. So you will actually be starting courses as well as some kind of more traditional orientation type activities. So that's August 1st. Your semester starts on August 1st, and then, at the end of that first two weeks is your white coat ceremony, which is very exciting. You get to invite your loved ones to that. There's no limit to how many you invite. Although I would say if you're planning to invite 50, maybe give us a heads up. But the venue, the Martin Center for the Arts, it's a really beautiful new venue at Etsu and, its capacity is quite large, so I don't think we'll have any issues with that. And then, beyond that, there's some opportunities to connect with your classmates, either through social media. And then, there is some financial aid information on there. So I would say make sure that you have your budget kind of set for the year. There are resources on the financial aid page that's linked there. And just kind of make sure that you've gone through the six steps that Angel, our financial aid director, has laid out for you there. It's pretty easy if you just follow her six steps. Make sure you have somewhere to live, that fits within your budget. And if you haven't done that yet, I would suggest you get on it today. And if you have trouble with that, just reach out. But we we do have resources on the web page that will help you figure out some good places to live with recommendations, even from current and former pharmacy students. Great. And that's nice. We do add academic information to that page as it's available. So like your academic calendar for the year is out there. And later on we'll send you your, fall exam schedule so that you'll know when your exams will be scheduled. Terrific. Yeah. So also on that page are your computer and technology requirements so that you'll know what to look for as you're purchasing those. Michele Williams So it sounds like a great resource. Michele Graybeal Yes. We want it to be helpful and not totally overwhelming. Michele Williams All right. So as we wrap this up, are there are there any things that, sort of parting words that you, you think our incoming P1s should know or that you'd like to say to our incoming P1s? You're going to get lots of opportunities to talk to them during getting ready as well. Michele Graybeal All right. So we like to talk about ourselves as a family or a family. Michele Williams I guess some people call it Michele Graybeal And it's not just, recruitment tactics. It is real. I've worked here for 14 years and I've seen it throughout my tenure here. We support each other, faculty, staff and students. And so, whether you're struggling or not, just know that we're here for you. And, we truly want you to come and and and seek us out. If you're having any issues or have a question that you think is a dumb question that nobody else has, most likely everybody else is thinking the same thing. But we we just want you to know that you're we we're glad that you're here. Michele Williams Yeah. Great. What about you, Reagan? Reagan Bell I would just say, first of all, congratulations. You've made it. I think I told you that if I saw you at Farmer Connect day. But I would kind of echo what Michelle said. You know, without the family atmosphere, the last three years would have been so hard, to make it through, to be successful, and to truly, like, come to school, excited to be here. I know I asked Michelle all kinds of those dumb questions that she was talking about. But truly, without building those connections with the other students in my class. Or with the faculty and staff here. My experience wouldn't have been the same. So I would encourage you just to really reach out and find someone that you connect with right off the bat. To make you feel at home here again. But congratulations. Michele Williams Well, thank you both so much for for participating in our first podcast or inaugural podcast. And, we'll hopefully have many more after this. And, Dan, do you have any parting words for us? Dan Vanzant I do not, but thank you for the opportunity. Michele Williams So with that, until next time.