PUTTING OUR (CLINICAL) SKILLS TO THE TEST

Written By: Monica Tong and An Nguyen, Fourth-Year Student Pharmacists

Each year, the American Society of Health-System Pharmacists (ASHP) hosts a clinical skills competition during its Midyear Clinical Meeting and Exhibition in December to provide student pharmacists with a chance to enhance their skills providing direct patient care in collaborative practice. Colleges and schools of pharmacy from across the country send representatives to compete each year. For the University of Maryland School of Pharmacy, representatives are selected through a local competition that includes a written case component — which is open to all students — and an oral presentation during which the top five teams selected from the written case component compete.

This year, 20 teams composed of two students each competed in the written case component. Our team decided to enter this year, as we saw the event as a great way to test all of the skills that we had learned during the first half of our fourth-year clinical rotations. In addition, Monica — who participated in the competition in 2015 and found the experience very rewarding — wanted to gauge how her skills had improved over the course of the year.

Devising a Plan

To prepare for the written case, which involved a patient who had been diagnosed with atrial fibrillation, we reviewed the competition’s guidelines and discussed how we might best apply the therapeutic experiment approach that we had learned in class to assess the case’s etiology (cause), symptom severity, desired outcomes, available treatment options, and parameters for disease monitoring. Ultimately, we decided that we would review the case together, but work separately to list the problems that we discovered, as well as our thoughts about how we would address those problems to meet goals for patient outcomes and disease monitoring. We then put our heads together again to discuss how to best prioritize the problems and treatment options to develop an initial therapeutic plan. Monica’s experience tutoring third-year student pharmacists proved to be a great asset as we reviewed the concepts and clinical background of the disease states.

For the oral presentation, we knew that we would have two minutes to present the patient and outline the most urgent problems that needed to be addressed and their associated therapies, as well as outcome goals and monitoring, which would then be followed by eight minutes of questioning from the judges. For our patient, we presented two main components for his therapy: anticoagulation and rate control. Because each of us had specialized knowledge based on our individual areas of interest – An had completed a clinical rotation in anticoagulation and Monica had multiple clinical experiences that spanned the surgical intensive care unit, general medicine, and geriatric pharmacotherapy – we decided to “split” our knowledge and tackle questions relevant to our areas of specialization independently. We also worked diligently to review potential questions that we thought the judges might ask.

Reaping the Reward

Honestly, we were more than a little nervous when we arrived to participate in the competition, but we stuck to our plan, which actually helped us identify and assess problems more thoroughly than if we had taken the more traditional approach to work together throughout the case. Although we were a bit apprehensive about how we prioritized our patient’s problems, at the end of the competition, we truly felt as if we had done the best that we could and that our overall plan of attack was a solid one.

Fortunately, the judges seemed to agree.

We both had to drive back to Shady Grove immediately after our presentation, and missed the announcement of the winner, so we were equally shocked to receive a phone call from our friend congratulating us on our win. We thought she was joking! After learning that she wasn’t and that we had, in fact, won the competition, we felt incredibly proud and very humbled. We appreciate all of the guidance that we received from our preceptors as we worked to develop our clinical skills, as well as the strong clinical foundation that faculty at the School of Pharmacy have provided us. We cannot wait to represent the University of Maryland School of Pharmacy in the semi-finals in Las Vegas in December.